The long-term mental health impact of peacekeeping: prevalence and predictors of psychiatric disorder.

PubMed

Forbes, David; O'Donnell, Meaghan; Brand, Rachel M; Korn, Sam; Creamer, Mark; McFarlane, Alexander C; Sim, Malcolm R; Forbes, Andrew B; Hawthorne, Graeme

2016-01-01

The mental health outcomes of military personnel deployed on peacekeeping missions have been relatively neglected in the military mental health literature. To assess the mental health impacts of peacekeeping deployments. In total, 1025 Australian peacekeepers were assessed for current and lifetime psychiatric diagnoses, service history and exposure to potentially traumatic events (PTEs). A matched Australian community sample was used as a comparator. Univariate and regression analyses were conducted to explore predictors of psychiatric diagnosis. Peacekeepers had significantly higher 12-month prevalence of post-traumatic stress disorder (16.8%), major depressive episode (7%), generalised anxiety disorder (4.7%), alcohol misuse (12%), alcohol dependence (11.3%) and suicidal ideation (10.7%) when compared with the civilian comparator. The presence of these psychiatric disorders was most strongly and consistently associated with exposure to PTEs. Veteran peacekeepers had significant levels of psychiatric morbidity. Their needs, alongside those of combat veterans, should be recognised within military mental health initiatives. None. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters.

PubMed

Stanley, Ian H; Boffa, Joseph W; Hom, Melanie A; Kimbrel, Nathan A; Joiner, Thomas E

2017-01-01

Firefighters are at increased risk for mental health problems. However, little is known about differences in psychiatric symptoms between volunteer and career firefighters. This study aimed to (1) describe differences in psychiatric symptoms and barriers to mental health care between U.S. firefighters in volunteer-only and career-only departments; and (2) determine if greater self-reported structural barriers to mental health care (e.g., cost, availability of resources) explain the differences in psychiatric symptom levels. Overall, 525 current U.S. firefighters participated. Analyses of covariance and logistic regression analyses were used to evaluate group differences between volunteer (n=204) and career (n=321) firefighters, adjusting for demographic and occupational characteristics. Volunteer firefighters reported significantly elevated levels of depression, posttraumatic stress, and suicidal symptoms compared to career firefighters. Career firefighters reported relatively elevated levels of problematic alcohol use. Volunteer firefighters additionally reported greater structural barriers to mental health care (e.g., cost, availability of resources), and these barriers accounted for the differences in mental health variables between volunteer and career firefighters. Findings suggest that volunteer firefighters report elevated psychiatric symptoms compared to career firefighters and greater structural barriers to mental health treatment may explain this link. Increased efforts are needed to develop firefighter-specific interventions and bolster mental health service utilization. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Critical Behaviors in Psychiatric-Mental Health Nursing. Volume 2: Behavior of Nurses.

ERIC Educational Resources Information Center

Jacobs, Angeline Marchese; And Others

Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as these activities relate to patient care, and contains abstracts of more than 4,000 critical behaviors of psychiatric nurses in 50 psychiatric hospitals, general hospitals with psychiatric units, and…

Critical Behaviors in Psychiatric-Mental Health Nursing. Volume 3: Behavior of Attendants.

ERIC Educational Resources Information Center

Jacobs, Angeline Marchese; And Others

Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as the activities relate to patient care and contains abstracts of more than 4,000 critical behaviors of psychiatric attendants in 50 psychiatric hospitals, general hospitals with psychiatric units, and…

Challenges to HIV prevention in psychiatric settings: Perceptions of South African mental health care providers

PubMed Central

Collins, Pamela Y.

2009-01-01

Mental health services in South Africa increasingly feel the brunt of the AIDS epidemic. Despite the high prevalence of infection in the psychiatric setting, HIV risk reduction interventions targeting South Africans with psychiatric illness remain few and far between. The attitudes of mental health care providers about sexual relations and HIV among people with mental illness continue to influence the extent to which these issues are addressed in care settings. This study examines these attitudes through the use of a semi-structured interview administered to 46 mental health care providers in four provinces of South Africa. I found that personal, contextual and political factors in the clinic and the hospital create barriers to integrating prevention activities. In particular, providers face at least three challenges to intervening in the epidemic among their patients: their own views of psychiatric illness, the transitions occurring in the mental health care system, and shifting social attitudes toward sexuality. Barriers operate at the individual level, the institutional level, and the societal level. At the individual level providers’ perceptions of psychiatric symptoms shape their outlook on intervention with psychiatric patients. At the institutional level disruptive transitions in service delivery relegate HIV services to lesser importance. At the societal level, personal beliefs about sexuality and mental illness have remained slow to change despite major political changes. Minimizing barriers to implementing HIV prevention services requires institutional and health care policies that ensure adequate resources for treating people with mental illness and for staff development and support. PMID:16647793

The long-term mental health impact of peacekeeping: prevalence and predictors of psychiatric disorder

PubMed Central

O’Donnell, Meaghan; Brand, Rachel M.; Korn, Sam; Creamer, Mark; McFarlane, Alexander C.; Sim, Malcolm R.; Forbes, Andrew B.; Hawthorne, Graeme

2016-01-01

Background The mental health outcomes of military personnel deployed on peacekeeping missions have been relatively neglected in the military mental health literature. Aims To assess the mental health impacts of peacekeeping deployments. Method In total, 1025 Australian peacekeepers were assessed for current and lifetime psychiatric diagnoses, service history and exposure to potentially traumatic events (PTEs). A matched Australian community sample was used as a comparator. Univariate and regression analyses were conducted to explore predictors of psychiatric diagnosis. Results Peacekeepers had significantly higher 12-month prevalence of post-traumatic stress disorder (16.8%), major depressive episode (7%), generalised anxiety disorder (4.7%), alcohol misuse (12%), alcohol dependence (11.3%) and suicidal ideation (10.7%) when compared with the civilian comparator. The presence of these psychiatric disorders was most strongly and consistently associated with exposure to PTEs. Conclusions Veteran peacekeepers had significant levels of psychiatric morbidity. Their needs, alongside those of combat veterans, should be recognised within military mental health initiatives. Declaration of interest None. Copyright and usage This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence. PMID:27703751

Racial Disparities in Mental Health Outcomes after Psychiatric Hospital Discharge among Individuals with Severe Mental Illness

ERIC Educational Resources Information Center

Eack, Shaun M.; Newhill, Christina E.

2012-01-01

Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…

Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview.

PubMed

Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren

2017-10-01

Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.

Gender-specific mental health care needs of women veterans treated for psychiatric disorders in a Veterans Administration Women's Health Clinic.

PubMed

Miller, Laura J; Ghadiali, Nafisa Y

2015-04-01

This pilot study aims to ascertain the prevalence of self-reported premenstrual, perinatal, and perimenopausal influences on mental health, and of gynecologic conditions that could interact with psychiatric conditions, among women veterans receiving psychiatric care within a Veterans Administration (VA) Women's Health Clinic (WHC). Participants included all women veterans (N=68) who received psychiatric evaluations within a VA WHC over a 5-month period. This setting encompasses colocated and coordinated primary care, gynecologic and mental health services. Evaluations included a Women's Mental Health Questionnaire, a psychiatric interview, and medical record review. Deidentified data were extracted from a clinical data repository for this descriptive study. High proportions of study participants reported that their emotional problems intensified premenstrually (42.6%), during pregnancy (33.3%), in the postpartum period (33.3%), or during perimenopause (18.2%). Unintended pregnancy (70.0% of pregnancies) and pregnancy loss (63.5% of women who had been pregnant) were prominent sex-linked stressors. Dyspareunia (22.1% of participants) and pelvic pain (17.6% of participants) were frequent comorbidities. Among women veterans receiving psychiatric care within a VA WHC, there are high rates of self-reported premenstrual, perinatal, and perimenopausal influences on mental health. This population also has substantial comorbidity of psychiatric disorders with dyspareunia and pelvic pain. This underscores the importance of recognizing and addressing women veterans' sex-specific care needs, including interactions among reproductive cycle phases, gynecologic pain, and psychiatric symptoms. The findings support the need for greater awareness of the sex-specific mental health needs of women veterans, and for more definitive studies to further characterize these needs.

Voluntary psychiatric emergencies in Los Angeles County after funding of California's Mental Health Services Act.

PubMed

Bruckner, Tim A; Yonsu, Kim; Chakravarthy, Bharath; Brown, Timothy Tyler

2012-08-01

Since 2006, California's Mental Health Services Act (MHSA) has distributed an estimated $6 billion in new tax revenues to county mental health systems. Although evaluations of MHSA's effectiveness find favorable outcomes among high-risk individuals that represent 6% of all mental health clients, scant research has tested whether MHSA funds improve the overall functioning of the public mental health system. The authors analyzed whether the incidence of voluntary emergency psychiatric visits, a key gauge of the functioning of the mental health system, fell below expected levels after the disbursement of MHSA funds. Los Angeles County, the most populous county in California, was examined. The authors obtained the monthly incidence of emergency psychiatric visits among Medi-Cal patients for 96 months spanning July 2000 to June 2008 (5.9 million overall admissions, of which 47,328 were emergency visits). Time-series methods controlled for temporal patterns in emergency visits as well as other potential confounders (unemployment, for example) that could induce spurious associations. The incidence of voluntary psychiatric emergencies fell below expected levels eight to 12 months after the disbursement of MHSA funds. After one year, emergency visits returned to their long-term mean level. Results remained robust after analyses controlled for outliers and potential confounders. In the short term, an infusion of public funds devoted to mental health services appeared to reduce psychiatric emergency visits. Explanations for the transient nature of the decline in emergency visits in Los Angeles County are discussed.

Impact of inpatient mental health rehabilitation on psychiatric readmissions: a propensity score matched case control study.

PubMed

Tsoutsoulis, Katrina; Maxwell, Anna; Menon Tarur Padinjareveettil, Aparna; Zivkovic, Frank; Rogers, Jeffrey M

2018-04-27

Examination of readmission data is a standard method for evaluating health service outcomes. Limited work has evaluated the efficacy of mental health rehabilitation, despite the need for evidence-based approaches. To evaluate the impact of inpatient mental health rehabilitation using metrics of psychiatric readmissions routinely collected at occasions of service. Consumers (n = 252) of a nonacute inpatient mental health rehabilitation unit were case matched with normative clients from community mental health services. The impact of inpatient care was measured on: (1) the occurrence of a psychiatric readmission within 12 months of discharge; (2) the total number of psychiatric readmissions within 12 months of discharge; and (3) the number of days to a psychiatric readmission after discharge. The proportion of consumers experiencing a readmission significantly decreased following inpatient care, comparable to the normative group. The number of readmissions also significantly decreased, approaching normative group levels, except in consumers with comorbid bipolar, substance use, or personality disorder. Time to a readmission significantly increased following inpatient care, approximating normative group values, and was related to the number of previous admissions. Routinely collected service data demonstrated nonacute inpatient mental health rehabilitation reduces re-hospitalization, which will have benefits for both consumers and health services.

Teaching psychiatric mental health nursing in the People's Republic of China.

PubMed

Harmon, Rebecca Bouterie

2008-12-01

According to the World Health Organization's Health Policy Resource Book, mental disorders account for a high proportion of disability worldwide and are predicted to grow significantly in the coming years. This is especially true in developing countries such as the People's Republic of China (PRC) where, for historical social, political, and economic reasons, psychiatric mental health (PMH) nursing has not been an integral part of nursing curricula. As the number of persons in the PRC increases, so is the demand for mental health nurses, yet the PRC lacks experienced PMH nursing instructors. This article describes the challenges and opportunities that await Western PMH nursing specialists and faculty in the PRC.

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey.

PubMed

Delaney, Kathleen R; Drew, Barbara L; Rushton, Amy

2018-06-01

Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.

Psychiatric wards with locked doors--advantages and disadvantages according to nurses and mental health nurse assistants.

PubMed

Haglund, K; von Knorring, L; von Essen, L

2006-04-01

To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for

Psychiatric mental health evidence-based practice.

PubMed

Rice, Michael J

2008-05-01

This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

Mental health related Internet use among psychiatric patients: a cross-sectional analysis.

PubMed

Kalckreuth, Sophie; Trefflich, Friederike; Rummel-Kluge, Christine

2014-12-24

The Internet is of great importance in today's health sector, as most Internet users utilize online functions for health related purposes. Concerning the mental health care sector, little data exist about the Internet use of psychiatric patients. It is the scope of this current study to analyze the quantity and pattern of Internet usage among mental health patients. Patients from all services of the Department of Psychiatry at a university hospital were surveyed by completing a 29-item questionnaire. The data analysis included evaluation of frequencies, as well as group comparisons. 337 patients participated in the survey, of whom 79.5% were Internet users. Social media was utilized by less than half of the users: social networks (47.8%), forums (19.4%), chats (18.7%), blogs (12.3%). 70.9% used the Internet for mental health related reasons. The contents accessed by the patients included: information on mental disorders (57.8%), information on medication (43.7%), search for mental health services (38.8%), platforms with other patients (19.8%) and platforms with mental health professionals (17.2%). Differences in the pattern of use between users with low, medium and high frequency of Internet use were statistically significant for all entities of social media (p < 0.01), search for mental health services (p = 0.017) and usage of platforms with mental health professionals (p = 0. 048). The analysis of differences in Internet use depending on the participants' type of mental disorder revealed no statistically significant differences, with one exception. Regarding the Internet's role in mental health care, the participants showed differing opinions: 36.2% believe that the Internet has or may have helped them in coping with their mental disorder, while 38.4% stated the contrary. Most psychiatric patients are Internet users. Mental health related Internet use is common among patients, mainly for information seeking. The use of social media is generally less

Mental health service use types among Asian Americans with a psychiatric disorder: considerations of culture and need.

PubMed

Nguyen, Duy; Bornheimer, Lindsay A

2014-10-01

Despite levels of need that are comparable with other groups, relatively few Asian Americans receive mental health care. While studies have described the tendency for Asian Americans to delay care until mental health symptoms are severe, relatively little research has examined how the severity of symptoms impact mental health service use. This study uses publicly available data from the National Latino and Asian American Study (NLAAS) and focuses solely on Asian American respondents with a psychiatric disorder (n = 230). Unexpectedly, few Asian Americans with a psychiatric disorder received care in a medical setting. The perception of mental health needs increased the likelihood of using mental health specialist care. Social and systemic barriers together hinder mental health service use. Implications for addressing Asian American mental health service use within a changing health care environment are discussed.

[Mental Health Professionals' Perspectives Towards Desire for Children and Family Planning Among Psychiatric Patients - Results of a Qualitative Study].

PubMed

Checchia, Carmen; Badura-Lotter, Gisela; Kilian, Reinhold; Becker, Thomas; Krumm, Silvia

2016-11-01

Study aims: Analysis of mental health professionals' attitudes to reproductive issues among psychiatric patients. Method: 31 problem-centered semi-structured interviews with psychiatric professionals were conducted and analyzed by content analysis methods. Results: Outside of psychotherapeutic treatment the desire for children is generally assessed as less important in the context of mental health care, it is often limited to effective birth control with regard to drug treatment. Mental health professionals perceive moral concerns, lack of expertise among professionals and individual doubts as barriers when dealing with reproductive issues. Discussion: In order to meet psychiatric patients' reproductive needs, perceptions of barriers among mental health professionals in dealing with reproductive issues should be reflected and discussed. Recommendations could support professionals and help ensure adequate support for psychiatric patients. © Georg Thieme Verlag KG Stuttgart · New York.

Expanding the Role of Psychiatric Mental Health Nurse Practitioners in a State Psychiatric System: The New Hampshire Experience.

PubMed

de Nesnera, Alexander; Allen, Diane E

2016-05-01

Psychiatric mental health nurse practitioners (PMHNPs) are assuming increasing clinical responsibilities in the treatment of individuals with mental illness as the shortage of psychiatrists and their maldistribution continues to persist in the United States. States vary widely in their statutes and administrative rules delineating PMHNP's scope of practice. This column describes the legislative process of incremental changes in New Hampshire statute and rules changes over the past 15 years that have significantly expanded PMHNP's ability to treat individuals with mental illnesses in the state mental health system. PMHNPs have worked closely with physician leaders and policy makers to allow this to occur.

Associations between self-rated mental health and psychiatric disorders among older adults: do racial/ethnic differences exist?

PubMed

Kim, Giyeon; DeCoster, Jamie; Chiriboga, David A; Jang, Yuri; Allen, Rebecca S; Parmelee, Patricia

2011-05-01

[corrected] This study examined racial/ethnic differences in the association between self-rated mental health (SRMH) and psychiatric disorders among community-dwelling older adults in the United States. Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys (2001-2003). In-person household interviews. Older adults aged 60 and older (N = 1,840), including non-Hispanic Whites (N = 351), Blacks (N = 826), Hispanics (N = 406), and Asians (N = 257). SRMH was measured with a single item, "How would you rate your own mental health?" Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses for mood and anxiety disorders were measured with the World Health Organization's World Mental Health version of the Composite International Diagnostic Interview. Results from logistic regression analyses showed significant main effects of both SRMH and race/ethnicity on the presence of mood and anxiety disorders: people who have poor SRMH and are non-Hispanic Whites were more likely to have mood and anxiety disorders. There were also significant interaction effects between SRMH and race/ethnicity, such that the relation of SRMH with diagnoses of psychiatric disorders was strongest in non-Hispanic Whites. Racial/ethnic variations were found in the relationship between self-perception of mental health and DSM-IV psychiatric disorders. The findings suggest the need to develop race/ethnicity-specific strategies to screen psychiatric disorders in diverse elderly populations. Future studies are needed to investigate possible reasons for the racial/ethnic group differences.

Predictors of mental health-related acute service utilisation and treatment costs in the 12 months following an acute psychiatric admission.

PubMed

Siskind, Dan; Harris, Meredith; Diminic, Sandra; Carstensen, Georgia; Robinson, Gail; Whiteford, Harvey

2014-11-01

A key step in informing mental health resource allocation is to identify the predictors of service utilisation and costs. This project aims to identify the predictors of mental health-related acute service utilisation and treatment costs in the year following an acute public psychiatric hospital admission. A dataset containing administrative and routinely measured outcome data for 1 year before and after an acute psychiatric admission for 1757 public mental health patients was analysed. Multivariate regression models were developed to identify patient- and treatment-related predictors of four measures of service utilisation or cost: (a) duration of index admission; and, in the year after discharge from the index admission (b) acute psychiatric inpatient bed-days; (c) emergency department (ED) presentations; and (d) total acute mental health service costs. Split-sample cross-validation was used. A diagnosis of psychosis, problems with living conditions and prior acute psychiatric inpatient bed-days predicted a longer duration of index admission, while prior ED presentations and self-harm predicted a shorter duration. A greater number of acute psychiatric inpatient bed-days in the year post-discharge were predicted by psychosis diagnosis, problems with living conditions and prior acute psychiatric inpatient admissions. The number of future ED presentations was predicted by past ED presentations. For total acute care costs, diagnosis of psychosis was the strongest predictor. Illness acuity and prior acute psychiatric inpatient admission also predicted higher costs, while self-harm predicted lower costs. The development of effective models for predicting acute mental health treatment costs using existing administrative data is an essential step towards a workable activity-based funding model for mental health. Future studies would benefit from the inclusion of a wider range of variables, including ethnicity, clinical complexity, cognition, mental health legal status

Structured learning and self-reflection: strategies to decrease anxiety in the psychiatric mental health clinical nursing experience.

PubMed

Ganzer, Christine Anne; Zauderer, Cheryl

2013-01-01

The purpose of this qualitative study was to test a teaching-learning strategy to help nursing students decrease stress and anxiety that may be brought about by the psychiatric mental health clinical experience. Undergraduate nursing students are known to experience affective stress prior to their first psychiatric mental health clinical practicum. A stressful learning environment can affect the success of the student's clinical performance. Thirty nursing students participated in this study. A structured preclinical workshop combined with self-reflection provided insight into students' perceptions of the psychiatric mental health clinical experience. Overall, students reported that participating in the teaching-learning strategy and self-reflection helped mitigate Combining structured learning with self-reflection is a useful tool for helping nursing students increase self-awareness and ease anxiety that may interfere with learning.

Tough Transitions: Mental Health Care Professionals' Perception of the Psychiatric Hospital to School Transition

ERIC Educational Resources Information Center

Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.

2010-01-01

Psychiatric reasons are among the most common causes of hospitalization for adolescents. A Consensual Qualitative Research approach was used to explore mental health professionals' perceptions of the needs of adolescents as they transition from psychiatric hospital to school. Academic, social, and emotional domains emerged as important areas of…

The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery-orientated policy in practice.

PubMed

Cusack, E; Killoury, F; Nugent, L E

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally. Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical

Discourses of culture and illness in South African mental health care and indigenous healing, Part I: Western psychiatric power.

PubMed

Yen, Jeffery; Wilbraham, Lindy

2003-12-01

This discourse analytic study explores constructions of culture and illness in the talk of psychiatrists, psychologists and indigenous healers as they discuss possibilities for collaboration in South African mental health care. Versions of 'culture', and disputes over what constitutes 'disorder', are an important site for the negotiation of power relations between mental health practitioners and indigenous healers. The results of this study are presented in two parts. Part I explores discourses about western psychiatric/psychological professionalism, tensions in diagnosis between cultural relativism and psychiatric universalism, and how assertion of 'cultural differences' may be used to resist psychiatric power. Part II explores how discursive constructions of 'African culture' and 'African madness' work to marginalize indigenous healing in South African mental health care, despite repeated calls for collaboration.

Malaysian mental health law.

PubMed

Khan, Nusrat N; Yahya, Badi'ah; Abu Bakar, Abd Kadir; Ho, Roger C

2015-05-01

The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.

Malaysian mental health law

PubMed Central

Khan, Nusrat N.; Yahya, Badi’ah; Abu Bakar, Abd Kadir; Ho, Roger C.

2015-01-01

The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations. PMID:29093848

Psychiatric genetic research at the National Institute of Mental Health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berg, K.; Mullican, C.; Maestri, N.

For some time it has been known through the results of family, twin, and adoption studies that hereditary appears to play a significant casual role in many mental disorders, including schizophrenia, bipolar disorder, and other mood disorders, Alzheimer`s Disease, panic disorder, obsessive compulsive disorder, autism, dyslexia, and Tourette`s syndrome. The precise patterns of inheritance of these complex disorders have not been determined, nor have the relevant genes been localized or cloned. Because the genetics are complex and because there is also clearly an environmental contribution to behavior, we expect the analysis of the genetics of mental illness to be arduousmore » and not quickly resolved. There are several compelling reasons to continue to focus our attention on uncovering the genetic factors for severe mental illness. Prominent among these are the implications for better treatment of mental disorders. The National Institute of Mental Health supports a wide range of studies on psychiatric genetic research. 16 refs.« less

Using Simulation in a Psychiatric Mental Health Nurse Practitioner Doctoral Program.

PubMed

Calohan, Jess; Pauli, Eric; Combs, Teresa; Creel, Andrea; Convoy, Sean; Owen, Regina

The use and effectiveness of simulation with standardized patients in undergraduate and graduate nursing education programs is well documented. Simulation has been primarily used to develop health assessment skills. Evidence supports using simulation and standardized patients in psychiatric-mental health nurse practitioner (PMHNP) programs is useful in developing psychosocial assessment skills. These interactions provide individualized and instantaneous clinical feedback to the student from faculty, peers, and standardized patients. Incorporating simulation into advanced practice psychiatric-mental health nursing curriculum allows students to develop the necessary requisite skills and principles needed to safely and effectively provide care to patients. There are no documented standardized processes for using simulation throughout a doctor of nursing practice PMHNP curriculum. The purpose of this article is to describe a framework for using simulation with standardized patients in a PMHNP curriculum. Students report high levels of satisfaction with the simulation experience and believe that they are more prepared for clinical rotations. Faculty feedback indicates that simulated clinical scenarios are a method to ensure that each student experiences demonstrate a minimum standard of competency ahead of clinical rotations with live patients. Initial preceptor feedback indicates that students are more prepared for clinical practice and function more independently than students that did not experience this standardized clinical simulation framework. Published by Elsevier Inc.

[Is "mental health" part of the common good? The sociopolitical framework of psychiatric ethics and the responsibility of health-care elites].

PubMed

Bohlken, Eike

2014-07-01

Psychiatric work can only be that ethical as the framework of a health-care system allows. Thus, the responsibility of the health-care elites to establish a sociopolitical framework that suits psychiatric ethics is discussed on the basis of a theory of the common good and of a philosophical and normative elite theory. "Mental health" is demonstrated to be part of a basic sphere of the common good which cannot be denied to any member of a society. The final section discusses which specific duties can be derived for health-care elites on the ground of the aforementioned conception of "mental health" as a part of the common good. © Georg Thieme Verlag KG Stuttgart · New York.

Finding Inspiration From the Philosophy of Maurice Merleau-Ponty for the Practice of Psychiatric-mental Health Nursing.

PubMed

Thomas, Sandra P

2018-06-01

The philosophy of Maurice Merleau-Ponty, a unique blend of existentialism and phenomenology, deserves to be better known in psychiatric-mental health nursing. This philosophy is particularly pertinent to the contemporary recovery movement that seeks to dispel the therapeutic nihilism regarding conditions such as schizophrenia, borderline personality, and substance use disorders. This paper provides an overview of Merleau-Ponty's life and work, with emphasis on selected elements of his philosophy that are inspirational for the clinical practice of psychiatric-mental health nursing. Copyright © 2017 Elsevier Inc. All rights reserved.

Making a case for systematic integration of theory-based tobacco education into graduate psychiatric/mental health nursing curriculum.

PubMed

Schwindt, Rhonda G; Sharp, Daryl

2013-08-01

Tobacco use and dependence is a serious public health issue that disproportionately affects the mentally ill client population. Mental health professionals, including psychiatric/mental health advanced practice nurses (PMHAPNs), are disinclined to integrate tobacco cessation interventions into their practice, due in part, to a general lack of tobacco-related knowledge (C. Essenmacher, C. Karvonen-Gutierrez, J. Lynch-Sauer, & S. A., Duffy, 2008; A. J. Molina, T. Fernandez, D. Fernandez, M. Delgado, S. de Abajo, & V. Martin, 2012; L. Sarna, L. L. Danao, S. Chan, S. Shin, L. Baldago, E. Endo, & M. E. Wewers, 2006); D. Sharp, S. Blaakman, R. Cole, & J. Evinger, 2009). This paper provides an in-depth literature review of tobacco education in nursing curricula and proposes the systematic integration of theory-based tobacco content into psychiatric/mental health graduate nursing programs. Copyright © 2013 Elsevier Inc. All rights reserved.

Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services.

PubMed

Brookman-Frazee, Lauren; Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Ganger, William

2017-09-01

Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.

Are long-term psychiatric patients causing more crisis consultations outside office hours in mental health care?

PubMed

Dekker, J; Theunissen, J; Van, R; Kikkert, M; van der Post, L; Zoeteman, J; Peen, J

2013-09-01

As well as an improvement in community services, the de-institutionalization of patients receiving long-term psychiatric care can lead to marginally staffed mental health services, more homelessness, rising admission rates and more people in prison cells. It is assumed that an imbalance between community and hospital care for chronic patients puts pressure on crisis services. In this study, the central question is whether patients receiving long-term psychiatric care in Amsterdam do indeed put pressure on the city's emergency mental health services. We compare the pressure exerted by this group with the pressure resulting from the use of these services by all registered patients. Data were taken from the client registration systems of three mental health organizations in Amsterdam in the period from 2000 to 2004. Inclusion criteria for long-term psychiatric patients were age above 19 years and uninterrupted receipt of mental health care for a minimum of two successive years. Annually, 6%-8% of all non-long-term patients experienced a crisis outside office hours in the period under investigation; this was 4%-6% for long-term patients. The non-long-term patients accounted for 83% of crisis contacts outside office hours over the entire study period, with long-term patients accounting for 17%. The assumption that crises are more prevalent in long-term patients in the community seems to be an example of stigmatization rather than an observation based on fact.

Psychiatric disorders among people living with HIV/AIDS in IRAN: Prevalence, severity, service utilization and unmet mental health needs.

PubMed

Shadloo, Behrang; Amin-Esmaeili, Masoumeh; Motevalian, Abbas; Mohraz, Minoo; Sedaghat, Abbas; Gouya, Mohammad Mehdi; Rahimi-Movaghar, Afarin

2018-07-01

HIV and psychiatric disorders are closely correlated and are accompanied by some similar risk factors. The aim of this study was to assess psychiatric comorbidity and health service utilization for mental problems among people living with HIV/AIDS in Iran. A total of 250 cases were randomly selected from a large referral center for HIV treatment and care in Tehran, Iran. Psychiatric disorders in the past 12 months including mood, anxiety, and substance use disorders were assessed through face-to-face interview, using a validated Persian translation of the Composite International Diagnostic Interview (CIDI v2.1). Severity of psychiatric disorders, social support, socio-economic status, service utilization and HIV-related indicators were assessed. Participants consisted of 147 men and 103 women. Psychiatric disorders were found in 50.2% (95% confidence interval: 43.8-56.6) of the participants. Major depressive disorder was the most prevalent diagnosis (32.1%), followed by substance use disorders (17.1%). In bivariate analysis, psychiatric disorders were significantly higher among male gender, single and unemployed individuals and those with lower social support. In multivariate regression analysis, only social support was independently associated with psychiatric disorders. Among those with a psychiatric diagnosis, 41.1% had used a health service for mental problems and 53% had received minimally adequate treatment. The findings of the study highlight the importance of mental health services in the treatment of people living with HIV/AIDS. Copyright © 2018 Elsevier Inc. All rights reserved.

The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing.

PubMed

Barker, P

2001-06-01

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample.

PubMed

Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth

2014-12-15

Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. Published by Elsevier Ireland Ltd.

Development of Veteran-Centric Competency Domains for Psychiatric-Mental Health Nurse Practitioner Residents.

PubMed

York, Janet; Sternke, Lisa Marie; Myrick, Donald Hugh; Lauerer, Joy; Hair, Carole

2016-11-01

The mental health needs of military service members, Veterans, and their families are a designated national priority; however, there has been little emphasis on the inclusion of Veteran-centric domains in competency-based nursing education for psychiatric-mental health nurse practitioners (PMHNPs). The current article describes the identification and application of Veteran-centric domains in an innovative pilot residency program for PMHNPs, funded by the Veterans Health Administration Office of Academic Affiliations. Fourteen Veteran-centric competency domains were developed from literature review, including knowledge, attitudes, and skill behaviors. Adoption and application of these domains in curricular components included the resident competency evaluation, baseline assessment of military experience, and evidence-based practice seminars and training. Methods of competency domain evaluation are presented, along with gaps related to the evaluation of competency skills. The delivery of mental health services reflecting these domains is consistent with the VA core values and goal of developing a positive service culture. [Journal of Psychosocial Nursing and Mental Health Services, 54(11), 31-36.]. Copyright 2016, SLACK Incorporated.

Confirming mental health care in acute psychiatric wards, as narrated by persons experiencing psychotic illness: an interview study.

PubMed

Sebergsen, Karina; Norberg, Astrid; Talseth, Anne-Grethe

2016-01-01

It is important that mental health nurses meet the safety, security and care needs of persons suffering from psychotic illness to enhance these persons' likelihood of feeling better during their time in acute psychiatric wards. Certain persons in care describe nurses' mental health care as positive, whereas others report negative experiences and express a desire for improvements. There is limited research on how persons with psychotic illness experience nurses' mental health care acts and how such acts help these persons feel better. Therefore, the aim of this study was to explore, describe and understand how the mental health nurses in acute psychiatric wards provide care that helps persons who experienced psychotic illness to feel better, as narrated by these persons. This study had a qualitative design; 12 persons participated in qualitative interviews. The interviews were transcribed, content analysed and interpreted using Martin Buber's concept of confirmation. The results of this study show three categories of confirming mental health care that describe what helped the participants to feel better step-by-step: first, being confirmed as a person experiencing psychotic illness in need of endurance; second, being confirmed as a person experiencing psychotic illness in need of decreased psychotic symptoms; and third, being confirmed as a person experiencing psychotic illness in need of support in daily life. The underlying meaning of the categories and of subcategories were interpreted and formulated as the theme; confirming mental health care to persons experiencing psychotic illness. Confirming mental health care acts seem to help persons to feel better in a step-wise manner during psychotic illness. Nurses' openness and sensitivity to the changing care needs of persons who suffer from psychotic illness create moments of confirmation within caring acts that concretely help the persons to feel better and that may enhance their health. The results show the

[Mental health of college students: experience of the university psychiatric outpatient clinic of Hospital de São João].

PubMed

Silveira, Celeste; Norton, Andreia; Brandão, Isabel; Roma-Torres, António

2011-12-01

The mental health of college students has been raising major awareness, due to the increased prevalence and severity of psychiatric disorders in this population. Higher education is associated with significant stressors that contribute to the development of mental health disturbances, and most college students are in the high-risk age group for the emergence of symptoms of major psychiatric disorders. Early diagnosis and treatment of these disorders in college students are important areas of effort, since they pose a high impact at the educational, economic, and social levels. Thus, specifically planned mental health services play a major role in the management of this population, should be specialized and have easy accessibility. The purpose of this study is to describe and characterize the College Students' psychiatric outpatient clinic of the Department of Psychiatry, Hospital de São João.

Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics.

PubMed

Torous, John; Chan, Steven Richard; Yee-Marie Tan, Shih; Behrens, Jacob; Mathew, Ian; Conrad, Erich J; Hinton, Ladson; Yellowlees, Peter; Keshavan, Matcheri

2014-01-01

Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. To provide data on psychiatric outpatients' prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population. These comprised a state clinic in Massachusetts (n=108), a county clinic in California (n=56), a hybrid public and private clinic in Louisiana (n=50), and a private/university clinic in Wisconsin (n=106). Smartphone ownership and interest in utilizing such to monitor mental health varied by both clinic type and age with overall ownership of 62.5% (200/320), which is slightly higher than the average United States' rate of ownership of 58% in January 2014. Overall patient interest in utilizing smartphones to monitor symptoms was 70.6% (226/320). These results suggest that psychiatric outpatients are interested in using their smartphones to monitor their mental health and own the smartphones capable of running mental healthcare related mobile applications.

Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics

PubMed Central

Chan, Steven Richard; Yee-Marie Tan, Shih; Behrens, Jacob; Mathew, Ian; Conrad, Erich J; Hinton, Ladson; Yellowlees, Peter; Keshavan, Matcheri

2014-01-01

Background Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. Objective To provide data on psychiatric outpatients’ prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. Methods We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population. These comprised a state clinic in Massachusetts (n=108), a county clinic in California (n=56), a hybrid public and private clinic in Louisiana (n=50), and a private/university clinic in Wisconsin (n=106). Results Smartphone ownership and interest in utilizing such to monitor mental health varied by both clinic type and age with overall ownership of 62.5% (200/320), which is slightly higher than the average United States’ rate of ownership of 58% in January 2014. Overall patient interest in utilizing smartphones to monitor symptoms was 70.6% (226/320). Conclusions These results suggest that psychiatric outpatients are interested in using their smartphones to monitor their mental health and own the smartphones capable of running mental healthcare related mobile applications. PMID:26543905

[Psychiatric care act of Ukraine and issues concerning reformation of the mental health protection service].

PubMed

Moskalenko, V F; Gorban', E N; Tabachnikov, S I; Syropiatov, O G; Shtengelov, V V

2000-01-01

An analysis was performed of the conception and content of a new Psychiatric Care Act by making a comparison with data from published literature and the present-day status of the mental health protection service. The main features of the crisis of psychiatry in Ukraine are characterized together with possible ways of resolving it. Main trends in reformation of the psychiatric service are identified that are to be secured by relevant acts of departmental and interdepartmental character based on law. Priority is emphasized to defence of the patients' rights and liberties together with a need for a guarantee of a highly skilled medical care to be provided for mental patients.

Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

PubMed

Ellis, Horace; Alexander, Vinette

2016-06-01

There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in

A systematic review of the psychiatric/mental health nursing research literature 1982-1992.

PubMed

Yonge, O; Austin, W; Qiuping, P Z; Wacko, M; Wilson, S; Zaleski, J

1997-06-01

The purpose of this study was to assess the quality of quantitative psychiatric/mental health nursing research articles published in English between 1982 and 1992, worldwide. Criteria for selection of articles included nurse authorship or co-authorship, use of a quantitative design and pertinence to an aspect of the nursing process with psychiatric/mental health patients. One hundred and ninety-four articles met these criteria. The quality of each article was assessed by two nurse experts using Duffy's Research Appraisal Checklist (RAC). Forty-six point nine per cent of the articles were rated as superior, 50% as average and 3.1% as below average. Other findings identified journals that published research articles, countries in which research was completed, applicability of funding and qualifications of the authors. The major implications of this study are that nurses can be directed to superior articles; more publication of research by nurse authors is warranted, research is being completed with little financial support, highly rated research publications tend to get funding and editorial policies affect the quality of publication.

Job satisfaction and resilience in psychiatric nurses: A study at the Institute of Mental Health, Singapore.

PubMed

Zheng, Zhimin; Gangaram, Poornima; Xie, Huiting; Chua, Stephanie; Ong, Samantha Bee Cheng; Koh, Sioh Eng

2017-12-01

Job satisfaction ranks highly as one of the main factors influencing turnover rates among nurses. Mental health nursing has been reported to be a particularly stressful specialty, yet little is known about the level of job satisfaction among psychiatric nurses in Singapore. Resilience is defined as a means of adapting to stress at the workplace, and could serve as a factor influencing job satisfaction. The present study aimed to explore the current level of job satisfaction among psychiatric nurses working in the only tertiary psychiatric institution in Singapore, the influencing factors, and the relationship between resilience and job satisfaction. A survey questionnaire consisting of the following was administered to all eligible nurses working in the Institute of Mental Health between the period of 16-24 December 2014: (i) The McCloskey and Mueller Satisfaction Scale; (ii) The Resilience Scale; and (iii) sociodemographic data form. A total of 874 nurses were eligible for participation in the study, and a total of 748 nurses responded, totalling 85.6% response. A mean satisfaction score of 95.21 and mean resilience score of 125.74 were obtained. Mean satisfaction and resilience scores were the highest for nurses with longer working experience and those of older age. A positive and significant association between satisfaction and resilience scores (P = 0.001) was obtained. Psychiatric nurses in Singapore are generally satisfied with their job, but this can be further improved with the strengthening of personal resilience. © 2017 Australian College of Mental Health Nurses Inc.

[Mental Health and Political Violence. Care of Psychiatric Patient or Acknowledge of the Micropolitics of the Subject].

PubMed

Arias López, Beatriz Elena

2013-09-01

Political violence is a global phenomenon, especially in low- to middle-income countries. This phenomenon increasingly involves civilians. This situation is a priority in collective health, as it produces multiple and complex effects on physical and mental health, and human and social ecosystems. The objective of this article is to present the main tendencies that coexist in research and practice on the understanding of the effects of political violence on mental health. The biomedical approach of psychiatric trauma and the wider perspective of social sciences, which incorporate the collective dimension of these effects, are also taken into account. Review of research determines the relationship with political violence / collective violence and mental health in international databases and national documentation centers, academics and NGOs within the last decade of the twentieth century, and the first of this century under the headings of trauma, war, armed conflict and political violence. The limitations of general explanations of psychiatric trauma in understanding the complex effects of political violence on mental health are shown. The constructs that incorporate social and collective dimensions increase this comprehension of these effects and knowledge of mental health, both conceptually as methodologically. In a political violence context it urgent to change attitudes about mental health. It is a way to overcome the biomedical, individualistic, and short term epidemiology, and to remove medication from mental health. This means acknowledging that people who experience the effects of political violence effects are not sick. They are powerful people who can transform and produce the life they dream of. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Sociodemographic and medical characteristics of involuntary psychiatric inpatients--retrospective study of five-year experience with Croatian Act on Mental Health.

PubMed

Potkonjak, Jelena; Karlović, Dalibor

2008-09-01

The aim of this study was to analyze sociodemographic and medical characteristics of involuntary psychiatric inpatients treated during the five-year period of implementation of the Croatian Act on Mental Health. Data on involuntarily hospitalized patients according to the Croatian Act on Mental Health were singled out from the pool of inpatients treated at University Department of Psychiatry, Sestre milosrdnice University Hospital from January 1, 1998 till December 31, 2002. Data were collected from medical records. Patients were diagnosed according to the International Classification of Diseases, 10th revision criteria. The prevalence of involuntary hospitalization was 2%, including a comparative number of male and female patients. Most patients had secondary school, were living alone, were unmarried, widowed or divorced, and did not work at the time of hospitalization; however, most patients had some kind of health insurance. Schizophrenia was the most common diagnosis in involuntary psychiatric inpatients. In conclusion, scientific evaluation of involuntary hospitalization poses a major problem because of the many different factors that can influence the prevalence of involuntary hospitalization. Some of this factors are type of institution (psychiatric hospital or psychiatry department at a general hospital), organization of psychiatric care in the region, psychiatric morbidity and dynamics of changes in psychiatric morbidity in a specific region, public opinion about people with mental disorders, legal provisions on this very sensitive topic, etc.

Teaching child psychiatric assessment skills: Using pediatric mental health screening tools.

PubMed

Hargrave, T M; Arthur, M E

2015-01-01

This article describes the workshop "Teaching Child Psychiatric Assessment Skills: Using Mental Health Screening Instruments," presented at the 35th Forum for Behavioral Sciences in Family Medicine on 20 September 2014. The goals of the presentation were (1) to teach family medicine behavioral health educators to use both general and problem-specific mental health screening tools (MHSTs) in their work with trainees to help satisfy the Accreditation Council for Graduate Medical Education (ACGME) mandate for behavioral and mental health experience during family medicine residency, (2) to reflect on how MHSTs might be integrated into the flow of family medicine teaching practices, and (3) to exemplify how evidence-based methods of adult education might be used in teaching such content. One general MHST, the Pediatric Symptom Checklist-17 and one problem-specific MHST for each of the four commonest pediatric mental health issues: for attention-deficit hyperactivity disorder, the Vanderbilt; for Anxiety, the Screen for Childhood Anxiety-Related Emotional Disorders; for Depression, the Patient Health Questionnaire-9 for teens; and for Aggression, the Retrospective-Modified Overt Aggression Scale, were practiced at least twice in the context of a clinical vignette. All of the selected MHSTs are free in the public domain and available for download from the website: www.CAPPCNY.org. Participants were asked to reflect on their own office practice characteristics and consider how MHSTs might be integrated into their systems of care. This workshop could be replicated by others wishing to teach the use of MHSTs in primary care settings or teaching programs. © The Author(s) 2015.

Impact of the New Mental Health Services on Rates of Suicide and Hospitalisations by Attempted Suicide, Psychiatric Problems, and Alcohol Problems in Brazil.

PubMed

Machado, Daiane B; Alves, Flávia Jôse; Rasella, Davide; Rodrigues, Laura; Araya, Ricardo

2018-05-01

A sizeable proportion of all suicides have mental health issues in the background. The association between access to mental health care in the community and decreased suicide rates is inconsistent in the literature. Brazil undertook a major psychiatric reform strengthening psychiatric community-based care. To evaluate the impact of the new Brazilian community mental health care units (CAPS-Psychosocial-Community-Centres) on municipal rates of suicide, and hospitalisations by attempted suicide, psychiatric and alcohol problems. We performed robust multivariable negative binomial regression models with fixed effect for panel data from all 5507 Brazilian municipalities. Suicide and hospitalization rates were calculated by sex and standardised by age for each municipality and year from 2008 to 2012. The main variable of interest was municipal CAPS coverage. CAPS municipal coverage was associated with lower suicide rates but this was not statistically significant (RR: 0.981; 95% CI 0.952-1.011). However, increased CAPS coverage was associated with lower hospitalizations for attempted suicide (RR: 0.887; 95% CI 0.841-0.935), psychiatric (RR: 0.841; 95% CI 0.821-0.862), and alcohol problems (RR: 0.882; 95% CI 0.860-0.904). Our results suggest that access to community mental health services seems to reduce hospitalisations due to attempted suicide, psychiatric and alcohol problems but not suicidal rates. Therefore, increased investments in community mental health services in low-middle-income countries might decrease costs associated with potentially avoidable hospitalizations.

Motivations of persons with psychiatric disabilities to work in mental health peer services: a qualitative study using self-determination theory.

PubMed

Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine

2014-03-01

Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental

[Population models of mental health in the Russian population: assessment of an impact of living conditions and psychiatric care resources].

PubMed

Mitikhin, V G; Yastrebov, V S; Mitikhina, I A

ОBJECTIVE: The development and use of population models of mental health in the Russian population to analyze the relationship between indicators of mental disorders, psychiatric care resources taking into account medical/demographic and socio-economic factors in the period of 1992-2015. The sources of information were: 1) the data of the Russian medical statistics on the main indicators of mental health of the Russian population and psychiatric care resources; 2) government statistics on the demographic and socio-economic situation of the population of Russia during this period. The study used system data analysis, correlation and regression analyses. Linear and nonlinear models with a high level of significance were obtained to assess the impact of socio-economic, health and demographic (population, life expectancy, migration, mortality) factors and resources of the service (primarily, manpower) on the dynamics of the main indicators (prevalence, incidence) of mental health of the population. In recent years, a decline in the prevalence and incidence of the Russian population is a consequence of the scarcity of mental health services, in particular, personnel resources.

Customized role play: strategy for development of psychiatric mental health nurse practitioner competencies.

PubMed

Hubbard, Grace B

2014-04-01

To discuss the teaching/learning strategy of customized role play to enhance psychiatric mental health nurse practitioner (PMHNP) students' entry level competency. Customized role play facilitates application of new content, understanding of the patient's experience, and assessment of skill deficits. New PMHNP graduates have entry level proficiency across the life span with a range of psychotherapeutic interventions. © 2013 Wiley Periodicals, Inc.

An Analysis of Canadian Psychiatric Mental Health Nursing through the Junctures of History, Gender, Nursing Education, and Quality of Work Life in Ontario, Manitoba, Alberta, and Saskatchewan

PubMed Central

2013-01-01

A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. PMID:23710367

Duration of daily TV/screen watching with cardiovascular, respiratory, mental and psychiatric health: Scottish Health Survey, 2012-2013.

PubMed

Shiue, Ivy

2015-01-01

The link of duration of TV and/or screen watching and chronic health conditions by subtypes is unclear. Therefore, the relationship between TV and/or screen watching hours and cardiovascular, respiratory, mental and psychiatric health and well-being (happiness) was assessed in an independent population-based survey to identify correlations of various hours with health conditions. Data was retrieved from the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, self-reported health conditions and TV and/or screen watching duration in both Scottish adults and children was collected by annual household interviews. Chi-square test and survey weighted logistic and multi-nominal modelling were performed. 5527 (57.0%) Scottish adults aged 16-99 watched TV and/or screen daily for 3 + h on average. There was a trend toward more hypertension, angina, stroke, diabetes, chronic obstructive pulmonary disease and poor self-rated health and mental health. Reporting watching TV and/or screen for 4 + h, for 5 + h and for 8 + h was associated with higher rates of heart attack, heart murmur or other heart troubles and abnormal heart rhythms, respectively. 414 (20.7%) Scottish children aged 4-12 watched TV and/or screen for 3h or more. They tended to have poor self-rated health and life difficulties perceived as emotional and behavioural problems. There were associations between various hours of TV and/or screen watching (3+h) and poor health observed both in Scottish adults and children. Future educational and public health programmes minimising TV and/or screen watching in order to protect cardiovascular, respiratory, mental and psychiatric health might be considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mental health care use in adolescents with and without mental disorders.

PubMed

Jörg, Frederike; Visser, Ellen; Ormel, Johan; Reijneveld, Sijmen A; Hartman, Catharina A; Oldehinkel, Albertine J

2016-05-01

The aim of the study was to estimate the proportion of adolescents with and without a psychiatric diagnosis receiving specialist mental health care and investigate their problem levels as well as utilization of other types of mental health care to detect possible over- and undertreatment. Care utilization data were linked to psychiatric diagnostic data of 2230 adolescents participating in the TRAILS cohort study, who were assessed biannually starting at age 11. Psychiatric diagnoses were established at the fourth wave by the Composite International Diagnostic Interview. Self-, parent- and teacher-reported emotional and behavioral problems and self-reported mental health care use were assessed at all four waves. Of all diagnosed adolescents, 35.3 % received specialist mental health care. This rate increased to 54.5 % when three or more disorders were diagnosed. Almost a third (28.5 %) of specialist care users had no psychiatric diagnosis; teachers gave them relatively high ratings on attention and impulsivity subscales. Diagnosed adolescents without specialist mental health care also reported low rates of other care use. We found no indication of overtreatment. Half of the adolescents with three or more disorders do not receive specialist mental health care nor any other type of care, which might indicate unmet needs.

A cross-sectional study about associations between personality characteristics and mental health service utilization in a Korean national community sample of adults with psychiatric disorders.

PubMed

Park, Subin; Lee, Yeeun; Seong, Su Jeong; Chang, Sung Man; Lee, Jun Young; Hahm, Bong Jin; Hong, Jin Pyo

2017-05-05

Personality traits are not only associated with psychiatric symptoms, but also with treatment seeking behavior. Our purpose was to examine the relationship between mental health service utilization and personality characteristics in a nationwide community sample of Korean adults. Of the 6022 subjects aged 18-74 years who participated in the Korean Epidemiologic Catchment Area study, 1544 (25.6%) with a lifetime diagnosis of any DSM-IV psychiatric disorder were analyzed. Diagnostic assessments were based on the Composite International Diagnostic Interview and personality constructs were measured by Big Five Personality Inventory-10. Of the 1544 participants, 275 (17.8%) had used mental health services. Multivariate analyses revealed positive associations between mental health service utilization and both neuroticism and openness, and an inverse association between mental health service utilization and agreeableness. These findings suggest that specific personality traits may have a role in treatment-seeking behaviors for mental health problems independent of the psychiatric disorder.

Supporting children whose parent has a mental health problem: an assessment of the education, knowledge, confidence and practices of registered psychiatric nurses in Ireland.

PubMed

Houlihan, D; Sharek, D; Higgins, A

2013-04-01

Health professionals, including nurses, stand accused of ignorance or oversight of children whose parent experience a mental health problem. Psychiatric nurses are in an ideal position to respond to children's needs and support their parents in a proactive and sensitive manner. The aim of this study was to explore psychiatric nurses' education, knowledge, confidence and practice with regard to the support needs of children whose parent has a mental health problem. This study employed a self-completion anonymous survey design with a sample of registered psychiatric nurses from one integrated mental health service in Ireland. The sample reported relatively low levels of education, knowledge, confidence and supportive clinical practice when it came to children whose parent has a mental health problem. There is an urgent need for education on family-focused care, and the development of guidelines and child focused services if the needs of parents and children are to be met. © 2012 Blackwell Publishing.

Money management, mental health, and psychiatric disability: a recovery-oriented model for improving financial skills.

PubMed

Elbogen, Eric B; Tiegreen, Joshua; Vaughan, Colleen; Bradford, Daniel W

2011-01-01

Although money management skills are essential for independent functioning in the community, when viewed from the framework of psychosocial rehabilitation, there have been few systematic models for teaching money management skills to consumers with psychiatric disabilities based on a recovery orientation. For those diagnosed with psychiatric disabilities, better money management has consistently been shown to be associated with superior quality of life, fewer hospitalizations, and greater self-efficacy. Consumers frequently indicate that learning how to budget and staying out of debt are among their top goals for recovery with mental illness. The current paper reviews the issues of money management and mental health among people with psychiatric disabilities and proposes a recovery-oriented approach to increasing money management skills to increase community functioning among consumers. Published literature, clinical cases, and financial literacy resources. Improving money management can lead to a number of benefits by helping consumers with psychiatric disabilities: 1) gain more knowledge about disability benefits, 2) improve basic financial skills, and 3) reduce vulnerability to financial exploitation. Future work on incorporating this model into psychiatric rehabilitation programs would address skills consumers can use in living, working, and social environments in a way that enhances consumer choice and promotes recovery.

[The Development of Psychiatric and Mental Health Nursing in Taiwan: Reflection From the Perspective of Recovery].

PubMed

Li, Jin-Biau; Tsai, Sing-Ling

2017-06-01

Evidence-based nursing science has identified psychological recovery, partnership, and medication adherence as factors that have influenced the development of mental health care. This article discusses the process by which mental health care has developed from a medical / rehabilitation-focused model to a model that focuses on patient empowerment. The current model aims to assist patients to achieve self-awareness and to develop coping skills that enhance their motivation to transform. Medical advances have improved the control of psychiatric symptoms. Following the introduction of 2nd generation antipsychotics, patients were invited to establish decisions related to these prescription medications. Under the principles of patient-centered service, Taiwanese mental health professionals have changed their relationship with patients from a therapeutic model to a mutual-partnership model. Furthermore, investigations of the therapeutic care of patients with mental illness have used the needs of patients as their starting point and emphasized various aspects of patient and caregiver needs. Taiwanese mental health professionals are searching for a model of mental health care that is superior to the traditional operative framework of medical authority.

Mortality and psychiatric disorders among public mental health care clients in Utrecht: a register-based cohort study.

PubMed

Termorshuizen, Fabian; van Bergen, Addi P L; Smit, Ronald B J; Smeets, Hugo M; van Ameijden, Erik J C

2014-08-01

Different studies have shown similar or even lower mortality among homeless persons with compared to homeless persons without a severe mental disorder. To clarify the association between presence of a psychiatric diagnosis and mortality among the socially marginalized. The Public Mental health care (PMHc) is a legal task of the municipal authority aiming at prevention and intervention in case of (imminent) homelessness among persons with a serious shortage of self-sufficiency. The data of PMHc clients (N=6,724) and personally matched controls (N=66,247) were linked to the registries of Statistics Netherlands and analysed in a Cox model. The increased mortality among PMHc clients, compared to the general population (HR=2.99, 95%-CI: 2.63-3.41), was associated with a broad range of death causes. Clients with a record linkage to the Psychiatric Case Registry Middle Netherlands ('PMHc+') had an increased risk of suicide (HR=2.63, 0.99-7.02, P=0.052), but a lower risk of natural death causes (HR=0.71, 0.54-0.92, P=0.011), compared to clients without this record linkage ('PMHc-'). Compared to controls, however, 'PMHc-' clients experienced substantially increased risks of suicide (HR=3.63, 1.42-9.26, P=0.007) and death associated with mental and behavioural disorders (ICD-10 Ch.V) (HR=7.85, 3.54-17.43, P<0.001). Psychiatric services may deliver an important contribution to the prevention of premature natural death among the socially marginalized. The earlier observed lower mortality among vulnerably housed and homeless persons with a psychiatric diagnosis compared to vulnerably housed and homeless persons without a psychiatric diagnosis appears to be due to a significantly lower risk of natural causes of death. Compared to controls from the general population, vulnerably housed and homeless persons without registered diagnosis at a local psychiatric service have a significantly increased mortality associated both with natural death causes and with suicide and death due to

Mental health legislation in Lebanon: Nonconformity to international standards and clinical dilemmas in psychiatric practice.

PubMed

Kerbage, Hala; El Chammay, Rabih; Richa, Sami

2016-01-01

Mental health legislation represents an important mean of protecting the rights of persons with mental disabilities by preventing human rights violations and discrimination and by legally reinforcing the objectives of a mental health policy. The last decade has seen significant changes in the laws relating to psychiatric practice all over the world, especially with the implementation of the Convention for the Rights of People with Disabilities (CRPD). In this paper, we review the existing legislation in Lebanon concerning the following areas in mental health: treatment and legal protection of persons with mental disabilities, criminal laws in relation to offenders with mental disorders, and laws regulating incapacity. We will discuss these texts in comparison with international recommendations and standards on the rights of persons with disabilities, showing the recurrent contradiction between them. Throughout our article, we will address the clinical dilemmas that Lebanese psychiatrists encounter in practice, in the absence of a clear legislation that can orient their decisions and protect their patients from abuse. Copyright © 2015. Published by Elsevier Ltd.

Empathy toward Patients with Mental Illness among Baccalaureate Nursing Students: Impact of a Psychiatric Nursing and Mental Health Educational Experience

ERIC Educational Resources Information Center

Mousa, Marwa Abd El-Gawad Ahmed

2015-01-01

Empathy is an ability and skill that can be learned and developed through appropriate education and practice. While the importance of nurses' empathy is widely acknowledged, little is known about the impact of passing through the psychiatric nursing and mental health educational experience at the Faculty of Nursing, Alexandria University on…

Experiences and Attitudes Among Psychiatric Mental Health Advanced Practice Nurses in the Use of Telemental Health: Results of an Online Survey.

PubMed

Baird, Martha B; Whitney, Lucinda; Caedo, Cassie E

Telemental health (TMH) growth is driven by recent trends in health delivery systems and disparities in access to mental health services. There are currently no standard educational guidelines to prepare psychiatric mental health advanced practice nurses (PMH-APRNs) in TMH delivery. To survey practicing PMH-APRNs across the United States about their experiences and attitudes about use of TMH. Eighty-three participants from the American Psychiatric Nurses Association online discussion board completed a nine-item survey. Length of time practicing as a PMH-APRN, TMH use in practice, populations served, and TMH background. A majority had been practicing as a PMH-APRN for less than a decade and had used TMH, although most reported no prior education or training in this delivery method. Participants did indicate a desire for TMH education. This survey affirms the prevalence of TMH use among PMH-APRN providers, lack of formal training, and necessity for standardized educational guidelines in TMH delivery.

Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study.

PubMed

Keszte, J; Danker, H; Dietz, A; Meister, E; Pabst, F; Guntinas-Lichius, O; Oeken, J; Singer, S; Meyer, A

2017-03-01

In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.

Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India.

PubMed

Kulesza, Magdalena; Raguram, R; Rao, Deepa

2014-06-01

Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. Copyright © 2014 Elsevier B.V. All rights reserved.

[Closing forensic psychiatric hospitals in Italy: a new deal for mental health care?].

PubMed

Casacchia, Massimo; Malavolta, Maurizio; Bianchini, Valeria; Giusti, Laura; Di Michele, Vittorio; Giosuè, Patricia; Ruggeri, Mirella; Biondi, Massimo; Roncone, Rita

2015-01-01

The date of March 31, 2015, following the Law 81/2014, has marked a historical transition with the final closure of the six forensic psychiatric hospitals in Italy. This law identifies a new pathway of care that involves small-scale high therapeutic profile facilities (Residenze per la Esecuzione della Misura di Sicurezza, REMS) instead of the old forensic psychiatric hospitals. The Law promotes a new recovery-oriented rehabilitation approach for the persons with mental disorders who committed a criminal offence, but lack criminal responsibility and deemed as socially dangerous. After a brief description of what happens abroad, this article highlights the positive aspects of the law that, as a whole, has to be considered innovative and unavoidable. The main debated problems are also reviewed, including the lack of changes to the Criminal Code; the improper equation between insanity and mental illness and social dangerousness; the evaluation of "socially dangerousness", based solely on "subjective qualities" of the person, assessed out of his/her context, without paying attention to family and social conditions suitable for discharge; the expensive implementation of the REMS, mainly based on security policies and less on care and rehabilitation, the delay in their construction, and the search for residential alternatives structures; the uncertain boundaries of professional responsibility. Finally, several actions are suggested that can support the implementation of the law: information programs addressed to the general population; training activities for mental health professionals; systematic monitoring and evaluation of the outcomes of the care provided to the forensic psychiatric population; implementation of Agreement Protocols and a better cooperation with the judiciary. Scientific societies dealing with psychosocial rehabilitation need to be involved in such issues relating to the identification of the best care and rehabilitation pathways, which should be

Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK.

PubMed

Fanner, Deborah; Urqhuart, Christine

2009-06-01

UK health policy advocates a patient-centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e-learning materials to provide therapeutic support). Part 2 of this two-part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. An e-mail questionnaire survey of psychiatric library members of the psychiatric lending co-operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.

Trends in acute mental health care: comparing psychiatric and substance abuse treatment programs.

PubMed

Timko, Christine; Lesar, Michelle; Calvi, Noël J; Moos, Rudolf H

2003-01-01

This study compared psychiatric and substance abuse acute care programs, within both inpatient and residential modalities of care, on organization and staffing, clinical management practices and policies, and services and activities. A total of 412 (95% of those eligible) Department of Veterans Affairs' programs were surveyed nationwide. Some 40% to 50% of patients in psychiatric and substance abuse programs, in both inpatient and residential venues of care, had dual diagnoses. Even though psychiatric programs had a sicker patient population, they provided fewer services, including basic components of integrated programs, than substance abuse programs did. Findings also showed that there is a strong emphasis on the use of clinical practice guidelines, performance monitoring, and obtaining client satisfaction and outcome data in mental health programs. The author's suggest how psychiatric programs might better meet the needs of acutely ill and dually diagnosed patients (e.g., by incorporating former patients as role models and mutual help groups, as substance abuse programs do; and by having policies that balance patient choice with program demand).

Psychiatric Mental Health Leadership at the Tipping Point.

PubMed

R Delaney, Kathleen

2015-05-01

Currently the United States health care system is responding to the Patient Protection and Affordable Care Act (PPACA) and the vision it contains for health care transformation. Along with sweeping changes in service delivery and payment structures, health care reform has championed concepts such as patient-centered care, integrated care, and wellness. Although these are not new ideas, their adaptation, in both ideology and service design has been accelerated in the context for reform. Indeed they are reaching a tipping point; the point where ideas gain wide acceptance and become influential trends. Although psychiatric mental health (PMH) nurses have been active in wellness, patient-centered care, and integrated care, at the current time they seem to be situated peripheral to these national trends. Increased presence of PMH nurses will facilitate their contribution to the development of these concepts within service structures and interventions. To increase knowledge and appreciation of PMH nurses' practice and unique perspective on these issues, leaders are needed who will connect and effectively communicate PMH nursing efforts to the broader health care arena. This article outlines the events that created a context for these three concepts (patient-centered care, wellness, and integrated care), and I suggest why they have reached a tipping point and discuss the need for greater PMH nursing presence in the American national dialog and the role of nursing leaders in facilitating these connections.

The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction.

PubMed

Wortans, J; Happell, B; Johnstone, H

2006-02-01

There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.

Care seeking and beliefs about the cause of mental illness among Nigerian psychiatric patients and their families.

PubMed

Aghukwa, Chikaodiri Nkereuwem

2012-06-01

This study examined treatment seeking by 219 psychiatric patients at a teaching hospital in Kano, Nigeria. Patients or their families were interviewed about the types of mental health healers that patients saw before seeking conventional psychiatric treatment and beliefs about the causes of the illness. The length of illness before the psychiatric consultation was 4.5 years, and 99 (45%) respondents reported that patients had previously sought religious healing. A majority of respondents (N=128, 59%) attributed the illness to supernatural forces. Up to 68% and 75% of respondents who believed in a medical or genetic cause of illness, respectively, reported seeking a psychiatric consultation within six months of onset, and about 70% who believed in supernatural forces reported seeking psychiatric consultation five years after onset or later (p<.05). Mental health planners should educate alternative mental health healers and integrate them in the care of mental illness.

Making strides in women’s mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006–2008)

PubMed Central

Chemali, Zeina N; Borba, Christina PC; Henderson, Tanya E; Tesfaye, Markos

2013-01-01

This paper presents the delivery of mental health care to a sample of women living in Jimma, rural Ethiopia, and their access to mental health services. A total of 226 psychiatric charts were reviewed for women seen at Jimma University Specialized Hospital. The mental health charts included documentation ranging from one paragraph to a full note. No psychiatric chart recorded medication status, detailed substance abuse history, or a history of violence. Rendering appropriate mental health care for women requires concerted efforts by multiple stake holders. Using our results, we advance concrete and practical suggestions for improving women’s mental health in rural Ethiopia. We point out that the health care system needs to be responsive, allowing for change starting with gender rights, so that rural women have access to basic mental health services. PMID:23901297

Mental health symptoms as prognostic risk markers of all-cause and psychiatric sickness absence in office workers.

PubMed

Roelen, Corné A M; Hoedeman, Rob; van Rhenen, Willem; Groothoff, Johan W; van der Klink, Jac J L; Bültmann, Ute

2014-02-01

To investigate mental health symptoms as prognostic risk markers of all-cause and psychiatric sickness absence (SA). Mental health symptoms were measured in 1137 office workers with the Four-Dimensional Symptom Questionnaire (4DSQ), including scales for distress, depression, anxiety and somatization. The total number of SA days was accumulated prospectively on the individual level and high SA was defined as ≥30 SA days during 1-year follow-up. Psychiatric SA was also tallied on the individual level during 1-year follow-up. Baseline 4DSQ scores were associated with high all-cause SA and psychiatric SA by logistic regression analysis. The Hosmer-Lemeshow test and calibration slope were used to assess the accuracy of predictions by 4DSQ scores. The ability of 4DSQ scores to discriminate high-risk from low-risk employees was estimated by the area under the receiver operating characteristic curve. Six hundred thirty-three office workers (56%) participated in the study. All 4DSQ scales were prospectively associated with high all-cause SA and with psychiatric SA. Distress and somatization scores showed acceptable calibration, but failed to discriminate between office workers with and without high all-cause SA. The distress scale did show adequate calibration (calibration slope = 0.95) and discrimination (area under the receiver operating characteristic curve = 0.71) for psychiatric SA. Distress was a valid prognostic risk marker for identifying office workers at work, but at risk of future psychiatric SA. Further research is necessary to investigate the prognostic performance of distress as risk marker of psychiatric SA in other working populations and to determine cut-off points for distress.

Mental Health Systems in Scandinavia.

ERIC Educational Resources Information Center

Vail, David J.

The guidebook is introduced by general observations on the Scandinavian countries concerning history, social policy, medicine, mental health, and psychiatric diagnosis. Discussed individually for Norway, Sweden, and Denmark are the following areas: mental health programs and statistics; mental illness programs, regional, hospital, aftercare,…

ECT IN MENTALLY RETARDED SUBJECTS WITH PSYCHIATRIC ILLNESS

PubMed Central

Chopra, V.K; Sinha, V.K.

2002-01-01

The mentally retarded subjects show a much higher prevalence of full range of psychiatric disorders than the non-retarded population. Whereas the role of psychotropic drugs in such patients is well discussed, the reports on the use of ECT are scarce. Many psychiatrists dealing with the mentally retarded psychiatric patients are reluctant to consider ECT due to lack of adequate experience. We report five mentally retarded patients with different psychiatric disorders who were successfully treated with ECT after failing adequate trials of pharmacotherapy. No disproportionately higher adverse events on account of mental retardation were observed. ECT need to be favorably considered in mentally retarded persons with psychiatric morbidity especially when treatment with psychotropic drugs either fail or is intolerable. PMID:21206883

Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

PubMed

Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid

2017-04-01

Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The

Refocusing on physical health: Community psychiatric nurses' perceptions of using enhanced health checks for people with severe mental illness.

PubMed

Bressington, Daniel; Mui, Jolene; Wells, Harvey; Chien, Wai Tong; Lam, Claire; White, Jacquie; Gray, Richard

2016-06-01

In the present qualitative, descriptive study, we explored Hong Kong community psychiatric nurses' (CPN) perceptions of using comprehensive physical health checks for service users diagnosed with severe mental illness (SMI). Research interviews were conducted with a purposive sample of 11 CPN in order to explore their perceptions about the use of the Health Improvement Profile (HIP) over a 1-year period. Interview data were analysed using inductive thematic analysis. The analysis revealed that the majority of CPN appreciated the comprehensive focus on the physical health of their clients and reported positive changes in their clinical practice. Many of them observed an increase in the motivation of their clients to improve their physical health, and also noted observable benefits in service users' well-being. The use of the HIP also helped the CPN identify implementation barriers, and highlighted areas of the tool that required modifications to suit the local cultural and clinical context. To our knowledge, this is the first study conducted in an Asian mental health service that explores nurses' views about using comprehensive health checks for people with SMI. The findings suggest that such approaches are viewed as being acceptable, feasible, and potentially beneficial in the community mental health setting. © 2016 Australian College of Mental Health Nurses Inc.

[Strategic planning and mental health policies].

PubMed

Tonini, Nelsi Salete; Kantorski, Luciane Prado

2007-03-01

This article discusses how mental health policies are prioritized in the process of strategic planning of mental health actions within the context of Brazilian psychiatric reform. The theoretical support of strategic planning provide health professionals, particularly those involved in metal health, with elements fir deepening discussions on existing mental health actions and policies.

Championing person-first language: a call to psychiatric mental health nurses.

PubMed

Jensen, Mary E; Pease, Elizabeth A; Lambert, Kris; Hickman, Diane R; Robinson, Ora; McCoy, Kathleen T; Barut, Jennifer K; Musker, Kathleen M; Olive, Dana; Noll, Connie; Ramirez, Jeffery; Cogliser, Dawn; King, Joan Kenerson

2013-01-01

At the heart of recovery-oriented psychiatric mental health care are the dignity and respect of each person and the ways in which helping professionals convey a person's uniqueness, strengths, abilities, and needs. "Person-first language" is a form of linguistic expression relying on words that reflect awareness, a sense of dignity, and positive attitudes about people with disabilities. As such, person-first language places emphasis on the person first rather than the disability (e.g., "person with schizophrenia" rather than "a schizophrenic"). This article champions the use of person-first language as a foundation for recovery-oriented practice and enhanced collaborative treatment environments that foster respect, human dignity, and hope.

[Development of the community mental health system and activities of the community mental health team in Kawasaki City].

PubMed

Ito, Masato

2012-01-01

Since the 1960s, Kawasaki City has been leading the nation in its efforts regarding community mental health practices. Public institutions such as the Psychiatric Rehabilitation Center in the central area of the city and the Mental Health and Welfare Center in the southern area have mainly developed the psychiatric rehabilitation system. However, since 2000, new mental health needs have emerged, as the target of mental health and welfare services has been diversified to include people with developmental disorders, higher brain dysfunction, or social withdrawal, in addition to those with schizophrenia. Therefore, Kawasaki City's plan for community-based rehabilitation was drawn up, which makes professional support available for individuals with physical, intellectual, and mental disabilities. As the plan was being implemented, in 2008, the Northern Community Rehabilitation Center was established by both the public and private sectors in partnership. After the community mental health teams were assigned to both southern and northern areas of the city, the community partnership has been developed not only for individual support but also for other objectives that required the partnership. Takeshima pointed out that the local community should be inclusive of the psychiatric care in the final stage of community mental health care in Japan. Because of the major policies regarding people with disabilities, the final stage has been reached in the northern area of Kawasaki City. This also leads to improvement in measures for major issues in psychiatry, such as suicide prevention and intervention in psychiatric disease at an early stage.

Mental illness and psychiatric treatment amongst firesetters, other offenders and the general community.

PubMed

Ducat, Lauren; Ogloff, James R P; McEwan, Troy

2013-10-01

Firesetting is often reported to be associated with psychopathology, but frequently these conclusions are based on studies reliant on selective forensic psychiatric samples without the use of comparison groups. The aim of the study was to examine the rates of mental illness, substance use disorders, personality pathology and psychiatric service usage in a population of convicted firesetters compared with other offenders and community controls. Using a data-linkage design, the study examined the psychiatric histories and usage of public mental health services by 1328 arsonists convicted between 2000 and 2009 in Victoria, Australia. These were compared with 1328 matched community controls and 421 non-firesetting offenders. Firesetters were significantly more likely to have been registered with psychiatric services (37%) compared with other offenders (29.3%) and community controls (8.7%). The firesetters were also more likely to have utilised a diverse range of public mental health services. Firesetters attracted psychiatric diagnoses more often than community controls and other offenders, particularly affective, substance use, and personality disorders. This study confirms that there is a link between firesetting and psychopathology, suggesting that there is a role for the psychiatric screening of known firesetters, and a need to consider psychopathology in formulating the risk for further firesetting.

Job Stress and Self-Efficacy among Psychiatric Nursing Working in Mental Health Hospitals at Cairo, Egypt

ERIC Educational Resources Information Center

Zaki, Rania. A.

2016-01-01

Nursing stress is considered a problem that affects the practice worldwide. Job stress is a harmful response physically and emotionally when the nurses' skills, resources, and needs could not fulfill the requirement of the job. This study was aimed to assess job stress and self-efficacy among psychiatric nursing working in mental health hospitals…

Psychiatric Disorders in Outpatients With Borderline Intellectual Functioning: Comparison With Both Outpatients From Regular Mental Health Care and Outpatients With Mild Intellectual Disabilities

PubMed Central

Wieland, Jannelien; Haan, Sara Kapitein-de; Zitman, Frans G

2014-01-01

Objective: In the Netherlands, patients with borderline intellectual functioning are eligible for specialized mental health care. This offers the unique possibility to examine the mix of psychiatric disorders in patients who, in other countries, are treated in regular outpatient mental health care clinics. Our study sought to examine the rates of all main Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Axis I psychiatric diagnoses in outpatients with borderline intellectual functioning of 2 specialized regional psychiatric outpatient departments and to compare these with rates of the same disorders in outpatients from regular mental health care (RMHC) and outpatients with mild intellectual disabilities (IDs). Method: Our study was a cross-sectional, anonymized medical chart review. All participants were patients from the Dutch regional mental health care provider Rivierduinen. Diagnoses of patients with borderline intellectual functioning (borderline intellectual functioning group; n = 235) were compared with diagnoses of patients from RMHC (RMHC group; n = 1026) and patients with mild ID (mild ID group; n = 152). Results: Compared with the RMHC group, psychotic and major depressive disorders were less common in the borderline intellectual functioning group, while posttraumatic stress disorder and V codes were more common. Compared with the mild ID group, psychotic disorders were significantly less common. Conclusion: Mental health problems in people with borderline intellectual functioning may not be well addressed in general psychiatry, or by standard psychiatry for patients with ID. Specific attention to this group in clinical practice and research may be warranted lest they fall between 2 stools. PMID:25007114

Psychiatric disorders in outpatients with borderline intellectual functioning: comparison with both outpatients from regular mental health care and outpatients with mild intellectual disabilities.

PubMed

Wieland, Jannelien; Kapitein-de Haan, Sara; Zitman, Frans G

2014-04-01

In the Netherlands, patients with borderline intellectual functioning are eligible for specialized mental health care. This offers the unique possibility to examine the mix of psychiatric disorders in patients who, in other countries, are treated in regular outpatient mental health care clinics. Our study sought to examine the rates of all main Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Axis I psychiatric diagnoses in outpatients with borderline intellectual functioning of 2 specialized regional psychiatric outpatient departments and to compare these with rates of the same disorders in outpatients from regular mental health care (RMHC) and outpatients with mild intellectual disabilities (IDs). Our study was a cross-sectional, anonymized medical chart review. All participants were patients from the Dutch regional mental health care provider Rivierduinen. Diagnoses of patients with borderline intellectual functioning (borderline intellectual functioning group; n = 235) were compared with diagnoses of patients from RMHC (RMHC group; n = 1026) and patients with mild ID (mild ID group; n = 152). Compared with the RMHC group, psychotic and major depressive disorders were less common in the borderline intellectual functioning group, while posttraumatic stress disorder and V codes were more common. Compared with the mild ID group, psychotic disorders were significantly less common. Mental health problems in people with borderline intellectual functioning may not be well addressed in general psychiatry, or by standard psychiatry for patients with ID. Specific attention to this group in clinical practice and research may be warranted lest they fall between 2 stools.

The Role of a Psychiatric Pharmacist in College Health

ERIC Educational Resources Information Center

Caley, Charles F.; Webber, Donna; Kurland, Michael; Holmes, Paula

2010-01-01

Published evidence indicates there is a growing prevalence of psychiatric illnesses on college campuses, and that approximately one quarter of students may be taking psychotropic medications. But attracting and retaining experienced mental health care professionals to college health settings is a challenging task. The psychiatric pharmacist is one…

Psychiatric Disorders Are Associated with an Increased Risk of Injuries: Data from the Iranian Mental Health Survey (IranMHS)

PubMed Central

SHADLOO, Behrang; MOTEVALIAN, Abbas; RAHIMI-MOVAGHAR, Vafa; AMIN-ESMAEILI, Masoumeh; SHARIFI, Vandad; HAJEBI, Ahmad; RADGOODARZI, Reza; HEFAZI, Mitra; RAHIMI-MOVAGHAR, Afarin

2016-01-01

Background: Injuries and psychiatric disorders, notably both major public health concerns, are associated with a high burden and are believed to be bi-directionally correlated. Those inflicted with injuries face increased risks of mental illnesses. Psychiatric disorders may make the individual prone to injuries. The objective of the study was to assess the correlation of mental disorders with non-fatal injuries. Methods: A total of 7886 participants aged 15 to 64 yr were interviewed in a national household survey in 2011 in Iran. Composite International Diagnostic Interview (CIDI v2.1) was implemented to assess the prevalence of psychiatric disorders in the past twelve months. Injuries were assessed using Short Form Injury Questionnaire (SFIQ-7). Results: Injury was reported in 35.9% and 22.8% of participants in the past twelve and past three months, respectively. Using multivariate logistic regression analysis, mental disorders were significantly associated with injuries in the past three months (OR=1.6, 95% CI:1.36–1.87), recurrent injuries (OR=1.7, 95% CI: 1.21–2.41) and road/traffic accidents (OR=2.4, 95% CI: 1.28–4.49). Conclusion: Psychiatric disorders were found to be associated with an increased risk of injuries. Early detection and treatment of mental illnesses can contribute to injury prevention. PMID:27398335

Follow-up study of female delinquent adolescents in a detention centre: effectiveness of psychiatric intervention as a mental health service.

PubMed

Ariga, Michio; Uehara, Toru; Takeuchi, Kazuo; Ishige, Yoko; Nakano, Reiko; Mikuni, Masahiko

2010-01-01

of previous studies suggest that many female offenders have co-morbid psychiatric disorders, which require mental health services. However, few longitudinal studies examined subjects during incarceration or detention. This study compares depressive symptoms, abnormal eating behaviour and impulsivity before release from a detention centre and after incarceration, thereby indicating the effectiveness of psychiatric intervention in a Japanese detention centre. Of 64 young women, 36 were followed up. Self-report measures were used to assess depression, eating behaviour and impulsivity after incarceration and one month before release. s: Of the 36 participants, nine were diagnosed using the MINI-kids as needing mental health services. Those who received psychiatric intervention were diagnosed as having major depression and/or post-traumatic stress disorder. Significant main effects of intervention and effects of time were shown in the DSD. The EAT-26 score demonstrated the significance of the effects of time and interaction. In the BIS-11 scores, neither intervention nor time showed significant effects. Results of this study showed that the time course and psychiatric intervention contributed to recovery of depression and therapeutic intervention. The time course might reduce eating problems. Psychiatric intervention might be necessary for female juvenile detainees, which presents an important issue for future studies.

Review of psychiatric services to mentally disordered offenders around the Pacific Rim.

PubMed

Every-Palmer, Susanna; Brink, Johann; Chern, Tor P; Choi, Wing-Kit; Hern-Yee, Jerome Goh; Green, Bob; Heffernan, Ed; Johnson, Sarah B; Kachaeva, Margarita; Shiina, Akihiro; Walker, David; Wu, Kevin; Wang, Xiaoping; Mellsop, Graham

2014-03-01

This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in-reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial ("disability") are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Utilization and Economic Contribution of Psychiatric Mental Health Nurse Practitioners in Public Behavioral Health Services.

PubMed

Chapman, Susan A; Phoenix, Bethany J; Hahn, Talia E; Strod, Deborah C

2018-06-01

Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems. This study used a mixed methods approach, selecting counties for use of PMHNPs, geography, population size, rural/urban, and availability of financial data. The authors conducted 1- to 2-day site visits in 2014-2015 including semi-structured interviews with management and clinical leaders and collected PMHNP staffing and billing data. Thematic analysis of interview data was conducted and aggregate staffing and billing data were analyzed to determine net PMHNP financial contribution. The primary billed service for PMHNPs is medication management. Barriers to full utilization included system-level barriers to hiring PMHNPs, lack of role-appropriate job descriptions, confusion related to scope of practice/supervision requirements, and challenges in recruitment and retention. Fiscal analysis showed a positive net contribution from PMHNP services. PMHNPs can make a significant contribution to behavioral healthcare delivery, particularly in public mental health settings, yet greater understanding of their role and addressing barriers to practice is needed. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Mental Health: Knowledge, Attitudes and Training of Professionals on Dual Diagnosis of Intellectual Disability and Psychiatric Disorder

ERIC Educational Resources Information Center

Werner, S.; Stawski, M.

2012-01-01

Background: Dual diagnosis (DD) refers to the coexistence of intellectual disability and psychiatric disorder. In order to provide individuals with DD with adequate care, it is essential for mental health workers to have adequate knowledge and positive attitudes. These may be achieved through proper training. Aims: To summarise the available…

Contextualizing mental health: gendered experiences in a Mumbai slum.

PubMed

Parkar, Shubhangi R; Fernandes, Johnson; Weiss, Mitchell G

2003-12-01

Urban mental health programmes in developing countries remain in their infancy. To serve low-income communities, research needs to consider the impact of common life experience in slums, including poverty, bad living conditions, unemployment, and crowding. Our study in the Malavani slum of Mumbai examines afflictions of the city affecting the emotional well-being and mental health of women and men with respect to gender. This is a topic for which mental health studies have been lacking, and for which psychiatric assumptions based on middle-class clinical experience may be most tenuous. This study employs ethnographic methods to show how environmental and social contexts interact in shaping local experience with reference to common mental health problems. Focusing on the social and environmental context of the mental health of communities, rather than psychiatric disorders affecting individuals, findings are broadly applicable and sorely needed to guide the development of locally appropriate community mental health programmes. Identified afflictions affecting mental health include not only access to health care, but also sanitation, addictions, criminality, domestic violence, and the so-called bar-girl culture. Although effective clinical interventions are required for mental health services to treat psychiatric disorders, they cannot directly affect the conditions of urban slums that impair mental health.

Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

PubMed

Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

2015-02-01

Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

Implications of Recovering for Mental Health Systems and Programs.

ERIC Educational Resources Information Center

Spaniol, LeRoy

This presentation outlines the implications of psychiatric disability recovery for mental health systems and programs. Schizophrenia and other serious psychiatric disabilities have been viewed as irreversible illnesses with increasing disability over time. Mental health program planning, policies, and practices have been developed and implemented…

Participation and retention of youth with perinatal HIV infection in mental health research studies: the IMPAACT P1055 psychiatric comorbidity study.

PubMed

Williams, Paige L; Chernoff, Miriam; Angelidou, Konstantia; Brouwers, Pim; Kacanek, Deborah; Deygoo, Nagamah S; Nachman, Sharon; Gadow, Kenneth D

2013-07-01

Obtaining accurate estimates of mental health problems among youth perinatally infected with HIV (PHIV) helps clinicians develop targeted interventions but requires enrollment and retention of representative youth into research studies. The study design for IMPAACT P1055, a US-based, multisite prospective study of psychiatric symptoms among PHIV youth and uninfected controls aged 6 to 17 years old, is described. Participants were compared with nonparticipants by demographic characteristics and reasons were summarized for study refusal. Adjusted logistic regression models were used to evaluate the association of psychiatric symptoms and other factors with loss to follow-up (LTFU). Among 2281 youth screened between 2005 and 2006 at 29 IMPAACT research sites, 580 (25%) refused to participate, primarily because of time constraints. Among 1162 eligible youth approached, 582 (50%) enrolled (323 PHIV and 259 Control), with higher participation rates for Hispanic youth. Retention at 2 years was significantly higher for PHIV than Controls (84% vs 77%, P = 0.03). In logistic regression models adjusting for sociodemographic characteristics and HIV status, youth with any self-assessed psychiatric condition had higher odds of LTFU compared with those with no disorder (adjusted odds ratio = 1.56, 95% confidence interval: 1.00 to 2.43). Among PHIV youth, those with any psychiatric condition had 3-fold higher odds of LTFU (adjusted odds ratio = 3.11, 95% confidence interval: 1.61 to 6.01). Enrollment and retention of PHIV youth into mental health research studies is challenging for those with psychiatric conditions and may lead to underestimated risks for mental health problems. Creative approaches for engaging HIV-infected youth and their families are required for ensuring representative study populations.

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice.

PubMed

Slemon, Allie; Jenkins, Emily; Bungay, Vicky

2017-10-01

The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

NASA Technical Reports Server (NTRS)

Santy, Patricia A.

1987-01-01

The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

The needs of older people with mental health problems in a Portuguese psychiatric setting.

PubMed

Passos, Joaquim; Fonte, Aníbal; Dias, Cláudia Camila; Fernandes, Lia

2017-05-01

This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems. A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE. The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients' main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = -8.58, p < 0.001; Z = -11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients. Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients' perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.

Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology

PubMed Central

Kohrt, Brandon A; Rasmussen, Andrew; Kaiser, Bonnie N; Haroz, Emily E; Maharjan, Sujen M; Mutamba, Byamah B; de Jong, Joop TVM; Hinton, Devon E

2014-01-01

Background Burgeoning global mental health endeavors have renewed debates about cultural applicability of psychiatric categories. This study’s goal is to review strengths and limitations of literature comparing psychiatric categories with cultural concepts of distress (CCD) such as cultural syndromes, culture-bound syndromes, and idioms of distress. Methods The Systematic Assessment of Quality in Observational Research (SAQOR) was adapted based on cultural psychiatry principles to develop a Cultural Psychiatry Epidemiology version (SAQOR-CPE), which was used to rate quality of quantitative studies comparing CCD and psychiatric categories. A meta-analysis was performed for each psychiatric category. Results Forty-five studies met inclusion criteria, with 18 782 unique participants. Primary objectives of the studies included comparing CCD and psychiatric disorders (51%), assessing risk factors for CCD (18%) and instrument validation (16%). Only 27% of studies met SAQOR-CPE criteria for medium quality, with the remainder low or very low quality. Only 29% of studies employed representative samples, 53% used validated outcome measures, 44% included function assessments and 44% controlled for confounding. Meta-analyses for anxiety, depression, PTSD and somatization revealed high heterogeneity (I2 > 75%). Only general psychological distress had low heterogeneity (I2 = 8%) with a summary effect odds ratio of 5.39 (95% CI 4.71-6.17). Associations between CCD and psychiatric disorders were influenced by methodological issues, such as validation designs (β = 16.27, 95%CI 12.75-19.79) and use of CCD multi-item checklists (β = 6.10, 95%CI 1.89-10.31). Higher quality studies demonstrated weaker associations of CCD and psychiatric disorders. Conclusions Cultural concepts of distress are not inherently unamenable to epidemiological study. However, poor study quality impedes conceptual advancement and service application. With improved study design and reporting using

Secondary Traumatization in Psychiatric Mental Health Nurses: Validation of Five Key Concepts.

PubMed

Hubbard, Grace B; Beeber, Linda; Eves, Erin

2017-04-01

The purpose of this study was to validate five concepts central to secondary traumatization (ST) using narratives of psychiatric mental health advanced practice nurses. The study was designed as a directed content analysis of narrative notes (N-30). Consistency was found between narrative notes and the concepts. This study revealed that exposure and vulnerability precede empathic engagement, reaction, and alteration/transformation. The bidirectional outcome of alteration/transformation suggested that conditions leading to ST could have a positive outcome. Failure to recognize symptoms of ST and provide reflective supervision may compromise the nurse's ability to maintain a work-life balance and provide quality patient care. © 2015 Wiley Periodicals, Inc.

Mental health/psychiatric issues in elder abuse and neglect.

PubMed

Cooper, Claudia; Livingston, Gill

2014-11-01

Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.

Issues in casemix funding for acute inpatient psychiatric services and their relevance to mental health nursing.

PubMed

Fanker, S

1996-09-01

With increased recognition by government, health administrators, and clinicians of the need to simultaneously contain health expenditure, improve the productivity and efficiency of health services and maintain quality of patient care, applications of casemix funding have been advocated as an alternative means of financing acute hospital care. Currently in Australia, the Commonwealth's casemix development program is encouraging the States and Territories to participate in certain casemix initiatives. Acute psychiatric hospital care and treatment have been excluded from the initial stages of the implementation of casemix in recognition of a number of inherent obstacles or challenges affecting the utility and accuracy of casemix in funding the psychiatric sector. Despite anecdotal claims that the reduced length of stay that often occurs under casemix payment systems may negatively impact upon the quality of care and patient outcomes, to date little empirical research has been directed towards measuring the potential impact of psychiatric casemix on the quality of patient care. Psychiatry cannot afford to ignore the casemix debate on account of its current exclusion from the early phases of implementation. To do so is to run the risk of having casemix imposed at some later stage in the absence of consultation. In the meantime it is vital that mental health professionals, including nurses, participate in the development and implementation of casemix, and contribute to research aimed at increasing or maximizing the relevance of casemix to the funding of psychiatric services.

Does gender matter? Exploring mental health recovery court legal and health outcomes.

PubMed

Kothari, Catherine L; Butkiewicz, Robert; Williams, Emily R; Jacobson, Caron; Morse, Diane S; Cerulli, Catherine

2014-12-05

Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking. Study goals were to examine gender-related differences in mental health court participation, and in criminal justice, psychiatric and health-related outcomes. This study utilized a quasi-experimental pre-posttest design without a control group. The data were abstracted from administrative records of Kalamazoo Community Mental Health and Substance Abuse agency, the county jail and both county hospitals, 2008 through 2011. Generalized estimating equation regression was used to assess gender-differences in pre-post program outcomes (jail days, psychiatric and medical hospitalization days, emergency department visits) for the 30 women and 63 men with a final mental health court disposition. Program-eligible females were more likely than males to become enrolled in mental health court. Otherwise they were similar on all measured program-participation characteristics: treatment compliance, WRAP participation and graduation rate. All participants showed significant reductions in emergency department visits, but women-completers had significantly steeper drops than males: from 6.7 emergency department visits to 1.3 for women, and from 4.1 to 2.4 for men. A similar gender pattern emerged with medical-hospitalization-days: from 2.2 medical hospital days down to 0.1 for women, and from 0.9 days up to 1.8 for men. While women had fewer psychiatric hospitalization days than men regardless of program involvement (2.5 and 4.6, respectively), both genders experienced fewer days after MHRC compared to before. Women and men showed equal gains from successful program completion in

Prevalence of cannabis residues in psychiatric patients: a case study of two mental health referral hospitals in Uganda.

PubMed

Awuzu, Epaenetus A; Kaye, Emmanuel; Vudriko, Patrick

2014-01-08

Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ(9)-THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ(9)-THC immunochromatographic kit (Standard Diagnostics(®), South Korea). Seventeen percent of the patients tested positive for Δ(9)-THC residues in their urine. There was strong association (P < 0.05) between history of previous abuse of cannabis and presence of Δ(9)-THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

Psychiatric morbidities among mentally ill wives of Nepalese men working abroad.

PubMed

Shakya, Dhana Ratna

2014-01-01

Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10(th) edition (ICD-10) criteria. Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.

All this happened, more or less: thoughts on 'truth', the role of fiction and its potential application in mental health and psychiatric nursing research.

PubMed

Biley, F C

2009-12-01

Fundamental differences in the philosophy of history as an academic discipline are briefly explored, primarily from two perspectives. The traditional psychiatric and mental health nursing historian objectively uses primary sources in order to be able to make 'truth' claims about the past. The post-modern psychiatric nursing historian, on the other hand, constructs truth claims, rather than discovers them, and in the process of doing so creates historical discourses that are different from the past. To the postmodern psychiatric nursing historian, all histories are fictions, created with the use of imagination, and have characteristics that are similar to the literary constructions that are more traditionally identified as fiction. A variety of literature is used in order to explore such claims, and the conclusion is drawn that, with caution and careful attention to the rigorous use of historical method, fiction can be used as a valid source for historical research in psychiatric and mental health nursing.

Philippines mental health country profile.

PubMed

Conde, Bernardo

2004-01-01

The Philippines is one of the world's most heavily populated countries. Even though democracy was restored in 1986 after years of occupation and dictatorship, a high level of poverty still exists and malnutrition and communicable diseases continue to be the main cause of morbidity. For almost 50 years people with mental disorders have been treated in a mental hospital setting. The National Mental Health Program aims to establish psychiatric wards in university and private hospitals and encourage community-based mental health care.

[Mentally Ill Parents in Psychiatric Hospitals].

PubMed

Markwort, Ilka; Schmitz-Buhl, Mario; Christiansen, Hanna; Gouzoulis-Mayfrank, Euphrosyne

2016-09-01

Offsprings of psychiatric patients are burdened and they are at risk of developing a mental disorder themselves. All admissions in a psychiatric hospital within a period of 6 months were screened for parenthood of underaged children. They were given standardized questionnaires for child behavior (SDQ), parenting behavior and subjective need for help in parenting. 21.5 % (N = 439) of the patients had underaged children, 194 patients participated in the study. They considered their children as having more psychological/behavioral problems than a control group (N = 97). Patients with personality or affective disorders and patients with a high level of psychiatric comorbidity rated their children most problematic. Although patients did not differ from controls in the evaluation of their parenting style, they expressed a higher need for help in parenting. Parenting and education issues need to be considered in the treatment of mentally ill patients. Effective support could be a relief for families and help to prevent mental disorders in offsprings. © Georg Thieme Verlag KG Stuttgart · New York.

Personnel attitudes toward people with mental illness at a psychiatric hospital in Taiwan.

PubMed

Chen, Ming-De; Chang, Yen-Ching

2016-06-01

The attitudes of psychiatric hospital personnel are critically related to the quality of mental health care, but few studies have investigated this issue. This study is aimed at an exploration of the attitudes of psychiatric hospital personnel toward people with mental illness and at an examination of the associated factors. A self-report questionnaire, the Mental Illness Attitude Scale (MIAS), was used to collect data from psychiatric hospital personnel in Taiwan (n = 290). The MIAS included 46 items and 4 dimensions: acceptance, rehabilitation and prognosis, social distance and recommendations for interventions. Rehabilitation and prognosis had the highest item average scores (4.03) and social distance had the lowest item average scores (3.22). Stigmatization and the number of different types of contacted clients were two significantly associated attitude factors. Psychiatric hospital personnel in Taiwan tend to have positive attitudes toward people with mental illness in general situations but hold less positive attitudes in terms of community integration-related issues and intimate relationships. More evidence-based community services should be conducted to decrease personnel concerns about the successful community integration of those who are mentally ill. Future studies can investigate the concept and impact of stigmatization more deeply. © The Author(s) 2016.

An American and Dutch partnership for psychiatric mental health advance nursing practice: nurturing a relationship across the ocean.

PubMed

Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke

2012-07-01

The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.

Short-sheeting the psychiatric bed: state-level strategies to curtail the unnecessary hospitalization of adolescents in for-profit mental health facilities.

PubMed

Sperber, M N

1992-01-01

Over the past decade, there has been an increase in the hospitalization of minors in private, for-profit, psychiatric facilities. This increase suggests a tension between what is medically necessary and what is financially desirable. This Note discusses the hospitalization of minors in private, for-profit, mental health facilities and its attendant implications. This Note then examines various state efforts aimed at protecting minors from inappropriate psychiatric hospitalization. Finally, while there is no catch-all solution to the problem, this Note offers specific recommendations for reforming the for-profit psychiatric industry.

Outpatient care programs of mental health organizations, United States, 1988.

PubMed

Redick, R W; Witkin, M J; Atay, J E; Manderscheid, R W

1991-09-01

In 1988, 2,989 (60 percent) of the 4,961 mental health organizations in the United States (including the territories) offered outpatient care programs. A total of 5.8 million patient care episodes were generated by these organized outpatient programs. These episodes included 3.1 million outpatient additions, produced 54 million outpatient visits, and represented 67 percent of all patient care episodes in mental health organizations in 1988. Although the number of mental health organizations with outpatient care programs increased by less than one percent between 1986 and 1988, the number of outpatient additions showed an 11 percent gain during this period. Multiservice mental health organizations were the primary locus of outpatient care in 1988, accounting for 41 percent of the 2,989 mental health organizations providing this care. Ranking next in this respect, were free-standing psychiatric outpatient clinics, and the separate psychiatric outpatient services in non-Federal general hospitals, with 25 and 16 percent, respectively, of the total outpatient care programs. In general, these three organization types had similar rankings with respect to the volume of the outpatient caseload. By definition, all of the freestanding psychiatric outpatient clinics provided outpatient care, and almost all of the VA mental health programs and multiservice mental health organizations also offered this care (99 and 92 percent, respectively). In contrast, psychiatric outpatient care was available in only 37 percent of non-Federal general hospitals with separate psychiatric services, 36 percent of private psychiatric hospitals, 29 percent of State mental hospitals, and 22 percent of RTCs for emotionally disturbed children. Outpatient care was available in mental health organizations in all States in 1988, with every State having at least two or more organization types providing this service. In general, the most populous States had the largest number and the greatest variety of

The recognition of mental health disorders and its association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors: an investigation using the overclaiming technique.

PubMed

Swami, Viren; Persaud, Raj; Furnham, Adrian

2011-03-01

The present study examined the general public's ability to recognise mental health disorders and this ability's association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors. A total of 477 members of the British general public completed an overclaiming scale, in which they were asked to rate the degree to which they believed 20 mental health disorders (of which five were foils designed to resemble real disorders) were real or fake. Participants also completed a novel scale measuring psychiatric scepticism, a single-item measure of knowledge of psychiatry, and a measure of the Big Five personality factors. Results showed that participants were significantly more likely to rate foils as fake disorders than real disorders. In addition, the difference between real and foil ratings was significantly predicted by knowledge of psychiatry, psychiatric scepticism, and the Big Five personality factors of agreeableness and openness to experience. These results are discussed in relation to the overclaiming technique as a novel method to study mental health literacy.

The effect of cognitive impairment on mental healthcare costs for individuals with severe psychiatric illness.

PubMed

Mackin, R Scott; Delucchi, Kevin L; Bennett, Robert W; Areán, Patricia A

2011-02-01

This study was conducted to determine the effect of cognitive impairment (CI) on mental healthcare costs for older low-income adults with severe psychiatric illness. Data were collected from 62 ethnically diverse low-income older adults with severe psychiatric illness who were participating in day programming at a large community mental health center. CI was diagnosed by a neuropsychologist utilizing the Mattis Dementia Rating Scale-Second Edition and structured ratings of functional impairment (Clinical Dementia Rating Scale). Mental healthcare costs for 6, 12, and 24-month intervals before cognitive assessments were obtained for each participant. Substance abuse history was evaluated utilizing a structured questionnaire, depression symptom severity was assessed utilizing the Hamilton Depression Rating Scale, and psychiatric diagnoses were obtained through medical chart abstraction. CI was exhibited by 61% of participants and was associated with significantly increased mental healthcare costs during 6, 12, and 24-month intervals. Results of a regression analysis indicated that ethnicity and CI were both significant predictors of log transformed mental healthcare costs over 24 months with CI accounting for 13% of the variance in cost data. CI is a significant factor associated with increased mental healthcare costs in patients with severe psychiatric illness. Identifying targeted interventions to accommodate CI may lead to improving treatment outcomes and reducing the burden of mental healthcare costs for individuals with severe psychiatric illness.

The impact of changes in psychiatric bed supply on jail use by persons with severe mental illness.

PubMed

Yoon, Jangho; Domino, Marisa E; Norton, Edward C; Cuddeback, Gary S; Morrissey, Joseph P

2013-06-01

There is an on-going concern that reductions in psychiatric inpatient bed capacity beyond a critical threshold will further exacerbate the incarceration of persons with mental illness. However, research to date to assess the proposed relationship between inpatient bed capacity and jail use has been limited in several ways. In addition, mechanisms through which changes in psychiatric bed capacity may affect jail use by persons with mental illness remain unexamined empirically. The aim of this study is to test whether changes in inpatient psychiatric resources, measured by per-capita psychiatric beds, inversely affect the likelihood of jail use by persons with severe mental illness. We also examine mechanisms that link psychiatric bed supply and jail detention. We analyze unique individual-level panel data on 41,236 adults in King County, Washington who were users of jails, the public mental health system, or the Medicaid program from 1993 to 1998. Using administrative records, we identify persons ever diagnosed with severe mental illness during the study period. Our analyses build upon a system of simultaneous equations that captures mechanisms from changes in psychiatric bed supply to jail detention. We estimate a reduced-form model and calculate the total effect of a shift in psychiatric bed supply on the likelihood of jail use by persons with severe mental illness. We also estimate a semi-reduced-form equation to examine whether changes in mental health and substance use mediate the relationship between bed supply and jail detention. We estimate linear probability models with person-level fixed effects to control for individual heterogeneity. Standard errors are adjusted for intra-cluster correlations. When an equation includes an endogenous variable, we calculate generalized method of moments estimators with instrumental variables. A decrease in the supply of psychiatric hospital beds is significantly associated with a greater probability of jail detention for

[The triad configuration, humanist-existential-personal: a theoretical and methodological approach to psychiatric and mental health nursing].

PubMed

Vietta, E P

1995-01-01

The author establishes a research line based on a theoretical-methodological referential for the qualitative investigation of psychiatric nursing and mental health. Aspects of humanist and existential philosophies and personalism were evaluated integrating them in a unique perspective. In order to maintain the scientific method of research in this referential the categorization process which will be adopted in this kind of investigation was explained.

Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1)

PubMed Central

2005-01-01

Background This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. Methods The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. Results Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392.200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply

Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1).

PubMed

Carta, Mauro Giovanni; Bernal, Mariola; Hardoy, Maria Carolina; Haro-Abad, Josep Maria

2005-08-31

This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392,200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health. Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of

An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization's Assessment Instrument for Mental Health Systems.

PubMed

Bitta, Mary A; Kariuki, Symon M; Chengo, Eddie; Newton, Charles R J C

2017-01-01

Little is known about the state of mental health systems in Kenya. In 2010, Kenya promulgated a new constitution, which devolved national government and the national health system to 47 counties including Kilifi County. There is need to provide evidence from mental health systems research to identify priority areas in Kilifi's mental health system for informing county health sector decision making. We conducted an initial assessment of state of mental health systems in Kilifi County and documented resources, policy and legislation and spectrum of mental, neurological and substance use disorders. This was a pilot study that used the brief version of the World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 to collect data. Data collection was based on the year 2014. Kilifi county has two public psychiatric outpatient units that are part of general hospitals. There is no standalone mental hospital in Kilifi. There are no inpatients or community based facilities for people with mental health problems. Although the psychiatric facilities in Kilifi have an essential drugs list, supply of drugs is erratic with frequent shortages. There is no psychiatrist or psychologist in Kilifi with only two psychiatric nurses for a population of approximately 1.2 million people. Schizophrenia was the commonest reason for visiting outpatient facilities (47.1%) while suicidal ideation was the least common (0.4%). Kenya's mental health policy, which is being used by Kilifi County, is outdated and does not cater for the current mental health needs of Kilifi. There is no specific legislation to protect the rights of people with mental health problems. No budget exists specifically for mental health care. There have been no efforts to integrate mental health care into primary care in Kilifi, and there is no empirical research work to evaluate its feasibility. There is an urgent need to increase resources allocated for mental health in particular

Implications of DSM-5 for Health Care Organizations and Mental Health Policy.

PubMed

Castillo, Richard J; Guo, Kristina L

2016-01-01

The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.

Exploring an Emotional Intelligence Model With Psychiatric Mental Health Nurses.

PubMed

Sims, Traci T

A lack of emotional skills may affect a nurse's personal well-being and have negative effects on patient outcomes. To compare psychiatric-mental health nurses' (PMHN) scores on the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to a normed population and compare the emotional intelligence (EI) scores of PMHNs using two tools, MSCEIT and Self-Rated Emotional Intelligence Scale (SREIS). Comparative descriptive and correlational study. PMHNs in the study had a higher mean EI compared with that of 5,000 participants in the normed MSCEIT sample. Significant weak correlations were seen between the perceiving and understanding emotion branches of the MSCEIT and SREIS. The current study added data about a sample of PMHN's EI levels in the United States, which may encourage dialog about EI among PMHNs. Future research is needed to examine the relationship between self-report EI tools (e.g., SREIS) and performance tools (e.g., MSCEIT) to determine if they are measuring the same construct.

Caffeine, mental health, and psychiatric disorders.

PubMed

Lara, Diogo R

2010-01-01

Caffeine intake is so common that its pharmacological effects on the mind are undervalued. Since it is so readily available, individuals can adjust their own dose, time of administration and dose intervals of caffeine, according to the perceived benefits and side effects of each dose. This review focuses on human studies of caffeine in subjects with and without psychiatric disorders. Besides the possibility of mild drug dependence, caffeine may bring benefits that contribute to its widespread use. These benefits seem to be related to adaptation of mental energy to the context by increasing alertness, attention, and cognitive function (more evident in longer or more difficult tasks or situations of low arousal) and by elevating mood. Accordingly, moderate caffeine intake (< 6 cups/day) has been associated with less depressive symptoms, fewer cognitive failures, and lower risk of suicide. However, its putative therapeutic effects on depression and ADHD have been insufficiently studied. Conversely, in rare cases high doses of caffeine can induce psychotic and manic symptoms, and more commonly, anxiety. Patients with panic disorder and performance social anxiety disorder seem to be particularly sensitive to the anxiogenic effects of caffeine, whereas preliminary data suggests that it may be effective for some patients with obsessive compulsive disorder (OCD). The threshold for the anxiogenic effect of caffeine is influenced by a polymorphism of the A2A receptor. In summary, caffeine can be regarded as a pharmacological tool to increase energy and effortful behavior in daily activities. More populational (cross-sectional and prospective) and experimental studies are necessary to establish the role of caffeine intake in psychiatric disorders, especially its putative efficacy on depressive mood and cognitive/attentional disorders.

Popular Musician Responses to Mental Health Treatment.

PubMed

Berg, Lloyd; King, Benjamin; Koenig, Jessica; McRoberts, Roger L

2018-06-01

Popular (i.e., nonclassical) musicians have higher rates of mental health disorders and mental health service utilization than the general population. Little is known, however, about how popular musicians perceive mental health interventions in terms of overall satisfaction and therapeutic benefit. An online client satisfaction survey was sent to all musicians and family members who received mental health services through a nonprofit mental health organization in Austin, Texas, between July 2014 and June 2015 (n=628). 260 individuals (41.4%) responded to the survey, of whom 94% (n=244) were musicians. A majority of musician respondents were male (60%) and white (82%). 87% received counseling, 32% received psychiatric medication treatment, and 8% received addiction recovery services. 97% of musicians (205/211) rated their counselor as 'very good' or 'excellent,' 88% (64/79) rated their psychiatric providers as 'very good' or 'excellent,' and 94% (17/19) rated their addiction recovery specialists as 'very good' or 'excellent' (nonsignificant between all categories, p>0.05). 89% of musicians receiving counseling, 84% receiving psychiatric medication treatment, and 95% receiving addiction recovery services agreed or strongly agreed that their symptoms and overall functioning improved as a result of their treatment (nonsignificant between all categories, p>0.05). Popular musicians express strong provider satisfaction and overall benefit when mental health interventions are accessible, affordable, and delivered by professionals familiar with their concerns. More research is needed to understand the unique psychosocial stresses popular musicians face to inform treatment planning for this high-risk, underserved population.

The role of religion and spirituality in mental health.

PubMed

Weber, Samuel R; Pargament, Kenneth I

2014-09-01

There has been increased interest in the relationship between religion and spirituality and mental health in recent years. This article reviews recent research into the capacity of religion and spirituality to benefit or harm the mental health of believers. We also examine the implications this may have for assessment and treatment in psychiatric settings. Studies indicate that religion and spirituality can promote mental health through positive religious coping, community and support, and positive beliefs. Research also shows that religion and spirituality can be damaging to mental health by means of negative religious coping, misunderstanding and miscommunication, and negative beliefs. Tools for the assessment of patients' spiritual needs have been studied, and incorporation of spiritual themes into treatment has shown some promise. Religion and spirituality have the ability to promote or damage mental health. This potential demands an increased awareness of religious matters by practitioners in the mental health field as well as ongoing attention in psychiatric research.

Advanced practice psychiatric mental health nursing, finding our core: the therapeutic relationship in 21st century.

PubMed

Perraud, Suzanne; Delaney, Kathleen R; Carlson-Sabelli, Linnea; Johnson, Mary E; Shephard, Rebekah; Paun, Olimpia

2006-11-01

Increasingly, students from various professional backgrounds are enrolling in Psychiatric Mental Health (PMH) Nursing graduate programs, especially at the post-master's level. Faculty must educate these students to provide increasingly complex care while socializing them as PMH advanced practitioners. To present how one online program is addressing these issues by reasserting the centrality of the relationship and by assuring it has at least equal footing with the application of a burgeoning knowledge base of neurobiology of mental illness. Published literature from nursing and psychology. The PMH graduate faculty believes that they have developed strategies to meet this challenge and to help build a PMH workforce that will maintain the centrality of the relationship in PMH practice.

Prognosis after Adolescent Suicide Attempt: Mental Health, Psychiatric Treatment, and Suicide Attempts in a Nine-Year Follow-Up Study

ERIC Educational Resources Information Center

Groholt, Berit; Ekeberg, Oivind

2009-01-01

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow-up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide…

Ethical issues in perinatal mental health research.

PubMed

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

[Effects of urban noise on mental health].

PubMed

Belojević, G; Jakovljević, B; Kocijancić, R; Pjerotić, L; Dimitrijević, J

1995-01-01

The results of the latest studies on the effects of urban noise on mental health are presented in this paper. Numerous psychiatric symptoms have been frequently noticed in the population of the settlements with a high level of urban noise: fatigue, headaches, tension, anxiety, irritability, bad concentration, insomnia, whith a consequently high consumption of psychotropic medicines. Higher admission rates in psychiatric hospitals have been noticed from noisy areas in comparison with low noise regions. By use of diagnostic psychiatric interviews it has been shown as well, that in sensitive categories of population positive correlation can be expected between the number of persons with mental disorder and the level of environmental noise. Noise annoyance and sleep disturbance, namely shortening or absence of the sleep phase 4 and REM, are the basic negative psychological effects of noise, with an adverse effect on mental health in general.

[Changing Forensic Mental Health in France: A Review].

PubMed

Nakatani, Yoji; Hasuzawa, Suguru

2015-01-01

This article describes the background and recent changes in French forensic mental health. The literature suggests that three law reforms have been crucial to changes in the mental health system. First, the Penal Code of 1992 redefined the provisions of criminal responsibility and introduced the category of diminished responsibility. Second, a controversial law for preventive detention (rétention de sûretê) was enacted in 2008, according to which criminals with severe personality disorders are subject to incarceration even after the completion of their prison sentences if they are still considered to pose a danger to the public. Third, the revision of mental health laws in 2011 altered the forms of involuntary psychiatric treatments, stipulating a judge's authority to decide treatment. In parallel with these legal reforms, the psychiatric treatment system for offenders with mental disorders has been reconstructed. The number of difficult patient units (unités pour malades difficiles) has increased from four to ten across the nation in order to meet the needs of patients transferred from general psychiatric institutions for the reason of being unmanageable. In the penitentiary system, new facilities have been established to cope with the growing number of inmates with mental disorders. As background to these changes, it is pointed out that the current psychiatric system has undergone deinstitutionalization and become less tolerant of aggressive behavior in patients. In the broader context, public sensitivity towards severe crime, as shown by the sensation triggered by serious crimes conducted by pedophiles, seems to urge tough policies. In the 2000 s, several homicides committed by psychiatric patients had a great impact on the public, which led President Sarkozy to issue a statement calling for stronger security in psychiatric institutions. The harsh attitude of courts towards psychiatric practices is illustrated by a 2012 ruling; after a patient escaped from

Mental health of female foreign spouses in transnational marriages in southern Taiwan.

PubMed

Shu, Bih-Ching; Lung, For-Wey; Chen, Ching-Hsien

2011-01-06

The aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women. One hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ). By multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05). In conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority for these women, particularly the

Mental health of female foreign spouses in transnational marriages in southern Taiwan

PubMed Central

2011-01-01

Background The aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women. Methods One hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ). Results By multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05). Conclusion In conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority

Integrated Educational and Mental Health Services within a Day Treatment Setting.

ERIC Educational Resources Information Center

Francis, Greta; Radka, Dale F.

This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

Mental health as rational autonomy.

PubMed

Edwards, R B

1981-08-01

Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real.

Strengths-based approach for mental health recovery.

PubMed

Xie, Huiting

2013-01-01

Many health systems have traditionally adopted a view of mental disorders based on pathologies and the risk individuals have towards mental disorders. However, with this approach, mental disorders continue to cost billions a year for the healthcare system. This paper aimed to introduce and explore what the strengths-based approach is in the psychiatric arena. Strengths-based approach moves the focus away from deficits of people with mental illnesses (consumers) and focuses on the strengths and resources of the consumers. The paper also aligned the relevance of strength-based approach to mental health nursing and its contribution to mental health recovery. None.

Psychiatric and somatic health in relation to experience of parental divorce in childhood.

PubMed

Angarne-Lindberg, Teresia; Wadsby, Marie

2012-01-01

The outcome of studies about the experience of parental divorce and its effects on mental and physical health differs, a result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-out of participants. To study the presence of psychiatric records and number of diagnosed somatic and mental healthcare visits in a group of young adults with childhood experience of parental divorce in comparison to a group without this experience. The presence of records at public psychiatric clinics and 10 years of administrative healthcare data (somatic and mental) were checked for both groups. Significantly more persons from the divorce group appeared in child and adolescent psychiatric care; this was most pronounced in females. However, there were no significant differences between the groups in the number of persons seeking adult psychiatry or in the number of psychiatric consultations. Experience of parental divorce was not found to be an indicator of larger somatic health problems. Experience of parental divorce in childhood is not an indicator of adult psychiatric or somatic need of care.

Mental capacity in patients involuntarily or voluntarily receiving psychiatric treatment for an acute mental disorder.

PubMed

Mandarelli, Gabriele; Tarsitani, Lorenzo; Parmigiani, Giovanna; Polselli, Gian M; Frati, Paola; Biondi, Massimo; Ferracuti, Stefano

2014-07-01

Despite the growing amount of data, much information is needed on patients' mental capacity to consent to psychiatric treatment for acute mental disorders. The present study was undertaken to compare differences in capacity to consent to psychiatric treatment in patients treated voluntarily and involuntarily and to investigate the role of psychiatric symptoms, competency, and cognitive functioning in determining voluntariness of hospital admission. Involuntary patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the 24-item Brief Psychiatric Rating Scale (BPRS), the Mini Mental State Examination (MMSE) and the Raven's Colored Progressive Matrices, and their data were compared with those for age- and sex-matched voluntary patients. Involuntary patients performed worse in all MacCAT-T subscales. Capacity to consent to treatment varied widely within each group. Overall, involuntary patients have worse consent-related mental capacity than those treated voluntarily, despite capacity to consent to treatment showing a significant variability in both groups. © 2014 American Academy of Forensic Sciences.

[Alteration of profile of treatment of the public psychiatric hospitals of Belo Horizonte, Brazil, in the context of mental health care reform].

PubMed

Coelho, Vívian Andrade Araújo; Volpe, Fernando Madalena; Diniz, Sabrina Stephanie Lana; Silva, Eliane Mussel da; Cunha, Cristiane de Freitas

2014-08-01

This article seeks to describe the profile of treatment and internment in public psychiatric hospitals in Belo Horizonte, Brazil, from 2002 to 2011. The changes in the characteristics of treatment and the profiles of the patients treated are analyzed in the context of health care reform. It is a study of temporal series with trend analysis by means of linear regression. There was a reduction in the total of patients treated in the period under scrutiny. Inversely, there was an increase in internments with a reduction in length of stay, though no change in readmission rates. Patients from Belo Horizonte prevailed, however a relative increase in demand from the surrounding area was observed. There was a reversal in the prevalence of morbidity switching from psychotic disorders to disorders resulting from the use of alcohol and/or other drugs. The alteration observed in the profile of treatment in public psychiatric hospitals in Belo Horizonte was concomitant with the progressive implementation of community mental health services, which have probably met the demand that was formerly directed to these hospitals. Currently the psychiatric hospital is not the first, much less the only venue for treatment in the mental health network in Minas Gerais.

Still on the Margins: Migration, English Language Learning, and Mental Health in Immigrant Psychiatric Patients

ERIC Educational Resources Information Center

Eamer, Allyson; Fernando, Shanti; King, Alyson E.

2017-01-01

This qualitative study explores the reflexive relationships among mental illness, acculturation, and progress toward English proficiency in five adult immigrants being treated at a Canadian psychiatric hospital. The research explores the additional challenges faced by mentally ill individuals when learning a new language and the extent to which…

Promoting resilience and recovery in a Buddhist mental health support group.

PubMed

Phoenix, Bethany

2014-04-01

Communities of faith are important arenas for psychiatric mental health nurses to promote emotional well-being and support recovery for persons with mental health problems. This article describes an innovative faith-based mental health group, based on Buddhist philosophy and practice and established by an advanced practice psychiatric nurse, that uses psychoeducation, peer support, and faith encouragement to help participants find hope and meaning in the experience of mental health problems. A brief overview of Buddhism and selected concepts relevant to the philosophical framework of the Buddhist mental health support group is followed by a review of the common themes of the group discussions. These include: finding value in the illness experience; differentiating the proper role of treatment from that of Buddhist practice in optimizing mental health; and experiencing a deeper sense of joy, despite current suffering.

Diagnosing Job Satisfaction in Mental Health Institutions.

ERIC Educational Resources Information Center

Buffum, William E.; Konick, Andrew

Job satisfaction in mental health organizations has been a neglected research topic, in spite of the fact that mental health organizations themselves are concerned with quality of life issues. To study job satisfaction at three long-term public psychiatric hospitals, the Job Satisfaction Index was administered to 44 direct service employees. In…

Pedagogy, power and practice ethics: clinical teaching in psychiatric/mental health settings.

PubMed

Ewashen, Carol; Lane, Annette

2007-09-01

Often, baccalaureate nursing students initially approach a psychiatric mental health practicum with uncertainty, and even fear. They may feel unprepared for the myriad complex practice situations encountered. In addition, memories of personal painful life events may be vicariously evoked through learning about and listening to the experiences of those diagnosed with mental disorders. When faced with such challenging situations, nursing students often seek counsel from the clinical and/or classroom faculty. Pedagogic boundaries may begin to blur in the face of student distress. For the nurse educator, several questions arise: Should a nurse educator provide counseling to students? How does one best negotiate the boundaries between 'counselor', and 'caring educator'? What are the limits of a caring and professional pedagogic relation? What different knowledges provide guidance and to what differential consequences for ethical pedagogic relationships? This paper offers a comparative analysis of three philosophical stances to examine differences in key assumptions, pedagogic positioning, relationships of power/knowledge, and consequences for professional ethical pedagogic practices. While definitive answers are difficult, the authors pose several questions for consideration in discerning how best to proceed and under what particular conditions.

Mixed methods research in mental health nursing.

PubMed

Kettles, A M; Creswell, J W; Zhang, W

2011-08-01

Mixed methods research is becoming more widely used in order to answer research questions and to investigate research problems in mental health and psychiatric nursing. However, two separate literature searches, one in Scotland and one in the USA, revealed that few mental health nursing studies identified mixed methods research in their titles. Many studies used the term 'embedded' but few studies identified in the literature were mixed methods embedded studies. The history, philosophical underpinnings, definition, types of mixed methods research and associated pragmatism are discussed, as well as the need for mixed methods research. Examples of mental health nursing mixed methods research are used to illustrate the different types of mixed methods: convergent parallel, embedded, explanatory and exploratory in their sequential and concurrent combinations. Implementing mixed methods research is also discussed briefly and the problem of identifying mixed methods research in mental and psychiatric nursing are discussed with some possible solutions to the problem proposed. © 2011 Blackwell Publishing.

Sociodemographic and Clinical Characteristics of Psychiatric Inpatients Hospitalized Involuntarily and Voluntarily in a Mental Health Hospital

PubMed Central

GÜLTEKİN, Bülent Kadri; ÇELİK, Seda; TİHAN, Aysu; BEŞKARDEŞ, Ali Fuat; SEZER, Umut

2013-01-01

Introduction In this study, we aimed to investigate and compare the sociodemographic and clinical characteristics of psychiatric inpatients hospitalized involuntarily and voluntarily. To our knowledge, there is no study analyzing involuntary psychiatric hospitalization in our country. Method In this retrospective study, we included a total of 504 patients who were involuntarily or voluntarily hospitalized in Bolu Izzet Baysal Mental Health Hospital between 1st of May and 31st October 2010. The data were obtained from the hospital records. Result In the 6-month period, 13.1% of 504 inpatients were hospitalized involuntarily. The number of male patients who were involuntarily hospitalized was higher than the number of female patients. Most of the patients in the involuntary hospitalized group were graduates of primary school, were not married and were not working at the time of hospitalization. Schizophrenia was the most common diagnosis in the involuntarily hospitalized psychiatric patients and these patients needed longer stay in the hospital. The next hospitalization of the involuntarily hospitalized patients was mostly involuntary. Conclusion Most of the involuntarily hospitalized psychiatric inpatients were male, were not working and had the diagnosis of schizophrenia. These general psychiatric risk factors were more important in involuntary hospitalization compared to voluntary hospitalization. We concluded that the high prevalence of involuntary hospitalizations deserved further studies. PMID:28360546

Medical Student Psychiatric Education in Neighborhood Health Settings.

ERIC Educational Resources Information Center

Morrison, Andrew P.

1978-01-01

Harvard medical students in a psychiatric rotation at the Massachusetts Mental Health Center may elect to do part of their work in a neighborhood comprehensive health center in which primary care services are offered. Students are exposed to a multiprofessional and mixed professional-paraprofessional staff, as well as to special patient problems.…

Burnout and work environments of public health nurses involved in mental health care.

PubMed

Imai, H; Nakao, H; Tsuchiya, M; Kuroda, Y; Katoh, T

2004-09-01

(1) To examine whether prevalence of burnout is higher among community psychiatric nurses working under recently introduced job specific work systems than among public health nurses (PHNs) engaged in other public health services. (2) To identify work environment factors potentially contributing to burnout. Two groups were examined. The psychiatric group comprised 525 PHNs primarily engaged in public mental health services at public health centres (PHCs) that had adopted the job specific work system. The control group comprised 525 PHNs primarily engaged in other health services. Pines' Burnout Scale was used to measure burnout. Respondents were classified by burnout score into three groups: A (mentally stable, no burnout); B (positive signs, risk of burnout); and C (burnout present, action required). Groups B and C were considered representative of "burnout". A questionnaire was also prepared to investigate systems for supporting PHNs working at PHCs and to define emergency mental health service factors contributing to burnout. Final respondents comprised 785 PHNs. Prevalence of burnout was significantly higher in the psychiatric group (59.2%) than in the control group (51.5%). Responses indicating lack of job control and increased annual frequency of emergency overtime services were significantly correlated with prevalence of burnout in the psychiatric group, but not in the control group. Prevalence of burnout is significantly higher for community psychiatric nurses than for PHNs engaged in other services. Overwork in emergency services and lack of job control appear to represent work environment factors contributing to burnout.

Communication and Mental Health: Psychiatric Forerunners.

ERIC Educational Resources Information Center

Brooks, Deems M.

The connections between human communication and mental health were first noted 50 to 60 years ago by such early psychiatrists as Alfred Adler, Harry Stack Sullivan, and Karen Horney. They were concerned with understanding those communication processes and skills that make for effective, fully functioning human beings. Adler emphasized faulty…

Next-Generation Psychiatric Assessment: Using Smartphone Sensors to Monitor Behavior and Mental Health

PubMed Central

Ben-Zeev, Dror; Scherer, Emily A.; Wang, Rui; Xie, Haiyi; Campbell, Andrew T.

2015-01-01

in loneliness were associated with sensor-derived kinesthetic activity (p<.01). Conclusions and implications for practice Smartphones can be harnessed as instruments for unobtrusive monitoring of several behavioral indicators of mental health. Creative leveraging of smartphone sensing will create novel opportunities for close-to-invisible psychiatric assessment at a scale and efficiency that far exceed what is currently feasible with existing assessment technologies. PMID:25844912

Next-generation psychiatric assessment: Using smartphone sensors to monitor behavior and mental health.

PubMed

Ben-Zeev, Dror; Scherer, Emily A; Wang, Rui; Xie, Haiyi; Campbell, Andrew T

2015-09-01

changes in depression and sensor-derived speech duration (p < .05), geospatial activity (p < .05), and sleep duration (p < .05). Changes in loneliness were associated with sensor-derived kinesthetic activity (p < .01). Smartphones can be harnessed as instruments for unobtrusive monitoring of several behavioral indicators of mental health. Creative leveraging of smartphone sensing could provide novel opportunities for close-to-invisible psychiatric assessment at a scale and efficiency that far exceeds what is currently feasible with existing assessment technologies. (c) 2015 APA, all rights reserved).

Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program.

PubMed

Coggins, M H; Pynchon, M R

1998-01-01

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.

Investigating the relationship between neighborhood experiences and psychiatric distress for individuals with serious mental illness.

PubMed

Kloos, Bret; Townley, Greg

2011-03-01

The present study examined the relationships between how research participants experienced their neighborhood, their neighborhood social climate, and psychological well-being. Participants (n = 525) were residents of supported housing programs who used mental health services at one of 17 community mental health centers in South Carolina. Hierarchical regression and mediation analyses were employed to answer research questions. Results suggest that neighbor relations, perceptions of neighborhood safety, and neighborhood satisfaction were significantly associated with perceptions of neighborhood social climate; and neighborhood social climate accounted for a significant amount of the variance in psychiatric distress. Of particular interest, perceptions of neighborhood social climate fully mediated the relationship between the specific reported neighborhood experiences and psychiatric distress. These findings have implications for interventions and policy aimed at promoting integration of individuals with serious mental illness into community settings.

Transsexual patients' psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: results from a longitudinal study.

PubMed

Colizzi, Marco; Costa, Rosalia; Todarello, Orlando

2014-01-01

The aim of the present study was to evaluate the presence of psychiatric diseases/symptoms in transsexual patients and to compare psychiatric distress related to the hormonal intervention in a one year follow-up assessment. We investigated 118 patients before starting the hormonal therapy and after about 12 months. We used the SCID-I to determine major mental disorders and functional impairment. We used the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS) for evaluating self-reported anxiety and depression. We used the Symptom Checklist 90-R (SCL-90-R) for assessing self-reported global psychological symptoms. Seventeen patients (14%) had a DSM-IV-TR axis I psychiatric comorbidity. At enrollment the mean SAS score was above the normal range. The mean SDS and SCL-90-R scores were on the normal range except for SCL-90-R anxiety subscale. When treated, patients reported lower SAS, SDS and SCL-90-R scores, with statistically significant differences. Psychiatric distress and functional impairment were present in a significantly higher percentage of patients before starting the hormonal treatment than after 12 months (50% vs. 17% for anxiety; 42% vs. 23% for depression; 24% vs. 11% for psychological symptoms; 23% vs. 10% for functional impairment). The results revealed that the majority of transsexual patients have no psychiatric comorbidity, suggesting that transsexualism is not necessarily associated with severe comorbid psychiatric findings. The condition, however, seemed to be associated with subthreshold anxiety/depression, psychological symptoms and functional impairment. Moreover, treated patients reported less psychiatric distress. Therefore, hormonal treatment seemed to have a positive effect on transsexual patients' mental health. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improving information technology competencies: implications for psychiatric mental health nursing.

PubMed

Fetter, Marilyn S

2009-01-01

While substantial evidence links information technology (IT) with improved patient safety, care quality, access, and efficiency, nurses must demonstrate competencies in computers, informatics, and information literacy in order to use IT for practice, education, and research. The nursing profession has established IT competencies for all nurses at beginning and experienced levels. Newly revised standards also articulate role-specific expectations for advanced practice nurses. Unfortunately, there is a concern that many nurses may not possess these capabilities and that nurse educators are not prepared to teach them. IT competency evaluations, which have focused predominately on nursing education, indicate novice skill levels for most faculty and students. In numerous studies, again conducted largely in nursing education, significant improvement in IT competencies has been achieved only with intensive interventions. Deficits in IT competencies are a significant concern, because the federal government has mandated full implementation of Electronic Health Records (EHR) by 2014. EHR will require all nurses to use IT to deliver, document, and obtain reimbursement for patient care. In response to these concerns, two recent initiatives, the "Health Information Technology Scholars (HITS)" and "Technology Informatics Guiding Education Reform (TIGER)" projects, have been launched. By enhancing IT competencies, these projects will enable nurses to use evidence-based practice and other innovations to transform clinical care, education, and research. This report updates psychiatric-mental health nurses on the IT competencies literature, recent enhancement initiatives and innovations, and their implications for the specialty.

Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform.

PubMed

Shen, Gordon C; Snowden, Lonnie R

2014-01-01

Policies generate accountability in that they offer a standard against which government performance can be assessed. A central question of this study is whether ideological imprint left by policy is realized in the time following its adoption. National mental health policy expressly promotes the notion of deinstitutionalization, which mandates that individuals be cared for in the community rather than in institutional environments. We investigate whether mental health policy adoption induced a transformation in the structure of mental health systems, namely psychiatric beds, using panel data on 193 countries between 2001 and 2011. Our striking regression results demonstrate that late-adopters of mental health policy are more likely to reduce psychiatric beds in mental hospitals and other biomedical settings than innovators, whereas they are less likely than non-adopters to reduce psychiatric beds in general hospitals. It can be inferred late adopters are motivated to implement deinstitutionalization for technical efficiency rather than social legitimacy reasons.

The long-term psychiatric and medical prognosis of perinatal mental illness.

PubMed

Meltzer-Brody, Samantha; Stuebe, Alison

2014-01-01

The perinatal period provides an important window into a woman's long-term health. Perinatal mental illness is a common condition conferring potential serious long-term psychiatric and medical consequences for the mother and family. It is known that childbirth acts as a powerful trigger for depressive episodes in some women, and that women with histories of a mood disorder are particularly vulnerable. Some evidence links perinatal mental illness with obstetrical complications and reduced lactation initiation and duration. Therefore, perinatal mental illness may be a marker for long-term risk, and may contribute directly to subsequent cardiometabolic disease through both neuroendocrine mechanisms and the effects of mental illness on health behaviours. In clinical practice, these associations underscore the importance of screening and treating women with perinatal mental illness to ensure best possible long-term outcomes. Early screening and treatment may both mitigate the primary disease process and reduce the risk of comorbid medical conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of comorbid psychiatric conditions in health status in epilepsy.

PubMed

Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

2007-06-01

Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.

Positive mental health among health professionals working at a psychiatric hospital

PubMed Central

Picco, Louisa; Yuan, Qi; Vaingankar, Janhavi Ajit; Chang, Sherilyn; Abdin, Edimansyah; Chua, Hong Choon; Chong, Siow Ann; Subramaniam, Mythily

2017-01-01

Background Positive mental health (PMH) is a combination of emotional, psychological and social well-being that is necessary for an individual to be mentally healthy. The current study aims to examine the socio-demographic differences of PMH among mental health professionals and to explore the association between job satisfaction and total PMH. Methods Doctors, nurses and allied health staff (n = 462) completed the online survey which included the multidimensional 47-item PMH instrument as well as a single item job satisfaction question. Associations of PMH with job satisfaction were investigated via linear regression models. Results Significant differences in PMH total and domain specific scores were observed across socio-demographic characteristics. Age and ethnicity were significantly correlated with PMH total scores as well as various domain scores, while gender, marital and residency status and the staff’s position were only significantly correlated with domain specific scores. Job satisfaction was also found to be a significantly associated with total PMH. Conclusion The workplace is a key environment that affects the mental health and well-being of working adults. In order to promote and foster PMH, workplaces need to consider the importance of psychosocial well-being and the wellness of staff whilst providing an environment that supports and maintains overall health and work efficiency. PMID:28591203

New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

ERIC Educational Resources Information Center

Chaplin, R.

2009-01-01

Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

Burden of psychiatric morbidity among attendees of a secondary level hospital in Northern India: Implications for integration of mental health care at subdistrict level.

PubMed

Haldar, Partha; Sagar, Rajesh; Malhotra, Sumit; Kant, Shashi

2017-01-01

There is little information available on the type, pattern, trend, and demographic differentials of psychiatric cases attending a subdistrict level facility in India. Our objectives were to describe the sociodemographic profile of the patients availing the psychiatric outpatient department services and document the diagnosis. This study is based on a retrospective analysis of routinely recorded administrative data collected during psychiatry consultations that took place between January 2010 and June 2014, at the subdistrict level hospital, Ballabgarh, Faridabad district, Haryana, Northern India. The data were abstracted in Microsoft Excel, scrutinized for duplicates, and cleaned in terms of the International Classification of Diseases 10 th Revision coding. Descriptive analysis was done for dependent variables and continuous variables were compared using independent t -test. A total of 2806 people (new registrations) were provided psychiatric consultations between January 2010 and June 2014. The mean age of males was 33.7 years (95% confidence interval [CI], 32.9, 34.5) and of females was 35.6 years (95% CI, 34.9, 36.3). Neurotic, stress-related, and somatoform disorders (F40-F48) comprised the major category of diagnoses with 661 cases (24%), followed by unspecified mental disorders (F99) with 528 cases (19%), mood (affective) disorders (F30-F39) with 448 cases (16%), and episodic and paroxysmal disorders (G40-G47) with 334 cases (12%). We reported an increase in level and trend in the monthly attendance of patients who required psychiatric at a secondary care hospital in Northern India. We suggest that setting up of mental health units only at district hospital might not be a sufficient health system's approach as has been envisaged under the District Mental Health Program.

Prevalence of burnout among public health nurses in charge of mental health services and emergency care systems in Japan.

PubMed

Imai, Hirohisa; Nakao, Hiroyuki; Nakagi, Yoshihiko; Niwata, Satoko; Sugioka, Yoshihiko; Itoh, Toshihiro; Yoshida, Takahiko

2006-11-01

The Community Health Act came into effect in 1997 in Japan. This act altered the work system for public health nurses (PHNs) in public health centers (PHCs) nationwide from region-specific to service-specific work. Such major changes to working environment in the new system seem to be exposing PHNs to various types of stress. The present study examined whether prevalence of burnout is higher among PHNs in charge of mental health services (psychiatric PHNs) than among PHNs in charge of other services (non-psychiatric PHNs), and whether attributes of emergency mental health care systems in communities are associated with increased prevalence of burnout. A questionnaire including the Pines burnout scale for measuring burnout was mailed to 525 psychiatric PHNs and 525 non-psychiatric PHNs. The 785 respondents included in the final analysis comprised 396 psychiatric PHNs and 389 non-psychiatric PHNs. Prevalence of burnout was significantly higher for psychiatric PHNs (59.2%) than for non-psychiatric PHNs (51.5%). When prevalence of burnout in each group was analyzed in relation to question responses regarding emergency service and patient referral systems, prevalence of burnout for psychiatric PHNs displayed significant correlations to frequency of cases requiring overtime emergency services, difficulties referring patients, and a feeling of "restriction". Prevalence of burnout is high among psychiatric PHNs, and inadequate emergency mental health service systems contribute to burnout among these nurses. Countermeasures for preventing such burnout should be taken as soon as possible.

Psychiatric agriculture: systemic nutritional modification and mental health in the developing world.

PubMed

London, Douglas S; Stoll, Andrew L; Manning, Bruce B

2006-01-01

Modernization of agricultural systems to increase output causes changes to the nutritional content of food entire populations consume. Human nutritional needs differ from their "food", thus producing healthy agricultural products is not equivalent to providing agricultural products that are healthy for humans. Inclusion of the food production system as a factor in the increase of neuropsychiatric disorders and other chronic diseases helps explain negative trends in modern chronic diseases that remain unchecked despite stunning advances in modern medicine. Diseases in which our own technology plays a significant role include obesity and resulting disorders, such as diabetes, heart disease, hypertension, stroke and arthritis. Modernization's lure leads to importation of modern agricultural practices into a nutritionally vulnerable, malnourished and sometimes starving developing world. Wealthier nations hedge their food portfolio by having access to a wider variety of foods. The developing world's reliance on staple foods means even a minor widespread nutritional modification of one key food can have profound effects. New agricultural techniques may improve or exacerbate neuropsychiatric disorders through nutritional modification in regions where populations walk a nutritional tightrope with little margin for error. In most of the developing world western psychiatric interventions have failed to make inroads. People's consumption of fish has a demonstrated beneficial effect on their mental health and the omega-3 fatty acid content is a significant factor. Epidemiological, biological and agricultural studies implicate a lack of dietary omega-3s as a factor in certain mental disorders. Replenishing omega-3s has improved mental illnesses in controlled clinical trials. This article's detailed tilapia fish-farming model demonstrates how aquaculture/agriculture techniques can function as a public health intervention by increasing dietary omega-3s through creation of

Pakistan mental health country profile.

PubMed

Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

2004-01-01

The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city.

PubMed

Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

2014-01-01

One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.

District nurses' involvement in mental health: an exploratory survey.

PubMed

Lee, Soo; Knight, Denise

2006-04-01

This article reports on a survey of district nurses' involvement in mental health interventions in one county. Seventy-nine questionnaires were sent and 46 were returned. Descriptive analysis was carried out using statistical software. The DNs reported encountering a wide range of mental health issues and interventions in practice: dementia, anxiety and depression featured highly. Over half (55%) of the respondents reported involvement in bereavement counselling, and 28% and 23% of respondents reported encountering anxiety management, and problem solving and alcohol advice respectively. A large proportion, however, reported no involvement in mental health interventions. Among the psychiatric professionals, district nurses tended to have most frequent contacts with social workers. GPs were the most likely person to whom DNs made referrals, followed by community psychiatric nurses. Despite the apparent awareness of the values of psychosocial interventions, DNs were equally influenced by the medical model of treatment. In order to realize the potential contribution of district nurses in mental health interventions, there is a need for primary care teams to foster a closer working relationship with mental health specialist services.

National mental health programme: Manpower development scheme of eleventh five-year plan.

PubMed

Sinha, Suman K; Kaur, Jagdish

2011-07-01

Mental disorders impose a massive burden in the society. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. India is facing shortage of qualified mental health manpower for District Mental Health Programme (DMHP) in particular and for the whole mental health sector in general. Recognizing this key constraint Government of India has formulated manpower development schemes under NMHP to address this issue. Under the scheme 11 centers of excellence in mental health, 120 PG departments in mental health specialties, upgradation of psychiatric wings of medical colleges, modernization of state-run mental hospitals will be supported. The expected outcome of the Manpower Development schemes is 104 psychiatrists, 416 clinical psychologists, 416 PSWs and 820 psychiatric nurses annually once these institutes/ departments are established. Together with other components such as DMHP with added services, Information, education and communication activities, NGO component, dedicated monitoring mechanism, research and training, this scheme has the potential to make a facelift of the mental health sector in the country which is essentially dependent on the availability and equitable distribution mental health manpower in the country.

National mental health programme: Manpower development scheme of eleventh five-year plan

PubMed Central

Sinha, Suman K.; Kaur, Jagdish

2011-01-01

Mental disorders impose a massive burden in the society. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. India is facing shortage of qualified mental health manpower for District Mental Health Programme (DMHP) in particular and for the whole mental health sector in general. Recognizing this key constraint Government of India has formulated manpower development schemes under NMHP to address this issue. Under the scheme 11 centers of excellence in mental health, 120 PG departments in mental health specialties, upgradation of psychiatric wings of medical colleges, modernization of state-run mental hospitals will be supported. The expected outcome of the Manpower Development schemes is 104 psychiatrists, 416 clinical psychologists, 416 PSWs and 820 psychiatric nurses annually once these institutes/ departments are established. Together with other components such as DMHP with added services, Information, education and communication activities, NGO component, dedicated monitoring mechanism, research and training, this scheme has the potential to make a facelift of the mental health sector in the country which is essentially dependent on the availability and equitable distribution mental health manpower in the country. PMID:22135448

[Distributions of Mental Disorders and Psychosocial Pressures in Children and Adolescence of a Psychiatric Health Care Population].

PubMed

Belhadj Kouider, Esmahan; Dupont, Marc; Lorenz, Alfred L; Petermann, Franz

2016-07-01

Distributions in children's or adolescents' mental disorders or in psychosocial pressures were demonstrated. The health care population in child- and adolescent psychiatric institutions of Bremen in 2005 - 2012 (N = 7190) was analyzed. Amongst other burden factors pressures in school context or abnormal social environments increased significantly. Adjustment stress disorders or externalizing disorders were dominant, but the prevalence in affective and anxiety disorders increased considerably. The co-operation with school authorities or agencies should be intensified. © Georg Thieme Verlag KG Stuttgart · New York.

Gender differences in the effects of community violence on mental health outcomes in a sample of low-income youth receiving psychiatric care.

PubMed

Javdani, Shabnam; Abdul-Adil, Jaleel; Suarez, Liza; Nichols, Sara R; Farmer, A David

2014-06-01

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth's experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.

Psychotherapy: Playing the Three Monkeys in Mental Health Service Provision?

PubMed Central

DEREBOY, Çiğdem; ŞENEL, Hakan; ŞAFAK ÖZTÜRK, Cennet; ŞAKİROĞLU, Mehmet; ESKİN, Mehmet

2017-01-01

Introduction The purpose of the present study was to investigate the effect of sociodemographic variables on the knowledge of, demand for, and reception of psychotherapy as a treatment modality among psychiatric outpatients. Methods Participants of the study were 240 psychiatric outpatients (170 females and 70 males). Data for mental health services were collected from a subgroup of 103 “experienced” patients (42.9%) having had received psychiatric help previously. All participants were administered a questionnaire containing questions about various forms of psychiatric services. Results Of all participants, 40.83% reported having heard of psychotherapy a few of times before, mostly (44.58%) from the media and only 3.33% from a mental health professional. Most participants with previous applications to psychiatric outpatient clinic had first received mental health service from a psychiatrist (93.2%) and at a state hospital (72.8%), and a small minority (17.4%) had subsequently received care from a psychologist. None had demanded to, but 5 patients (4.86%) had been recommended to receive psychotherapy by mental health professionals. Of these experienced patients, 20 (19.41%) have an idea that the interviews they had previously at the outpatient clinics were sort of psychotherapeutic interviews; yet, only 7 (6.79%) retained the same idea after reading the definition of appropriate psychotherapy written on the questionnaire. All of these patients declared that they have received both their medication and psychotherapy at the same time. Thus, only 2.91% of 240 participants received psychotherapy that corresponds to the given definition. Conclusions Findings from this study suggest that mental health care is mostly performed by psychiatrists alone, with a limited contribution by psychologists. Consequently, the choice of treatment is solely pharmacotherapy for most patients, while psychotherapy as a treatment modality is neither offered nor demanded in routine

[Mental health in primary health care: practices of the family health team].

PubMed

Correia, Valmir Rycheta; Barros, Sônia; Colvero, Luciana de Almeida

2011-12-01

The inclusion of mental health care actions in the context of the Brazilian Public Health System (SUS; Sistema Único de Saúde) contributes to the consolidation of the Brazilian Psychiatric reform and demands redirecting the practices of family health teams with users with mental health needs. The objective of this study is to identify and analyze the scientific production and actions developed by family health team professionals in mental health care. Systematic analysis originated the following themes: home visits to mentally ill patients and their relatives; attachment and welcoming; referrals; therapeutic workshops. In conclusion, the mental health actions developed in primary care are not performed consistently and depend on the professional or on the political decision of the administrator, which shows that professionals should use new practices to develop comprehensive care, and, therefore, there is a need to invest in improving the qualification of the professionals.

Effects of eliminating psychiatric rehabilitation from the secure levels of a mental-health service system.

PubMed

Tarasenko, Melissa; Sullivan, Mary; Ritchie, A Jocelyn; Spaulding, William D

2013-11-01

Psychiatric rehabilitation (PR) is widely recognized as a treatment approach and an array of evidence-based practices effective for promoting the recovery of people with serious mental illness (SMI). However, its use in institutional settings is not widespread for unclear reasons. Policymakers may sometimes believe the superiority of PR in controlled research does not apply in the real world, for various reasons. This study exploits an unusual set of real-world circumstances surrounding the closure of a well-developed PR program in a state hospital. The program was closed after a period of mental-health services reform that significantly augmented the surrounding community-service system. The PR program was converted to conventional medical-institutional model-treatment units with no reduction in beds or funding within the state hospital. A database composed of public documents was used to analyze the consequences of the closing. Within the institution, the consequences included a persistent presence of long-term difficult-to-discharge patients, a slowed discharge rate, a net increase in the hospital's per capita treatment costs, and higher use of restraint/seclusion. Effects were also detectable in the surrounding mental-health service system, including degraded outcome of community-based step-down services and increased pressure on emergency/crisis services. The consequences of closing the program are consistent with expectations based on research, and demonstrate danger in assuming that real world exigencies obviate research findings.

From mental disorder to iatrogenic hypogonadism: dilemmas in conceptualizing gender identity variants as psychiatric conditions.

PubMed

Meyer-Bahlburg, Heino F L

2010-04-01

The categorization of gender identity variants (GIVs) as "mental disorders" in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association is highly controversial among professionals as well as among persons with GIV. After providing a brief history of GIV categorizations in the DSM, this paper presents some of the major issues of the ongoing debate: GIV as psychopathology versus natural variation; definition of "impairment" and "distress" for GID; associated psychopathology and its relation to stigma; the stigma impact of the mental-disorder label itself; the unusual character of "sex reassignment surgery" as a psychiatric treatment; and the consequences for health and mental-health services if the disorder label is removed. Finally, several categorization options are examined: Retaining the GID category, but possibly modifying its grouping with other syndromes; narrowing the definition to dysphoria and taking "disorder" out of the label; categorizing GID as a neurological or medical rather than a psychiatric disorder; removing GID from both the DSM and the International Classification of Diseases (ICD); and creating a special category for GIV in the DSM. I conclude that-as also evident in other DSM categories-the decision on the categorization of GIVs cannot be achieved on a purely scientific basis, and that a consensus for a pragmatic compromise needs to be arrived at that accommodates both scientific considerations and the service needs of persons with GIVs.

Mental health care reforms in Asia: the urgency of now: building a recovery-oriented, community mental health service in china.

PubMed

Tse, Samson; Ran, Mao-Sheng; Huang, Yueqin; Zhu, Shimin

2013-07-01

For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.

Can Completing a Mental Health Nursing Course Change Students' Attitudes?

PubMed

Hastings, Todd; Kroposki, Margaret; Williams, Gail

2017-05-01

Nursing program graduates rarely choose mental health nursing as a career. A quasi-experimental study was conducted to examine attitudes of 310 nursing students towards persons with mental illness. Students completed surveys on the first and last days of their program's psychiatric mental health nursing course. The pre- and post-test survey analysis indicated that students improved their attitude, knowledge and preparedness to care for persons with mental illness. However, students maintained little interest in working as a mental health nurse. Modifications in mental health nursing courses could be made to improve students' interest in choosing a career in mental health nursing.

Diagnostic ambivalence: psychiatric workarounds and the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Whooley, Owen

2010-03-01

In 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in-depth interviews with psychiatrists, I explore the 'sociological ambivalence' psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop 'workarounds' that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.

Self-reported Mental Health Issues Among Arrestees in the Paris, France Area.

PubMed

Vidal, Camille; Lepresle, Aude; Chariot, Patrick

2017-07-01

We studied (May-September 2014) all arrestees who reported mental health issues during the medical examination performed by a forensic physician for the assessment of fitness for detention. Among 4814 arrestees, 420 (9%) reported a current mental health issue. The suspected crimes among arrestees reporting a current mental health issue were more often related to violent behaviors (physical assault, 23% vs. 16%, p < 0.001, sexual assault, 3% vs. 1%, p = 0.01) and less often drug offenses (18% vs. 29%, p < 0.001). Among arrestees reporting mental health issues, 80% reported psychiatric or psychological care, of whom 33% reported previous mental health care. Decisions of unfitness for detention were more frequent among arrestees reporting mental health issues than in other detainees (3% vs. 1%, p < 0.001). The high proportion of patients with interrupted mental health care among those reporting mental disorders suggests that the medical examination during custody could be a significant opportunity to restore psychiatric care. © 2017 American Academy of Forensic Sciences.

Disparities in the Geography of Mental Health: Implications for Social Work

ERIC Educational Resources Information Center

Hudson, Christopher G.

2012-01-01

This article reviews recent theory and research on geographic disparities in mental health and their implications for social work. It focuses on work emerging from the fields of mental health geography, psychiatric epidemiology, and social work, arguing that a wide range of spatial disparities in mental health are important to understand but that…

American Psychiatric Nurses Association-Transitions in Practice Certificate Program: Bridging the Knowledge Gap in Caring for Psychiatric Patients Within the General Nursing Workforce.

PubMed

Adams, Susie M; Black, Patricia

2016-01-01

The purpose of this article is to publicize an important new Web-based educational program. Recognizing the growing gap in psychiatric-mental health knowledge and the need to better prepare new graduates and nurses transitioning from other service lines into psychiatric inpatient nursing settings, the American Psychiatric Nurses Association developed a 15-hour, modularized curriculum to provide foundational psychiatric-mental health knowledge. This modularized curriculum, called American Psychiatric Nurses Association Transitions in Practice (ATP) focuses on the knowledge and skills to insure the success of nurses new to psychiatric-mental health nursing settings and to improve the overall care for persons with mental health and substance use disorders. The ATP program is also proving to be useful content for nurses in emergency departments, hospitals, and other health settings to improve their care of patients with psychiatric and mental health needs. A summary of the program modules and a toolkit with suggested measures for nurses, patients, and agency outcomes is described. Feedback from participants completing the ATP program within the first 6 months is overwhelmingly positive and holds promise for widespread application across a variety of health care settings.

Does section 63 of the Mental Health Act 1983 disempower patients with mental illness? Analysis of the case law.

PubMed

Senasinghe, Bhanuka

2018-03-01

In England and Wales, detained psychiatric inpatients are treated under section 63 of the Mental Health Act 1983. This paper critically analyses the relevant law and considers the arbitrary distinctions between consent for treatments for mental illnesses and physical conditions, which may disempower patients with mental illness. Section 63 states that (for detained psychiatric patients) consent for medical treatment for patients' mental disorder is not required. The treating clinician responsible for a patient decides what this medical treatment entails. This article focuses on three main legal cases: B v Croydon Health Authority, Tameside and Glossop v CH and Nottinghamshire Healthcare NHS Trust v RC and considers whether s 63 disempowers patients with mental illnesses.

A nursing career in mental health care: choices and motives of nursing students.

PubMed

Hoekstra, Hanneke J; van Meijel, Berno B; van der Hooft-Leemans, Truus G

2010-01-01

This article describes the results of a study into how first-year nursing students' perceptions of psychiatric patients and mental health care influence their choice of specialization in mental health care and future working in this sector. A descriptive qualitative study design with semi-structured interviews. Respondents were selected through purposive sampling among all first-year bachelor students attending a Dutch school of nursing. First-year nursing students have stereotype, mostly negative perceptions of psychiatric patients and mental health care. These perceptions strongly influence their future professional choices. The respondents provided various reasons for their decision not to major in mental health care, one of these being that the school did too little to counsel and inform them about mental health issues and a career in mental health care. As a result, their unrealistic perceptions prevailed. If schools offering bachelor of nursing programmes do not sufficiently counsel and inform students about mental health care, students will leave school with their stereotype, negative perception of mental health care intact. Mental health care institutions will run a great risk of losing potentially good nurses.

Economic recession and mental health: an overview.

PubMed

Cooper, Brian

2011-01-01

Effects of the current global economic downturn on population mental health will emerge in the years ahead. Judging from earlier experience of financial crises in various parts of the world, stresses associated with rising unemployment, poverty and social insecurity will lead to upward trends in many national suicide rates, as well as to less readily charted increase in the prevalence of psychiatric illness, alcohol-related disorders and illicit drug use. At the same time, mental health services are being cut back as part of government austerity programs. Budget cuts will thus affect psychiatric services adversely just when economic stressors are raising the levels of need and demand in affected populations. Proactive fiscal and social policies could, however, help to mitigate the health consequences of recession. Evidence- based preventive measures include active labor market and family support programs, regulation of alcohol prices and availability, community care for known high-risk groups, and debt relief projects. Economic mental health care could best be achieved, not by decimating services but by planning and deploying these to meet the needs of defined area populations.

Thailand mental health country profile.

PubMed

Siriwanarangsan, Porntep; Liknapichitkul, Dusit; Khandelwal, Sudhir K

2004-01-01

Thailand, a constitutional monarchy, has undergone a rapid shift in its demography and economy in last two decades. This has put a great burden on the health services, including mental health care of the country. The current emphasis of the Ministry of Public Health is to change its role from health care provider to policymaker and regulator of standards, and to provide technical support to health facilities under its jurisdiction as well as in the private sector. The Department of Mental Health, established in 1994, has laid down a mental health policy that aims to promote mental health care within the community with the help of people's participation in health programmes. Focus has been placed on developing suitable and efficient technology by seeking cooperation both within and outside the Ministry of Public Health. Consequently, the Department of Mental Health has been receiving increasing budgetary allocations. Since there is a paucity of trained manpower, the emphasis is being laid on the utilization of general health care for mental health care. Some of the specific interventions are community services, prison services, psychiatric rehabilitation, and use of media in mental health operations. There have been active efforts towards international cooperation for developing technologies for specific programmes. Private and non-governmental organizations are supported and encouraged to provide mental health care to the marginalized sections of society. Efforts have also been made by the Department of Mental Health to inspect and raise the efficiency of its operations to result in quality service.

Retrospective views of psychiatric in-patients regaining mental capacity

PubMed Central

Owen, Gareth S.; David, Anthony S.; Hayward, Peter; Richardson, Genevra; Szmukler, George; Hotopf, Matthew

2009-01-01

Background An individual’s right to self-determination in treatment decisions is a central principle of modern medical ethics and law, and is upheld except under conditions of mental incapacity. When doctors, particularly psychiatrists, override the treatment wishes of individuals, they risk conflicting with this principle. Few data are available on the views of people regaining capacity who had their treatment wishes overridden. Aims To investigate individuals’ views on treatment decisions after they had regained capacity. Method One hundred and fifteen people who lacked capacity to make treatment decisions were recruited from a sample of consecutively admitted patients to a large psychiatric hospital. After 1 month of treatment we asked the individuals for their views on the surrogate treatment decisions they received. Results Eighty-three per cent (95% CI 66–93) of people who regained capacity gave retrospective approval. Approval was no different between those admitted informally or involuntarily using Mental Health Act powers (χ2 = 1.52, P = 0.47). Individuals were more likely to give retrospective approval if they regained capacity (χ2 = 14.2, P = 0.001). Conclusions Most people who regain capacity following psychiatric treatment indicate retrospective approval. This is the case even if initial treatment wishes are overridden. These findings moderate concerns both about surrogate decision-making by psychiatrists and advance decision-making by people with mental illness. PMID:19880929

Living arrangements and mental health in Finland

PubMed Central

Joutsenniemi, Kaisla; Martelin, Tuija; Martikainen, Pekka; Pirkola, Sami; Koskinen, Seppo

2006-01-01

Background Non‐married persons are known to have poor mental health compared with married persons. Health differences between marital status groups may largely arise from corresponding differences in interpersonal social bonds. However, official marital status mirrors the social reality of persons to a decreasing extent, and living arrangements may be a better measure of social bonds. Little is known about mental health in different living arrangement groups. This study aims to establish the extent and determinants of mental health differences by living arrangement in terms of psychological distress (GHQ) and DSM‐IV psychiatric disorders (CIDI). Methods Data were used from the nationally representative cross sectional health 2000 survey, conducted in 2000–1 in Finland. Altogether 4685 participants (80%) aged 30–64 years were included in these analyses; comprehensive information was available on measures of mental health and living arrangements. Living arrangements were measured as follows: married, cohabiting, living with other(s) than a partner, and living alone. Results Compared with the married, persons living alone and those living with other(s) than a partner were approximately twice as likely to have anxiety or depressive disorders. Cohabiters did not differ from the married. In men, psychological distress was similarly associated with living arrangements. Unemployment, lack of social support, and alcohol consumption attenuated the excess psychological distress and psychiatric morbidity of persons living alone and of those living with other(s) than a partner by about 10%–50% each. Conclusions Living arrangements are strongly associated with mental health, particularly among men. Information on living arrangements, social support, unemployment, and alcohol use may facilitate early stage recognition of poor mental health in primary health care. PMID:16698975

Mental Health From the Perspective of Primary Care Residents: A Pilot Survey

PubMed Central

Sharma, Taral; Alishayev, Ilya; Mingoia, Joseph; Vance, John Eric; Ali, Rizwan

2014-01-01

Objective: Primary care physicians are increasingly providing psychiatric care in the United States. Unfortunately, there is limited learning opportunity or exposure to psychiatry during their residency training. This survey was conducted to assess primary care resident interaction with mental health professionals and their satisfaction, knowledge, preference, and comfort with the delivery of mental health care in primary health care settings. Method: On the basis of available published literature, a 20-question survey was formulated. Following receipt of the institutional review board’s approval, these questions were sent via e-mail in February 2012 to internal and family medicine residents (N = 108) at 2 teaching hospitals in southwest Virginia. Analysis of the electronically captured data resulted in a response rate of 32%. Descriptive analysis was used to examine the results. Results: The responses were equally divided among male and female residents and family medicine and internal medicine residents. There were several interesting findings from the survey. No correlations were noted between the gender of residents, type or location of the medical school, or having had a psychiatric rotation during residency and the reported comfort level treating patients with psychiatric illness or the desire to see psychiatric patients in the future. A positive correlation was found between the residents’ training level and their belief about the percentage of mental health providers who have mental health problems. Conclusions: The current training model to acclimate primary care residents to the field of mental health appears to have major limitations. Results of this pilot survey can serve as a guide to conduct prospective, multicenter studies to identify and improve psychiatric training for primary care residency programs. PMID:25664216

Mental health from the perspective of primary care residents: a pilot survey.

PubMed

Iskandar, Joseph W; Sharma, Taral; Alishayev, Ilya; Mingoia, Joseph; Vance, John Eric; Ali, Rizwan

2014-01-01

Primary care physicians are increasingly providing psychiatric care in the United States. Unfortunately, there is limited learning opportunity or exposure to psychiatry during their residency training. This survey was conducted to assess primary care resident interaction with mental health professionals and their satisfaction, knowledge, preference, and comfort with the delivery of mental health care in primary health care settings. On the basis of available published literature, a 20-question survey was formulated. Following receipt of the institutional review board's approval, these questions were sent via e-mail in February 2012 to internal and family medicine residents (N = 108) at 2 teaching hospitals in southwest Virginia. Analysis of the electronically captured data resulted in a response rate of 32%. Descriptive analysis was used to examine the results. The responses were equally divided among male and female residents and family medicine and internal medicine residents. There were several interesting findings from the survey. No correlations were noted between the gender of residents, type or location of the medical school, or having had a psychiatric rotation during residency and the reported comfort level treating patients with psychiatric illness or the desire to see psychiatric patients in the future. A positive correlation was found between the residents' training level and their belief about the percentage of mental health providers who have mental health problems. The current training model to acclimate primary care residents to the field of mental health appears to have major limitations. RESULTS of this pilot survey can serve as a guide to conduct prospective, multicenter studies to identify and improve psychiatric training for primary care residency programs.

Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.

PubMed

Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole

2017-10-01

An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

[Mental Health Care Utilization of First Generation Vietnamese Migrants in Germany].

PubMed

Ta, Thi Minh Tam; Neuhaus, Andres H; Burian, Ronald; Schomerus, Georg; von Poser, Anita; Diefenbacher, Albert; Röttger-Rössler, Birgitt; Dettling, Michael; Hahn, Eric

2015-07-01

Vietnamese migrants underutilize and are a "hard to reach group" within the existing mental health care system in Germany. We analyzed migration related and clinical data for all first-time Vietnamese migrants seeking psychiatric help, within the first 30 months of a newly established outpatient clinic, offering culture-sensitive psychiatric treatment in native Vietnamese language. Most first time patients were female, first generation Vietnamese migrants with poor German language skills. Only 1 /3 of all patients had a psychiatric history, while this number was higher in patients with schizophrenia. Over time, more first time patients with depression were seeking psychiatric care, accompanied with an increase of non-professional referrals within the Vietnamese communities. This first study on mental health care utilization in Vietnamese migrants in Germany points towards the fact that "migrants" cannot be considered as a homogeneous group. Mental health care utilization must be evaluated for specific migrant groups, and can be initially improved if offered in native language and when it is referred to by members of migrant communities. © Georg Thieme Verlag KG Stuttgart · New York.

Profile of children placed in residential psychiatric program: Association with delinquency, involuntary mental health commitment, and reentry into care.

PubMed

Yampolskaya, Svetlana; Mowery, Debra; Dollard, Norín

2014-05-01

This study examined characteristics and profiles of youth receiving services in 1 of Florida's Medicaid-funded residential mental health treatment programs--State Inpatient Psychiatric Program (SIPP)--between July 1, 2004, and June 30, 2008 (N=1,432). Latent class analysis (LCA) was used to classify youth, and 3 classes were identified: Children With Multiple Needs, Children With No Caregivers, and Abused Children With Substantial Maltreatment History. The results of LCA showed that Children With Multiple Needs experienced the greatest risk for adverse outcomes. Compared with youth in the other 2 classes, these children were more likely to get readmitted to SIPP, more likely to become involved with the juvenile justice system, and more likely to experience involuntary mental health assessments. Implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

The challenge of gun control for mental health advocates.

PubMed

Pandya, Anand

2013-09-01

Mass shootings, such as the 2012 Newtown massacre, have repeatedly led to political discourse about limiting access to guns for individuals with serious mental illness. Although the political climate after such tragic events poses a considerable challenge to mental health advocates who wish to minimize unsympathetic portrayals of those with mental illness, such media attention may be a rare opportunity to focus attention on risks of victimization of those with serious mental illness and barriers to obtaining psychiatric care. Current federal gun control laws may discourage individuals from seeking psychiatric treatment and describe individuals with mental illness using anachronistic, imprecise, and gratuitously stigmatizing language. This article lays out potential talking points that may be useful after future gun violence.

Mother's perceptions of child mental health problems and services: A cross sectional study from Lahore.

PubMed

Imran, Nazish; Ashraf, Sania; Shoukat, Rabia; Pervez, Muhammad Ijaz

2016-01-01

To assess the perceptions of mothers regarding child mental health problems, its causes, preferred treatment options, and to determine whom they would consult, if their child had a psychiatric illness. Following informed consent, a questionnaire covering perceptions regarding various aspects of child mental illness was used for data collection from mothers. They were asked to identify the symptoms and behaviours they considered psychopathological in children, which treatments they would prefer, where they would turn for help with a mentally ill child, and their understanding of the causes of child psychiatric disorders in addition to ways to increase awareness of child psychiatric issues in the society. Ninety one mothers participated in the study. They equally perceived emotional, behavioural and cognitive symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, economic difficulties, social adversity and possession by evil spirits. A substantial proportion preferred medication, recitation of Holy Quran and psychotherapy as the preferred treatment options. Overall, mothers preferred consulting health professionals than religious scholars and faith healers. They were keen for steps to increase mental health awareness within their society. Despite different cultural perspective, mothers exhibit good understanding of symptoms of child mental health issues and appear open to various services and treatment options. Understanding parental perceptions and expectations from child psychiatric services are crucial in increasing families' engagement in treatment.

Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

PubMed

Stone, Amanda M; Merlo, Lisa J

2011-02-01

Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P < .001). Psychiatric medication misusers reported less stigmatized beliefs toward mental illness, including lower anxiety around the mentally ill (t = 3.26, P < .001) as well as more favorable attitudes toward psychiatric medications (t = 2.78, P < .01) and stronger beliefs in the potential for recovery from mental illness (t = -2.11, P < .05). Students with more stigmatized beliefs had greater concerns about psychiatric medications and less favorable beliefs regarding their effectiveness. Reasons for misuse varied by medication class, with 57.1% of stimulant misusers noting help with studying as their primary reason for use and 33.3% of benzodiazepine misusers noting attempts to get high or "party" as their primary reason for misuse. Results suggest the need for improved education regarding the

A Historical Overview of Psychiatric/Mental Health Nursing Education in the United Kingdom: Going around in Circles or on the Straight and Narrow?

ERIC Educational Resources Information Center

Cutcliffe, John

2003-01-01

Addresses historical issues in psychiatric/mental health nursing in the United Kingdom including attempts to integrate it with general nursing, the balance of theory/research and practice, and tensions over the recent shift to university-level nurse preparation. Discusses needs for the future. (Contains 42 references and commentary by Sheri…

The role of physical and mental health multimorbidity in suicidal ideation.

PubMed

Kavalidou, Katerina; Smith, Daniel J; O'Connor, Rory C

2017-02-01

Previous research has focused on the separate roles of mental illness and physical health conditions in suicide risk, with relatively few studies investigating the importance of physical and psychiatric disorder co-occurrence. We aimed to investigate whether suicidal ideation might be influenced by physical and mental ill-health multimorbidity. Data from the Adult Psychiatric Morbidity Survey of England were analysed. Participants who responded to the suicidal thoughts question were grouped into four distinct categories based on their health conditions (Common mental disorders (CMD) only, physical health conditions only, CMD/physical health multimorbidity and a control group with neither physical nor mental health conditions). Multinomial logistic regression analyses were conducted and odds ratios (OR) and 95% CIs are presented. In the fully adjusted model, both the multimorbidity and CMD-only groups were associated with higher levels of suicidal ideation relative to the control group. Secondary analyses of cross-sectional data. Although multimorbidity was associated with suicidal thoughts, it does not appear to elevate risk beyond the independent effects of common mental disorders or physical health problems. Primary care and mental health clinicians should consider assessment of suicidal ideation among patients with multimorbid physical/mental health conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

The Mental Health Care Bill 2013: A Critical Appraisal

PubMed Central

Narayan, Choudhary Laxmi; Shekhar, Shivendra

2015-01-01

The Mental Health Care Bill – 2013 has been introduced in Rajya Sabha and is now waiting for enactment. The Bill entails unprecedented measures to be undertaken by the Government ensuring everyone right to access mental health care and treatment from services run or funded by the Government. The Government is to meet the man-power requirement of mental health professionals according to international standard within a period of ten years. Various rights of persons with mental illness have been ensured. All the places where psychiatric patients are admitted and treated including the general hospital psychiatry units (GHPU) are to be registered as mental health establishments. Unmodified ECT has been banned and ECT to minors can be given only after approval from the Mental Health Review Board. This article advocates for exemption of GHPU from the purview of the Bill, taking into consideration impediment created in the treatment of vast majority of psychiatric patients who retain their insight into the illness and seldom require involuntary admissions. It is also advocated to reconsider ban on unmodified ECT and restriction placed on ECT to minor which are very effective treatment methods based on scientific evidence. In our country, family is an important asset in management of mental illness. But requirement of seeking approval from the Board in many of the mental health care decision may discourage the families to be proactive in taking care of their wards. The Board and Mental Health Authorities at the central and the state levels are authorized to take many crucial decisions, but these panels have very few experts in the field of mental health. PMID:25969610

Pediatric and adolescent mental health emergencies in the emergency medical services system.

PubMed

Dolan, Margaret A; Fein, Joel A

2011-05-01

Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

Role of the police in linking individuals experiencing mental health crises with mental health services

PubMed Central

2012-01-01

Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

Mental Health Problems of Disaster Victims.

ERIC Educational Resources Information Center

Lima, Bruno R.; And Others

The mental health needs of disaster victims remains a largely neglected area, possibly due to other pressing demands placed on available resources and to the difficulties in correctly detecting psychiatric cases by the general health worker. This study attempted to use a questionnaire suitable to primary care settings for the detection of probable…

"Next-generation psychiatric assessment: Using smartphone sensors to monitor behavior and mental health": Correction to Ben-Zeev et al. (2015).

PubMed

2015-12-01

Reports an error in "Next-generation psychiatric assessment: Using smartphone sensors to monitor behavior and mental health" by Dror Ben-Zeev, Emily A. Scherer, Rui Wang, Haiyi Xie and Andrew T. Campbell (Psychiatric Rehabilitation Journal, 2015[Sep], Vol 38[3], 218-226). Model fit statistics in Table 1 are reported as a row for Model 2, but not for Model 1, due to a production error. Model 1 fit statistics should appear as a row with the following information: 2LL 1490.0, AIC 1498.0 & BIC 1505.3. (The following abstract of the original article appeared in record 2015-14736-001.) Optimal mental health care is dependent upon sensitive and early detection of mental health problems. We have introduced a state-of-the-art method for the current study for remote behavioral monitoring that transports assessment out of the clinic and into the environments in which individuals negotiate their daily lives. The objective of this study was to examine whether the information captured with multimodal smartphone sensors can serve as behavioral markers for one's mental health. We hypothesized that (a) unobtrusively collected smartphone sensor data would be associated with individuals' daily levels of stress, and (b) sensor data would be associated with changes in depression, stress, and subjective loneliness over time. A total of 47 young adults (age range: 19-30 years) were recruited for the study. Individuals were enrolled as a single cohort and participated in the study over a 10-week period. Participants were provided with smartphones embedded with a range of sensors and software that enabled continuous tracking of their geospatial activity (using the Global Positioning System and wireless fidelity), kinesthetic activity (using multiaxial accelerometers), sleep duration (modeled using device-usage data, accelerometer inferences, ambient sound features, and ambient light levels), and time spent proximal to human speech (i.e., speech duration using microphone and speech

Community mental health care in India.

PubMed

Padmavati, R

2005-04-01

Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

Longitudinal study of religiosity and mental health of adolescents with psychiatric problems. The TRAILS study.

PubMed

van der Jagt-Jelsma, W; de Vries-Schot, M; Scheepers, P; van Deurzen, P A M; Klip, H; Buitelaar, J K

2017-09-01

This study used longitudinal data to examine the influence of the religiosity of pre-adolescents with psychiatric problems on the course of mental health during adolescence. In the TRAILS clinical cohort of 543 pre-adolescents (10-12 years), mental health problems were assessed using self-report at baseline, T2 (12-14 years), T3 (14-17 years), and T4 (17-21 years). The Youth Self Report (YSR) was used at baseline, T2, and T3, and the Adult Self Report (ASR) was used at T4. Religiosity was assessed at baseline using self-report and information from mothers and fathers, resulting in three categorical religiosity variables and six SOCON (Social Cultural Developments Questionnaire) religiosity scales that assess religiosity in greater detail. Repeated measure ANOVA analyses were performed for each independent religiosity variable with internalizing and externalizing problem behavior as dependent variables, gender as a factor and time (T1, T2, T3 and T4) as within factor. Results were adjusted for marital status of parents and socioeconomic status and corrected for multiple testing. There were main effects of the self-report SOCON scale "Humanistic beliefs" and gender and gender "by Humanistic beliefs" interaction effect on internalizing problems. Follow-up tests revealed that among females "high" scores on "Humanistic beliefs" were associated with increased internalizing problems. There were hardly any associations between religiosity and mental health in a clinical cohort of pre-adolescents up to adolescence. The exception being that among females strong humanistic beliefs were associated with internalizing problems. Implications of these findings are discussed. Copyright © 2017. Published by Elsevier Masson SAS.

Mental health screening and evaluation within prisons.

PubMed

Metzner, J L; Miller, R D; Kleinsasser, D

1994-01-01

Current national standards and/or guidelines for correctional mental health care programs emphasize the importance of various levels of mental health screening and evaluation that should be performed by qualified personnel on all inmates as part of the admission process to a prison. The authors describe the results of a study that included data from all 50 state departments of corrections regarding prison mental health screening and evaluation models. The vast majority of states appear to have adopted some variation of the most recognized guidelines and/or standards (e.g., American Psychiatric Association, National Commission on Correctional Health Care, American Public Health Association) concerning correctional health care systems. Results are also provided concerning the use of standardized psychological tests and informed consent issues.

WAR & Military Mental Health

PubMed Central

Pols, Hans; Oak, Stephanie

2007-01-01

Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future. PMID:17971561

Psychiatric service use and psychiatric disorders in adults with intellectual disability.

PubMed

Bhaumik, S; Tyrer, F C; McGrother, C; Ganghadaran, S K

2008-11-01

UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric disorders in this population. A cross-sectional study was carried out on all adults with ID using specialist services in Leicestershire and Rutland, UK, between 2001 and 2006. Characteristics of individuals seen by psychiatric services and the nature and prevalence of psychiatric disorders were investigated. Of 2711 adults identified, 1244 (45.9%) accessed specialist psychiatric services at least once during the study period. Individuals attending psychiatric services were more likely to be older and to live in residential settings; they were less likely to be south Asian or to have mild/moderate ID. The prevalence of psychiatric disorders among the total study population was 33.8%; the most common disorders were behaviour disorder (19.8%) and autistic spectrum disorders (8.8%). Epilepsy was highly prevalent (60.8%) among those attending psychiatric services without a mental health diagnosis. Behaviour disorders and autistic spectrum disorders were more common in men and in adults with severe/profound ID, whereas schizophrenia and organic disorders were more common in women and in adults with mild/moderate ID. Depression was also more common in women with ID. Psychiatric disorders and specialist health problems are common among adults with ID and the profile of psychiatric disorders differs from that found in general psychiatry. Close collaboration between general and specialist service providers is needed if the current move towards use of general psychiatric services in this population is to be achieved. The measures should include a clear care pathway for people with ID and mental health problems to facilitate the smooth transfer of

Correlates of Mental Health among Latino Farmworkers in North Carolina

ERIC Educational Resources Information Center

Crain, Rebecca; Grzywacz, Joseph G.; Schwantes, Melody; Isom, Scott; Quandt, Sara A.; Arcury, Thomas A.

2012-01-01

Purpose: Latino farmworkers are a vulnerable population who confront multiple threats to their mental health. Informed by the stress-process model of psychiatric disorder, the goal of this paper is to determine primary and context-specific stressors of poor mental health among Latino farmworkers. Methods: Structured interview data were obtained…

Internet information-seeking in mental health: population survey.

PubMed

Powell, John; Clarke, Aileen

2006-09-01

A major use of the of the internet is for health information-seeking. There has been little research into its use in relation to mental health. To investigate the prevalence of internet use for mental health information-seeking and its relative importance as a mental health information source. General population survey. Questions covered internet use, past psychiatric history and the 12-item General Health Questionnaire. Eighteen per cent of all internet users had used the internet for information related to mental health. The prevalence was higher among those with a past history of mental health problems and those with current psychological distress. Only 12% of respondents selected the internet as one of the three most accurate sources of information, compared with 24% who responded that it was one of the three sources they would use. The internet has a significant role in mental health information-seeking. The internet is used more than it is trusted.

Smartphone Ownership and Interest in Mobile Applications to Monitor Symptoms of Mental Health Conditions

PubMed Central

Friedman, Rohn; Keshavan, Matcheri

2014-01-01

Background Patient retrospective recollection is a mainstay of assessing symptoms in mental health and psychiatry. However, evidence suggests that these retrospective recollections may not be as accurate as data collection though the experience sampling method (ESM), which captures patient data in “real time” and “real life.” However, the difficulties in practical implementation of ESM data collection have limited its impact in psychiatry and mental health. Smartphones with the capability to run mobile applications may offer a novel method of collecting ESM data that may represent a practical and feasible tool for mental health and psychiatry. Objective This paper aims to provide data on psychiatric patients’ prevalence of smartphone ownership, patterns of use, and interest in utilizing mobile applications to monitor their mental health conditions. Methods One hundred psychiatric outpatients at a large urban teaching hospital completed a paper-and-pencil survey regarding smartphone ownership, use, and interest in utilizing mobile applications to monitor their mental health condition. Results Ninety-seven percent of patients reported owning a phone and 72% reported that their phone was a smartphone. Patients in all age groups indicated greater than 50% interest in using a mobile application on a daily basis to monitor their mental health condition. Conclusions Smartphone and mobile applications represent a practical opportunity to explore new modalities of monitoring, treatment, and research of psychiatric and mental health conditions. PMID:25098314

Smartphone ownership and interest in mobile applications to monitor symptoms of mental health conditions.

PubMed

Torous, John; Friedman, Rohn; Keshavan, Matcheri

2014-01-21

Patient retrospective recollection is a mainstay of assessing symptoms in mental health and psychiatry. However, evidence suggests that these retrospective recollections may not be as accurate as data collection though the experience sampling method (ESM), which captures patient data in "real time" and "real life." However, the difficulties in practical implementation of ESM data collection have limited its impact in psychiatry and mental health. Smartphones with the capability to run mobile applications may offer a novel method of collecting ESM data that may represent a practical and feasible tool for mental health and psychiatry. This paper aims to provide data on psychiatric patients' prevalence of smartphone ownership, patterns of use, and interest in utilizing mobile applications to monitor their mental health conditions. One hundred psychiatric outpatients at a large urban teaching hospital completed a paper-and-pencil survey regarding smartphone ownership, use, and interest in utilizing mobile applications to monitor their mental health condition. Ninety-seven percent of patients reported owning a phone and 72% reported that their phone was a smartphone. Patients in all age groups indicated greater than 50% interest in using a mobile application on a daily basis to monitor their mental health condition. Smartphone and mobile applications represent a practical opportunity to explore new modalities of monitoring, treatment, and research of psychiatric and mental health conditions.

Invited commentaries on... Abortion and mental health disorders.

PubMed

Casey, Patricia; Oates, Margaret; Jones, Ian; Cantwell, Roch

2008-12-01

The finding that induced abortion is a risk factor for subsequent psychiatric disorder in some women raises important clinical and training issues for psychiatrists. It also highlights the necessity for developing evidence-based interventions for these women. P.C. / Evidence suggesting a modest increase in mental health problems after abortion does not support the prominence of psychiatric issues in the abortion debate, which is primarily moral and ethical not psychiatric or scientific. M.O. et al.

Mapping mental health finances in Ghana, Uganda, Sri Lanka, India and Lao PDR

PubMed Central

2010-01-01

Background Limited evidence about mental health finances in low and middle-income countries is a key challenge to mental health care policy initiatives. This study aimed to map mental health finances in Ghana, Uganda, India (Kerala state), Sri Lanka and Lao PDR focusing on how much money is available for mental health, how it is spent, and how this impacts mental health services. Methods A researcher in each region reviewed public mental health-related budgets and interviewed key informants on government mental health financing. A total of 43 key informant interviews were conducted. Quantitative data was analyzed in an excel matrix using descriptive statistics. Key informant interviews were coded a priori against research questions. Results National ring-fenced budgets for mental health as a percentage of national health spending for 2007-08 is 1.7% in Sri Lanka, 3.7% in Ghana, 2.0% in Kerala (India) and 6.6% in Uganda. Budgets were not available in Lao PDR. The majority of ring-fenced budgets (76% to 100%) is spent on psychiatric hospitals. Mental health spending could not be tracked beyond the psychiatric hospital level due to limited information at the health centre and community levels. Conclusions Mental health budget information should be tracked and made publically accessible. Governments can adapt WHO AIMS indicators for reviewing national mental health finances. Funding allocations work more effectively through decentralization. Mental health financing should reflect new ideas emerging from community based practice in LMICs. PMID:20507558

The significance of services in a psychiatric hospital for family members of persons with mental illness.

PubMed

Shor, Ron; Shalev, Anat

2015-03-01

Hospitalization of persons with mental illness may cause their family members to experience multiple stressors that stem from the hospitalization as well as from the duties of helping him or her. However, providing support services in psychiatric hospitals for family members has received only limited attention. To change this situation, mental health professionals in a psychiatric hospital in Israel developed an innovative family-centered practice model, the Family Members' Support and Consultation (FMSC) service center. We examined the significance to family members of the services they received from the FMSC service center in a study that included 20 caregivers. Ten participated in 2 focus groups of 5 participants each; 10 were interviewed personally. We implemented a thematic analysis to analyze the data. According to the participants, the staff of the FMSC service center provided support services that helped them cope with the stressors and difficulties they experienced within the context of the psychiatric hospital. The participants emphasized the significance of the immediacy and accessibility of support provided, as well as the positive effects of systemic interventions aimed at changing the relationships between family members and systems in the psychiatric hospital. Our findings show the importance of integrating a service that focuses on the needs of family members of persons with mental illness within a psychiatric hospital. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Atheism and mental health.

PubMed

Whitley, Rob

2010-01-01

The exploration of the impact of religiosity on mental health is an enduring, if somewhat quiet, tradition. There has been virtually no exploration, however, of the influence of atheism on mental health. Though not a "religion," atheism can be an orienting worldview that is often consciously chosen by its adherents, who firmly believe in the "truth" of atheism-a phenomenon known as "positive atheism." Atheism, especially positive atheism, is currently enjoying something of a renaissance in the Western liberal democracies-a trend often referred to as the "new atheism." I argue that atheism, especially positive atheism, should be treated as a meaningful sociocultural variable in the study of mental health. I argue that atheism (just like theism) is an appropriate domain of study for social and cultural psychiatrists (and allied social scientists) interested in exploring socio-environmental stressors and buffers relating to mental health. Specifically, I argue that (1) atheism needs to be accurately measured as an individual-level exposure variable, with the aim of relating that variable to psychiatric outcomes, (2) there needs to be greater systematic investigation into the influence of atheism on psychiatry as an institution, and (3) the relation of atheism to mental health needs to be explored by examining atheistic theory and its practical application, especially as it relates to the human condition, suffering, and concepts of personhood.

Stigma and mental health challenges in medical students

PubMed Central

Hankir, Ahmed Khaldoon; Northall, Amy; Zaman, Rashid

2014-01-01

Despite the perception that medical students and doctors should be ‘invincible’, mental health challenges are common in this population. Medical students and doctors have low levels of help seeking for their own psychiatric problems often only presenting to mental health services once a crisis arises. Fear of exposure to stigmatisation is a crucial factor contributing to symptom concealment and is a barrier to accessing mental health services. Autobiographical narratives of the ‘Wounded Healer’ are gaining popularity among medical students and doctors with mental health challenges both as an effective form of adjunctive therapy and as a means to campaign against stigma. Indeed, the results of a randomised controlled trial to assess the efficacy of Coming Out Proud with mental illness revealed immediate positive effects on stigma stress-related variables. We provide an autobiographical narrative from a medical student who has first-hand experience with mental health challenges. PMID:25183806

Integration of mental health into primary care in Kenya

PubMed Central

JENKINS, RACHEL; KIIMA, DAVID; NJENGA, FRANK; OKONJI, MARX; KINGORA, JAMES; KATHUKU, DAMMAS; LOCK, SARAH

2010-01-01

Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

Psychological predictors of mental health and health-related quality of life after bariatric surgery: a review of the recent research.

PubMed

Wimmelmann, Cathrine L; Dela, Flemming; Mortensen, Erik L

2014-01-01

Improvement of mental health and health-related quality of life (HRQOL) is an important success criterion for bariatric surgery. In general, mental health and HRQOL improve after surgery, but some patients experience negative psychological reactions postoperatively and the influence of pre-surgical psychological factors on mental wellbeing after surgery is unclear. The aim of the current article therefore is to review recent research investigating psychological predictors of mental health and HRQOL outcome. We searched PubMed, PsycInfo and Web of Science for studies investigating psychological predictors of either mental health or HRQOL after bariatric surgery. Original prospective studies published between 2003 and 2012 with a sample size >30 and a minimum of 1 year follow-up were included. Only 10 eligible studies were identified. The findings suggest that preoperative psychological factors including psychiatric symptoms, body image and self-esteem may be important for mental health postoperatively. Predictors of postoperative HRQOL seem to include personality, severe psychiatric disorder at baseline and improvement of depressive symptoms. In addition, psychiatric symptoms that persist after surgery and inappropriate eating behaviour postoperatively are likely to contribute to poor health-related quality of life outcome. Certain psychological factors appear to be important for mental health and HRQOL after bariatric surgery. However, the literature is extremely sparse and further research is highly needed. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Mental health, health care utilisation of migrants in Europe.

PubMed

Lindert, J; Schouler-Ocak, M; Heinz, A; Priebe, S

2008-01-01

Migration during the 1990s has been high and has been characterised by new migrations. Migration has been a key force in the demographic changes of the European population. Due to the different condition of migration in Europe, variables related to mental health of migrants are: motivation for migration, living conditions in the home and in the host country. To give an overview on (i) prevalence of mental disorders; suicide; alcohol and drug abuse; (ii) access to mental health and psychosocial care facilities of migrants in the European region, and (iii) utilisation of health and psychosocial institution of these migrants. Non-system review of the literature concerning mental health disorders of migrants and their access to and their consumption of health care and psychosocial services in Europe. It is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. The literature showed (i) mental health differs between migrant groups, (ii) access to psychosocial care facilities is influenced by the legal frame of the host country; (iii) mental health and consumption of care facilities is shaped by migrants used patterns of help-seeking and by the legal frame of the host country. Data on migrant's mental health is scarce. Longitudinal studies are needed to describe mental health adjusting for life conditions in Europe to identify those factors which imply an increased risk of psychiatric disorders and influence help seeking for psychosocial care. In many European countries migrants fall outside the existing health and social services, particularly asylum seekers and undocumented immigrants.

Discrimination and mental health among Latinos: variation by place of origin.

PubMed

Held, Mary L; Lee, Sungkyu

2017-10-01

The US Latino population experiences high rates of discrimination, which may contribute to psychiatric disorders. Yet, little is known about the distinctions in this relationship for Latino subgroups. Using data from the National Latino and Asian American study, we examined the association between discrimination and mental health for 2503 Latinos. Logistic regression analyses were used to examine variation in the relationship by place of origin (Cuba, Puerto Rico, Mexico, or Other). Results suggest that perceived discrimination increased the probability of having a psychiatric disorder. The effect of discrimination on having a psychiatric disorder was greater for Mexicans than Puerto Ricans. The findings of this study suggest that variation exists in the relationship between discrimination and mental health by origin. Implications for practice include increasing awareness of place of origin, in addition to discrimination, as a risk factor for mental illness. Future research should examine this relationship longitudinally and consider immigration status.

Mother’s perceptions of child mental health problems and services: A cross sectional study from Lahore

PubMed Central

Imran, Nazish; Ashraf, Sania; Shoukat, Rabia; Pervez, Muhammad Ijaz

2016-01-01

Objective: To assess the perceptions of mothers regarding child mental health problems, its causes, preferred treatment options, and to determine whom they would consult, if their child had a psychiatric illness. Methods: Following informed consent, a questionnaire covering perceptions regarding various aspects of child mental illness was used for data collection from mothers. They were asked to identify the symptoms and behaviours they considered psychopathological in children, which treatments they would prefer, where they would turn for help with a mentally ill child, and their understanding of the causes of child psychiatric disorders in addition to ways to increase awareness of child psychiatric issues in the society. Results: Ninety one mothers participated in the study. They equally perceived emotional, behavioural and cognitive symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, economic difficulties, social adversity and possession by evil spirits. A substantial proportion preferred medication, recitation of Holy Quran and psychotherapy as the preferred treatment options. Overall, mothers preferred consulting health professionals than religious scholars and faith healers. They were keen for steps to increase mental health awareness within their society. Conclusion: Despite different cultural perspective, mothers exhibit good understanding of symptoms of child mental health issues and appear open to various services and treatment options. Understanding parental perceptions and expectations from child psychiatric services are crucial in increasing families’ engagement in treatment. PMID:27375732

Italian quality assurance in mental health.

PubMed

Rossi, Giovanni; Agnetti, Germana; Bosio, Roberto; De Luca, Pasquale; Erlicher, Arcadio; Morganti, Carla; Neri, Giovanni; Re, Edoardo; Semisa, Domenico; Fioritti, Angelo

2014-06-01

Since the radical changes in Italian mental health law in the 1970s, quality assurance models have gained consensus as the most suitable service assessment tool. In the 1990s, the whole Italian National Health System changed into a corporate model, and an accreditation system was implemented.The Italian Association for Quality and Accreditation in Mental Health (Associazione Italiana per la Qualità e l'Accreditamento in Salute Mentale [QUASM]) was founded in 1984, and since then, it offers consultation and support for Mental Health Departments and Regional Governments to help them to develop psychiatric programs, self-evaluation, educational programs, and professional peer-model accreditation. The QUASM accreditation manual has now gone through several revisions, the last in 2008. Until 2008, QUASM was successful in promoting quality and facilitating both institutional and professional accreditation. However, radical changes triggered by financial crisis have jeopardized quality assurance implementation. Nowadays, the challenge for QUASM is to maintain quality and accreditation geared to excellence against prevailing leveling trends.

Use of Inpatient Psychiatric Services by Children and Youth under Age 18, United States, 1980. Mental Health Statistical Note No. 175.

ERIC Educational Resources Information Center

Milazzo-Sayre, Laura J.; And Others

The report examines data from three sample surveys of admissions during 1980 to the inpatient psychiatric services of state and mental hospitals and private psychiatric hospitals and the separate inpatient psychiatric services of non-federal general hospitals. Findings revealed that an estimated 81,532 persons under 18 years were admitted to…

Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria.

PubMed

Wagner, Gudrun; Zeiler, Michael; Waldherr, Karin; Philipp, Julia; Truttmann, Stefanie; Dür, Wolfgang; Treasure, Janet L; Karwautz, Andreas F K

2017-12-01

This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10-18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens' Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.

U.S. military enlisted accession mental health screening: history and current practice.

PubMed

Cardona, Robert Andrew; Ritchie, Elspeth Cameron

2007-01-01

Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.

[Evaluation of the mental health system in Mexico: where is it headed?].

PubMed

Berenzon Gorn, Shoshana; Saavedra Solano, Nayelhi; Medina-Mora Icaza, María Elena; Aparicio Basaurí, Víctor; Galván Reyes, Jorge

2013-04-01

Evaluate some of the key indicators that characterize the Mexican mental health system using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). The strategy for examining the WHO-AIMS indicators included: (i) a review of documentary sources; (ii) application of the questionnaire; and (iii) group work with a team of experts using the consensus technique. To facilitate collection of the data, a questionnaire was prepared in which the indicators were turned into simple questions. The people gathering the data were trained, and the activity was monitored. It was found that, of the total budget for health, only 2% is allocated for mental health, and, of that share, 80% is used in the operation of psychiatric hospitals. The pivotal point for mental health care is in the psychiatric hospital; there are very few psychiatric units in the general hospitals, few residential establishments, and few services targeted specifically to care for children and adolescents. Access is limited because of the centralized health care system, with the majority of establishments located in the large cities. Only 30% of primary care services have protocols for the evaluation and treatment of mental disorders. Finally, in the mental health facilities, the ratios of psychiatrists, other physicians, nurses, and psychologists per 100 000 population are 1.6, 1.3, 3.4, and 1.5, respectively. More funding will be needed in order to bridge the gap between the mental health burden and the budget allocated for its care, and resources will need to be used more rationally, with the first level of care becoming the pivot. In addition, it will be necessary to increase the number of specialists, offer periodic in-service training for personnel at the first level of care, and enlist greater participation by the rest of society.

Mental Health Service Use Among Lesbian, Gay, and Bisexual Older Adults.

PubMed

Stanley, Ian H; Duong, Jeffrey

2015-07-01

Empirical efforts to measure use of mental health services among lesbian, gay, and bisexual (LGB) older adults have been notably lacking. Thus this study assessed associations between sexual orientation and mental health service use among older adults and determined the mediating role of nonspecific psychological distress, excessive alcohol use, and self-perceived poor general medical health. Data from the 2011 New York City Community Health Survey were analyzed. The analytic sample comprised 5,138 adults ages 50 and over. Logistic regression modeling was used to examine associations between sexual orientation (LGB versus heterosexual) and past-year mental health service use (counseling or medication), adjusting for sociodemographic and clinical characteristics. Mediation analyses using bootstrapping were conducted. Among LGB older adults, 23.9% reported receiving counseling, and 23.4% reported taking psychiatric medication in the past year. LGB respondents were significantly more likely than heterosexuals to have received counseling (adjusted odds ratio [AOR]=2.16, 95% confidence interval [CI]=1.49-3.13) and psychiatric medication (AOR=1.97, CI=1.36-2.86). Psychological distress, excessive alcohol use, and self-perceived poor general medical health did not mediate the association between sexual orientation and mental health service use. LGB older adults were more likely than heterosexuals to utilize mental health services, and this association was not explained by indicators of general medical, mental, or behavioral health.

What parents of mentally ill children need and want from mental health professionals.

PubMed

Scharer, Kathleen

2002-09-01

Child psychiatric hospitalization is a time of crisis for the parents of a child with a mental disorder. Prior to hospitalization, the child's problematic behavior has escalated. Parents have various types of contact with mental health professionals prior to, during, and after the hospitalization, which influence their ability to care for their child. This paper reports a qualitative descriptive study of what parents need and want from mental health professionals during this time frame. During the study, parents spontaneously talked about what they needed and wanted from mental health professionals, including nursing personnel. The perspectives of 38 parents of 29 hospitalized children were obtained through interviews. Parents identified needing informational, emotional, and instrumental support most often in the interviews. Specific examples from the data are included in this report.

From Mental Disorder to Iatrogenic Hypogonadism - Dilemmas in Conceptualizing Gender Identity Variants as Psychiatric Conditions

PubMed Central

Meyer-Bahlburg, Heino F. L.

2009-01-01

The categorization of gender identity variants (GIVs) as “mental disorders” in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA) is highly controversial among professionals as well as among persons with GIV. After providing a brief history of GIV categorizations in the DSM, this paper presents some of the major issues of the ongoing debate: GIV as psychopathology versus natural variation; definition of “impairment” and “distress” for GID; associated psychopathology and its relation to stigma; the stigma impact of the mental-disorder label itself; the unusual character of “sex reassignment surgery” as a psychiatric treatment; and the consequences for health and mental-health services if the disorder label is removed. Finally, several categorization options are examined: Retaining the GID category, but possibly modifying its grouping with other syndromes; narrowing the definition to dysphoria and taking “disorder” out of the label; categorizing GID as a neurological or medical rather than a psychiatric disorder; removing GID from both the DSM and the International Classification of Diseases (ICD); and creating a special category for GIV in the DSM. I conclude that--as also evident in other DSM categories--the decision on the categorization of GIVs cannot be achieved on a purely scientific basis, and that a consensus for a pragmatic compromise needs to be arrived at that accommodates both scientific considerations and the service needs of persons with GIVs. PMID:19851856

The World Health Organization and the contested beginnings of psychiatric epidemiology as an international discipline: one rope, many strands.

PubMed

Lovell, Anne M

2014-08-01

This paper focuses on the relatively late emergence of psychiatric epidemiology as an international discipline, through local-global exchanges during the first 15 years of the World Health Organization (WHO). Building an epidemiological canon within WHO's Mental Health Programme faced numerous obstacles. First, an idealist notion of mental health inherent in WHO's own definition of health contributed to tensions around the object of psychiatric epidemiology. Second, the transfer of methods from medical epidemiology to research on mental disorders required mobilizing conceptual justifications, including a 'contagion argument'. Third, epidemiological research at WHO was stymied by other public health needs, resource scarcity and cultural barriers. This history partly recapitulates the development of psychiatric epidemiology in North America and Europe, but is also shaped by concerns in the developing world, translated through first-world 'experts'. Resolving the tensions arising from these obstacles allowed WHO to establish its international schizophrenia research, which in turn provided proof of concept for psychiatric epidemiology in the place of scepticism within and without psychiatry. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Attitudes toward concordance in psychiatry: a comparative, cross-sectional study of psychiatric patients and mental health professionals

PubMed Central

2012-01-01

Background Concordance and Shared Decision-Making (SDM) are considered measures of the quality of care that improves communication, promotes patient participation, creates a positive relationship with the healthcare professional, and results in greater adherence with the treatment plan. Methods This study compares the attitudes of 225 mental health professionals (125 psychiatrists and 100 psychiatry registrars) and 449 psychiatric outpatients towards SDM and concordance in medicine taking by using the "Leeds Attitude toward Concordance Scale" (LATCon). Results The internal consistency of the scale was good in all three samples (Cronbach's α: patients = 0.82, psychiatrists = 0.76, and registrars = 0.82). Patients scored significantly lower (1.96 ± 0.48) than professionals (P < .001 in both cases), while no statistically significant differences between psychiatrists (2.32 ± 0.32) and registrars (2.23 ± 0.35) were registered; the three groups showed a positive attitude towards concordance in most indicators. Patients are clearly in favor of being informed and that their views and preferences be taken into account during the decision-making process, although they widely consider that the final decision must be the doctor's responsibility. Among mental health professionals, the broader experience provides a greater conviction of the importance of the patient's decision about treatment. Conclusions We observed a positive attitude towards concordance in the field of psychotropic drugs prescription both in professionals and among patients, but further studies are needed to address the extent to which this apparently accepted model is reflected in the daily practice of mental health professionals. PMID:22646974

The Impact of Organizational Factors and Government Policy on Psychiatric Nurses' Family-Focused Practice With Parents Who Have Mental Illness, Their Dependent Children, and Families in Ireland.

PubMed

Grant, Anne; Reupert, Andrea

2016-05-01

Government policy and organizational factors influence family-focused practice (FFP) in adult mental health services. However, how these aspects shape psychiatric nurses' practice with parents who have mental illness, their dependent children, and families is less well understood. Drawing on the findings of a qualitative study, this article explores the way in which Irish policy and organizational factors might influence psychiatric nurses' FFP, and whether (and how) FFP might be further promoted. A purposive sample of 14 psychiatric nurses from eight mental health services completed semi-structured interviews. The analysis was inductive and presented as thematic networks. Both groups described how policies and organizational culture enabled and/or hindered FFP, with differences between community and acute participants seen. This study indicates a need for policies and organizational supports, including child and family skills training, to promote a whole family approach in adult mental health services. © The Author(s) 2016.

Mental health treatment after major surgery among Vietnam-era Veterans with posttraumatic stress disorder.

PubMed

Tsan, Jack Y; Stock, Eileen M; Greenawalt, David S; Zeber, John E; Copeland, Laurel A

2016-07-01

The purpose of this study was to examine mental health treatment use among Vietnam Veterans with posttraumatic stress disorder and determine whether undergoing major surgery interrupted mental health treatment or increased the risk of psychiatric hospitalization. Using retrospective data from Veterans Health Administration's electronic medical record system, a total of 3320 Vietnam-era surgery patients with preoperative posttraumatic stress disorder were identified and matched 1:4 with non-surgical patients with posttraumatic stress disorder. The receipt of surgery was associated with a decline in overall mental health treatment and posttraumatic stress disorder-specific treatment 1 month following surgery but not during any subsequent month thereafter. Additionally, surgery was not associated with psychiatric admission. © The Author(s) 2014.

Attitudes of Brazilian Medical Students Towards Psychiatric Patients and Mental Illness: A Quantitative Study Before and After Completing the Psychiatric Clerkship.

PubMed

da Rocha Neto, Helio Gomes; Rosenheck, Robert A; Stefanovics, Elina A; Cavalcanti, Maria Tavares

2017-06-01

The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.

Tidal waves: Implementing a new model of mental health recovery and reclamation.

PubMed

Brookes, Nancy; Murata, Lisa; Tansey, Margaret

2008-10-01

The Royal Ottawa Mental Health Centre was the first North American site to implement the Tidal Model of Mental Health Recovery and Reclamation. This empowering approach to practice focuses on learning persons' stories as the key to practising person-centred nursing. The authors, who constituted the Tidal implementation team at ROMHC, describe the journey to excellence in psychiatric and mental health nursing practice following the introduction of the model.

[Bioethics and research into mental health].

PubMed

Braz, Marlene; Schramm, Fermin Roland

2011-04-01

This article discusses research in the field of mental health, examining the ethical is sues involved and the use of Informed Consent. In order to achieve these objectives two main approaches were used: (1) a brief history of the different treatments and research with patients with mental illness or disability; (2) theoretical and conceptual analysis of the main problems concerning the mental health field, namely the notion of vulnerability, responsibility and autonomy and the use of placebo control groups. Two main questions prompted the reflection on whether the patient with a mental disorder can sign an Informed Consent, and whether the use of a placebo is acceptable. The existence of antagonistic and contradictory positions indicates that mental health research is hampered by biases that are difficult to overcome. Ethical investigation that may contribute to the healing of mental disorders should not however be overlooked merely because of the difficulties involved in its implementation. It must be borne in mind that changes occurring in the context of Psychiatric Reform in Brazil are gradually altering archaic concepts about what constitutes mental illness and how this group should be understood and treated.

Mental Health Stigma among Adolescents: Implications for School Social Workers

ERIC Educational Resources Information Center

Kranke, Derrick; Floersch, Jerry

2009-01-01

This study investigated adolescents with a mental health diagnosis and their experience of stigma in schools. Forty adolescents between the ages of twelve and seventeen who met DSM-IV criteria for a psychiatric illness and who were prescribed psychiatric medication were selected. The Teen Subjective Experience of Medication Interview was used to…

Racial-ethnic variation in U.S. mental health service use among Latino and Asian non-U.S. citizens.

PubMed

Lee, Sungkyu; Laiewski, Laurel; Choi, Sunha

2014-01-01

This study examined the factors associated with service utilization for mental health conditions among Latino and Asian non-U.S. citizens in the United States by service type and race. Data were obtained from the National Latino and Asian American Study (NLAAS). The sample for this study was 849 Latino and 595 Asian non-U.S. citizens between ages 18 and 64 (N=1,444). Mental health services obtained through three types of service providers were examined: specialty mental health services, general medical services, and other services. Guided by the modified Andersen health behavioral model, analyses involved logistic regression models conducted with penalized maximum likelihood estimation. Although having a psychiatric disorder increased mental health service use in both groups, only 32% of Latino and 52% of Asian non-U.S. citizens with psychiatric needs reported using mental health services during the past 12 months. Overall, noncitizen Latinos and Asians were more likely to use mental health services from general health care providers and other providers than from specialty mental health providers. Several significant predisposing, enabling, and need factors, such as age, health insurance, and having psychiatric conditions, also interacted with race. Findings of the study suggest that there are ethnoracial variations in mental health service use between Latino and Asian non-U.S. citizens. Mental health professionals should consider developing tailored mental health interventions that account for cultural variations to enhance access to services for these vulnerable subgroups of Latinos and Asians. Further research should examine ethnic disparities in mental health service use among various non-U.S. citizen racial-ethnic subgroups.

Prevalence of psychiatric morbidity at Mobile Health Clinic in an urban community in North India.

PubMed

Salve, Harshal; Goswami, Kiran; Nongkynrih, Baridalyne; Sagar, Rajesh; Sreenivas, V

2012-01-01

The objective was to estimate the prevalence of psychiatric morbidity amongst patients attending Mobile Health Clinic (MHC) in an urban community in South Delhi. Adult subjects were recruited by systematic random sampling at outpatient MHC. Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PHQ) was used for screening, and Mini International Neuropsychiatric Interview (M.I.N.I.) was used for the confirmation of diagnosis of psychiatric disorder of all PHQ-positive and 20% of PHQ-negative patients. Association of selected sociodemographic factors with psychiatric morbidity was also assessed. In total, 350 subjects were recruited, out of which 92 (26.3%) [95% confidence interval (CI) 21.7-31.0] were found to be PHQ positive. M.I.N.I. was administered to 141 subjects (92 PHQ positives and 52 PHQ negatives). Total estimated magnitude of psychiatric morbidity by M.I.N.I. was 25.4% (95% CI 20.9-29.9). Depression (15.7%) was observed to be the most common psychiatric disorder followed by generalized anxiety disorder (11.1%) and phobic disorders (10.1%). Suicidal ideation was reported by 37 (10.6%) patients. Literate status [odds ratio (OR)=0.43] and duration of migration >20 years to study area (OR=1.27) were found to be significantly associated with psychiatric morbidity. In resource-poor country like India, high psychiatric morbidity at MHC justifies the use of MHC for providing outreach mental health services in difficult areas. Copyright © 2012 Elsevier Inc. All rights reserved.

Descriptive Analysis of a Novel Health Care Approach: Reverse Colocation—Primary Care in a Community Mental Health “Home”

PubMed Central

Sirna, Megan; Mangurian, Christina; Dilley, James W.; Shumway, Martha

2013-01-01

Objective: Persons with serious mental illness have increased rates of chronic medical conditions, have limited access to primary care, and incur significant health care expenditures. Few studies have explored providing medical care for these patients in the ambulatory mental health setting. This study describes a real-world population of mental health patients receiving primary care services in a community mental health clinic to better understand how limited primary care resources are being utilized. Method:Chart review was performed on patients receiving colocated primary care (colocation group, N = 143) and randomly chosen patients receiving mental health care only (mental-health group, N = 156) from January 2006 through June 2011. Demographic and mental and physical health variables were assessed. Results: Compared to the mental-health group, the colocation patients had more psychiatric hospitalizations (mean = 1.07 vs 0.23, P < .01), were more likely to be homeless (P < .01), and were more likely to require intensive case management (P < .01). Interestingly, the colocation group was not more medically ill than the mental-health group on key metabolic measures, including mean body mass index (colocation = 27.8 vs mental-health = 28.7, P = .392), low-density liprotein (colocation = 110.0 vs mental-health = 104.4, P = .480), and glucose (colocation = 94.1 vs mental-health = 109.2, P = .059). The most common medical disorders in the colocation group were related to metabolic syndrome. Conclusions: Colocated primary care services were allocated on the basis of severity of psychiatric impairment rather than severity of medical illness. This program serves as a model for other systems to employ for integrated primary and behavioral health services for patients with serious mental illness. PMID:24511447

Quality of life of mental health consumers in Hong Kong: Analysis of service perceptions.

PubMed

Wu, Crystal F M; Mak, Winnie W S; Wan, Deborah L Y

2007-02-01

Successful psychiatric rehabilitation entails fostering overall quality of life of individuals recovering from severe mental illnesses. Understanding how service-related perceptions may be related to quality of life can be useful in improving the effectiveness of community-based care. This study investigated the quality of life of mental health consumers using a service-oriented paradigm. 162 mental health consumers from community-based psychiatric rehabilitation centers were interviewed. Analyses were conducted to investigate the relationships between service perceptions (perceived treatment coercion, rehabilitation needs, and continuity of care) and quality of life. Physical health quality was negatively related to rehabilitation needs. Mental health quality was negatively related to both rehabilitation needs and poorer continuity of service. Life satisfaction was negatively related to poorer continuity of service and higher perceived treatment coercion. This study highlighted the significance of service perceptions in the well-being of individuals with severe mental illness.

No place to turn: nursing students' experiences of moral distress in mental health settings.

PubMed

Wojtowicz, Bernadine; Hagen, Brad; Van Daalen-Smith, Cheryl

2014-06-01

While researchers have documented the significant issue of moral distress among nurses, few have explored moral distress among mental health nurses. In addition, no research to date has explored nursing students' experiences of moral distress during mental health clinical rotations, despite nursing students typically reporting negative attitudes towards mental health nursing. This manuscript reports on a qualitative study involving seven Canadian baccalaureate nursing students, who reported on their experiences of moral distress during a 13-week clinical rotation on inpatient psychiatric units. Overall, nursing students reported significant moral distress related to the perceived lack of nurses talking meaningfully to patients on the unit, a hierarchical power structure for physicians, a lack of information given to patients about their psychiatric medications, and an inability of their nursing instructors to advocate for ethical change on the units. Several students made a specific connection between their moral distress and not wanting to pursue a career in mental health nursing. © 2013 Australian College of Mental Health Nurses Inc.

Psychiatric Disorders and Health-Related Quality of Life in Children With Type 1 Diabetes Mellitus.

PubMed

Butwicka, Agnieszka; Fendler, Wojciech; Zalepa, Adam; Szadkowska, Agnieszka; Zawodniak-Szalapska, Malgorzata; Gmitrowicz, Agnieszka; Mlynarski, Wojciech

2016-01-01

Type 1 diabetes mellitus (T1DM) is a chronic condition with major effect on health-related quality of life (HRQoL) and mental health. In 1990s, high rates of psychiatric disorders were reported among children with T1DM. Little is known, however, about current prevalence of psychiatric disorders in children with T1DM and the relation between psychiatric diagnosis and HRQoL. The aim of the study was to determine the prevalence of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) psychiatric disorders and the association between psychiatric comorbidity and HRQoL in the pediatric population with T1DM. We conducted a cross-sectional study of 207 children, aged 8-18 years, diagnosed with T1DM. The presence of psychiatric disorders has been assessed by the standard diagnostic interview according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. HRQoL was measured by the general and diabetes mellitus-specific modules of the Paediatric Quality of Life Inventory. Of the evaluated patients, 26.6% (N = 55) met the criteria for psychiatric disorders at the time of evaluation. The most common diagnoses were anxiety (N = 32; 15.5%) and mood disorders (N = 8; 3.9%). One-third of the patients (N = 66, 31.9%) met the criteria for at least 1 psychiatric diagnosis in their lifetime. The presence of psychiatric disorders was related to an elevated hemoglobin A1c level (8.6% vs 7.6%) and a lowered HRQoL level in the general pediatric quality of life inventory. In the diabetes mellitus-specific pediatric quality of life inventory, children with psychiatric disorders revealed more symptoms of diabetes mellitus, treatment barriers, and lower adherence than children without psychiatric disorders. T1DM in children is associated with a very high prevalence of psychiatric comorbidity, which is related to elevated hemoglobin A1c and lower HRQoL levels. Copyright © 2016 The Academy of Psychosomatic Medicine

Perpetuating stigma? Differences between advertisements for psychiatric and non-psychiatric medication in two professional journals.

PubMed

Foster, Juliet L H

2010-02-01

Continuing debates regarding advertising and the pharmaceutical industry, and others detailing the continued stigmatization of mental health problems. To establish whether there are any differences in advertisements for psychiatric and non-psychiatric medication aimed at health professionals. Quantitative (t-tests, Chi-squared) and qualitative analysis of all unique advertisements for medication that appeared in two professional journals (the British Medical Journal and the British Journal of Psychiatry) between October 2005 and September 2006 was undertaken. Close attention was paid to both images and text used in the advertisements. Significant differences were found between advertisements for psychiatric and non-psychiatric medication in both quantitative and qualitative analysis: advertisements for psychiatric medication contain less text and are less likely to include specific information about the actual drug than non-psychiatric medication advertisements; images used in advertisements for psychiatric medication are more negative than those used for non-psychiatric medication, and are less likely to portray people in everyday situations. A distinction between mental health problems and other forms of ill health is clearly being maintained in medication advertisements; this has potentially stigmatizing consequences, both for professional and public perceptions. There are also troubling implications in light of the debates surrounding Direct to Consumer Advertising.

[Dependency levels and health care services' utilization in psychiatric hospitals in Aragon (Spain)].

PubMed

de Miguel, Marcos; Torrijos, Mónica; Abad, José María; Lou, Marta Luz

2004-01-01

To determine the characteristics of patients living in psychiatric hospitals in Aragon, to assess their dependency levels, and to analyze health care services' utilization by these patients. We performed a cross-sectional study between July 1 and November 31. The questionnaire used was the Resident Assessment Instrument- Mental Health (RAI-MH). The sample consisted of 437 patients living in public psychiatric hospitals in Aragon. These hospitals provide care to chronically mentally ill patients and to patients undergoing rehabilitation. The Resource Utilization Group (RUG-I) system was used to classify patients by their dependency levels for activities of daily life (ADL). Of the 437 patients, 259 (59.3%) were men with a mean age of 62.2 years. A total of 82.1% of the patients were classified as RUG-I group 1. Patients in groups 1 and 2 required more formal health care services. At least one visit by a psychiatrist was required by 25.3% of patients in group 1 and by 15.2% of those in group 2 compared with no visits by the other groups. Nursing interventions were more frequently required by patients in the more dependent groups. All of the of patients in groups 2 to 8 needed daily physical assistance for ADL vs. 26.3% of those in group 1. In the multivariate analysis, predictive variables were the hospital and type of unit. There is wide variation in health care services' utilization by patients living in psychiatric hospitals, which is related to dependency levels. Many psychiatric patients do not need formal psychiatric care. Health care professionals should assess the real needs of patients to provide each of them with appropriate care.

Racial and Ethnic Disparities in Mental Health Care for Children and Young Adults: A National Study.

PubMed

Marrast, Lyndonna; Himmelstein, David U; Woolhandler, Steffie

2016-10-01

Psychiatric and behavior problems are common among children and young adults, and many go without care or only receive treatment in carceral settings. We examined racial and ethnic disparities in children's and young adults' receipt of mental health and substance abuse care using nationally representative data from the 2006-2012 Medical Expenditure Panel Surveys. Blacks' and Hispanics' visit rates (and per capita expenditures) were about half those of non-Hispanic whites for all types and definitions of outpatient mental health services. Disparities were generally larger for young adults than for children. Black and white children had similar psychiatric inpatient and emergency department utilization rates, while Hispanic children had lower hospitalization rates. Multivariate control for mental health impairment, demographics, and insurance status did not attenuate racial/ethnic disparities in outpatient care. We conclude that psychiatric and behavioral problems among minority youth often result in school punishment or incarceration, but rarely mental health care. © The Author(s) 2016.

Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults.

PubMed

Marino, Leslie; Wissow, Lawrence S; Davis, Maryann; Abrams, Michael T; Dixon, Lisa B; Slade, Eric P

2016-12-01

To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults. Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated . Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P < 0.01 and OR = 0.36, P < 0.01, respectively). In addition, those who utilized any outpatient public mental health services during the 180 days prior to their index hospitalization (N = 625, 55.4%) were more likely to have a follow-up visit than those without prior outpatient use (OR = 2.45, P < 0.01). Prior Medicaid-reimbursed primary care visits were not significantly associated with follow-up. In this predominantly urban, low-income statewide sample of young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans. © 2015 Wiley Publishing Asia Pty Ltd.

Emotional intelligence of mental health nurses.

PubMed

van Dusseldorp, Loes R L C; van Meijel, Berno K G; Derksen, Jan J L

2011-02-01

The aim of this study is to gain insight into the level of emotional intelligence of mental health nurses in the Netherlands. The focus in research on emotional intelligence to date has been on a variety of professionals. However, little is known about emotional intelligence in mental health nurses. The emotional intelligence of 98 Dutch nurses caring for psychiatric patients is reported. Data were collected with the Bar-On Emotional Quotient Inventory within a cross-sectional research design. The mean level of emotional intelligence of this sample of professionals is statistically significant higher than the emotional intelligence of the general population. Female nurses score significantly higher than men on the subscales Empathy, Social Responsibility, Interpersonal Relationship, Emotional Self-awareness, Self-Actualisation and Assertiveness. No correlations are found between years of experience and age on the one hand and emotional intelligence on the other hand. The results of this study show that nurses in psychiatric care indeed score above average in the emotional intelligence required to cope with the amount of emotional labour involved in daily mental health practice. The ascertained large range in emotional intelligence scores among the mental health nurses challenges us to investigate possible implications which higher or lower emotional intelligence levels may have on the quality of care. For instance, a possible relation between the level of emotional intelligence and the quality of the therapeutic nurse-patient relationship or the relation between the level of emotional intelligence and the manner of coping with situations characterised by a great amount of emotional labour (such as caring for patients who self-harm or are suicidal). © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Pathways to psychiatric care in European prison systems.

PubMed

Dressing, Harald; Salize, Hans-Joachim

2009-01-01

The aims of this study were to describe and analyse the concepts of provision of mental health services for prison inmates in 24 countries in the European Union and the EFTA. Data were gathered by means of a structured questionnaire that was completed by national experts in the participating countries. This article stresses the different organizational models of mental health care for inmates, different legal standards for screening their mental health status and different pathways to psychiatric care and aftercare. The study revealed serious shortcomings. Even the most rudimentary health reporting standards for mental health care in prison are lacking almost everywhere in Europe. Psychiatric screening and assessment procedures at prison entry and during imprisonment differ substantially and do not fulfil recognized quality standards. In many countries, the appointment of inadequately trained staff to perform such screenings increases considerably the risk that mental disorders or psychiatric needs of the inmates will remain undetected. Furthermore, the pathways to care in the case of an acute psychotic episode differ significantly, since referral to prison hospitals, medical prison wards, forensic hospitals, or general psychiatric hospital are used in various combinations depending on different national legal regulations and on the availability of services or other regional circumstances. Therefore, the collaborating experts place the quality of European prison mental health care into serious question. (c) 2009 John Wiley & Sons, Ltd.

Childhood Mental Ability and Lifetime Psychiatric Contact: A 66-Year Follow-Up Study of the 1932 Scottish Mental Ability Survey.

ERIC Educational Resources Information Center

Walker, Nicholas P.; McConville, Pauline M; Hunter, David; Deary, Ian J.; Whalley, Lawrence J.

2002-01-01

Tested the hypothesis that intelligence is related to the risk of mental illness by linking childhood mental ability data to registers of psychiatric contact in a stable population of 4,199 adults in Scotland. Findings show intelligence to be an independent predictor of psychiatric contact, with each standard deviation decrease in IQ resulting in…

Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

PubMed Central

Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

2014-01-01

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

Mental health and abortion: review and analysis.

PubMed

Ney, P G; Wickett, A R

1989-11-01

This survey of studies which relate to the emotional sequelae of induced abortion, draws attention to the need for more long-term, in-depth prospective studies. The literature to this point finds no psychiatric indications for abortion, and no satisfactory evidence that abortion improves the psychological state of those not mentally ill; abortion is contra-indicated when psychiatric disease is present, as mental ill-health has been shown to be worsened by abortion. Recent studies are turning up an alarming rate of post-abortion complications such as P.I.D., and subsequent infertility. The emotional impact of these complications needs to be studied. Other considerations looked at are the long-term demographic implications of abortion on demand and the effect on the medical professions.

Long-term mental health outcomes following the 2004 Asian tsunami disaster

PubMed Central

Kar, Nilamadhab; Krishnaraaj, Rameshraj; Rameshraj, Kavitha

2014-01-01

There is inadequate information on the long-term mental health outcomes among disaster victims in low and middle income countries. It is especially so for the vast majority of victims who are indirectly exposed to disasters. To address this gap in knowledge we examined the prevalence of psychiatric morbidity, particularly anxiety, depression and post-traumatic stress disorder (PTSD) in the 2004 Asian tsunami victims in India, 4.5 y after the disaster. It was also intended to compare the mental health outcomes of the victims with direct exposure to tsunami waters and those who were indirectly exposed to tsunami disaster (people living near the sea who escaped tsunami waters but witnessed the disaster and suffered various losses). In a cross-sectional epidemiological study, 666 randomly selected victims in South India were assessed for psychiatric morbidity through the Self-Reporting questionnaire (SRQ), Zung Self-Rating Depression Scale, Zung Self-Rating Anxiety Scale, Self-Rating Scale for PTSD (SRS-PTSD) and suicidality screening. The disaster experience, quality of life and socio-demographic profile were also assessed. Psychiatric morbidity based on SRQ was 77.6% and estimated prevalence of anxiety symptoms (23.1%), depression (33.6%), PTSD (70.9%) and comorbidity (44.7%) suggested nature and extent of the psychiatric morbidity in the tsunami victims. The direct exposure group had a significantly greater proportion of psychiatric morbidity based on SRQ, anxiety symptoms and suicide attempts. Factors which predicted psychiatric morbidity were: lack of formal education, perception of disaster as highly stressful, damage to home and loss of livelihood and livestock. In conclusion, a large proportion of Asian tsunami victims were observed to have continuing mental health problems 4.5 y after the disaster, which highlighted the need for psychiatric services for the affected communities. PMID:28228999

The attitudes, role & knowledge of mental health nurses towards euthanasia because of unbearable mental suffering in Belgium: a pilot study.

PubMed

Demedts, Dennis; Roelands, Marc; Libbrecht, Julien; Bilsen, Johan

2018-05-26

Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n=133) as a pilot study. Self-administered questionnaires were provided to mental health nurses. Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare

Behavioral Interviewing in Psychiatric Rehabilitation Assessment.

ERIC Educational Resources Information Center

Davis, Alan

Psychiatric rehabilitation differs from traditional approaches to mental health, because it places much greater emphasis on the importance of the person's relationship with the environment. In psychiatric rehabilitation, the importance is not placed on finding a cure for the client's mental illness; rather, what matters is the ability to hold a…

India mental health country profile.

PubMed

Khandelwal, Sudhir K; Jhingan, Harsh P; Ramesh, S; Gupta, Rajesh K; Srivastava, Vinay K

2004-01-01

, development of mental health services has been linked with general health services and primary health care. Training opportunities for various kinds of mental health personnel are gradually increasing in various academic institutions in the country and recently, there has been a major initiative in the growth of private psychiatric services to fill a vacuum that the public mental health services have been slow to address. A number of non-governmental organizations have also initiated activities related to rehabilitation programmes, human rights of mentally ill people, and school mental health programmes. Despite all these efforts and progress, a lot has still to be done towards all aspects of mental health care in India in respect of training, research, and provision of clinical services to promote mental health in all sections of society.

Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems.

PubMed

Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen

2016-01-01

Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.

Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression.

PubMed

Rasmussen, Line Ryberg; Mainz, Jan; Jørgensen, Mette; Videbech, Poul; Johnsen, Søren Paaske

2018-04-26

The relationship between inpatient volume and the quality of mental health care remains unclear. This study examined the association between inpatient volume in psychiatric hospital wards and quality of mental health care among patients with depression admitted to wards in Denmark. In a nationwide, population-based cohort study, 17,971 patients (N=21,120 admissions) admitted to psychiatric hospital wards between 2011 and 2016 were identified from the Danish Depression Database. Inpatient volume was categorized into quartiles according to the individual ward's average caseload volume per year during the study period: low volume (quartile 1, <102 inpatients per year), medium volume (quartile 2, 102-172 inpatients per year), high volume (quartile 3, 173-227 inpatients per year) and very high volume (quartile 4, >227 inpatients per year). Quality of mental health care was assessed by receipt of process performance measures reflecting national clinical guidelines for care of depression. Compared with patients admitted to low-volume psychiatric hospital wards, patients admitted to very-high-volume wards were more likely to receive a high overall quality of mental health care (≥80% of the recommended process performance measures) (adjusted relative risk [ARR]=1.78, 95% confidence interval [CI]=1.02-3.09) as well as individual processes of care, including a somatic examination (ARR=1.35, CI=1.03-1.78). Admission to very-high-volume psychiatric hospital wards was associated with a greater chance of receiving guideline-recommended process performance measures for care of depression.

[Children of mentally ill parents: the impact of parental psychiatric diagnosis, comorbidity, severity and chronicity on the well-being of children].

PubMed

Wiegand-Grefe, S; Geers, P; Petermann, F; Plass, A

2011-01-01

Children of mentally ill parents are known as a high-risk population for the development of psychological disturbances. In this study, the psychiatric diagnoses, the severity and chronicity and the comorbidity of a parental mental illness as well as the non-specific parameters were examined in terms of their influence on the children's mental health. n = 62 children of psychiatric inpatients were examined regarding their psychic symptomatology, assessed with the CBCL-Parent Report Form. The psychiatric ICD-10 diagnoses and comorbidities as well as the severity (CGI) of the mentally ill parents were collected from psychiatric assessment forms. Children of parents with personality disorders (PD) are evaluated as highly affected by their parents, regardless of whether the PD is the primary or the comorbid diagnosis. Children of parents suffering from addictive disorders are seen as the least affected by their parents. Overall, children of parents with multiple diagnoses tend to be rated as more affected. Severity of illness and chronicity do not have a considerable impact on the children's development of mental health problems. Strikingly, children with a high length of exposure to a parental illness are psychologically less affected than children with shorter times of exposure. Thus, children possibly acquire effective coping mechanisms with increasing time of exposure. The results reveal the necessity of preventive programmes, especially in case of personality disorders. In addition the necessity for external assessment of the children becomes clear, especially in those cases where the parents exhibit a poor acceptance of their disease. © Georg Thieme Verlag KG Stuttgart · New York.

Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services.

PubMed

Blomqvist, Marjut; Sandgren, Anna; Carlsson, Ing-Marie; Jormfeldt, Henrika

2018-02-01

It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.

Pioneering the psychiatric nurse role in foster care.

PubMed

Bertram, Julie E; Narendorf, Sarah Carter; McMillen, J Curtis

2013-12-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. © 2013.

Pioneering the Psychiatric Nurse Role in Foster Care (*)

PubMed Central

Bertram, Julie E.; Narendorf, Sarah Carter; McMillen, J. Curtis

2013-01-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse’s work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. PMID:24238008

Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well.

PubMed

Ormel, J; Oerlemans, A M; Raven, D; Laceulle, O M; Hartman, C A; Veenstra, R; Verhulst, F C; Vollebergh, W; Rosmalen, J G M; Reijneveld, S A; Oldehinkel, A J

2017-05-01

Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes. We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use). Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder. To understand current functioning, it is necessary to examine both current and past psychiatric status.

Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.

PubMed

Ortega, Alexander N; Goodwin, Renee D; McQuaid, Elizabeth L; Canino, Glorisa

2004-01-01

Previous research documents an association of poor parental mental health with asthma in children. This study aims to determine whether the associations between parental mental health problems and childhood asthma attacks persist after controlling for childhood anxiety and depression and other confounding factors. A community household sample of youth ages 4 to 17 years and their primary caregivers from the US Commonwealth of Puerto Rico was studied to determine the associations between parental mental health and childhood asthma attacks. Regression models that predicted asthma attacks in youth controlled for parental mental health problems, childhood anxiety and depression, zone of residence, and parents' age, education, and perception of poverty. After adjusting for children's depressive and anxiety disorders as well as other important confounders, associations between parental depression, suicide attempts, ataque de nervios, and history of mental health treatment and asthma attacks in offspring, by parental report, persisted. Additionally, the frequency of parental mental health problems was associated with children's asthma attacks. Parents with mental health problems were more likely to report histories of asthma attacks in their children compared with parents without mental health problems in Puerto Rico. These associations were not attributable to internalizing disorders in youth but persisted independent of childhood psychopathology and other confounding factors. Clinicians and researchers should recognize the relations between poor parental mental health and childhood asthma and explore the potential role of family psychosocial and behavioral factors related to the manifestation of the disease.

Understanding Bipolar Disorder: Implications for Mental Health Counselors.

ERIC Educational Resources Information Center

Withrow, J. Steve; Hinkle, J. Scott

1990-01-01

Provides an overview of bipolar disorder, including a discussion of diagnostic indicators, etiological theories, and psychopharmacological treatment. Examines treatment implications for mental health counselors, including role in psychiatric liaison, individual counseling, marriage and family therapy, and vocational counseling. (Author/ABL)

Psychiatric care in the Middle East: a "mental health supermarket" in the town of Lod.

PubMed

Shaked, Ginette; Renert, Noa; Mahuda, Israela; Strous, Rael D

2004-01-01

It is often in times of political tension and hostilities that community mental health care is neglected. We describe a novel and creative community mental health program where a combination of professional mental health workers and an innovative mental health system network combine to provide a remarkably successful and tension free mental health care arrangement in an area of high political and intergroup hostility. The system, termed the "mental health supermarket," encompasses multi-component rehabilitation, hospital liaison and interagency collaborative care. The framework succeeds in settling fears and insecurities between various communities as well as catering to a fragmented and lower income community, while introducing an element of self-determination in personal mental health care.

Beliefs about using consumer consultants in inpatient psychiatric units.

PubMed

McCann, Terence V; Baird, John; Clark, Eileen; Lu, Sai

2006-12-01

A key recommendation of consumer organizations and governments has been the employment of consumer consultants in inpatient psychiatric facilities, but the attitudes of mental health clinicians towards this measure remain inconsistent. The aims of this study were to examine mental health clinicians' attitudes about the role of mental health consumer consultants in inpatient psychiatric units, and to ascertain if participants' age, type of inpatient unit, or grade of staff influenced their attitudes towards consultants. The Consumer Participation and Consultant Questionnaire was used, which was adapted from the Mental Health Consumer Participation Questionnaire. A convenience sample of 47 mental health professionals from two adult inpatient psychiatric units located in a large Australian public general hospital participated in the study. The findings, overall, showed that participants supported the inclusion of consumer consultants in psychiatric units in areas that indirectly impinged on their current roles. Age, level of nurses, and place of employment did not affect their beliefs, but type of occupation was influential. Nurses were less supportive of aspects of consumer consultants' roles that overlapped with the traditional roles of the nurse. The findings have implications for clinical practice, education, and further research, and these are discussed.

Psychiatric dilemmas--surgery and the Mental Health Act (1983).

PubMed Central

Porter, S; Williams, C

1997-01-01

Clinicians commonly face an ethical conundrum when the patient declines a treatment they believe to be necessary. The decision, whether to give or to withhold treatment, may also have legal repercussions. Two illustrative cases are presented. Although the Mental Health Act (1983) is concerned with treatment of mental disorder, treatments for physical disorders may be given in certain circumstances if the patient is deemed to lack the competence to understand the issues involved in the decision, and treatment is deemed to be in their best interests. PMID:9227381

Mental health emergencies.

PubMed

Skinner, Anita

I gained experience of psychiatric assessment in previous roles when working in a secure psychiatric ward and within the prison service. Although I have often performed mental state assessments and assessments of suicidal intent as part of my work, I read the CPD article to refresh my knowledge in this area.

Modifying mental health help-seeking stigma among undergraduates with untreated psychiatric disorders: A pilot randomized trial of a novel cognitive bias modification intervention.

PubMed

Stanley, Ian H; Hom, Melanie A; Joiner, Thomas E

2018-04-01

Help-seeking stigma is a potent barrier to the utilization of mental health services. This study aimed to determine if, compared to a psychoeducation condition, individuals randomized to a novel cognitive bias modification intervention for help-seeking stigma (CBM-HS) demonstrate greater reductions in help-seeking stigma, as well as increases in readiness to change and help-seeking behaviors. Participants included 32 undergraduates with a DSM-5 psychiatric disorder who denied past-year mental health treatment. Post-randomization, three intervention sessions were delivered in one-week intervals (45 min total). Participants were assessed at baseline, mid-intervention, one-week post-intervention, and two-month follow-up. RM-ANOVAs were utilized among the intent-to-treat sample. There were no significant differences across time points between the intervention groups for help-seeking stigma and readiness to change. At two-month follow-up, 25% of participants initiated mental health treatment (29.4% CBM-HS, 20.0% psychoeducation). Strikingly, across groups, there was a statistically significant reduction in help-seeking self-stigma (F[2.214,66.418] = 5.057, p = 0.007, η p 2  = 0.144) and perceived public stigma (F[3,90] = 6.614, p < 0.001, η p 2  = 0.181) from baseline to two-month follow-up, indicating large effects; 18.8% achieved clinically significant change, among whom two-thirds were in the CBM-HS condition. Two brief, scalable interventions appear to reduce help-seeking stigma among undergraduates with untreated psychiatric disorders. Studies are needed to evaluate these interventions against an inactive control. Copyright © 2018 Elsevier Ltd. All rights reserved.

Psychiatric History, Deployments, and Potential Impacts of Mental Health Care in a Combat Theater.

PubMed

Varga, Colleen M; Haibach, Michael A; Rowan, Anderson B; Haibach, Jeffrey P

2018-01-01

Increasing numbers of U.S. service members access mental health care while deployed and at home station. Multiple deployments carry with them a higher risk of exposure to combat as well as the impact of cumulative stressors associated with separation from family, hostile environments, and high operations tempo. However, mental health care resources continue to be underutilized, potentially because of higher levels of stigma regarding mental health care and concerns about career impact among service members. Some studies indicate that service members who have previously sought mental health care are likely to continue to do so proactively as needed. This study examined the associations between prior deployments, prior mental health treatment, and subsequent career-impacting recommendations (e.g., duty limitations and medical evacuation) among deployed service members seeking mental health care. Materials and. This study is a retrospective review of clinical records from three U.S. military Combat and Operational Stress Control units in Afghanistan. Data were drawn from the mental health records of 1,639 Army service members presenting for outpatient mental health services while deployed in Afghanistan from years 2006 to 2008. In an unadjusted logistic regression model, service members with at least one prior deployment had a 38% greater odds (odds ratio [OR] = 1.38, 95% confidence interval [95% CI] 1.06, 1.80; p < 0.05) of receiving career-impacting recommendations than those without a prior deployment. However, after adjusting for demographics (age, gender, marital status, rank, and military status), there was no association between prior deployments and career-impacting recommendations (OR = 1.06, 95% CI 0.78, 1.43; p = 0.716). In the second unadjusted model, service members with prior mental health treatment had a 57% lower odds (OR = 0.43, 95% CI 0.34, 0.56; p < 0.001) of receiving career-impacting recommendations than those without prior mental health treatment

Suicide Ideation in Older Adults: Relationship to Mental Health Problems and Service Use

ERIC Educational Resources Information Center

Corna, Laurie M.; Cairney, John; Streiner, David L.

2010-01-01

Purpose: To assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Design and Methods: We use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of…

Mental health nursing and the politics of recovery: a global reflection.

PubMed

Barker, Phil J; Buchanan-Barker, Poppy

2011-10-01

The concept of recovery increasingly dominates mental health policy and practice agendas in most Western countries. However, the many, often conflicting, definitions of recovery have led to theoretical and practical confusion. More importantly, the concept clashes with some of the established assumptions of psychiatric/mental health nursing, especially the traditional notion that the person is "ill" and requires "treatment" or some other active "intervention." The implications of recovery for the further development of person-centered care, especially within a globalized form of mental health nursing, are discussed with specific reference to the Tidal Model, an international midrange theory of mental health nursing. Copyright © 2011. Published by Elsevier Inc.

Infant Growth after Preterm Birth and Mental Health in Young Adulthood.

PubMed

Sammallahti, Sara; Lahti, Marius; Pyhälä, Riikka; Lahti, Jari; Pesonen, Anu-Katriina; Heinonen, Kati; Hovi, Petteri; Eriksson, Johan G; Strang-Karlsson, Sonja; Järvenpää, Anna-Liisa; Andersson, Sture; Kajantie, Eero; Räikkönen, Katri

2015-01-01

Faster growth after preterm birth benefits long-term cognitive functioning. Whether these benefits extend to mental health remains largely unknown. We examined if faster growth in infancy is associated with better self-reported mental health in young adults born preterm at very low birth weight (VLBW) (< 1500 g). As young adults, participants of the Helsinki Study of Very Low Birth Weight Adults self-reported symptoms of depression and attention deficit/hyperactivity disorder (ADHD) (n = 157) and other psychiatric problems (n = 104). As main predictors of mental health outcomes in linear regression models, we used infant weight, length, and head circumference at birth, term, and 12 months of corrected age, and growth between these time points. Growth data were collected from records and measures at term and at 12 months of corrected age were interpolated. Additionally, we examined the moderating effects of intrauterine growth restriction. Size at birth, term, or 12 months of corrected age, or growth between these time points were not associated with mental health outcomes (p-values >0.05). Intrauterine growth restriction did not systematically moderate any associations. Despite the high variability in early growth of VLBW infants, the previously described association between slow growth in infancy and poorer cognitive functioning in later life is not reflected in symptoms of depression, ADHD, and other psychiatric problems. This suggests that the development of cognitive and psychiatric problems may have dissimilar critical periods in VLBW infants.

Infant Growth after Preterm Birth and Mental Health in Young Adulthood

PubMed Central

Sammallahti, Sara; Lahti, Marius; Pyhälä, Riikka; Lahti, Jari; Pesonen, Anu-Katriina; Heinonen, Kati; Hovi, Petteri; Eriksson, Johan G.; Strang-Karlsson, Sonja; Järvenpää, Anna-Liisa; Andersson, Sture; Kajantie, Eero; Räikkönen, Katri

2015-01-01

Objectives Faster growth after preterm birth benefits long-term cognitive functioning. Whether these benefits extend to mental health remains largely unknown. We examined if faster growth in infancy is associated with better self-reported mental health in young adults born preterm at very low birth weight (VLBW) (<1500g). Study Design As young adults, participants of the Helsinki Study of Very Low Birth Weight Adults self-reported symptoms of depression and attention deficit/hyperactivity disorder (ADHD) (n = 157) and other psychiatric problems (n = 104). As main predictors of mental health outcomes in linear regression models, we used infant weight, length, and head circumference at birth, term, and 12 months of corrected age, and growth between these time points. Growth data were collected from records and measures at term and at 12 months of corrected age were interpolated. Additionally, we examined the moderating effects of intrauterine growth restriction. Results Size at birth, term, or 12 months of corrected age, or growth between these time points were not associated with mental health outcomes (p-values >0.05). Intrauterine growth restriction did not systematically moderate any associations. Conclusions Despite the high variability in early growth of VLBW infants, the previously described association between slow growth in infancy and poorer cognitive functioning in later life is not reflected in symptoms of depression, ADHD, and other psychiatric problems. This suggests that the development of cognitive and psychiatric problems may have dissimilar critical periods in VLBW infants. PMID:26327229

Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

PubMed Central

Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

2013-01-01

Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder.

PubMed

Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Ojvind; Mortensen, Preben Bo

2012-02-01

Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth. Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007. Denmark. All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth. Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group. Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.

Recent Advances in Shared Decision Making for Mental Health

PubMed Central

Patel, Sapana R.; Bakken, Suzanne; Ruland, Cornelia

2009-01-01

Purpose of review To advance integration of shared decision making (SDM) into mental health care service delivery, researchers have outlined several priorities for future research [2–3]. These include: 1) SDM and its role in mental health care; 2) Patient and provider perspectives on SDM; 3) The degree to which SDM is practice in mental health settings; and 4) Outcomes of SDM in mental health populations. This article will review recent advances in these areas. Recent findings The current literature shows that 1) SDM can play a role in the mental health treatment process from entry into care to recovery; 2) Patients and providers find SDM acceptable and express a willingness to engage in SDM for reasons that are multifactorial; 3) Barriers to SDM exist in mental health decision making including patient preferences and provider level biases; and 4) Outcomes research provide encouraging preliminary evidence for feasibility and effectiveness of SDM during the mental health encounter. Summary Although there have not been a great number of SDM studies in mental health to date, the positive effects of SDM are comparable to those documented in general non-mental health patient groups, suggesting that future research is likely to be helpful for patients with psychiatric disorders. PMID:18852569

Mental disorder and victimisation in prison: Examining the role of mental health treatment.

PubMed

Daquin, Jane C; Daigle, Leah E

2018-04-01

There is evidence that people with mental disorders are at increased risk of victimisation in prison. It is unclear whether this risk of victimisation varies across types of disorders or symptoms and what role mental health treatment has on victimisation risk in this context. To examine the relationship between specific mental disorders, psychiatric symptoms, and victimisation in prison and the effect of treatment for the disorders on victimisation risk. Using a nationally-representative sample of prisoners, path analyses were conducted to examine the relationship between mental disorder and victimisation. The analyses also examined whether receiving mental health treatment in prison affected any such relationship. Victimisation risk varied with the type of mental disorder or symptoms. Depression, personality disorder, hopelessness, paranoia, and hallucinations were associated with increased victimisation risk. Psychotic illnesses were otherwise negatively associated with victimisation. Receiving mental health treatment in prison was associated with greater risk of victimisation there. Receiving treatment appeared to mediate the relationship between mental disorders, symptoms, and victimisation. The findings suggest that not all inmates with mental disorders are at an increased risk of victimisation. Further, mental health treatment in prison also appears to be a risk factor of victimisation. More research is needed to further elucidate the relationship between mental disorders, treatment, and victimisation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Community Mental Health Services in Latin America for People with Severe Mental Disorders

PubMed Central

Minoletti, Alberto; Galea, Sandro; Susser, Ezra

2013-01-01

Mental disorders are highly prevalent in Latin American countries and exact a serious emotional toll, yet investment in public mental health remains insufficient. Most countries of the region have developed national and local initiatives to improve delivery of mental health services over the last 22 years, following the technical leadership of the Pan American Health Organization/World Health Organization (PAHO/WHO). It is especially notable that PAHO/WHO facilitated the development of national policies and plans, as well as local programs, to deliver specialized community care for persons with severe mental disorders. Nevertheless, at present, the majority of Latin American countries maintain a model of services for severe mental disorders based primarily on psychiatric hospitals that consume most of the national mental health budget. To accelerate the pace of change, this article emphasizes the need to develop cross-country regional initiatives that promote mental health service development, focusing on severe mental disorders. As one specific example, the authors describe work with RedeAmericas, which has brought together an interdisciplinary group of international investigators to research regional approaches and train a new generation of leaders in public mental health. More generally, four regional strategies are proposed to complement the work of PAHO/ WHO in Latin America: 1) to develop multi-country studies on community services, 2) to study new strategies and interventions in countries with more advanced mental health services, 3) to strengthen advocacy groups by cross-country interchange, and 4) to develop a network of well-trained leaders to catalyze progress across the region. PMID:25339792

Detection of domestic violence by community mental health teams: a multi-center, cluster randomized controlled trial.

PubMed

Ruijne, Roos E; Howard, Louise M; Trevillion, Kylee; Jongejan, Femke E; Garofalo, Carlo; Bogaerts, Stefan; Mulder, Cornelis L; Kamperman, Astrid M

2017-08-07

Domestic Violence and Abuse (DVA) is associated with a range of psychosocial and mental health problems. Having a psychiatric illness increases likelihood of being a victim of DVA. Despite the evidence of a high risk for DVA and the serious effects of violent victimization in psychiatric patients, detection rates are low and responses are inadequate. The aim of the BRAVE (Better Reduction trough Assessment of Violence and Evaluation) study is to improve detection of and response to DVA in psychiatric patients. In this article, we present the protocol of the BRAVE study which follows the SPIRIT guidelines. The BRAVE study is a cluster randomized controlled trial. We will include 24 community mental health teams from Rotterdam and The Hague. Twelve teams will provide care as usual and 12 teams will receive the intervention. The intervention consists of 1) a knowledge and skills training for mental health professionals about DVA, 2) a knowledge and skills training of DVA professionals about mental illness, 3) provision and implementation of a referral pathway between community mental health and DVA services. The follow up period is 12 months. Our primary outcome is the rate of detected cases of recent or any history of DVA in patients per team in 12 months. Detection rates are obtained through a systematic search in electronic patient files. Our secondary aims are to obtain information about the gain and sustainability of knowledge on DVA in mental health professionals, and to obtain insight into the feasibility, sustainability and acceptability of the intervention. Data on our secondary aims will be obtained through structured in depth interviews and a questionnaire on knowledge and attitudes on DVA. This study is the first cluster randomized controlled trial to target both male and female psychiatric patients that experience DVA, using an intervention that involves training of professionals. We expect the rate of detected cases of DVA to increase in the

EPA guidance on mental health and economic crises in Europe.

PubMed

Martin-Carrasco, M; Evans-Lacko, S; Dom, G; Christodoulou, N G; Samochowiec, J; González-Fraile, E; Bienkowski, P; Gómez-Beneyto, M; Dos Santos, M J H; Wasserman, D

2016-03-01

This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

Mental Health Practitioners' Reflections on Psychological Work in Uganda: Exploring Perspectives from Different Professions

ERIC Educational Resources Information Center

Hall, Jennifer; d'Ardenne, Patricia; Nsereko, James; Kasujja, Rosco; Baillie, Dave; Mpango, Richard; Birabwa, Harriet; Hunter, Elaine

2014-01-01

The Butabika-East London Link collaborated with Ugandan mental health services to train mental health professionals (psychiatric clinical officers, "PCOs", and clinical psychologists and psychiatrists, "Core Group") in psychological therapies. The aims of this research were to investigate how professionals were applying and…

Mental Health: A Focus on Stress, Coping, and Mental Illness as it Relates to Treatment Retention, Adherence, and Other Health Outcomes

PubMed Central

Perry, Nicholas; Safren, Steven A.

2013-01-01

Mental health problems are prevalent among HIV-infected individuals, with some estimates that 50% likely meet criteria for one or more psychiatric disorders. The mental health of HIV-infected individuals is important not only for quality-of-life concerns, but also in regard to HAART adherence and biological disease progression. The current review focuses on research published between 2009 and April of 2011, exploring mental health, coping, and stress in relation to HIV care behaviors including HAART adherence, quality of life, treatment retention, health care utilization, and disease progression amongst HIV-infected individuals. Specifically, we reviewed the most prevalent and interfering concerns among HIV-infected individuals—depression, post-traumatic stress disorder, interpersonal violence, stigma and shame, and body image concerns. Despite advances over the last 2 years documenting the deleterious effects of mental health on important HIV self-care behaviors, there is continued need for developing and disseminating evidence-based psychosocial interventions that integrate treating mental health problems with improving self-care behaviors for those living with HIV. PMID:21822626

Family planning: an integral part of mental health care.

PubMed

Muhuhu, P

1982-01-01

Discusses problems in the provision of maternal health care to mentally ill women; delineates problems faced in terms of health care, and ways in which these problems can be solved. The pregnant woman who is also emotionally ill faces some special problems during pregnancy. Emotional reactions to pregnancy, present in all women, may be exacerbated to dangerous levels. Also, the effect of psychotropic drugs on the fetus is a matter of concern, since long term treatment regimens have been found to negatively affect the fetus. Issues of social concern also arise, having to do with the frequent and unplanned pregnancies which often typify the mentally ill woman. In this regard, selection of a contraceptive method for the mentally ill requires careful thought because of the side effects brought on by the combination of oral contraceptives with certain psychotropic medication. The need for family planning education in psychiatric settings and for effective identification of mentally ill individuals during the general admission process are highlighted. As it is, traditional admissions procedures are failing to detect mentally ill maternal patients. Support groups in psychiatric settings have been found to be effective in maintaining motivation towards family planning among women, as well as in answering concerns regarding emotional problems. It is suggested that a workshop or a series of inservice classes would be of great benefit in alerting personnel to the special needs of this category of patients and in promoting the integration of family planning with mental health services.

Microbiome and mental health in the modern environment.

PubMed

Deans, Emily

2016-06-27

A revolution in the understanding of the pathophysiology of mental illness combined with new knowledge about host/microbiome interactions and psychoneuroimmunology has opened an entirely new field of study, the "psychobiotics". The modern microbiome is quite changed compared to our ancestral one due to diet, antibiotic exposure, and other environmental factors, and these differences may well impact our brain health. The sheer complexity and scope of how diet, probiotics, prebiotics, and intertwined environmental variables could influence mental health are profound obstacles to an organized and useful study of the microbiome and psychiatric disease. However, the potential for positive anti-inflammatory effects and symptom amelioration with perhaps few side effects makes the goal of clarifying the role of the microbiota in mental health a vital one.

Increasing mental health awareness and appropriate service use in older Chinese Americans: a pilot intervention.

PubMed

Teng, Ellen J; Friedman, Lois C

2009-07-01

This study evaluated the effectiveness of a community intervention in increasing awareness of mental health issues and available resources among elderly Chinese Americans. Twenty-seven members of a community church received a 1-h didactic presentation, in English and Mandarin, and completed surveys regarding their help-seeking preferences before and after the intervention. Results were analyzed using a series of Wilcoxon matched-pair signed rank tests and comparing pre- and post-test scores. Findings indicated an increase (p<.05) in intention to consult a mental health professional for psychiatric symptoms at post-test. A significant increase also was found in preference for consulting a physician for physical symptoms. The pilot educational intervention increased awareness of mental health and treatment issues and the role of mental health professionals, lending support to evaluate the intervention on a larger scale. Greater awareness of mental health among Chinese Americans can be promoted via education forums provided through faith-based organizations. Stigma of mental illness leads many Chinese individuals to seek help for psychiatric problems from primary care physicians. Integrating mental health practitioners in primary care settings may help decrease stigma and encourage appropriate help-seeking behavior.

Mental Health-related Emergency Department Visits Associated With Cannabis in Colorado.

PubMed

Hall, Katelyn E; Monte, Andrew A; Chang, Tae; Fox, Jacob; Brevik, Cody; Vigil, Daniel I; Van Dyke, Mike; James, Katherine A

2018-02-24

Cannabis legalization in Colorado resulted in increased cannabis-associated health care utilization. Our objective was to examine cooccurrence of cannabis and mental health diagnostic coding in Colorado emergency department (ED) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review. We collected statewide ED International Classification of Diseases, 9th Revision, Clinical Modification diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Diagnosis codes identified visits associated with mental health and cannabis. Codes for mental health conditions and cannabis were confirmed by manual records review in the academic hospital subpopulation. Prevalence ratios (PRs) of mental health ED discharges were calculated to compare cannabis-associated visits to those without cannabis. Rates of mental health and cannabis-associated ED discharges were examined over time. Statewide data demonstrated a fivefold higher prevalence of mental health diagnoses in cannabis-associated ED visits (PR = 5.35, 95% confidence interval [CI], 5.27-5.43) compared to visits without cannabis. The hospital subpopulation supported this finding with a fourfold higher prevalence of psychiatric complaints in cannabis attributable ED visits (PR = 4.87, 95% CI = 4.36-5.44) compared to visits not attributable to cannabis. Statewide rates of ED visits associated with both cannabis and mental health significantly increased from 2012 to 2014 from 224.5 to 268.4 per 100,000 (p < 0.0001). In Colorado, the prevalence of mental health conditions in ED visits with cannabis-associated diagnostic codes is higher than in those without cannabis. There is a need for further research determining if these findings are truly attributed to cannabis or merely coincident with concurrent increased use and availability. © 2018 by the Society

From Community to Meta-Community Mental Health Care.

PubMed

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-04-20

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care.

From Community to Meta-Community Mental Health Care

PubMed Central

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-01-01

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. PMID:29677100

Genetic and Environmental Influences on the Mental Health of Children: A Twin Study.

PubMed

Yin, Ping; Hou, Xiao; Qin, Qing; Deng, Wei; Hu, Hua; Luo, Qinghua; Du, Lian; Qiu, Haitang; Qiu, Tian; Fu, Yixiao; Meng, Huaqing; Li, Tao

2016-08-01

The current study explored the influences of genetic and environmental factors on the mental health of twins between ages 6 and 16. A total of 41 monozygotic (MZ) twins and 35 dizygotic twins were recruited. The psychological attributes and environmental information of children were evaluated. A significant correlation was found between twins in the diagnostic categories of any psychiatric disorder and attention deficit/hyperactivity disorder (ADHD)/hyperkinesis based on the Strengths and Difficulties Questionnaire scale in MZ twins. Furthermore, fathers' authoritarian parenting style was positively correlated with the probability of any psychiatric disorders and oppositional/conduct disorders, whereas mothers' authoritative parenting style was negatively correlated with the probability of any psychiatric disorders and ADHD/hyperkinesis. The probability of emotional disorders was negatively correlated with scores on the Stressful Life Events Scale. These results collectively suggest that genetic and environmental elements, such as parental rearing style and stressful life events, may influence children's mental health. [Journal of Psychosocial Nursing and Mental Health Services, 54(8), 29-34.]. Copyright 2016, SLACK Incorporated.

Culturally competent psychiatric nursing care.

PubMed

Wilson, D W

2010-10-01

Evidence-based descriptions of culturally competent psychiatric nursing care are scarce. This study explored the perceptions of clients with mental illness regarding the overall effectiveness of psychiatric nursing care in meeting their cultural needs, and psychiatric nurses' perceptions of how and to what extent they provided culturally competent psychiatric mental health nursing care to diverse client populations. This descriptive study employed a qualitative research design using a multi-method data collection approach consisting of in-depth individual client interviews and a self-administered nurse questionnaire. Client participants tended to minimize the importance of receiving care related to their cultural needs. They described (1) encouraging and reassuring me; (2) speaking up for me; and (3) praying a lot as essential to their care. Nurse participants perceived their psychiatric nursing care to be culturally competent; however, few described specific strategies for incorporating cultural beliefs and practices into nursing care. Client participant lacked awareness of their cultural needs and had difficulty identifying and describing specific nursing interventions that contributed to positive mental health outcomes. Nurses perceived that they provided culturally competent care but actually lacked specific knowledge and skills to do so effectively. © 2010 Blackwell Publishing.

How psychiatric patients perceive the public's stereotype of mental illness.

PubMed

Freidl, M; Lang, T; Scherer, M

2003-05-01

It is well established that the general public has devaluating attitudes towards psychiatric patients. In order to avoid rejection, many of these patients develop coping strategies, such as withdrawal and concealing their treatment history. These efforts are in themselves stressing, which might have negative consequences for the course of the disorder. It is not clear, however, how many and which patients do actually perceive the public's stereotype as threatening and, therefore, expect rejection. Ninety psychiatric patients and a sample of 1042 persons of the Austrian general population were asked whether they agreed with five devaluating statements about mental patients contained in a questionnaire developed by Link et al. Matched pairs comparisons and multiple logistic regression were employed in order to find out whether patients agreed with these statements to the same extent as the general population did. For the statements that most people believe that psychiatric patients are "less intelligent", "less trustworthy" and "taken less seriously", patients thought significantly less often than the general population that most people devalue mental patients. For two statements ("personal failure", "think less of") no difference was found. It seems that some psychiatric patients are less convinced than the general population that most people devalue psychiatric patients in specific respects; these patients might fear rejection less than other patients do. Those who actually fear rejection might need antistigma assistance more urgently than the first group.

Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

PubMed

Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

2015-01-01

Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

Undergraduate nursing students' attitudes toward mental health nursing.

PubMed

Thongpriwan, Vipavee; Leuck, Susan E; Powell, Rhonda L; Young, Staci; Schuler, Suzanne G; Hughes, Ronda G

2015-08-01

The purpose of this study was to describe undergraduate nursing students' attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing. A descriptive, online survey was utilized to examine students' perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey. Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing as a future career; and (d), and beliefs that psychiatric nurses provide a valuable contribution to consumers and the community. Negative stereotypes were significantly different between students who had mental health nursing preparation either in class (p=0.0147) or in clinical practice (p=0.0018) and students who had not. There were significant differences in anxiety about mental illness between students who had classes on mental health nursing (p=.0005), clinical experience (p=0.0035), and work experience in the mental health field (p=0.0012). Significant differences in an interest in a future career in mental health nursing emerged between students with and without prior mental health experience and between students with and without an interest in an externship program with p-values of 0.0012 and <0.0001, respectively. The more exposure that students have to mental health nursing through clinical experiences, theory classes, and previous work in the field, the more prepared they feel about caring for persons with mental health issues. Published by Elsevier Ltd.

How family members of mentally ill offenders experience the internment measure and (forensic) psychiatric treatment in Belgium: A qualitative study.

PubMed

Rowaert, Sara; Vandevelde, Stijn; Lemmens, Gilbert; Audenaert, Kurt

Mentally ill offenders in Belgium can be subjected to mandated care under an "internment measure" if they are viewed as a danger to society. This study investigated how family members of mentally ill offenders experience this internment measure and view the (forensic) psychiatric treatment of their relative. Semi-structured interviews were conducted with 24 relatives and analysed using Nvivo 11. Six different themes emerged: (1) the criminal offence and the internment measure as an additional stigma, (2) ambivalent feelings towards the judicial system, (3) prison is not the right place to be, (4) mental health support as an answer to problems, (5) fight a losing battle, and (6) while there is life there is hope. The experiences of family members indicate the need for improved treatment guidelines that allow earlier compulsory interventions to prevent crime and preferential admission to (forensic) psychiatric facilities rather than prisons. In addition, family members expressed the need for better communication from mental health professionals and the judicial system during the process and greater availability of peer support. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health Status of Individuals With Serious Mental Illness

PubMed Central

Dickerson, Faith B.; Brown, Clayton H.; Daumit, Gail L.; LiJuan, Fang; Goldberg, Richard W.; Wohlheiter, Karen; Dixon, Lisa B.

2006-01-01

We examined indices of the health of persons with serious mental illness. A sample of 100 adults with schizophrenia and 100 with major mood disorder were recruited from randomly selected outpatients who were receiving community-based psychiatric treatment. Participants were surveyed about health indicators using items from the National Health and Nutrition Examination Study III and the National Health Interview Survey. Their responses were compared with those of matched samples from the general population surveys. A total of 1% of persons with serious mental illness, compared with 10% from the general population sample, met criteria for all 5 of selected health indicators: nonsmoker, exercise that meets recommended standards, good dentition, absence of obesity, and absence of serious medical co-occurring illness. Within the mentally ill group, educational level, but not a diagnosis of schizophrenia versus mood disorder, was independently associated with a composite measure of health behaviors. We conclude that an examination of multiple health indicators may be used to measure overall health status in persons with serious mental illness. PMID:16469943

Epidemiology of Suicidal Risk in Rural Community Mental Health Systems.

ERIC Educational Resources Information Center

Bailey, Bruce E.; And Others

While the popular literature frequently makes mention of the suicide risk of mentally ill persons, few studies have actually focused on the suicide risk of persons under psychiatric treatment. This study collected data regarding the suicidal risk of persons served by rural community mental health centers from records of 181 outpatients and 218…

[Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

PubMed

Daansen, P J; van Schilt, J

2014-01-01

As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

Decentralizing provision of mental health care in Sri Lanka.

PubMed

Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

2017-04-01

In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

Mental Health Problems in Adults with Williams Syndrome

ERIC Educational Resources Information Center

Stinton, Chris; Elison, Sarah; Howlin, Patricia

2010-01-01

Although many researchers have investigated emotional and behavioral difficulties in individuals with Williams syndrome, few have used standardized diagnostic assessments. We examined mental health problems in 92 adults with Williams syndrome using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities--PAS-ADD (Moss,…

Adolescents' and Young Adults' Beliefs about Mental Health Services and Care: A Systematic Review.

PubMed

Goodwin, John; Savage, Eileen; Horgan, Aine

2016-10-01

Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care. The aim of this study was to systematically examine literature on the beliefs of adolescents and young people from the general population about mental health services and care. Factors that positively and negatively influence these beliefs are also explored. Relevant electronic databases were searched for papers published in the English language between January 2004 and October 2015. Culture seemed to influence how adolescents and young adults perceived mental health interventions. This was particularly evident in countries such as Palestine and South Africa where prayer was highly valued. Adolescents and young people were uninformed about psychiatric medication. They believed that accessing mental health care was a sign of weakness. Furthermore, they viewed psychiatric hospitals and various mental health professionals negatively. Film was found to have a negative impact on how adolescents and young people perceived mental health services, whereas open communication with family members was found to have a positive impact. Adolescents and young adults hold uninformed and stigmatizing beliefs about mental health treatments, mental health professionals, and access to care. The sources of these beliefs remain unclear although some at least seem influenced by culture. Further research, (particularly qualitative research) in this area is recommended in order to address current gaps in knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

Global health training in US graduate psychiatric education.

PubMed

Tsai, Alexander C; Fricchione, Gregory L; Walensky, Rochelle P; Ng, Courtney; Bangsberg, David R; Kerry, Vanessa B

2014-08-01

Global health training opportunities have figured prominently into medical students' residency program choices across a range of clinical specialties. To date, however, the national scope of global mental health education has not heretofore been systematically assessed. We therefore sought to characterize the distribution of global health training opportunities in US graduate psychiatric education. We examined the web pages of all US psychiatry residency training programs, along with search results from a systematic Google query designed to identify global health training opportunities. Of the 183 accredited US psychiatry residency programs, we identified 17 programs (9.3%) offering 28 global health training opportunities in 64 countries. Ten psychiatry residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered research activities, and six offered extended field-based training. Most global health training opportunities occurred within the context of externally administered, institution-wide initiatives generally available to residents from a range of clinical specialties, rather than within internally administered departmental initiatives specifically tailored for psychiatry residents. There are relatively few global health training opportunities in US graduate psychiatric education. These activities have a clear role in enhancing mastery of Accreditation Council for Graduate Medical Education core competencies, but important challenges related to program funding and evaluation remain.

The attitudes of mental health professionals towards patients' desire for children.

PubMed

Krumm, Silvia; Checchia, Carmen; Badura-Lotter, Gisela; Kilian, Reinhold; Becker, Thomas

2014-03-02

When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues. Seven focus groups with a total of 49 participants from all professional groups active in mental health (nurses, psychologists, social workers and psychiatrists) were conducted in a 330-bed psychiatric hospital. Group discussions were transcribed verbatim and analysed by the documentary method described by Bohnsack. Mental health professionals did not feel that their patients' desire for children was as important in daily practice as were parenting issues. When discussing the desire for children on the part of patients, the following themes emerged: "the patient's own decision", "neutrality", "the patient's well-being", "issues affecting the children of mentally ill parents" and "appropriate parenthood". In order to cope with what they perceived as conflicting norms, mental health professionals developed the following (discursive) strategies: "subordination of child welfare", "de-professionalisation", "giving rational advice" and "resignation". The theme of "reproductive autonomy" dominated mental health professionals' discourse on the desire for children among psychiatric patients. "Reproductive autonomy" stood in conflict with another important theme (patient's children). Treating reproductive issues as taboo is the result of the gap between MHPs' perceptions of (conflicting) norms when dealing with a patient's desire for children and the limited opportunities to cope with them appropriately.In order to support both patients with a desire for children and mental health professionals who are charged with providing counselling for such patients, there is a need to encourage ethical reflection and to focus on clinical recommendations in this important area.

Undetected psychiatric morbidity among HIV/AIDS patients attending Comprehensive Care Clinic (CCC) in Nairobi Kenya: towards an integrated mental health care.

PubMed

Ng'ang'a, Pauline W; Mathai, Muthoni; Obondo, Anne; Mutavi, Teresia; Kumar, Manasi

2018-01-01

Psychiatric morbidity is commonly associated with HIV disease and may have adverse effects. This aspect may be overlooked at comprehensive HIV care centers in Low and Middle-Income Countries. The aim of this study was to determine the prevalence of undetected psychiatric morbidity among HIV/AIDS adult patients attending Comprehensive Care Centre in a semi-urban clinic, in Nairobi, Kenya. Descriptive cross-sectional study of adult HIV patients not receiving any psychiatric treatment was conducted. The participants consisted of consecutive sample of adults ( n  = 245) attending HIV Comprehensive Care Clinic at Kangemi Health Centre, Nairobi. The Mini International Neuropsychiatric Interview (MINI) was administered to screen for undetected psychiatric morbidity. Socio-demographic characteristics were recorded in a questionnaire. Sample descriptive analysis was performed and prevalence of undetected psychiatric morbidity calculated. Chi-square test for independence was used to examine the associations between patient characteristics and undetected morbidity. Multivariable logistic regression analysis was performed to determine independent predictors of undetected psychiatric morbidity. The mean age of our participants was 37.3 years (SD 9.2) Three-quarters (75.9%) of participants were females and median duration of HIV illness was 5 years. The prevalence of (previously undetected) psychiatric morbidity was 71.4% (95% CI 65.3-77). The leading psychiatric disorders were MDD (32.2%), PTSD (18.4%), Dysthymia (17.6%), and OCD (17.6%). Overall psychiatric morbidity was associated with low income (psychiatric morbidity and social determinants such as gender, marital status, level of education, religious affiliation, and occupation or employment status. The burden of psychiatric morbidity in Kenyan HIV patients remains high and

Evaluating the Effectiveness of Mental Health First Aid Program for Chinese People in Hong Kong