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Mental Health Problems (mental + health_problem)
Kinds of Mental Health Problems Selected AbstractsCognitive-Behavioural Integrated Treatment (C-BIT): a Treatment Manual for Substance Misuse in People with Severe Mental Health ProblemsADDICTION, Issue 6 2004ALAN MARLATT No abstract is available for this article. [source] Mental Health Problems in Young People with Intellectual Disabilities: The Impact on ParentsJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 5 2008Hannah Faust Background, Young people with intellectual disabilities seem to be at increased risk of developing mental health problems. The present study set out to examine the impact such difficulties can have on parents. Method, Semi-structured in-depth interviews were carried out with 13 parents and one adult sibling of 11 young people with intellectual disabilities and additional mental health problems. Results, Parents described far reaching negative consequences of the young person's mental health problems. In many parents these re-evoked intense past feelings of grief and triggered feelings of helplessness and despair. Conclusions, Parents' experiences appear to be characterized by confusion, loss and hardship. Services do not seem to be attuned to the high level of emotional and practical needs of these parents. [source] Mental Health Problems Among Single Mothers: Implications for Work and Welfare ReformJOURNAL OF SOCIAL ISSUES, Issue 4 2000Rukmalie Jayakody Welfare reform's emphasis on work and self-sufficiency assumes that poor single mothers are similar in their status and functioning to the rest of the population. However, we find that their status is quite distinct. Logistic regression results reveal that the likelihood of working is 25% lower for those with a psychiatric disorder. Mental health problems may prevent women from undertaking the tasks necessary to find employment, or women with these problems may lack the self-confidence needed to take on new challenges. Our findings suggest that mental health problems among single mothers deserve greater attention as a barrier to self-sufficiency and highlight the need for more effective intervention and treatment efforts to improve economic and social outcomes. [source] Postdeployment, Self-Reporting of Mental Health Problems, and Barriers to CarePERSPECTIVES IN PSYCHIATRIC CARE, Issue 4 2009Rosanne Visco PhD PURPOSE., This study explored the relationship between self-reported mental health symptoms and help-seeking behaviors of active-duty Air Force members. DESIGN AND METHODS., Mixed-methods approach reviewed 200 postdeployment surveys from active-duty members assigned to Eglin Air Force Base, Florida, USA. Chi-square analysis examined significance between self-reporting mental health problems and accessing treatment. FINDINGS., As the rate of self-reported mental health symptoms increased, active-duty members were less inclined to seek help. There were inconsistencies among gender for self-reporting and accessing services. PRACTICE IMPLICATIONS., Air Force psychiatric nurses need to be at the forefront of outreach services when treating combat-stressed troops. [source] Assessing the Effects of Maternal Symptoms and Homelessness on the Mental Health Problems in their ChildrenCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2009Ilan Harpaz-Rotem Objective:, This study examines the longitudinal association between measures of child well being and maternal posttraumatic stress disorder symptoms, homelessness, substance abuse, and other psychiatric conditions. Method:, A sample of 142 mothers who were veterans of the US armed forces were assessed at program entry and every three months thereafter for one year. A repeated-measures with mixed-effects analytic strategy was used to assess the association of children's mental health, school enrolment and attendance with measures of maternal psychiatric symptoms and homelessness. Results:, Significant associations between mothers' psychiatric symptoms and child well-being were identified. However, the multivariable mixed-models suggest that increased depression and anxiety symptoms among children were associated primarily with mothers' PTSD, and not depression, symptoms. Conclusions:, These findings provide evidence of an association between maternal and child mental health and may suggest that treating maternal PTSD symptoms may also benefit children, regardless of whether the child was also exposed to the traumatic experience. [source] Children with Complex Mental Health Problems: Needs, Costs and Predictors over One YearCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2005Andrew F. Clark Background:, Little is known regarding children of greatest concern with complex mental health problems. Method:, A one-year prospective study of psychiatric diagnosis, psychosocial functioning, need status and service receipt in 60 children identified as most concerning. Results:, Thirty-two (53%) had two or more disorders. The mean number of needs per child was five. One year later mean needs were unchanged but with considerable individual variation. Mean weekly costs were £1017 (,1627) (SD = £957 (,1531)). Higher costs related to social factors rather than diagnosis or need. Conclusions:, The mean annual cost of services to children with complex mental health problems is ten times that in other studies of children with mental health problems. [source] The Interface Between Physical and Mental Health Problems and Medical Help Seeking in Children and Adolescents: A Research PerspectiveCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2004M. Elena Garralda This paper addresses child and adolescent psychopathology as it presents to general practitioners and paediatricians, and explores psychosocial aspects of unexplained medical symptoms in children and adolescents. High rates of psychopathology have been identified amongst children and adolescents attending general practice and paediatric services, most of it ,,hidden'' at presentation and emotional in nature. It is often linked to poor physical well being and to maternal stress focused on the child. It may be of special relevance to medical help seeking in socio-economically advantaged areas. Co-morbid psychopathology, mainly emotional disorders, is common amongst children with unexplained medical symptoms. However, there are specific psychosocial aspects that differentiate these children from those with emotional disorders. They involve disease beliefs, illness behaviour and predicament. The latter may be characterised by special reactivity to stress in children with personality vulnerability, in a context of parents with high levels of mental distress, unexplained medical symptoms and emotional over-involvement with the child. There is comparatively little interface work between CAMHS and primary health care. An important research priority would seem to lie in the development of interventions that can be adapted for use by primary care staff. Similarly, there are few dedicated CAMHS paediatric liaison teams. Their more extensive development should help attend in a more informed and focused way than at present to children and adolescents suffering from unexplained physical symptoms and disorders. Further research is needed into vulnerability mechanisms and maintaining factors, health beliefs, treatment engagement and interventions. [source] Addressing the Population Burden of Child and Adolescent Mental Health Problems: A Primary Care ModelCHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2000Peter L. Appleton A model for primary care child and adolescent mental health (CAMH) services is presented, the overall goal of which is to reduce population burden of CAMH problems. The theoretical orientation of the model is based on ecological systems theories. Features of the model include: local population outcome measures; small area service focus; primary-care-based CAMH specialists; a locally comprehensive service framework based in primary care (schools and general practices); and an explicit process of community engagement. The model is illustrated by reference to a primary care CAMH service (currently the subject of a controlled trial) in Flintshire, North Wales. [source] Illicit tranquilliser use and dependence among female opiate usersDRUG AND ALCOHOL REVIEW, Issue 5 2006GAIL GILCHRIST Abstract This study determined the predictors of 12-month dependence on illicit tranquillisers among female opiate users attending three services in Glasgow, Scotland, UK. Twelve-month drug dependence was measured using the Diagnostic Interview Schedule. The Revised Clinical Interview Schedule (CIS-R) measured current neurotic symptoms. 60% (159/266) had used illicit tranquillisers in the past 30 days, and 50% (132/266) met criteria for 12-month dependence on illicit tranquillisers. Polydrug use, injecting drug use, childhood and adulthood abuse, adverse life experiences and current and previous mental health problems were associated with 12-month dependence on illicit tranquillisers. Using multiple logistic regression, polydrug use in last 30 days (OR 3.2, 95% CI 1.5,7.0), history of deliberate self-harm (OR 2.5, 95% CI 1.4-4.4), history of injecting drug use (OR 2.5, 1.2,5.2) and likely to need treatment for current neurotic symptoms (CIS-R , 18) (OR 2.4, 95% CI 1.3,4.4) predicted 12-month dependence on illicit tranquillisers. Drug users in general and female drug users in particular who are using illicit tranquillisers are also particularly likely to have psychiatric symptoms requiring treatment. Mental health problems should be assessed and monitored among this client group and counselling and psychosocial support should be provided when indicated. [source] Mental Health and Academic Achievement: Role of School NursesJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2007Kathryn Rose Puskar PURPOSE.,This article discusses how school nurses promote mental health and subsequent academic achievement by screening and referral for children demonstrating mental health problems. Nursing interventions are discussed at the individual, systems, and community levels. CONCLUSION.,Mental health problems can affect school performance and academic achievement. When mental health problems are not recognized, students may be unable to reach their academic potential. School nurses are in a key position to provide interventions to address mental health and academic achievement. PRACTICE IMPLICATIONS.,The role of school nurses and examples of mental health collaborative activities are provided. [source] Does controlling for comorbidity matter?AGGRESSIVE BEHAVIOR, Issue 3 2010DSM-oriented scales, violent offending in chicago youth Abstract Mental health problems have long been linked to antisocial behaviors. Despite an impressive body of literature demonstrating this relationship and claims that comorbidity matters, few studies examine comorbidity using multiple distinct mental health indicators, with most studies instead adopting single or composite mental health measures. This study tested separate and comorbid effects of five DSM-oriented mental health issues on self-reported violence using a community-based sample of Chicago youths from the Project on Human Development in Chicago Neighborhoods. Moreover, it utilized both primary caregiver and youth self-reports of psychopathology across four developmental stages of childhood and adolescence. When examined separately, the results indicated affective/depressive, anxiety, attention deficit hyperactivity, and oppositional defiant/antisocial personality problems independently predicted violence. When considering comorbidity, however, only oppositional defiant and antisocial personality problems significantly predicted violence at any stage, regardless of informant type. Implications for future studies and policy are discussed. Aggr. Behav. 36:141,157, 2010. © 2010 Wiley-Liss, Inc. [source] Mental Health Problems Among Single Mothers: Implications for Work and Welfare ReformJOURNAL OF SOCIAL ISSUES, Issue 4 2000Rukmalie Jayakody Welfare reform's emphasis on work and self-sufficiency assumes that poor single mothers are similar in their status and functioning to the rest of the population. However, we find that their status is quite distinct. Logistic regression results reveal that the likelihood of working is 25% lower for those with a psychiatric disorder. Mental health problems may prevent women from undertaking the tasks necessary to find employment, or women with these problems may lack the self-confidence needed to take on new challenges. Our findings suggest that mental health problems among single mothers deserve greater attention as a barrier to self-sufficiency and highlight the need for more effective intervention and treatment efforts to improve economic and social outcomes. [source] Prevalence and morbidity associated with non-malignant, life-threatening conditions in childhoodCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2001S Lenton Summary Objective To determine the prevalence of non-malignant life-threatening illness in childhood and associated morbidity in the affected child and their family members. Design Cross-sectional survey. Setting Bath Clinical Area (total population 411 800). Subjects Children aged 0,19 years. Results One hundred and twenty-three children were identified, giving a prevalence of 1.2/1000 children. Morbidity assessed in 93 children showed 60% in pain or discomfort, 35% unable to walk and 25% with severe cognitive impairment. Mental health problems were found in 54% of mothers and 30% of fathers, and significant emotional and behavioural problems in 24% of healthy siblings. Conclusions Non-malignant life-threatening illness is more prevalent than reported in previous studies. Considerable morbidity is experienced by the child and their family. An individual and family approach is required. Key messages (1) The prevalence of non-malignant life-threatening illness is four times greater than previous estimates. (2) This group of conditions have significant implications for all family members. (3) Early comprehensive assessment and access to effective interventions may pre-empt later problems. [source] Patterns of co-morbidity between alcohol use and other substance use in the Australian populationDRUG AND ALCOHOL REVIEW, Issue 1 2003Dr. LOUISA DEGENHARDT Abstract The present study describes patterns of co-morbidity between alcohol use and other substance use problems in the Australian population using data from the 1997 National Survey of Mental Health and Well-Being. Multiple regression analyses examined whether the observed associations between alcohol and other drug use disorders were explained by other variables, including demographic characteristics and neuroticism. We also assessed whether the presence of co-morbid substance use disorders affected treatment seeking for a mental health problem. Alcohol use was related strongly to the use of other substances. Those who did not report alcohol use within the past 12 months were less likely to report using tobacco, cannabis, sedatives, stimulants or opiates. Higher rates again were observed among those with alcohol use disorders: half (51%) of those who were alcohol-dependent were regular tobacco smokers, one-third had used cannabis (32%); 15% reported other drug use; 15% met criteria for a cannabis use disorder and 7% met criteria for another drug use disorder. These associations were not accounted for by the demographic and other variables considered here. Co-morbid substance use disorders (sedatives, stimulants or opioids) predicted a high likelihood of seeking treatment for a mental health problem among alcohol-dependent people. [source] Health service utilization for eating disorders: Findings from a community-based study,INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2007Jonathan M. Mond PhD Abstract Background: Prior use of health services was examined in a community sample of women with bulimic-type eating disorders. Method: Participants (n = 159) completed a structured interview for the assessment of eating disorder psychopathology as well as questions concerning treatment-seeking and type of treatment received. Results: Whereas a minority (40.3%) of participants had received treatment for an eating problem, most had received treatment for a general mental health problem (74.2%) and/or weight loss (72.8%), and all had used one or more self-help treatments. Where treatment was received for an eating or general mental health problem, this was from a primary care practitioner in the vast majority of cases. Only half of those participants who reported marked impairment associated with an eating problem had ever received treatment for such a problem and less than one in five had received such treatment from a mental health professional. Conclusion: Women with bulimic-type eating disorders rarely receive treatment for an eating problem, but frequently receive treatment for a general mental health problem and/or for weight loss. The findings underscore the importance of programs designed to improve the detection and management of eating disorders in primary care. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source] Ordinary people, extraordinary voices: The emotional labour of lay people caring for and about people with a mental health problemINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 5 2010Christine Hogg ABSTRACT Many attempts to reduce the stigmatization of people with mental illness have often been predicated, based on the desire to persuade the public that people with mental illness are ,ill' in the same way as people with medical conditions. This paper presents one aspect from the findings of a study that examined the ways in which lay people perceived mental health and illness. Data are drawn from the discussion of the roles and experiences of different non-mental health professionals who cared for and about people they met in their everyday employment. In this paper, we argue that central to these roles is the importance of listening to people in an arena which is non-statutory and without judgment. We demonstrate that people use popular sectors when they are unsure of the problem they have, or they are reluctant to refer themselves to the professional sector. The paper presents narrative extracts illustrating the emotional labour operating in each participant's role and the extent to which they provide support for their client's emotional and psychological well-being. The implications for mental health nursing are discussed in relation to working with and alongside people experiencing mental distress, in relation to ,ordinary human qualities'. [source] Reynolds Adolescent Depression Scale , Second Edition: initial validation of the Korean versionJOURNAL OF ADVANCED NURSING, Issue 3 2009Myung-Sun Hyun Abstract Title.,Reynolds Adolescent Depression Scale , Second Edition: initial validation of the Korean version. Aim., This paper is a report of a study conducted to test the validity and reliability of the Reynolds Adolescent Depression Scale , Second Edition in Korean culture. Background., Depression is a significant mental health problem in adolescents. The Reynolds Adolescent Depression Scale , Second Edition has been shown to be a useful tool to assess depression in adolescents, with extensive research on this measure having been conducted in western cultures. Measures developed in western cultures need to be tested and validated before being used in Asian cultures. Method., The participants were a convenience sample of 440 Korean adolescents with a mean age of 13·78 years (sd = 0·95) from grades 7 to 9 in three public middle schools in South Korea. A cross-sectional design was used. Back-translation was used to create the Korean version, with additional testing for cultural meaning and comprehension. The data were collected at the end of 2004. Results., Internal consistency reliability for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition was 0·89, with subscale reliability ranging from 0·66 to 0·81. Evidence for criterion-related, convergent and discriminant validity for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition was found. Confirmatory factor analysis supported the 4-factor structure of Reynolds Adolescent Depression Scale , Second Edition. Conclusion., Our results support the validity and reliability for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition as a measure of depression and suggest that it can be used to screen students and to evaluate the effectiveness of preventive interventions in school settings. [source] Two-Minute Mental Health Care for Elderly Patients: Inside Primary Care VisitsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2007(See editorial comments by Drs. Charles Reynolds, Bruce L. Rollman), Carrie Farmer Teh, Mario Cruz OBJECTIVES: To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. DESIGN: Mixed-method observational analysis of the nature of the topics discussed, content of discussion, and the time spent on mental health. SETTINGS: Three types of settings: an academic medical center, a managed care group, and fee-for-service solo practitioners. PARTICIPANTS: Thirty-five primary care physicians and 366 of their elderly patients. MEASUREMENTS: Videotapes of 385 visits covering 2,472 diverse topics were analyzed. Coding of the videotapes identified topics, determined talk time, and coded the dynamics of talk. RESULTS: Mental health topics occurred in 22% of visits, although patient survey indicated that 50% of the patients were depressed. A typical mental health discussion lasted approximately 2 minutes. Qualitative analysis suggested wide variations in physician effort in providing mental health care. Referrals to mental health specialists were rare even for severely depressed and suicidal patients. CONCLUSION: Little time is spent on mental health care for elderly patients despite heavy disease burdens. Standards of care based on a count of visits "during which a mental health problem is discussed" may need to be supplemented with guidelines about what should happen during the visit. System-level interventions are needed. [source] Developing a Mental Health Guide for Families and Carers of People with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2007Anastasia Gratsa Background, Although there is already information available about caring for someone with a mental health problem, there is very little written for families and carers of people with intellectual disabilities. Materials and methods, This paper describes the development of a Guide as such a resource. The consultation stage involved interviews and focus groups with families, service users and paid carers (n = 20) to highlight their needs and preferred format. Additional carers (n = 12) completed structured questionnaires to evaluate the Guide. Results, The initial consultation showed that an easily accessible and user-friendly information resource was needed. The evaluation showed that family carers were satisfied with the Guide, finding it easy to read and covering most of the information required. However, they did highlight areas that needed further detail. Conclusions, The involvement of carers in the development of such resources is essential, emphasizing the benefit of carers' knowledge and experience to professionals. [source] Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unitJOURNAL OF CLINICAL NURSING, Issue 9-10 2010Lorna Moxham Objective., To implement and evaluate strategies suggested by general nurses to improve management of children and adolescents with mental health problems admitted to a paediatric unit of a general hospital. Background., The first phase of a study using a Participatory Action Research approach identified several concerns associated with general nurses providing care to young people with mental disorders in paediatric units of general hospitals, together with suggestions for strategies to address these issues. This paper describes the second and third phase of the Participatory Action Research study, involving the implementation and evaluation of these strategies. Design., Participatory Action Research. Methods., Actions that occurred during phase two of the Participatory Action Research study included revision and introduction of policies and procedures for mental health care in the unit, education and training sessions for paediatric nursing staff and opportunities to strengthen communication between existing mental health services. In phase three, two focus groups were conducted to explore current perceptions of mental health care delivery in the unit and evaluate change, following phase two. Results., Changes in clinical practice for paediatric mental health care were acknowledged by participants. Reflection has assisted nurses to better understand their strengths and weaknesses and to acknowledge and challenge the assumptions on which their ideas, feelings and actions about patients with mental health issues are based. Participants also recognised the existing skills and expertise they possess that are relevant to the management of young people with a mental health problem, although they continue to seek ongoing education and support in this field. Conclusions., This study demonstrates that through Participatory Action Research it is possible to enhance mental health nursing care in a rural paediatric unit. Relevance to clinical practice., Such changes have the potential to improve the experience of young people and their families whilst receiving treatment for mental health conditions in a general paediatric unit. [source] Treating the aged in rural communities: the application of cognitive-behavioral therapy for depressionJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2010Martha R. Crowther Abstract Many rural communities are experiencing an increase in their older adult population. Older adults who live in rural areas typically have fewer resources and poorer mental and physical health status than do their urban counterparts. Depression is the most prevalent mental health problem among older adults, and 80% of the cases are treatable. Unfortunately, for many rural elders, depressive disorders are widely under-recognized and often untreated or undertreated. Psychotherapy is illustrated with the case of a 65-year-old rural married man whose presenting complaint was depressive symptoms after a myocardial infarction and loss of ability to work. The case illustrates that respect for rural elderly clients' deeply held beliefs about gender and therapy, coupled with an understanding of their limited resources, can be combined with psychoeducational and therapeutic interventions to offer new options. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,11, 2010. [source] Postpartum depression: what we knowJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009Michael W. O'Hara Abstract Postpartum depression (PPD) is a serious mental health problem. It is prevalent, and offspring are at risk for disturbances in development. Major risk factors include past depression, stressful life events, poor marital relationship, and social support. Public health efforts to detect PPD have been increasing. Standard treatments (e.g., Interpersonal Psychotherapy) and more tailored treatments have been found effective for PPD. Prevention efforts have been less consistently successful. Future research should include studies of epidemiological risk factors and prevalence, interventions aimed at the parenting of PPD mothers, specific diathesis for a subset of PPD, effectiveness trials of psychological interventions, and prevention interventions aimed at addressing mental health issues in pregnant women. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,12, 2009. [source] Integrating family therapy in adolescent depression: an ethical stanceJOURNAL OF FAMILY THERAPY, Issue 3 2009Glenn Larner Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice. [source] The reliability and validity of general psychotic rating scales with people with mild and moderate intellectual disabilities: an empirical investigationJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2005C. Hatton Abstract Background Whilst assessment tools have been developed to diagnose schizophrenia in people with mild intellectual disabilities (IDs), little attention has been paid to developing reliable and valid dimensional measures of psychotic experiences with this population. This study investigates the reliability and validity of two such measures developed for the general adult psychiatric population, the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scales (PSYRATS), with a population of adults with mild IDs. Method Sixty-two adults with mild IDs were interviewed using the PANSS and PSYRATS, and independently interviewed using the Psychiatric Assessment Schedule , Adults with Developmental Disability (PAS-ADD) to obtain psychiatric diagnoses to the criteria of the International Classification of Diseases , Tenth Revision (ICD-10). On the basis of ICD-10 diagnosis, participants were divided into three groups: psychosis (n = 11); other mental health problem (n = 14); no mental health problem (n = 37). PANSS and PSYRATS subscale scores were compared across these three groups and were correlated with PAS-ADD symptom scores across a number of PAS-ADD symptom domains. Results All PANSS and PSYRATS subscales showed adequate internal reliability, largely good test-retest reliability, and logical inter-correlations between subscales. The PANSS positive symptoms and the PSYRATS auditory hallucinations subscales differentiated between the psychosis group and the other groups; the PANSS general symptoms subscale differentiated between the psychosis and no mental health problem groups; and the PANSS negative symptoms and the PSYRATS delusions subscales did not differentiate between the three groups. Conclusions The PANSS and PSYRATS are promising measures for use with people with mild IDs and psychotic experiences, although further investigation of items relating to negative symptoms and delusions is warranted. [source] Section 5(4) (The nurse's holding power): patterns of use in one mental health trust (1983,2006)JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010R. ASHMORE bsc(hons) rmn ma pgce dip coun Accessible summary ,,Section 5(4) (Nurses' holding power) allows a mental health nurse to detain a patient admitted informally to hospital for treatment of a mental health problem for up to 6 h or until they are assessed by a doctor. ,,The use of the holding power has risen significantly since its introduction in 1983 to an average of 1442 per annum (range 789,1953 per annum). ,,The study identifies a number of factors in relation to the use of Section 5(4) including: gender, clinical setting, temporal patterns and medical response time. ,,Although the majority of patients are assessed by a doctor within 4 h of the holding power being applied, 8.3% are detained for 6 h or longer. There is a need to explore this and other issues further. Abstract The majority of studies exploring the use of Section 5(4) (Nurses' holding power) of the Mental Health Act 1983 are now dated, report on small numbers and have been undertaken over relatively short periods of time. A retrospective study was undertaken which sought to identify the factors associated with the use of the section in one mental health trust over a 24-year period (1983,2006). Section 5(4) was applied on 803 occasions, an average of 33.4 times per annum. The majority of sections were applied to female patients (58.4%) by male nurses (54.9%) within adult acute inpatient settings (93.4%). Significant differences were noted in the use of the section over the 24-h period but not for month of the year or day of the week. A total of 349 (43.5%) sections were implemented during doctors' ,office hours' (Monday,Friday, 9:00 h to 17:00 h). The mean length of time spent on the section was 140 min; 80.6% of patients were assessed by a doctor within 4 h; and 8.3% remained on the section for 6 h or more. The holding power was converted to another section of the Act on 642 (80%) occasions. A similar, multi-sited prospective study could be undertaken to validate the findings of this study. [source] Annotation: Economic evaluations of child and adolescent mental health interventions: a systematic reviewTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 9 2005Renée Romeo Background:, Recognition has grown over recent years of the need for economic information on the impacts of child and adolescent mental health problems and the cost-effectiveness of interventions. Methods:, A range of electronic databases were examined using a predefined search strategy to identify economic studies which focused on services, pharmacological interventions and other treatments for children and adolescents with a diagnosed mental health problem or identified as at risk of mental illness. Published studies were included in the review if they assessed both costs and outcomes, with cost-effectiveness being the primary interest. Studies meeting the criteria for inclusion were assessed for quality. Results:, There are still relatively few economic evaluations in this field. Behavioural disorders have been given relatively greater attention in economic evaluations of child and adolescent mental health. These studies tentatively suggest child behavioural gains and parent satisfaction from parent and child training programmes, although the cost-effectiveness of the location of delivery for behavioural therapies is less clear. In general, the quality of economic evaluations was limited by small sample sizes, constrained measurement of costs, narrow perspectives and over-simple statistical and econometric methods. Conclusion:, Economic evaluations in the field of child and adolescent mental health interventions are few in number and generally poor in quality, although the number of studies being undertaken now appears to be rising. [source] Promoting mental health care in a rural paediatric unit through participatory action researchAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2009Brenda Happell Abstract Objective:,To explore, advance and evaluate mental health practices in a rural general paediatric unit through participatory action research. Design:,A participatory action research approach guided this study, providing an opportunity for nursing staff to become actively involved in the design, direction and outcomes of the research. Setting:,A 16-bed paediatric unit of a rural general hospital. Participants:,A purposive convenience sample of all paediatric nursing staff (n = 20; of 24 nurses). Outcome measures:,In the first phase of this study, focus groups were conducted to explore the experiences of nurses. Results:,Participants considered mental health to be a specialist discipline area and the role of the mental health nurse to be complex. They felt that their lack of training and experience with mental health issues was detrimental to the delivery of optimal patient care. There was concern about differing approaches to treatment, relationships with other mental health services and the suitability of the ward environment for young people with a mental health problem. Participants called for training by qualified mental health staff and the development of policies and clinical guidelines to facilitate their delivery of care to patients with a mental health problem in an acute medical environment. Conclusions:,There is a clear need for nursing specialities to work together to ensure that optimal care is given to patients admitted to general hospital with a mental health issue. Given the absence of accessible specialist child mental health inpatient units in regional and remote areas, upskilling paediatric nurses must be a priority. [source] Does fear of coercion keep people away from mental health treatment?BEHAVIORAL SCIENCES & THE LAW, Issue 4 2003Evidence from a survey of persons with schizophrenia, mental health professionals Mental health consumer advocates have long argued that involuntary treatment frightens persons with mental disorder and thus deters them from voluntarily seeking help. We surveyed 85 mental health professionals and 104 individuals with schizophrenia spectrum conditions to assess their experience with and perceptions of involuntary treatment and other treatment mandates. Of the clinicians, 78% reported that overall they thought legal pressures made their patients with schizophrenia more likely to stay in treatment. Regarding involuntary outpatient commitment, 81% of clinicians disagreed with the premise that mandated community treatment deters persons with schizophrenia from seeking voluntary treatment in the future. Of the consumer sample, 63% reported a lifetime history of involuntary hospitalization, while 36% reported fear of coerced treatment as a barrier to seeking help for a mental health problem,termed here "mandated treatment-related barriers to care." In bivariate analyses, reluctance to seek outpatient treatment associated with fear of coerced treatment (mandated treatment-related barriers to care) was significantly more likely in subjects with a lifetime history of involuntary hospitalization, criminal court mandates to seek treatment, and representative payeeship. However, experience with involuntary outpatient commitment was not associated with barriers to seeking treatment. Recent reminders or warnings about potential consequences of treatment nonadherence, recent hospitalization, and high levels of perceived coercion generally were also associated with mandated treatment-related barriers to care. In multivariable analyses, only involuntary hospitalization and recent warnings about treatment nonadherence were found to be significantly associated with these barriers. These results suggest that mandated treatment may serve as a barrier to treatment, but that ongoing informal pressures to adhere to treatment may also be important barriers to treatment. Copyright © 2003 John Wiley & Sons, Ltd. [source] MENTAL HEALTH AND SEN: Mental health and special educational needs: exploring a complex relationshipBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 1 2009Richard Rose The relationship between mental health and special educational needs is both complex and misunderstood. In this article, Richard Rose, Professor of Special and Inclusive Education, Marie Howley, Senior Lecturer, Ann Fergusson, Senior Lecturer, and Johnson Jament, a PhD student, all from the Centre for Special Needs Education and Research directed by Richard Rose at the University of Northampton, discuss findings from a national research project which explored the perceptions of pupil mental health needs by staff working in residential special schools. Teachers and other professional colleagues often feel ill-prepared to address mental health difficulties experienced by their pupils. This is, at times, exacerbated by a wider confusion when atypical behaviours are attributed to a diagnosed learning difficulty rather than being recognised as symptomatic of a mental health problem. The article suggests a need for clarification of the relationship between complex special educational needs and mental health and for increases in training opportunities and the development of resources for teaching about and supporting mental health and emotional well-being. [source] Primary care services provided to adolescents in detention: a cross-sectional study using ICPC-2ACTA PAEDIATRICA, Issue 7 2010DM Haller Abstract Aim:, The aim of this study was to provide a detailed description of the health problems for which primary care services are provided to adolescents in a juvenile detention facility in Europe. Methods:, We reviewed the medical files of all detainees in a juvenile detention centre in Switzerland in 2007. The health problems for which primary care services were provided were coded using the International Classification for Primary Care, version 2. Analysis was descriptive, stratified by gender. Results:, A total of 314 adolescents (18% female) aged 11,19 years were included. Most (89%) had a health assessment and 195 (62%) had consultations with a primary care physician; 80% of the latter had a physical health problem, and 60% had a mental health problem. The most commonly managed problems were skin (49.7%), respiratory (23.6%), behavioural (22.6%) and gynaecological problems (females: 23.9%); 13% females (no males) had sexually transmitted infections (STI), and 8.7% were pregnant. Substance abuse was common (tobacco: 64.6%, alcohol: 26.2%, cannabis: 31.3%). Conclusion:, In addition to health problems known to be more prevalent among young offenders, such as mental health problems and STI, these adolescent detainees required care for a range of common primary care problems. These data should inform the development of comprehensive primary care services in all juvenile detention facilities in Europe. [source] | |||||||||||||||||||||||||||||||||||||||||||