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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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Celia Brown, Clarencetine (Teena) Brooks, Jonathan P. Edwards, Chyrell D. Bellamy and Kathleen O’Hara
The United Nation’s treaty from the Convention on the Rights of Persons with Disabilities (CRPD) speaks to the assurance of rights and access to justice. To assure the rights…
Abstract
The United Nation’s treaty from the Convention on the Rights of Persons with Disabilities (CRPD) speaks to the assurance of rights and access to justice. To assure the rights addressed in the treaty, disability scholars have argued for a collaborative approach between police officers, mental health, Intellectual and Developmental Disabilities, professionals, and disability rights organisations. Internationally, we have witnessed that rights are being trampled at the intersection of race/ethnicity, gender identity, disability, and sexual orientation. Interactions with the police and the various systems are sometimes experienced as sources of trauma, racism, disrespect, pain, and abuse by individuals living with disabilities. Allyship and organising with the community, particularly with BIPOC and other ‘minoritised’ communities, is essential for policy and other systemic change. Community conversations were done to learn how Black, Indigenous, and People of Color (BIPOC) and allies experience and address policing and disability and act at these intersections. The advocacy and activism of Surviving Race: The Intersection of Injustice, Disability, and Human Rights served as the impetus for this study. Surviving Race was created to unite psychiatric survivors, BIPOC impacted by the mental health and disability systems, White allies, and members of the LGBQTIA+ community to stand in solidarity with activists who were demanding systemic change after the deaths of far too many. This chapter explores intersectional and cross-disability allyship, allyship to BIPOC disability, and psychiatric survivor communities. It examines how people with disabilities and allies can more effectively work at the intersection of race, rights, equity, and justice.
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Robert J. Kane, Jordan M. Hyatt and Matthew J. Teti
The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models…
Abstract
Purpose
The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models, introducing the concept of “untethered” co-response.
Design/methodology/approach
This paper conducts a review of literature to trace the evolution of police responses to individuals with serious mental illness (SMI) and vulnerable populations. It categorizes four generations of police approaches—zero-policing, over-policing, crisis intervention and co-response—and introduces a fifth generation, the “untethered” co-response model exemplified by Project SCOPE in Philadelphia.
Findings
The review identifies historical patterns of police response to SMI individuals, emphasizing the challenges and consequences associated with over-policing. It outlines the evolution from crisis intervention teams to co-response models and introduces Project SCOPE as an innovative “untethered” co-response approach.
Research limitations/implications
The research acknowledges the challenges in evaluating the effectiveness of crisis intervention teams and co-response models due to variations in implementation and limited standardized models. It emphasizes the need for more rigorous research, including randomized controlled trials, to substantiate claims about the effectiveness of these models.
Practical implications
The paper suggests that the “untethered” co-response model, exemplified by Project SCOPE, has the potential to positively impact criminal justice and social service outcomes for vulnerable populations. It encourages ongoing policy and evaluative research to inform evidence-based practice and mitigate collateral harms associated with policing responses.
Social implications
Given the rising interactions between police and individuals with mental health issues, exacerbated by the COVID-19 pandemic, the paper highlights the urgency for innovative, non-policing-driven responses to vulnerable persons.
Originality/value
The paper contributes to the literature by proposing a fifth generation of police response to vulnerable persons, the “untethered” co-response model and presenting Project SCOPE as a practical example.
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Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke and Suzanne Guerin
This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented…
Abstract
Purpose
This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.
Design/methodology/approach
A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.
Findings
Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.
Practical implications
The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.
Originality/value
This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.
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Joana Andrade, Hugo Gomes, Rui Gonçalves and Andreia Castro-Rodrigues
Remand prisoners (RPs) are known to be in a more vulnerable situation than those already convicted. Beyond the difficulties to adapt to the prison, RP also tend to experience…
Abstract
Purpose
Remand prisoners (RPs) are known to be in a more vulnerable situation than those already convicted. Beyond the difficulties to adapt to the prison, RP also tend to experience tough circumstances due to the uncertainty of their future. This study aims to further test the psychometric properties of the Suicide Concerns for Offenders in the Prison Environment (SCOPE-2) in a sample of RP.
Design/methodology/approach
The authors have carried out a confirmatory factor analysis to test the psychometric qualities of the SCOPE-2. The authors tested the originally proposed two-factor structure composed of two subscales: optimism and protective self-worth. Also, the authors examined internal consistency through Cronbach’s alphas. Convergent validity was tested by correlational analyses between SCOPE-2 subscales and the Suicide Behaviors Questionnaire-Revised and Brief Symptom Inventory (BSI) total scores. Finally, the authors have tested known-groups validity by carrying out discriminant analysis by testing the SCOPE-2 subscales’ ability to predict belonging to a group with previous suicide attempts.
Findings
The confirmatory factor analysis showed an acceptable model fit, even though the subscale “Protective self-worth” presented a less acceptable fit. The correlation analysis supported the convergent validity of the SCOPE-2. Both the “Optimism” and “Protective self-worth” subscales showed a positive correlation with the total scores of BSI. Finally, the Portuguese version of SCOPE-2 also showed known groups validity. Concretely, the “Optimism” scores revealed an acceptable predictive accuracy.
Practical implications
This study embraces important contributions to the practice as it was the first study to validate a measure to assess vulnerability for suicide and self-harm in male and female RP.
Originality/value
To the best of the authors’ knowledge, this was the first study to validate an instrument to assess vulnerability for suicide and self-harm in both male and female pretrial detainees. Knowing their particular case, as well as the lack of responses for these individuals, it is particularly important to access suicide concerns that could precede suicide attempts.
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Nava Rothschild, Jonathan Schler, David Sarne and Noa Aharony
People with pre-existing mental health conditions are more likely to be affected by global crises. The Covid-19 pandemic has presented them with unique challenges, including…
Abstract
Purpose
People with pre-existing mental health conditions are more likely to be affected by global crises. The Covid-19 pandemic has presented them with unique challenges, including reduced contact with the psychiatric rehabilitation and support systems. Thus, understanding the emotional experience of this population may assist mental health organizations in future global crises.
Design/methodology/approach
In this paper, researchers analyzed the discourse of the mentally ill during the Covid-19 pandemic, as reflected in Israeli Facebook groups: three private groups and one public group. Researchers explored the language, reactions, emotions and sentiments used in these groups during the year before the pandemic, outbreak periods and remission periods, as well as the period before the vaccine’s introduction and after its appearance.
Findings
Analyzing groups’ discourse using the collective emotion theory suggests that the group that expressed the most significant difficulty was the Depression group, while individuals who suffer from social phobia/anxiety and PTSD were less affected during the lockdowns and restrictions forced by the outbreak.
Originality/value
Findings may serve as a tool for service providers during crises to monitor patients’ conditions, and assist individuals who need support and help.
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Matej Nakić, Mirna Koričan Lajtman and Goran Oblaković
Drawing on prospect theory, terror management theory, and social influence theories, this study explores the phenomenon of panic buying amid the COVID-19 pandemic, namely its…
Abstract
Purpose
Drawing on prospect theory, terror management theory, and social influence theories, this study explores the phenomenon of panic buying amid the COVID-19 pandemic, namely its situational antecedents such as fear of COVID-19, increased media exposure to COVID-19-related news, and context-specific paranoia. It offers insight into the situational nature of panic buying, contrary to the purely dispositional/trait conceptualization of irrational spending, usually depicted through the phenomenon of compulsive buying.
Design/methodology/approach
This is a cross-sectional study. An online questionnaire was used for data collection from 621 Croatian citizens. The questionnaire features a series of validated instruments designed to measure compulsive buying, fear of COVID-19, and context-specific paranoia. The media exposure scale (MES) was also specifically developed and empirically tested for the purpose of this research.
Findings
The results suggest that individuals who exhibited greater fear of COVID-19 while also experiencing increased exposure to COVID-19-related news were more likely to engage in panic buying. This connection has remained significant even after controlling for compulsive buying tendencies, suggesting that panic buying witnessed during the coronavirus pandemic was a situational phenomenon, not strictly dispositional. This establishes the fear of COVID-19 and increased exposure to pandemic-related news content as situational antecedents to panic buying. After controlling for compulsive buying, this paper does not demonstrate a significant connection between context-specific paranoia and panic buying. Furthermore, context-specific paranoia does not mediate the relationship between media exposure to pandemic-related content and panic buying, whereas the fear of COVID-19 significantly mediates the same relationship.
Practical implications
This study recognizes people's panic behavior amid the COVID-19 pandemic as a byproduct of a situational, reactive process – not a psychopathological one. Furthermore, it recognizes media sensationalism and the audience's impaired capacity for rational spending as major risk factors preceding the event of panic buying.
Originality/value
This study proposes a novel conceptual framework of irrational spending amid crises such as COVID-19 pandemic, introducing the differentiation between the situational nature of the phenomenon (panic buying), thereby separating it from its previous dispositional operationalizations (hoarding, compulsive buying).
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Yara Levtova, Irma Melunovic, Caroline Louise Mead and Jane L. Ireland
This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.
Abstract
Purpose
This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.
Design/methodology/approach
To discern the connection between COVID-19-related distress and multiple factors, the study involved 31 patients and 34 staff who completed assessments evaluating coping strategies, resilience, emotional reactivity, ward atmosphere and work-related aspects.
Findings
Results demonstrated that around a third of staff (31.2%) experienced COVID-19-related distress levels that met the clinical cut-off for possible post-traumatic stress disorder. Emotional reactivity, staff shortages, secondary traumatic stress and coping strategies were all positively correlated with COVID-19-related-distress. Resilience was negatively associated with distress, thus acting as a potential mitigating factor. In comparison, the prevalence of distress among patients was low (3.2%).
Practical implications
The authors postulate that increased staff burdens during the pandemic may have led to long-term distress, while their efforts to maintain minimal service disruption potentially shielded patients from psychological impacts, possibly lead to staff “problem-focused coping burnout”. This highlights the need for in-depth research on the enduring impacts of pandemics, focusing on mechanisms that intensify or alleviate distress. Future studies should focus on identifying effective coping strategies for crisis situations, such as staff shortages, and strategies for post-crisis staff support.
Originality/value
The authors postulate that the added burdens on staff during the pandemic might have contributed to their distress. Nonetheless, staff might have inadvertently safeguarded patients from the pandemic’s psychological ramifications by providing a “service of little disruption”, potentially leading to “problem-focused coping burnout”. These findings underscore the imperative for further research capturing the enduring impacts of pandemics, particularly scrutinising factors that illuminate the mechanisms through which distress is either intensified or alleviated across different groups. An avenue worth exploring is identifying effective coping styles for pandemics.
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Aderonke Oyetunji, Kailee Bunte and Val Bellman
This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional…
Abstract
Purpose
This paper aims to illuminate the issue of workplace violence (WPV) against psychiatry residents. Workplace violence is known to negatively impact physical and emotional well-being, professional development and the quality of the care that mental health professionals provide to patients. The authors discuss the prevalence of, risk factors for and consequences of WPV against psychiatry residents, as well as the need for support and resources to help residents cope with the emotional challenges of their job.
Design/methodology/approach
This paper is a review of the literature on WPV against psychiatry residents, and includes studies on its prevalence, associated risk factors and consequences.
Findings
Psychiatry residents face a heightened risk of WPV, including physical and verbal attacks, which can harm their mental and physical health and disrupt their continuity of care. Factors that contribute to WPV against psychiatry residents include exposure to aggressive or violent behaviors, inadequate training in WPV, understaffing, the stigmatization of mental illnesses, and discriminatory treatment. Furthermore, psychiatry residents who encounter WPV may develop negative emotions and attitudes toward their patients, which can compromise the care they provide.
Research limitations/implications
The inherent heterogeneity of study designs highlighted in this review could hinder the establishment of definitive conclusions about the impact of workplace violence on psychiatry residents. A focus on studies published in English may inadvertently exclude relevant literature in other languages, potentially limiting the comprehensiveness of study findings.
Originality/value
This paper highlights resident physicians’ personal experiences with and perceptions of WPV encountered during residency training. In response, potential solutions are proposed to address WPV, including increased support for resident physicians, mandatory reporting of WPV incidents, and a cultural shift toward zero tolerance for WPV. In addition, the paper raises awareness of the limited research on this topic and the importance of further investigation.
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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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