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Mental Health Settings (mental + health_setting)
Selected AbstractsWorking Therapeutically with Women in Secure Mental Health SettingsJOURNAL OF ADVANCED NURSING, Issue 5 2006Tracey Cassidy BA MSc DipHE No abstract is available for this article. [source] Assessment and Diagnosis of Nicotine Dependence in Mental Health SettingsTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2003Alan L. Peterson Ph.D. This study evaluated the frequency of documented assessment of smoking status and the diagnosis of nicotine dependence in a random sample of 153 mental health records and 152 medical records. The results indicated that tobacco use was routinely documented in the mental health records (88%) and medical records (87%). However, a diagnosis of nicotine dependence was given in only 2% of the mental health records (1/49) and 7% of the medical records (2/30) for those patients with documented regular tobacco use. These results suggest that clinicians do not routinely diagnose Nicotine Dependence even when diagnostic criteria are met. [source] Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitationACTA PSYCHIATRICA SCANDINAVICA, Issue 2002J. Skipworth Objective:, To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. Method:, The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. Results: There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Conclusion:, Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated. [source] Art psychotherapy in a consumer diagnosed with borderline personality disorder: A case studyINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2009Scott Lamont ABSTRACT This case study reviews 11 sessions of art psychotherapy with a consumer diagnosed with having borderline personality disorder. A consumer who reported difficulty in communicating her lived trauma verbally and engaged in self-harming behaviour was offered individual art therapy sessions following a consultation between an art therapy student and clinical nurse consultant in an attempt to understand her experiences and to collaboratively engage her. Notes were taken after each session by the art therapy student, reflecting conversations with this consumer while they were engaged in art making, which were subsequently explored within formal clinical supervision sessions with a mental health nurse consultant. An art portfolio is reproduced. It illustrates the expressive power of image creation. The key features of the images were that of lived trauma, the externalization of thoughts and feelings, and intense emotional expression. The results of this chronological art portfolio case study indicated therapeutic benefits from the intervention for this consumer. Further investigations of this type of intervention are warranted within the mental health setting. [source] Undergraduate nursing students attitude to mental health nursing: a cluster analysis approachJOURNAL OF CLINICAL NURSING, Issue 22 2009Karla Gough Aims., The use of cluster analysis to determine if specific groups of students could be identified based on their attitudes towards mental health nursing following the completion of a clinical experience in a mental health setting. Background., Research suggests that nursing students generally have a negative image of mental health nursing. This can be improved following clinical exposure in mental health settings, however, specific aspects of clinical experience that might facilitate attitudinal change have been under-researched. Design., Survey. Methods., A survey was administered to students (n = 703) immediately after completion of their clinical experience. Cluster analysis was used to identify natural groupings within the study cohort. Results., Three distinct clusters were identified. Cluster 1 demonstrated more positive attitudes, greater confidence and viewed mental health more positively than students in the other two Clusters. They were more likely to be male, have spent at least 30 minutes per shift with a preceptor and have completed shifts of eight hours rather than seven hours. Conclusions., Attitudes to mental health nursing may be influenced by specific demographic characteristics of students and by specific aspects of their clinical experience. Relevance to clinical practice., The nursing workforce is an essential element of quality mental health service delivery. Knowledge about factors influencing more positive attitudes is important for structuring clinical experience and designing effective recruitment strategies to attract more students into this field of practice. [source] A study of the views of patients and nurses about the administration of medication in the acute mental health settingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 7 2009J. A. DUXBURY phd ma bsc rgn rmn rn rnt [source] A researcher's journey for clarity: clarifying liability and indemnity issues when carers take on a role in medicines managementJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 9 2008J. CROWLEY bsc msc rn A client attending a depot clinic in a mental health setting requested that her husband be enabled to give her injection. This request was followed up in a practice development project. Following the success of the project, the local National Health Service (NHS) Mental Health Trust supported a research project to explore the issues raised further. The Local Research Ethics Committee raised a question around carer liability. This question led to a 2-year liaison with the NHS Litigation Authority, the local NHS Trust's legal team, Royal College of Nursing and others. The journey clarified that liability for a carer was covered under the Third Party Liability Scheme, where the carer came under the umbrella of being an ,authorised voluntary worker'. While the experience delayed the research project, it was a significant learning opportunity in the NHS ethical approval system. [source] An evaluation of a supervised self-help programme for bulimic disordersCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2001Lorraine Bell Self-help programmes are recommended as cost-effective initial interventions for the treatment of bulimic disorders. This is a report of the effectiveness of such a programme in routine clinical practice. Twenty-one patients completed the programme and both pre- and post- measures. Patients were treated in a secondary mental health setting over an 11-month period from July 1998 to June 1999. Outcome was assessed using standardized measures and records of symptom levels and drop-out rates. Significant improvements in depression, bulimic symptom and severity were observed. Multi-impulsive clients (as indicated by clinically significant scores on bingeing and two other areas of impulsivity) had similar levels of bulimia but higher depression scores pre-treatment. They made significant gains in most areas but, despite reduction in depression scores, remained significantly depressed. They also made less improvement in disordered attitudes than non-impulsive clients. A global measure of motivation did not predict drop-out or outcome though numbers were small. Patients who used Getting Better Bit(e) by Bit(e) and received motivational enhancement sessions made a greater reduction in fasting behaviour and were less likely to drop out than those who used a more standard CBT programme, but these results could be due to other factors. Copyright © 2001 John Wiley & Sons, Ltd. [source] What is problem solving?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2001A review of theory, applications, research Introduction Structured training or therapy programmes designed to develop cognitive problem-solving skills are now widely used in criminal justice and mental health settings. Method This paper describes the conceptual origins and theoretical models on which such programmes are based, and provides a historical overview of their development. Theoretical formulations of problem-solving deficits have also been used to inform the design of intervention programmes, and a number of studies and evaluations of such interventions are reviewed, with particular reference to criminal and other antisocial behaviour. Discussion In recent years there has been steadily growing supportive evidence for the benefits of this approach. However, there are also several aspects of its application that require further investigation, and some of the remaining questions are identified. Copyright © 2001 Whurr Publishers Ltd. [source] Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the national survey of American life,DEPRESSION AND ANXIETY, Issue 12 2008Joseph A. Himle Ph.D. Abstract Background: There is limited research regarding the nature and prevalence of obsessive-compulsive disorder (OCD) among various racial and ethnic subpopulations within the United States, including African Americans and blacks of Caribbean descent. Although heterogeneity within the black population in the United States has largely been ignored, notable differences exist between blacks of Caribbean descent and African Americans with respect to ethnicity, national heritage, and living circumstances. This is the first comprehensive examination of OCD among African Americans and blacks of Caribbean descent. Methods: Data from the National Survey of American Life, a national household probability sample of African Americans and Caribbean blacks in the United States, were used to examine rates of OCD among these groups. Results: Lifetime and 12-month OCD prevalence estimates were very similar for African Americans and Caribbean blacks. Persistence of OCD and rates of co-occurring psychiatric disorders were very high and also similar between African American and Caribbean black respondents. Both groups had high levels of overall mental illness severity and functional impairment. Use of services was low for both groups, particularly in specialty mental health settings. Use of anti-obsessional medications was also rare, especially among the Caribbean black OCD population. Conclusions: OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment. It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups. Depression and Anxiety, 2008. Published 2008 Wiley-Liss, Inc. [source] Motives for substance use among young people seeking mental health treatmentEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2008Leanne Hides Abstract Aims: To explore substance use motives among young people seeking mental health treatment. Methods: Participants consisted of 103 young people seeking mental health treatment, who had used drugs or alcohol in the past year. The young people completed a 42-item substance use motives measure based on the Drinking Motives Measure for their most frequently used substance in the past year. Results: Exploratory factor analysis of the substance use motives scale indicated the young people reported using substances for positive and negative drug effects, to socialize with their peers, and to cope with a negative affect. They did not report using substances for enhancement or conformity motives. Coping motives predicted the presence of a current substance use disorder. Conclusions: The findings support the need for integrated treatment approaches within mental health settings, particularly targeted at young people with co-occurring mental health and substance use problems. [source] A structured observation of the interaction between nurses and patients during the administration of medication in an acute mental health unitJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Joy A Duxbury Aims., This aims of this study are to describe current practice in the administration of medication in an acute psychiatric unit and explore factors that influence nurses' decisions regarding the administration of medication during ,rounds'. Background., Medication ,rounds' form part of the ward routine in many inpatient mental health settings. Nurses make several clinical decisions about administrating medication; yet, concerns have been raised about the poor assessment of patients' needs and the quality of the information exchanged. Design., A structured non-participant observational design was used for this research. Method., This study involved the observation of 20 medication ,rounds' over three months. The Ward Administration of Medication Schedule was used to report on the interactions between nurses and patients and aspects of their communication during each round. Results., From the rounds observed nurses appeared adept at communicating a positive interpersonal style but less so in demonstrating skills portraying collaboration and information giving. For example whilst nurses communicated warmth in 97% of cases, using non-verbal behaviours such as good eye contact, the provision of information was only initiated in 46% of cases. Enquiries regarding the patient's general health and medication taking (35% and 17% respectively) were less commonly observed. Verbal consent was sought in only 25% of cases. Procedural matters were adhered to overall. Conclusions., Findings suggest limited collaboration between nurses and patients and the poor monitoring of health status and medication effects. Information exchange could be improved; however, this may be related to medication procedures that make it difficult to explore sensitive information with patients, rather than nursing skills and behaviour. Relevance to clinical practice., The Ward Administration of Medication Schedule can be used as a clinical or educational tool in the administration of medication. In both instances, it may be self-administered and used to reflect on personal skills or employed as an observational tool during peer review and audit. [source] Undergraduate nursing students attitude to mental health nursing: a cluster analysis approachJOURNAL OF CLINICAL NURSING, Issue 22 2009Karla Gough Aims., The use of cluster analysis to determine if specific groups of students could be identified based on their attitudes towards mental health nursing following the completion of a clinical experience in a mental health setting. Background., Research suggests that nursing students generally have a negative image of mental health nursing. This can be improved following clinical exposure in mental health settings, however, specific aspects of clinical experience that might facilitate attitudinal change have been under-researched. Design., Survey. Methods., A survey was administered to students (n = 703) immediately after completion of their clinical experience. Cluster analysis was used to identify natural groupings within the study cohort. Results., Three distinct clusters were identified. Cluster 1 demonstrated more positive attitudes, greater confidence and viewed mental health more positively than students in the other two Clusters. They were more likely to be male, have spent at least 30 minutes per shift with a preceptor and have completed shifts of eight hours rather than seven hours. Conclusions., Attitudes to mental health nursing may be influenced by specific demographic characteristics of students and by specific aspects of their clinical experience. Relevance to clinical practice., The nursing workforce is an essential element of quality mental health service delivery. Knowledge about factors influencing more positive attitudes is important for structuring clinical experience and designing effective recruitment strategies to attract more students into this field of practice. [source] A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settingsJOURNAL OF CLINICAL NURSING, Issue 9 2008John A Baker BNurs, MPhil Aims and objectives., This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards. Design., The study employed a best-evidence synthesis review design. Background., The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness. Methods., A best-evidence synthesis review. Results., Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24-hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered. Conclusions., Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables. Relevance to clinical practice., Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under-researched clinical intervention used in mental health wards. [source] Attitudes and perceptions of mental health nurses towards borderline personality disorder clients in acute mental health settings: a review of the literatureJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 7 2010L. WESTWOOD First page of article [source] Ethnography and the ethics of undertaking research in different mental healthcare settingsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010H. ALLBUTT rgn ba msc phd Accessible summary ,,We report our experiences of seeking regulatory approval to undertake a qualitative research study using observation and interviews in three different mental healthcare settings. ,,All users of mental health services are classified as ,vulnerable' research participants by UK regulatory research systems. We argue that this is both disempowering to users and also at odds with current health care policy to promote service user involvement in research processes. ,,Access to mental healthcare sites was difficult in spite of agreement by senior area managers. Front-line team leaders acted as gatekeepers to influence which service users could be approached to take part in the study. This type of intervention may bias research samples and dilute the knowledge claims researchers can make from research undertaken in practice settings. Abstract This paper draws on our experiences of seeking research ethics and management approval for a 1-year ethnographic research study in three mental health settings. We argue that the increased bureaucratization of research governance in the UK is paternalistic and unfit for qualitative, non-interventionist study designs. The classification of all mental health services users as ,vulnerable' is also disempowering and contrary to government calls to increase user involvement in research processes. We relate our difficulties in accessing National Health Service sites to undertake our study despite endorsement by senior managers. The current research ethics system reinforces the gatekeeping role of front-line National Health Service staff but this may work to bias samples in favour of ,amenable' service users and exclude others from having their views and experiences represented in studies over the long-term. [source] Medicine use in older people's inpatient mental health servicesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010J. A. BAKER phd mphil msc bnurs (hons) rmn Accessible summary ,,Aging increases the risks associated with medicines. ,,Complex regimes of medicines are used with older people in mental health services. ,,Mental Health Nurses need to consider their skills and knowledge in dealing with these complex regimes. Abstract The aims of this audit were to establish the range and volumes of medicines used in older people's mental health settings and to explore the safety of the prescribing habits through the application of the revised Beers criteria. An audit of all patients on all selected wards (both functional and organic) for current prescriptions of all drugs routinely prescribed on the census day was undertaken on 11 wards in three Mental Health NHS Trusts in the North West of England. Data were collected on 154 patients in 11 different inpatient settings in three Mental Health Trusts. A total of 153 patients had 882 prescriptions of 196 drugs (mean 5.8 drugs). Most frequently prescribed drugs were aspirin (n= 57, 6.5%), paracetamol (n= 36, 4.1%) and quetiapine (n= 35, 4.0%). Nine of the 48 potentially inappropriate medicines in the revised Beers criteria had been prescribed, although at within appropriate limits. The audit highlights the complexity of poly-pharmacotherapy in older adults admitted to mental health services. Further works needs to establish whether nurses have the clinical knowledge and skills to ensure safe practice. There appears to be continued variation in prescribing practice. [source] How reliable is the current evidence looking at the efficacy of harm reduction and motivational interviewing interventions in the treatment of patients with a dual diagnosis?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2007C. J. LAKER ba bsc rmn Current policy from the Department of Health advocates for an integrated approach to treating patients with a dual diagnosis. However, pragmatic and clinically effective brief interventions that can be delivered by nurses across mental health settings remain underdeveloped. Motivational interviewing has had some successful exposure in the field of dual diagnosis; however, harm reduction remains unexplored both conceptually and in terms of clinical intervention. This literature review examines the notion of harm reduction as a method of identifying and reducing the harm associated with the misuse of drugs and alcohol in relation to mental health problems. Currently there is a paucity of good quality evidence for integrated interventions in the treatment of dually diagnosed patients. Therefore, the papers are analysed in respect of their methodological quality and contribution to the evidence base to inform both future research and mental health nursing practice. [source] Sources of stress experienced by occupational therapists and social workers in mental health settingsOCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2005Chris Lloyd Senior Lecturer Abstract This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists. Copyright © 2005 Whurr Publishers Ltd. [source] Preserving Family Bonds: Examining Parent Perspectives in the Light of Practice Standards for Out-of-Home TreatmentAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2005Adjoa D. Robinson PhD Family participation is a core system of care value that is supported by previous research in medical, child welfare, and mental health settings. However, many parents with children receiving out-of-home mental health treatment experience restrictions on contact. This cross-sectional study examines the experiences of families (N = 102) regarding parent-child contact in relation to examples of national accreditation standards. Results of the national survey found that most respondents (79.4%) reported restrictions on contact, including limits based on behavioral contingencies (65.7%) and point and level systems (52.5%). [source] Empirical evidence on the use and effectiveness of telepsychiatry via videoconferencing: Implications for forensic and correctional psychiatryBEHAVIORAL SCIENCES & THE LAW, Issue 3 2008Diana J. Antonacci M.D. A growing body of literature now suggests that use of telepsychiatry to provide mental health services has the potential to solve the workforce shortage problem that directly affects access to care, especially in remote and underserved areas. Live interactive two-way audio,video communication,videoconferencing,is the modality most applicable to psychiatry and has become synonymous with telepsychiatry involving patient care, distance education, and administration. This article reviews empirical evidence on the use and effectiveness of videoconferencing in providing diagnostic and treatment services in mental health settings that serve child, adolescent, and adult populations. Descriptive reports, case studies, research articles, and randomized controlled trials related to clinical outcomes were identified and reviewed independently by two authors. Articles related to cost-effectiveness, technological issues, or legal or ethical aspects of telepsychiatry were excluded. The review of the evidence broadly covers mental health service provision in all settings, including forensic settings. Given the sparse literature on telepsychiatry in forensic settings, we discuss implications for mental health care across settings and populations and comment on future directions and potential uses in forensic or correctional psychiatry. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||