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The most recent wave of the opioid epidemic in the USA has been complicated by a sharp increase in methamphetamine use. In addition, many people classified with opioid use…
Abstract
Purpose
The most recent wave of the opioid epidemic in the USA has been complicated by a sharp increase in methamphetamine use. In addition, many people classified with opioid use disorder (OUD) and methamphetamine use disorder (MUD) present indications of psychiatric conditions. These diagnoses are also highly prevalent among people who are admitted to jails, but research conducted with this population is limited, due in part to the challenges associated with gaining access to local detention centers. This paper aims to examine the patterns of psychiatric conditions, OUD, and MUD among an understudied population to help inform the development of service delivery systems.
Design/methodology/approach
The present study was designed to assess the prevalence of OUD, MUD and common psychiatric conditions in a large sample of adults (n = 846) collected from four local jails. Diagnostic patterns were evaluated according to the current criteria established in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; American Psychiatric Association, 2013).
Findings
More than half (57.3%) of the sample met criteria for MUD, one-third (37.2%) exceeded the threshold for an OUD diagnosis and 15.7% were classified with both conditions. Participants who met criteria for both MUD and OUD were significantly more likely to experience symptoms of major depression [adjusted odd ratios (aOR) = 1.76, 9, confidence intervals (CI) = 1.16–2.67], post-traumatic stress disorder (aOR = 2.51, 1.64–3.83), panic attacks (aOR = 3.24, 95% CI = 2.05–5.13), obsessive compulsive disorder (aOR = 2.74, 95% CI = 1.66–4.51) and antisocial personality (aOR = 3.03, 95% CI = 1.97–4.64).
Originality/value
These results, which were derived from an understudied population of adults detained in local jails, indicate the co-–occurrence of MUD and OUD are associated with certain psychiatric conditions.
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Sami Abdulrahman Alhamidi and Seham Mansour Alyousef
The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.
Abstract
Purpose
The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.
Design/methodology/approach
A focus group of 10 graduate psychiatric nurses with more than two years’ practice in inpatient psychiatric settings reflected on their last six months’ work placements and continuous employment. The transcripts and field notes were analyzed through thematic analysis of inductive data.
Findings
Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.
Originality/value
Multiple practice issues emerged. The participants perceived that psychiatric nurse specialists are required to perform more caring functions than practicable in the inpatient setting due to an excess of noncaring duties, structural minimization of the caring role and inadequate training. They felt that many of the functions performed were not within their expectations of the caring role of a psychiatric nurse specialist and believed that changes in nurse education and attention to clarification of nurses’ roles might enhance the role they play in patient care.
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Miisa Törölä and Mika Rautanen
Globally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association…
Abstract
Purpose
Globally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association of these psychiatric issues with their committed crime. The legal-medical term “reduced criminal responsibility” refers to a weakened sense of reality and the ability to control one’s behaviour because of compromised mental health and without an evaluated need for forensic psychiatric hospitalisation. However, little is known about the actual need for the health care of prisoners with reduced criminal responsibility (PRCR). The purpose of this study was to explore treatment-related visits to prison by PRCR in Finland.
Design/methodology/approach
The research data comprise information on PRCR’s treatment-related visits and that of a matched control group (n = 222). Descriptive cross-tabulation with X²- and nonparametric Mann–Whitney U-tests and Cox regression analyses are applied.
Findings
The results show that almost every PRCR had at least one treatment-related visit during their sentences. Visits to a psychiatric hospital for prisoners, to the prison hospital and especially to a civil hospital are more common among PRCR. The need for treatment appears significantly earlier in their sentences.
Originality/value
These findings demonstrate the PRCR’s greater need for access to health services and the need for further development between the Health Care Services for Prisoners, Prison and Probation Service of Finland and public health and social services in Finland. More exploration of the medical reasons and locational distribution of the vast amount of civil hospitalisation is needed.
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Ketan Ramesh Sonigra, Lucy McIvor, James Payne-Gill, Tim Smith and Alison Beck
There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service…
Abstract
Purpose
There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.
Design/methodology/approach
Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.
Findings
HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.
Practical implications
Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.
Originality/value
The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.
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Rabia H. Haddad, Bushra Kh. Alhusamiah, Razan H. Haddad, Mo’tasem M. Aldaieflih, Khalid Yaseen, Younis H. Abuhashish, Ayman M. Hamdan-Mansour and Jafar A. Alshraideh
This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of…
Abstract
Purpose
This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.
Design/methodology/approach
The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.
Findings
A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.
Research limitations/implications
Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.
Practical implications
This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.
Social implications
CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.
Originality/value
This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.
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Laura Khalil and Joao Da Silva Guerreiro
The purpose of this paper is to examine the current state of the literature on the variables associated with self-harm and aggression in women who committed a criminal offence.
Abstract
Purpose
The purpose of this paper is to examine the current state of the literature on the variables associated with self-harm and aggression in women who committed a criminal offence.
Design/methodology/approach
Studies were identified through online databases, namely, PsycINFO, PubMed, ERIC and EBSCOhost, as well as manual searches of reference lists of the selected studies. The target population included women who committed a criminal offence and have engaged in self-harm and aggressive behaviors during their incarceration, either in correctional institutions or in forensic psychiatric settings.
Findings
Of the 1,178 studies identified, nine met inclusion criteria. The studies were conducted in six different countries and included data from 6360 female participants. Few studies examine self-harm and aggression in women who committed a criminal offence which speaks to the still sparse literature on this topic. This review of the association between self-harm and aggression in women offenders highlights the finding that a small group of women is often involved in both self-harm and aggression. The authors have identified possible psychological factors associated with women engaging in both self-harm and aggression. The findings also reveal a possible connection between types of aggressive behaviors and specific time periods during sentences or stays in forensic psychiatry.
Practical implications
The findings of this scoping review have clinical implications which may be considered by both researchers and the case management teams of women involved in both self-harm and aggression.
Originality/value
Despite the limited number of studies examining self-harm and aggression in women, this scoping review highlights gaps in the literature as well as notable psychological correlates of women who engage in self-harm and aggression.
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John McEwan McManus, Styliani Gkika and Elaine Swift
Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a…
Abstract
Purpose
Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a service user’s admission time and lead to an unhelpful experience. Therefore, a hearing voices group (HVG) was developed to create a safe space where voice hearers could share their story with others with lived experience and access support.
Design/methodology/approach
The group was developed by the first author under the supervision of the inpatient psychology lead. Both a practice-based and expert by experience-based approach were considered during the development of the group structure. The group also aligned with the Hearing Voices Network and the Trust’s values. A questionnaire was developed to evaluate the effectiveness of the group using six five-point Likert scale questions and three open questions to collect the data, which was then analysed.
Findings
The themes from the qualitative data showed that staff and ward-based promotion of the group were paramount to ensuring patient engagement. The results also showed that voice hearers found the group therapeutic, and some found the coping skills shared to be beneficial and effective.
Research limitations/implications
A large percentage of women (76%) reported that they had attended a HVG before. This was not the case for service users from the male unit and psychiatric intensive care unit. This result is considered to reflect the fact that women in that unit had the opportunity to attend more than once during their admission, rather than that they had accessed these groups in other settings or in the community. Therefore, in the future, it would be useful to change this question to “have you attended any other HVGs in the past, prior to this admission?”, which might be more appropriate for data collection.
Originality/value
To the best of the authors’ knowledge, this is the original work of the first author, who is an expert by experience and an assistant psychologist. The results suggest that HVGs can be beneficial for patients in acute and intensive mental health care and highlight some necessary adaptations and the importance of adopting an MDT approach in promoting therapeutic groups.
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Olivia Mendoza, Anupam Thakur, Ullanda Niel, Kendra Thomson, Yona Lunsky and Nicole Bobbette
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental…
Abstract
Purpose
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care.
Design/methodology/approach
In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations.
Findings
Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care.
Originality/value
This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.
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Paul Ter Horst, Marinus Spreen and Stefan Bogaerts
This paper aims to illustrate by means of a case study how HKT-R Spider reference profiles of recidivists and non-recidivists may be supportive in leave decisions.
Abstract
Purpose
This paper aims to illustrate by means of a case study how HKT-R Spider reference profiles of recidivists and non-recidivists may be supportive in leave decisions.
Design/methodology/approach
The authors describe what is known for recidivists and non-recidivists about changes in risk factors during treatment. The HKT-R Spider is introduced. By comparing a case study to group profiles, the authors illustrate how discussions about leave may be rationalised. From a study among 278 patients to explore the profiles, the authors report the inter agreement, and differences between recidivists and non-recidivists of the clinical HKT-R factors. Intra correlation coefficients, Wilcoxon signed ranks test and independent and paired t-tests are applied. To explore which combination of factors are discriminating between both groups, the authors also performed logistic regression analyses at six treatment stages.
Findings
The inter agreement reliability and internal consistency of the clinical HKT-R scale were acceptable to good in all six stages studied. The HKT-R Spider and profiles can be used to assist in evidence-informed decision-making about leave.
Practical implications
Globally recidivists had somewhat higher levels of clinical risk factors at all six decision moments, but the interpretation of HKT-R Spiders profiles should always be adapted to the individual’s context.
Originality/value
Applying the HKT-R Spider reference profiles on individual cases may structure and rationalize discussions lead to decisions based on clinical facts.
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Naureen Akber Ali, Anam Feroz, Noshaba Akber and Adeel Khoja
Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented mental health repercussions in the lives of every individual including university students. Therefore, study…
Abstract
Purpose
Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented mental health repercussions in the lives of every individual including university students. Therefore, study on students’ psychological state and its associated factors during the pandemic are of importance. This study aims to discuss the aforementioned issue.
Design/methodology/approach
An online survey was done on a total of 207 university students of Pakistan to collect information on socio-demographic characteristics, concerns or fears amidst COVID-19 and mental distress. Validated tools; Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9)-Depression were used to assess stress, anxiety and depression, respectively.
Findings
Around 14% of the university students were experiencing severe stress and anxiety, while 8.2% had severe depression. The authors found that stress among university students was related to psychiatric illness or symptoms (OR = 5.1: 1.1, 22.9) and unpredictability due to the pandemic (OR = 3.7: 1.2, 11.2). The significant determinants of anxiety were psychiatric illness/symptoms (OR = 6.6: 3.4, 12.9), implementation of public health measures (OR = 3.7: 1.1, 11.6), employed mothers (OR = 2.4: 1.1, 5.0) and lack of support from university administration (OR = 2.2: 1.0, 5.0). While the factors associated with depression included psychiatric illness or symptoms (OR = 8.4: 3.3, 21.5), unpredictability due to pandemic (OR = 6.8: 2.2, 20.7), impaired social support system (OR = 3.7: 1.3, 10.4) and studying without a scholarship (OR = 2.1: 1.0, 4.4).
Research limitations/implications
These findings call for an urgent need to develop appropriate interventions and educational programs that could address the psychological needs of students.
Practical implications
The study directs the role of university and faculty in dealing the mental health needs of the student in COVID-19 pandemic time.
Social implications
Educational programs are important that could address the psychological needs of students in COVID-19 pandemic.
Originality/value
University students reported mental distress during COVID-19 pandemic which shows that younger people are at risk of COVID-19 repercussions. Moreover, several stressors (i.e. impaired social support system and lack of support from universities) were revealed that could be mitigated by implementing appropriate strategies.
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