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Mental Health Clinicians (mental + health_clinician)
Selected AbstractsRisk axis: Implementation of structured clinical guidelines for the assessment and management of risk in psychiatryASIA-PACIFIC PSYCHIATRY, Issue 2 2009Shailesh Kumar FRANZCP MRCPsych Abstract Introduction: Mental health clinicians routinely assess risk in three domains: suicide, violence and self neglect. While the published work on the assessment of these risks has increased, concerns are often expressed that assessment alone does not lead to management of the identified risk. Not all axes of multiaxial classificatory systems are used by clinicians to the same extent, despite their proven usefulness. It is possible that a dedicated axis for risk management as a part of a multiaxial classificatory system could align risk assessment with management and increase utility of multiaxial classificatory systems. Methods: Based on our earlier work we developed a comprehensive risk management axis (RMA), which was then further refined by conducting a pilot study and then used to collect data retrospectively from the case notes of 100 patients consecutively discharged from a general psychiatric ward. Results: Common association between risk factors and three risk domains were as follows. Violence: active symptoms of major mental illness, employment problems, and major mental illness; Suicide: history of abuse, clinically significant depressive symptoms, and alcohol and drug use; Self neglect: neglect of home, personal safety, noncompliance with treatment, male gender, and low income. We also investigated whether the presence of a particular risk factor acted as a barrier or prompt for clinicians to address management factors in the RMA. Discussion: It is possible to assess risk across the three domains and to derive management plans by using the proposed RMA. Minimal clinical background is necessary for collecting data retrospectively. It should be possible to apply this axis prospectively. [source] Reflective practice in infant mental health training and consultationINFANT MENTAL HEALTH JOURNAL, Issue 6 2009Julie A. Larrieu This article describes models of training in infant mental health that utilize reflective supervision as a fundamental component of the educational and clinical experiences. The design and structure of these programs, offered by two medical centers, are described. Benefits and challenges to the adoption of infant mental health practice by trainees are outlined. Incorporation of reflective supervision in the training is discussed, and clinical examples are provided to illustrate its essential role in the development of the infant mental health clinician. [source] Pharmacological issues in the management of people with mental illness and problems with alcohol and illicit drug misuseCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2007Trudi Hilton Background,While there is plentiful information on the pharmacological management of detoxification from alcohol and on withdrawal from or maintenance of opiates for people with a principal problem of substance misuse or dependency, the pharmacological management of substance misusers presenting with a mental illness can be more complicated. Mental health and substance misuse services tend to be separate, but there is now a drive to increase effective overlap between them by equipping mental health clinicians with the skills and confidence to manage substance misuse disorders in conjunction with major mental illness. Aims,This paper aims to highlight, for a multi-professional readership, some of the prescribing options and precautions to consider when psychotropic medicines are prescribed for treatment of a mental illness in someone who may continue to use illicit substances or alcohol. It also considers interactions with the completely licit substances, nicotine and caffeine. With recent legislation prohibiting smoking in public places people are likely to reduce or stop smoking, which can have a substantial effect on the levels of medication in their blood. Copyright © 2007 John Wiley & Sons, Ltd. [source] Clinician attitudes towards early psychosis intervention: the first 4 yearsACTA PSYCHIATRICA SCANDINAVICA, Issue 2002J. Gorrell Objectives, A questionnaire was administered with an aim to assess the attitudes of mental health clinicians towards the adoption of an early intervention approach and to monitor attitudinal change during the introduction of this approach. Method, The perceptions of Early Psychosis Intervention (PEPI) questionnaire was developed and then completed by clinicians at three time points over 4 years during the introduction of a best practice early intervention approach (n=143, 178, 102, respectively). Results, Indicate that at all three time points clinicians generally agreed with the potential advantages of early intervention but were unsure about their own readiness to implement such intervention. Responses to an open-ended question regarding concerns about the new approach indicated a positive shift up the developmental process of change, from initial concerns about personal skills, resources and workload, to a gradually more specific focus on particular aspects of clinical interventions and on the impact of the new approach. Conclusions, Our services have introduced early psychosis intervention. Clinicians have moved up the developmental process of change. The questionnaire has provided a means for clinicians to influence the change process. [source] Healthy babies for mothers with serious mental illness: A case management framework for mental health cliniciansINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2008Yvonne Hauck ABSTRACT Women with a serious mental illness (SMI), notably schizophrenia, bipolar disorder, and personality disorders are considered high risk for adverse pregnancy and birth outcomes, which in turn, are associated with poor neurodevelopment in the child. Failure to access antenatal care, poor adherence with folate supplementation, an unhealthy lifestyle, and inappropriate health decisions can contribute to poor outcomes. Many women with SMI continue contact with mental health services while pregnant. This primary prevention project aimed to develop a framework for community mental health clinicians to improve the reproductive health outcomes for women with SMI. The consultation process involved discussions with key stakeholders, an environmental scan to determine current service delivery issues, a literature review, and individual and group interviews with community mental health clinicians, consumers, general practitioners, and midwives. Three key elements underpin the framework: early detection and monitoring of pregnancy, providing reproductive choices, and implementing a ,small known team approach' in the management of the pregnant client. Specific modules within the framework focus upon establishing a professional support network, assessing the risk of pregnancy, the early detection of pregnancy, monitoring during pregnancy, preparing for birth, and planning for the postnatal period. Implementation of the framework has the potential to significantly improve obstetric and neonatal outcomes for this high-risk group. [source] The phenomenon of resilience in crisis care mental health cliniciansINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2005Karen-leigh Edward ABSTRACT:, The purpose of this study, undertaken in 2003, was to explore the phenomenon of resilience as experienced by Australian crisis care mental health clinicians working in a highly demanding, complex, specialized and stressful environment. For the purpose of this research, the term ,resilience' was defined as the ability of an individual to bounce back from adversity and persevere through difficult times. The six participants for this study were drawn from Melbourne metropolitan mental health organizations , the disciplines of nursing, allied health and medicine. A number of themes were explicated from the participants' interview transcripts , Participants identified the experience of resilience through five exhaustive descriptions, which included: ,The team is a protective veneer to the stress of the work'; Sense of self; Faith and hope; Having insight; and Looking after yourself. These exhaustive descriptions were integrated into a fundamental structure of resilience for clinicians in this role. The study's findings have the potential to inform organizations in mental health to promote resilience in clinicians, with the potential to reduce the risk of burnout and hence staff attrition, and promote staff retention and occupational mental health. [source] Integrative outpatient treatment for returning service membersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2008Sonja V. Batten Abstract Veterans returning from Operations Enduring and Iraqi Freedom (OEF/OIF) frequently present with multiple psychological and physical symptoms. The authors propose an innovative approach in which primary care providers, polytrauma specialists, vocational rehabilitation specialists, and mental health clinicians work together to provide care that is not simply concurrent, but truly integrated. All members of this interdisciplinary team must provide a consistent message that supports treatment engagement and progress. The authors illustrate this approach with a case report of a soldier deployed to both OEF and OIF, requiring subsequent treatment for joint pain, headaches, mild traumatic brain injury, posttraumatic stress disorder, depression, and substance abuse. Despite the emphasis on early intervention, treatment engagement and retention remain challenges in this population. © 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64:1,12;, 2008. [source] Mental health professionals' attitudes towards consumer participation in inpatient unitsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2008T. V. MCCANN rmn rgn phd ma ba dipnurs (lond) rnt rcnt Consumer participation has been a major focus in mental health services in recent years, but the attitudes of mental health professionals towards this initiative remain variable. The purpose of this study was to describe mental health professionals' attitudes towards mental health consumer participation in inpatient psychiatric units. The Consumer Participation and Consultant Questionnaire was used with a non-probability sample of 47 mental health professionals from two adult inpatient psychiatric units situated in a large Australian public general hospital. Ethics approval was obtained from a university and a hospital ethics committee. Data were analysed using spss, Version 12. Overall, respondents had favourable attitudes towards consumer participation in management, care and treatment, and mental health planning. They were less supportive about matters that directly or indirectly related to their spheres of responsibility. The type of unit that the respondents worked in was not a factor in their beliefs about consumer participation. Recommendations are made about the development of guidelines for consumer participation in inpatient units, the educational preparation of mental health clinicians, and the need for mental health professionals to reflect on, and discuss their own beliefs and practices about, consumer participation. [source] Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric settingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2006T. MARTIN rpn dn Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention. [source] Self-inflicted bodily harm among victims of intimate-partner violenceCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 5 2007Randy A. Sansone In this study, we surveyed 113 women psychiatric inpatients with regard to histories of intimate-partner violence and six self-harm behaviours related to the intentional damage of one's body (e.g., cutting, hitting, scratching self). Multiple regression analysis revealed that a history of domestic violence was a statistically significant predictor of bodily self-harm even after controlling for age and having ever been married. Among some victims of domestic violence, this statistical relationship may indicate an underlying common psychodynamic theme such as a high threshold for body maltreatment and/or low body esteem. Regardless, these data suggest that mental health clinicians need to explore among women victims of intimate-partner violence the presence of self-initiated bodily self-harm.,Copyright © 2007 John Wiley & Sons, Ltd. [source] | |||||||||||||