eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State.

Science.gov (United States)

Kip, Hanneke; Bouman, Yvonne H A; Kelders, Saskia M; van Gemert-Pijnen, Lisette J E W C

2018-01-01

Treatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients. To examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness. A systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients. The search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of. To overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth's potential, further research on development, implementation, and evaluation should be conducted.

[Changing Forensic Mental Health in France: A Review].

Science.gov (United States)

Nakatani, Yoji; Hasuzawa, Suguru

2015-01-01

This article describes the background and recent changes in French forensic mental health. The literature suggests that three law reforms have been crucial to changes in the mental health system. First, the Penal Code of 1992 redefined the provisions of criminal responsibility and introduced the category of diminished responsibility. Second, a controversial law for preventive detention (rétention de sûretê) was enacted in 2008, according to which criminals with severe personality disorders are subject to incarceration even after the completion of their prison sentences if they are still considered to pose a danger to the public. Third, the revision of mental health laws in 2011 altered the forms of involuntary psychiatric treatments, stipulating a judge's authority to decide treatment. In parallel with these legal reforms, the psychiatric treatment system for offenders with mental disorders has been reconstructed. The number of difficult patient units (unités pour malades difficiles) has increased from four to ten across the nation in order to meet the needs of patients transferred from general psychiatric institutions for the reason of being unmanageable. In the penitentiary system, new facilities have been established to cope with the growing number of inmates with mental disorders. As background to these changes, it is pointed out that the current psychiatric system has undergone deinstitutionalization and become less tolerant of aggressive behavior in patients. In the broader context, public sensitivity towards severe crime, as shown by the sensation triggered by serious crimes conducted by pedophiles, seems to urge tough policies. In the 2000 s, several homicides committed by psychiatric patients had a great impact on the public, which led President Sarkozy to issue a statement calling for stronger security in psychiatric institutions. The harsh attitude of courts towards psychiatric practices is illustrated by a 2012 ruling; after a patient escaped from

Validity of assessing people experiencing mental illness who have offended using the Camberwell Assessment of Need-Forensic and Health of the Nation Outcome Scales-Secure.

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Abou-Sinna, Rana; Luebbers, Stefan

2012-10-01

Evidence-based practices for forensic mental health services have been slow to develop, and there is a lack of measures that assess the mental health and criminogenic needs of people experiencing mental illness who have offended. The present study aimed to investigate the interrelationship between a clinician-rated forensic mental health needs assessment (Health of the Nation Outcomes Scales-Secure (HoNOS-S)), a forensic mental health needs assessment that considers both clinician and patient perspectives (Camberwell Assessment of Need-Forensic (CANFOR)), and measures of general and violent recidivism (Level Service-Case Management Inventory (LS-CMI) and HCR-20 Violence Risk Assessment Scheme (HCR-20)). Needs were assessed for 72 forensic patients aged between 20 and 62 years of age, located in a secure forensic mental health facility. The findings revealed significant positive correlations between the HoNOS-S, CANFOR, and HCR-20. Only the CANFOR was positively correlated with the LS-CMI, and uniquely contributed variance to the HCR-20. Patients and nurses differed in the total number of needs and met needs they identified as present. The findings suggest that the collaborative approach of the CANFOR might be more appropriate for measuring outcomes in the treatment of individuals experiencing mental illness who have offended. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Housing preferences of Irish forensic mental health service users on moving into the community.

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Sweeney, Patricia; Rani Shetty, Shobha

2013-01-01

Housing is one of the important services required by forensic mental health service users on reintegration into the community. In the Republic of Ireland, a recent amendment to Section 13 of the Criminal Law Insanity Act (2006) has given the prospect of conditional discharge, which has increased the need for housing among Irish forensic mental health service users. This article reports findings of a qualitative descriptive study aimed to explore the housing preferences of these service users. While identifying and capturing their views, the study also identified the strengths and weaknesses of current housing services from a service user perspective. Data were collected from nine service users using semistructured interviews. Colaizzi's (1978) approach was used to analyze the data. Three themes that emerged from the analysis are as follows: (a) living choices; (b) future considerations; and (c) service users' expectations. Although concerns were raised regarding legislation and policy, service users strongly preferred normal independent living and recommended continued community support, gradual discharge, and community hostels. Findings suggest that service users' expectations may be fulfilled with effective collaboration between forensic mental health service and housing services. This is the first study to be carried out in Ireland that adds a new dimension to the literature on housing policy and service users' perspectives.

eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State

Directory of Open Access Journals (Sweden)

Hanneke Kip

2018-02-01

Full Text Available BackgroundTreatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients.ObjectiveTo examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness.MethodsA systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients.ResultsThe search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of.DiscussionTo overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth’s potential, further research on development, implementation, and evaluation should be conducted.

Sex on show. Issues of privacy and dignity in a Forensic mental health hospital: Nurse and patient views.

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Quinn, Chris; Happell, Brenda

2015-08-01

To explore perceptions of privacy and dignity for sexual relationships in a Forensic mental health hospital. The role of nurses in forensic mental health hospitals is frequently complicated by opposing expectations of therapeutic relationships and maintaining security. What can result is an over-emphasis on risk reduction by controlling patient behaviour, which can extend to patient intimacy and sexual relationships. An exploratory, qualitative approach. Individual interviews were conducted with 12 nurses and 10 patients in a forensic mental health hospital. Thematic data analysis was undertaken to identify the main themes. The need for a private and dignified place for patient intimacy was one major theme to emerge from this research from both nurse and patient participants and is the focus of this article. A disparity is reported between the level of support reported by nurse participants with the experience of the patient participants. Sexual intimacy and sexual relationships are important components of normal human behaviour. Institutional rules and rule adherence create barriers for patients, forcing their intimacy and sexual relationships into secrecy. There is a need for further research to consider the benefits and risks of patient intimacy and sexual relationships for long-term patients in forensic mental health settings. Patients in forensic hospitals are sexually active and seek support from nurses. Nurses are in an ideal role to recognise the important part they can play in supporting the intimacy and sexual relationship needs of patients. Strategies to assist in developing confidence in responding to normal human behaviour is a matter of priority. © 2015 John Wiley & Sons Ltd.

The observation of mental disorder and dangerousness in arsonists : a contemporary appraisal of changes in Dutch forensic mental health cases

NARCIS (Netherlands)

Dalhuisen, Lydia; Koenraadt, Frans

2015-01-01

In the Netherlands pre-trial forensic mental health assessments are conducted to examine whether a mental disorder was present at the time of the offence that affected the free will of a person, in which case criminal accountability is considered diminished or absent. This study aims to investigate

Walking a fine line: Forensic mental health practitioners' experience of working with correctional officers.

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Lazzaretto-Green, Danille; Austin, Wendy; Goble, Erika; Buys, Lisa; Gorman, Tom; Rankel, Marlene

2011-09-01

This paper explores mental health professionals' experiences working with correctional staff--one aspect of an interdisciplinary phenomenological study of ethical practice in forensic psychiatry. Professionals describe this relationship as coexisting within the system, despite their often conflicting roles. In correctional officers' overt concern for custody and control, practitioners can perceive a "paramilitary mentality" with which they struggle to work. Conversely, practitioners can experience conflict with security personnel for appearing "too caring" or "too sympathetic" to offenders--being "con-lovers." The balance practitioners establish between working with inmates and working alongside facility security is one of walking a fine line. © 2011 International Association of Forensic Nurses.

Forensic community mental health nurses' perceptions of statutory community aftercare: implications for practice.

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Riordan, Sharon; Wix, Stuart; Humphreys, Martin

2005-01-01

The key role played by forensic community mental health nurses in statutory community aftercare for mentally disordered offenders in England and Wales has been successful. The nurses often have the most contact with this patient population, yet paradoxically, have not been asked to express their views about the process. The pivotal role undertaken by this professional group appears to be fundamental to the success of statutory aftercare for this patient group.

An Exploration of the Use of a Sensory Room in a Forensic Mental Health Setting: Staff and Patient Perspectives.

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Wiglesworth, Sophie; Farnworth, Louise

2016-09-01

Despite the increased use of sensory rooms, there is little published evidence related to their benefits. The purpose of this study was to explore staff and patient perspectives of the use of a sensory room in an Australian forensic mental health setting. Staff and patients on a forensic hospital unit were recruited for this study. Focus group data was obtained from the perspective of the healthcare staff. A sensory assessment identified patients' sensory preferences. The details of the patients sensory room use and stress experienced before and after using the sensory room were recorded. The results showed a mean decrease in stress that was attributed to the use of the sensory room. Stress reducing benefits of sensory room use may improve a patient's experience within a forensic mental health facility while applying a recovery approach. As a limitation of the study, patient stress was rated on an un-validated scale. Further research is needed for greater insight and evidence in evaluating the use of sensory rooms in forensic mental health settings in reducing stress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Improving forensic mental health care to Indigenous Australians: theorizing the intercultural space.

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Durey, A; Wynaden, D; O'Kane, M

2014-05-01

This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension

Using social bonding theory to examine 'recovery' in a forensic mental health hospital: A qualitative study.

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Nijdam-Jones, Alicia; Livingston, James D; Verdun-Jones, Simon; Brink, Johann

2015-07-01

For people living with mental illness, recovery involves learning to overcome and manage their symptoms and striving to live fulfilling lives. The literature on achieving recovery emphasises the importance of social connections and positive role models. Hirschi's social bonding theory posits that an individual's attachment to others, belief in social norms, and their commitment and involvement in conventional activities are the major contributors to normalising social behaviour. The aim of this study is to understand the qualities of service identified by patients in a forensic hospital as being important and meaningful to recovery. Semi-structured interviews with 30 inpatients in a forensic mental health hospital in British Columbia, Canada, were audio recorded, and the transcriptions were analysed using thematic analysis. Five themes emerged: involvement in programmes, belief in rules and social norms, attachment to supportive individuals, commitment to work-related activities and concern about indeterminacy of stay. The first four themes map closely onto Hirschi's criminologically derived social bonding theory; however, indeterminacy of stay also arose as a common theme. In addition, the theory was too simple in its separation of elements; our data suggested the complex integration of themes. Our findings may be useful for informing evaluation of forensic mental health services. Copyright © 2014 John Wiley & Sons, Ltd.

Recording routine forensic mental health evaluations should be a standard of practice in the 21st century.

Science.gov (United States)

Siegel, David M; Kinscherff, Robert

2018-04-25

The standard of practice for forensic interviews in criminal and delinquency cases, other than those conducted as part of brief preliminary screening evaluations or in emergency situations, should include a digital recording requirement. This standard should be adopted because of the greater availability of, and familiarity with, recording technology on the part of mental health professionals, the greater use and proven effectiveness of recording in other contexts of the criminal justice system, and the improvement in court presentation and accuracy of judicial determinations involving forensic assessments that recording will provide. The experience of practitioners with recording since professional associations last studied the issue should be taken into account, as informal data suggest it has been positive. Unfortunately, the legal system is unlikely to prompt this advance without its reconsideration by the forensic mental health professions, because current constitutional jurisprudence does not require recording and effectively makes it contingent upon request by examiners. Forensic evaluators thus have a valuable opportunity to educate the legal system on the utility and importance of this key reform, and so should adopt it as a best practice. Copyright © 2018 John Wiley & Sons, Ltd.

Improving forensic mental health care for Aboriginal Australians: challenges and opportunities.

Science.gov (United States)

Durey, Angela; Wynaden, Dianne; Barr, Lesley; Ali, Mohammed

2014-06-01

Mental illnesses constitute a major burden of disease in Aboriginal Australians and Torres Strait Islanders (hereafter Aboriginal Australians), who are also overrepresented in the prison system. A legacy of colonization compounds such prevalence, and is further exacerbated by the persistence of racial discrimination and insensitivity across many sectors, including health. This research completed in a Western Australian forensic mental health setting identifies non-Aboriginal health professionals' support needs to deliver high-quality, culturally-safe care to Aboriginal patients. Data were collected from health professionals using an online survey and 10 semistructured interviews. Survey and interview results found that ongoing education was needed for staff to provide culturally-safe care, where Aboriginal knowledge, beliefs, and values were respected. The findings also support previous research linking Aboriginal health providers to improved health outcomes for Aboriginal patients. In a colonized country, such as Australia, education programmes that critically reflect on power relations privileging white Anglo-Australian cultural dominance and subjugating Aboriginal knowledge, beliefs, and values are important to identify factors promoting or compromising the care of Aboriginal patients and developing a deeper understanding of 'cultural safety' and its clinical application. Organizational commitment is needed to translate the findings to support non-Aboriginal health professionals deliver high-quality care to Aboriginal patients that is respectful of cultural differences. © 2013 Australian College of Mental Health Nurses Inc.

[Closing forensic psychiatric hospitals in Italy: a new deal for mental health care?].

Science.gov (United States)

Casacchia, Massimo; Malavolta, Maurizio; Bianchini, Valeria; Giusti, Laura; Di Michele, Vittorio; Giosuè, Patricia; Ruggeri, Mirella; Biondi, Massimo; Roncone, Rita

2015-01-01

The date of March 31, 2015, following the Law 81/2014, has marked a historical transition with the final closure of the six forensic psychiatric hospitals in Italy. This law identifies a new pathway of care that involves small-scale high therapeutic profile facilities (Residenze per la Esecuzione della Misura di Sicurezza, REMS) instead of the old forensic psychiatric hospitals. The Law promotes a new recovery-oriented rehabilitation approach for the persons with mental disorders who committed a criminal offence, but lack criminal responsibility and deemed as socially dangerous. After a brief description of what happens abroad, this article highlights the positive aspects of the law that, as a whole, has to be considered innovative and unavoidable. The main debated problems are also reviewed, including the lack of changes to the Criminal Code; the improper equation between insanity and mental illness and social dangerousness; the evaluation of "socially dangerousness", based solely on "subjective qualities" of the person, assessed out of his/her context, without paying attention to family and social conditions suitable for discharge; the expensive implementation of the REMS, mainly based on security policies and less on care and rehabilitation, the delay in their construction, and the search for residential alternatives structures; the uncertain boundaries of professional responsibility. Finally, several actions are suggested that can support the implementation of the law: information programs addressed to the general population; training activities for mental health professionals; systematic monitoring and evaluation of the outcomes of the care provided to the forensic psychiatric population; implementation of Agreement Protocols and a better cooperation with the judiciary. Scientific societies dealing with psychosocial rehabilitation need to be involved in such issues relating to the identification of the best care and rehabilitation pathways, which should be

Study protocol: a randomised controlled trial of cognitive remediation for a national cohort of forensic mental health patients with schizophrenia or schizoaffective disorder.

Science.gov (United States)

O'Reilly, Ken; Donohoe, Gary; O'Sullivan, Danny; Coyle, Ciaran; Mullaney, Ronan; O'Connell, Paul; Maddock, Catherine; Nulty, Andrea; O'Flynn, Padraic; O'Connell, Carina; Kennedy, Harry G

2016-01-13

Evidence is accumulating that cognitive remediation therapy (CRT) is an effective intervention for patients with schizophrenia or schizoaffective disorder. To date there has been no randomised controlled trial (RCT) cohort study of cognitive remediation within a forensic hospital. The goal of this study is to examine the effectiveness of a trial of cognitive remediation for forensic mental health patients with schizophrenia or schizoaffective disorder. An estimated sixty patients will be enrolled in the study. Participants will be randomised to one of two conditions: CRT with treatment as usual (TAU), or TAU. CRT will consist of 42 individual sessions and 14 group sessions. The primary outcome measure for this study is change in cognitive functioning using the MATRICS Consensus Cognitive Battery (MCCB). Secondary outcomes include change in social and occupational functioning, disorganised symptoms, negative symptoms, violence, participation in psychosocial treatment and recovery. In addition to these effectiveness measures, we will examine patient satisfaction. Cognitive difficulties experienced by schizophrenia spectrum patients are associated with general functioning, ability to benefit from psychosocial interventions and quality of life. Research into the treatment of cognitive difficulties within a forensic setting is therefore an important priority. The results of the proposed study will help answer the question whether cognitive remediation improves functional outcomes in forensic mental health patients with schizophrenia or schizoaffective disorder. Forensic mental health patients are detained for the dual purpose of receiving treatment and for public protection. There can be conflict between these two roles perhaps causing forensic services to have an increased length of stay compared to general psychiatric admissions. Ultimately a focus on emphasising cognition and general functioning over symptoms may decrease tension between the core responsibilities of

'Forensic' labelling: an empirical assessment of its effects on self-stigma for people with severe mental illness.

Science.gov (United States)

Livingston, James D; Rossiter, Katherine R; Verdun-Jones, Simon N

2011-06-30

Increasingly, specialized 'forensic' mental health services are being developed to address the criminogenic and clinical needs of people with mental illness who are involved in the criminal justice system. Theoretically, the construction of such specialized services can produce simultaneous positive benefits and negative consequences. This mixed methods study examined and compared the level of self-stigma that was experienced by people who receive compulsory community-based treatment services in the forensic (n=52) and civil (n=39) mental health systems of British Columbia, Canada. The quantitative findings indicate that 'forensic' labelling was not associated with elevated levels of self-stigma. Quantitative level of self-stigma was significantly associated with psychiatric symptom severity, history of incarceration, and history of homelessness. The qualitative findings suggest that access to high-quality, well-resourced forensic mental health services may, for some service users, come at the risk of increased exposure to social and structural stigma. Together, these findings reveal some of the strengths and weaknesses that are associated with organizing forensic mental health services using a specialized service delivery model. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Evaluation of service users' experiences of participating in an exercise programme at the Western Australian State Forensic Mental Health Services.

Science.gov (United States)

Wynaden, Dianne; Barr, Lesley; Omari, Omar; Fulton, Anthony

2012-06-01

Approximately 210 patients are admitted each year to the Western Australian State Forensic Mental Health Service, and most present with psychotic illness, along with other physical and mental comorbidities. In 2010, a healthy lifestyle programme, which included a formal exercise programme coordinated by an exercise physiologist, was introduced at the service. A self-report questionnaire was developed to obtain feedback on the programme, and 56 patients completed the questionnaire during the 6-month evaluation period. As well as providing patients with access to regular physical activity, the programme also supports the recovery philosophy, where patients work in partnership with forensic mental health staff. Overall, patients reported that the programme assisted them to manage their psychiatric symptoms, as well as improving their level of fitness, confidence, and self-esteem. In addition, patients received education about the importance of regular exercise to their mental health, and the role exercise plays in preventing chronic illness and obesity. While the benefits of exercise on mental health outcomes for people with depression and anxiety are well established, this evaluation adds to the evidence that such programmes provide similar benefits to people who have a psychotic illness and are hospitalized in an acute secure setting. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Exploring sexual risks in a forensic mental health hospital: perspectives from patients and nurses.

Science.gov (United States)

Quinn, Chris; Happell, Brenda

2015-01-01

Patients utilising forensic mental health inpatient services experience a range of sexual risks, including vulnerability to sexual exploitation and exposure to sexually transmissible infections. However, there is a paucity of research exploring the issue of sexual risks from the standpoint of patients and the nurses who work closely with them in inpatient secure settings. This article presents findings from a qualitative exploratory study, which investigated the views of patients and nurses about sexual relationships in forensic mental health settings. Risk was a major theme arising from the data and is the focus of this article. Subthemes from nurse participants included sexual safety, sexual vulnerability, unplanned pregnancies, and male sexuality issues. Subthemes from patients included risks associated with sexual activity, access to information and sexual health care, unplanned pregnancies, vulnerability, and male sexuality issues. Knowledge about these sexual risks by patients and nurses were well articulated, however information and assistance were considered by patients to be less than satisfactory in improving their knowledge or in providing the support they considered important to reduce sexual risks. The issue of risk needs to be addressed, and nurses would be well placed to contribute; however they require education to improve their ability to provide sexual health education to patients along with strategies to ensure patients receive the support and services they require to reduce their exposure to sexual risks.

Developing forensic mental healthcare in Kosovo

Directory of Open Access Journals (Sweden)

Hans Joachim Salize

2014-04-01

Full Text Available In many economically struggling societies forensic psychiatry is still in its initial developmental stages and thus forensic patients pose an ongoing challenge for the healthcare and juridical systems. In this article we present the various issues and problems that arose when establishing the first forensic psychiatric institute in Kosovo- a country whose population has constantly been reported as suffering from a high psychiatric morbidity due to long-lasting traumatic experiences during the war of 1999. The implementation of a new forensic psychiatric institute in the developing mental healthcare system of Kosovo, still characterized by considerable shortages, required substantial effort on various levels. On the policy and financial level, it was made possible by a clear intent and coordinated commitment of all responsible national stakeholders and authorities, such as the Ministries of Health and Justice, and by the financial contribution of the European Commission. Most decisive in terms of the success of the project was capacity building in human resources, i.e. the recruitment and training of motivated staff. Training included essential clinical and theoretical issues as well as clearly defined standard operation procedures, guidelines and checklists to aid daily routine work and the management of challenging situations.

Forensic psychiatry in Singapore.

Science.gov (United States)

Chan, Lai Gwen; Tomita, Todd

2013-12-01

Singapore is a geographically small nation-state that has transformed itself from a third-world country to a developed nation after attaining political independence 46 years ago. The pace of change has been tremendous and mental health care is no exception. This paper provides an overview of mental health care and a review of key mental health legislation, including a National Mental Health Blueprint that was rolled out in 2007. On this background, the paper focuses on a description of forensic psychiatric services in Singapore. The role of the Department of Forensic Psychiatry at the Institute of Mental Health, which is the only forensic psychiatry department in the country, will be highlighted. Civil commitment and the treatment of unfit accused persons and insanity acquittees is reviewed. The role of forensic psychiatric assessments in the Singapore courts is examined. The application of the insanity and diminished responsibility defenses are reviewed. A trend is identified in the Singapore courts towards a more rehabilitation-focused sentencing approach and the role that forensic psychiatric assessments play in cases involving mentally disordered offenders is highlighted. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Autism spectrum disorder: forensic issues and challenges for mental health professionals and courts.

Science.gov (United States)

Freckelton, Ian

2013-09-01

Autism spectrum disorder (ASD), as defined in DSM-V, can be relevant in a variety of ways to decision-making by courts and tribunals. This includes the family, disciplinary, discrimination and criminal law contexts. By reviewing decisions made by superior courts in a number of common law jurisdictions, this article identifies a pivotal role for mental health professionals closely familiar with both the disorder and forensic exigencies to educate courts about the inner world of those with ASD. Highlighting areas of criminality that court decisions have dealt with, especially in relation to persons with Asperger's Disorder, as defined by DSM-IV, it calls for further research on the connection between ASD, on the one hand, and conduct, capacities and skills, on the other hand. It urges enhancement of awareness of the forensic repercussions of the disorder so that expert evidence can assist the courts more humanely and informedly to make criminal justice and other decisions. © 2013 John Wiley & Sons Ltd.

Causes and management of aggression and violence in a forensic mental health service: perspectives of nurses and patients.

Science.gov (United States)

Dickens, Geoffrey; Piccirillo, Maria; Alderman, Nick

2013-12-01

Nurses' attitudes about the causes and management of aggression affects their choice of intervention. We aimed to compare the attitudes held by patients and staff in a forensic mental health service with the Management of Aggression and Violence Attitudes Scale, and examine the factor validity of the tool in this setting by conducting a prospective comparative questionnaire survey. Staff (n = 72) and patient (n = 98) attitudes differed to a limited extent. Confirmatory factor analysis refuted the previously reported structure of the tool. Exploratory factor analysis suggested three underlying factors related to modifiability of aggression, hands on management, and hands off management. Patients were more optimistic than nurses about the modifiability of aggressive behaviour. Male patients and those with diagnoses other than personality disorder were significantly more likely to agree about modifiability than controls. Forensic inpatients recognize the need for the use of a range of techniques to prevent and manage aggression and violence, but selected groups are most likely to believe that aggression is modifiable. Prevention and management of aggression training should emphasize the modifiability of aggressive behaviour. The development of measures of modifiability and management style would assist in the evaluation of training and would offer new avenues for research. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Forensic mental health clinician's experiences with and assessment of alliance regarding the patient's readiness to be released from mechanical restraint

DEFF Research Database (Denmark)

Nielsen, Lea Deichmann; Gildberg, Frederik Alkier; Bech, Per

2018-01-01

One of the main reasons for prolonged duration of mechanical restraint is patient behaviour in relation to the clinician-patient alliance. This article reports on the forensic mental health clinicians experiences of the clinician-patient alliance during mechanical restraint, and their assessment...

Mental health services in KwaZulu-Natal | Mkize | South African ...

African Journals Online (AJOL)

... is divided into nine sections, namely organisational structure; education, training and research; mental health service provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.

Detached concern of forensic mental health nurses in therapeutic relationships with patients the application of the early recognition method related to detached concern.

Science.gov (United States)

Fluttert, Frans; van Meijel, Berno; Nijman, Henk; Bjørkly, Stål; Grypdonck, Mieke

2010-08-01

Improvement of the interaction between forensic mental health nurses and patients may lead to a reduction of inpatient violence. The concept under study is detached concern, which refers to nurses' skills to neutralize the emotional appeal of patients by a balanced attitude between objectivity and emotional involvement. The Patient Contact Questionnaire (PCQ) aims at measuring the degree of concern of nurses for their patients. The PCQ was applied in a pretest-posttest design, evaluating the effects of the Early Recognition Method (ERM). This method aims at the prevention of inpatient violence in forensic psychiatry. Subjects were 116 forensic mental heath nurses working on 16 wards of a large Dutch forensic hospital. First, the baseline scores were compared to scores reported in an earlier study conducted in general psychiatry. Second, pretest-posttest comparisons were carried out for all nurses, and for subgroups of nurses with regard to gender, educational level, years of working experience, and patient population. Third, pretest-posttest comparisons were made on the PCQ item level. The baseline scores of male nurses indicated significantly higher levels of concern than those of female nurses. In addition, more experienced nurses scored significantly higher with regard to concern than less experienced nurses. When comparing the scores before and after applying ERM, no significant differences were found. However, the sores of female nurses showed a tendency toward more concern after implementation of ERM. Detached concern may be a meaningful concept in forensic mental health nursing in measuring nurses' concern for their patients. Levels of detached concern did not change significantly after application of ERM. However, the application of the PCQ could contribute to a better understanding of the interaction between nurses and their patients. 2010 Elsevier Inc. All rights reserved.

Survey of forensic mental health experts on pro se competence after Indiana v. Edwards.

Science.gov (United States)

Kaufman, Andrew R; Knoll, James L; Way, Bruce B; Leonard, Cecilia; Widroff, Jacob

2011-01-01

In Indiana v. Edwards (2008) the U.S. Supreme Court held that a higher standard may be required for pro se competence (PSC) than for competence to stand trial (CST), but provided little guidance for the trial court judge. This survey of forensic mental health experts studied potential PSC criteria. Sixty-eight (22.7%) forensic evaluators replied. Three McGarry criteria were reported as requiring a much higher standard for PSC: to appraise the available legal defenses (45.6%), to plan a legal strategy (51.5%), and to question and challenge witnesses (44.1%). Sixty percent agreed that standby counsel should be mandatory. Respondents opined that average abilities were sufficient for intelligence (77.9%), literacy (69.1%), and verbal ability (70.6%) were sufficient. PSC examiners may wish to assess appraisal of available legal defenses, planning a legal strategy, and questioning and challenging witnesses for a higher standard than CST. Evaluators should also assess the defendant's willingness to accept standby counsel (SBC) and the defendant's motivation for attempting a pro se defense.

The Therapeutic Approach to a Patient's Criminal Offense in a Forensic Mental Health Nurse-Patient Relationship-The Nurses' Perspectives.

Science.gov (United States)

Askola, Riitta; Nikkonen, Merja; Putkonen, Hanna; Kylmä, Jari; Louheranta, Olavi

2017-07-01

The purpose of this study is to describe the therapeutic approach to a patient's criminal offense in a forensic mental health nurse-patient relationship from the nurse's perspective. Eight nurses in a Finnish forensic psychiatric hospital were interviewed, and the resultant research material was analyzed by inductive content analysis. The results revealed the process of the therapeutic approach to a patient's offense, which comprises numerous steps and various phases. For the nurse, the process of working through the offense can be divided into stages in which an attempt is made to respond to the patient's behavior and interaction in a manner that leads to working through the criminal act. © 2016 Wiley Periodicals, Inc.

Intellectual disability, mental illness and offending behaviour: forensic cases from early twentieth-century Ireland.

Science.gov (United States)

Kelly, B D

2010-09-01

The history of institutional care for individuals with intellectual disability is under-researched, complex and troubling. To explore the experiences of women who may have had intellectual disability and/or mental illness and were admitted to forensic psychiatric care in early twentieth-century Ireland. All female case records at the Central Mental Hospital, Dublin from 1910 to 1948 (n = 42) were studied for evidence of possible intellectual disability and a series of five cases is presented in detail. These committals occurred in the context of adverse social conditions, over-crowding in asylums and a belief that rates of mental illness were rising. Particular challenges included diagnostic issues (especially in relation to intellectual disability), adjustment to asylum environments, mental illness and physical ill-health. The institutional experiences of individuals with intellectual disability represents an important area for further historical research, using larger and more varied forensic populations.

Detached Concern of Forensic Mental Health Nurses in Therapeutic Relationships With Patients: The Application of the Early Recognition Method Related to Detached Concern

NARCIS (Netherlands)

Fluttert, F.A.J.; Meijel, B.K.G. van; Nijman, H.L.I.; Björkly, S.; Grypdonck, M.H.F.

2010-01-01

Objective - Improvement of the interaction between forensic mental health nurses and patients may lead to a reduction of inpatient violence. The concept under study is detached concern, which refers to nurses' skills to neutralize the emotional appeal of patients by a balanced attitude between

The DUNDRUM Quartet: validation of structured professional judgement instruments DUNDRUM-3 assessment of programme completion and DUNDRUM-4 assessment of recovery in forensic mental health services

Directory of Open Access Journals (Sweden)

McDonnell Kim

2011-07-01

Full Text Available Abstract Background Moving a forensic mental health patient from one level of therapeutic security to a lower level or to the community is influenced by more than risk assessment and risk management. We set out to construct and validate structured professional judgement instruments for consistency and transparency in decision making Methods Two instruments were developed, the seven-item DUNDRUM-3 programme completion instrument and the six item DUNDRUM-4 recovery instrument. These were assessed for all 95 forensic patients at Ireland's only forensic mental health hospital. Results The two instruments had good internal consistency (Cronbach's alpha 0.911 and 0.887. Scores distinguished those allowed no leave or accompanied leave from those with unaccompanied leave (ANOVA F = 38.1 and 50.3 respectively, p Conclusions The DUNDRUM-3 programme completion items distinguished significantly between levels of therapeutic security while the DUNDRUM-4 recovery items consistently distinguished those given unaccompanied leave outside the hospital and those in the lowest levels of therapeutic security. This data forms the basis for a prospective study of outcomes now underway.

Forensic psychiatry approach to mental disorders resulting from substance abuse

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Ćirić Zoran

2014-01-01

relevant from the point of view of forensic psychiatry. The author's primary goal in this paper is to present the basic postulates underlying the perception of drug abuse and drug addiction in forensic psychiatry, both from the theoretical and practical point of view. In exploring the practical aspect of this issue, the author focuses on presenting the basic principles of forensic-psychiatric expertise of criminal offenders who have been diagnosed as having mental disorders caused by drug abuse. The expertise includes different aspects of assessing mental disorders: giving professional opinions on the offender's mental capacity (sanity, assessing the potential danger of recidivism or commission of a more serious criminal act, and giving proposals for relevant of security measures concerning the mandatory treatment of drug addicts both in outpatient clinics and in other relevant in-patient medical institutions. Given the fact that mental disorders stemming from drug abuse frequently have numerous financial, family and professional implications, the author presents some forensic psychiatric attitudes pertaining to the assessment of contractual capacity of these persons, the assessment of their working capacity (including the remaining working ability or temporary inability to work, the assessment of mental capacity for exercising the parental right or custodianship rights. In that context, the author provides the forensic psychiatric aspects of these mental disorders from the aspect of civil law. Drug abuse and drug addiction involve serious and complex socio-pathological problems which are difficult to treat/cure. This paper is the author's contribution to casting light on these issues, primarily from the aspect of forensic psychiatry.

An evaluation of an employment pilot to support forensic mental health service users into work and vocational activities.

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Samele, Chiara; Forrester, Andrew; Bertram, Mark

2018-02-01

Few employment programmes exist to support forensic service users with severe mental health problems and a criminal history. Little is known about how best to achieve this. The Employment and Social Inclusion Project (ESIP) was developed and piloted to support forensic service users into employment and vocational activities. This pilot service evaluation aimed to assess the number of service users who secured employment/vocational activities and explored services users' and staff experiences. Quantitative data were collected to record the characteristics of participating service users and how many secured employment and engaged in vocational activities. Eighteen qualitative interviews were conducted with service users and staff. Fifty-seven service users engaged with the project, most were men (93.0%) and previously employed (82.5%). Four service users (7.0%) secured paid competitive employment. Eight (14.0%) gained other paid employment. Tailored one-to-one support to increase skills and build confidence was an important feature of the project. Creation of a painting and decorating programme offered training and paid/flexible work. This exploratory project achieved some success in assisting forensic service users into paid employment. Further research to identify what works well for this important group will be of great value.

Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders.

Science.gov (United States)

Fujii, Chiyo; Fukuda, Yusuke; Ando, Kumiko; Kikuchi, Akiko; Okada, Takayuki

2014-01-01

Until the recent enactment of the Medical Treatment and Supervision Act (MTSA) in 2005, neither legislations nor facilities for mentally disordered offenders were available in Japan. The aim of the country's forensic mental health services, based on this new law, is to improve the social reintegration of mentally disordered offenders. In order to provide optimal psychiatric care to these individuals, specialised court proceedings, treatment facilities, and concrete guidelines have been established. The aim of this study was to review the current status of the new system and to clarify future challenges for improving services. The authors collected official statistics regarding the new system published separately by the Ministry of Health, Labour and Welfare, the Ministry of Justice, and the Supreme Court of Japan. We aggregated the data and examined the system's current implementation status, nationwide. There were 2,750 requests for enrolment in the MTSA system between its initiation in 2005 and 31 December 2012. Of those requests, 2,724 cases had been concluded in court. In 63.1% of the cases, an inpatient treatment order had been made; 82.4% of those inpatients were diagnosed with schizophrenia. By the end of March 2012, two patients completing treatment under the MTSA had re-committed a serious offense. While overall designated inpatient and outpatient treatment facilities have reached national targets in terms of resources and beds available, a regional gap in MTSA designated facilities remains and the number of patients under inpatient treatment order is on the increase. Overall, the MTSA system has been running smoothly without encountering any serious problems. However, several concerns have emerged, such as the accumulation of patients under inpatient treatment order and insufficient regional resources. To more successfully promote the reintegration of mentally disordered offenders, improvements in outpatient treatment and welfare services are crucial. In

Mental Health and the Law.

Science.gov (United States)

Weinstein, Henry C.

1982-01-01

Briefly reviews historical development of mental health and the law as a multidisciplinary field and considers variety of information seekers addressing certain topics of special importance. Pertinent information sources and services are outlined. Fifteen references and a recommended core library for fellowship programs in forensic psychiatry are…

Forensic psychiatry in India: Past, present, and future.

Science.gov (United States)

Nambi, S; Ilango, Siva; Prabha, Lakshmi

2016-12-01

Forensic psychiatry is a subspecialty of psychiatry, in which scientific and clinical expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional, or legislative matters. Forensic psychiatry is still in an infant stage in India and other developing countries. Law is the sanctioning discipline, and Psychiatry is the therapeutic discipline. Due to various reasons, Forensic Psychiatry is reared as Cinderella in our country; "which is much neglected, ignored, misinterpreted, and misunderstood. Legislation forms an integral component in the implementation of Mental Health Care; there is a dynamic relationship between the concept of mental illness, treatment of the mentally ill, and the law. Mental Health legislation is essential in protecting the rights and dignity of persons with Mental Disorders and for implementing effectively the mental health services. "Effective mental health legislation can provide a legal frame work to integrate mental health services in the community as to overcome stigma, discrimination, and exclusion of mentally ill persons. Legislations can also create enforceable standards for high quality medical care and improve access to care and protect civil, political, social, and economic rights of the mentally ill individual, including right to access to education, employment, housing, and social security."

Physical health of patients with severe mental illness: an intervention on medium secure forensic unit.

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Vasudev, Kamini; Thakkar, Pratish B; Mitcheson, Nicola

2012-01-01

Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side-effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year. A physical health monitoring sheet was introduced in all the patients' records on a 15-bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re-audit were compared. At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re-audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status. This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward. There is a need for improved access to physical health care in long-stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients. Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.

The forensic float nurse: a new concept in the effective management of service delivery in a forensic program.

Science.gov (United States)

Cyr, J J; Paradis, J

2012-12-01

A major challenge faced by Forensic Program management teams is to balance their budgets due to the unpredictability of the forensic patient population, particularly in the context of managing staffing costs where the hospital is not the "gatekeeper" and does not have control over who is admitted and when. In forensic mental health, the justice system, either via the courts, or review boards, determines who is ordered for admission to hospital for assessment or treatment and rehabilitation. Hospitals have little, if any, recourse but to admit these mentally disordered offenders. This typically results in increased levels of staffing with concomitant overtime costs. The literature suggests that clustered float pool nurses develop enhanced relationships with staff and patients, thereby enabling them to attain specialized clinical expertise to treat specific patient populations, promoting safer, high quality care, and overall are more cost effective. Forensic nursing is recognized as a mental health subspecialty. The "Forensic Float Nurse" concept was piloted to provide readily available, highly adaptable, skilled forensic nurses to assist in times of unpredictably heavy workloads and/or unplanned staffing shortages. A significant reduction approaching 50% in overtime was achieved. Heuristic implications of this finding are presented. © 2012 International Association of Forensic Nurses.

[Psychiatric patients at the police station in the southern South Holland region: assessment by the District Health Service forensic doctor].

Science.gov (United States)

Aardoom, H A; Huisman-Wolfs, M M; Nijs, H G T

2002-09-21

To describe the epidemiological characteristics of ambulant psychiatric patients who were either brought to the police station or who came by themselves, but who were not kept in a cell, as a basis for the development of a reception protocol. Descriptive. The data from the medical records from 2000 kept by the forensic doctors employed by the district health services for the Southern South Holland region were inventoried. On request by the police, the forensic doctors examined 203 clients. The majority of these were middle-aged men who did have a place of residence. The reason for police involvement was bizarre or confused behaviour in public. Half of the patients had received or were receiving some form of psychiatric treatment from the mental health service. In approximately half of the cases the forensic doctor found a solution together with the police. In the other half of the cases the forensic doctor asked the crisis intervention team at the mental health service for an evaluation. Two thirds of these patients were hospitalised and one third was sent away. Because examination by both the forensic doctor and the mental health service psychiatrist and other procedures were lengthy (up to 6 hours), patients had to spend a long time in a holding cell at the police station that was not designed for stays of this length of time, and often lacked toilet facilities. The forensic doctor treated about half the clients without the need of assistance from the crisis intervention psychiatrist. The temporary accommodation for these confused clients was inadequate.

The DUNDRUM Quartet: validation of structured professional judgement instruments DUNDRUM-3 assessment of programme completion and DUNDRUM-4 assessment of recovery in forensic mental health services.

LENUS (Irish Health Repository)

O'Dwyer, Sarah

2011-07-03

Abstract Background Moving a forensic mental health patient from one level of therapeutic security to a lower level or to the community is influenced by more than risk assessment and risk management. We set out to construct and validate structured professional judgement instruments for consistency and transparency in decision making Methods Two instruments were developed, the seven-item DUNDRUM-3 programme completion instrument and the six item DUNDRUM-4 recovery instrument. These were assessed for all 95 forensic patients at Ireland\\'s only forensic mental health hospital. Results The two instruments had good internal consistency (Cronbach\\'s alpha 0.911 and 0.887). Scores distinguished those allowed no leave or accompanied leave from those with unaccompanied leave (ANOVA F = 38.1 and 50.3 respectively, p < 0.001). Scores also distinguished those in acute\\/high security units from those in medium or in low secure\\/pre-discharge units. Each individual item distinguished these levels of need significantly. The DUNDRUM-3 and DUNDRUM-4 correlated moderately with measures of dynamic risk and with the CANFOR staff rated unmet need (Spearman r = 0.5, p < 0.001). Conclusions The DUNDRUM-3 programme completion items distinguished significantly between levels of therapeutic security while the DUNDRUM-4 recovery items consistently distinguished those given unaccompanied leave outside the hospital and those in the lowest levels of therapeutic security. This data forms the basis for a prospective study of outcomes now underway.

Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

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Siekkonen Inkeri

2010-06-01

Full Text Available Abstract Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme

Routine Violence Risk Assessment in Community Forensic Mental Healthcare

NARCIS (Netherlands)

van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

2010-01-01

We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

Age onset of offending and serious mental illness among forensic psychiatric patients: A latent profile analysis.

Science.gov (United States)

Penney, Stephanie R; Prosser, Aaron; Simpson, Alexander I F

2018-01-16

Developmental typologies regarding age of onset of violence and offending have not routinely taken account of the role of serious mental illness (SMI), and whether age of onset of offending in relation to onset of illness impacts on the manifestation of offending over the life course. To test whether forensic psychiatric patients can be classified according to age of onset of SMI and offending, and, if so, whether subtypes differ by sex. Details of all 511 patients enrolled into a large forensic mental health service in Ontario, Canada, in 2011 or 2012 were collected from records. A latent profile analysis supported a 2-class solution in both men and women. External validation of the classes demonstrated that those with a younger age onset of serious mental illness and offending were characterised by higher levels of static risk factors and criminogenic need than those whose involvement in both mental health and criminal justice systems was delayed to later life. Our findings present a new perspective on life course trajectories of offenders with SMI. While analyses identified just two distinct age-of-onset groups, in both the illness preceded the offending. The fact that our sample was entirely drawn from those hospitalised may have introduced a selection bias for those whose illness precedes offending, but findings underscore the complexity and level of need among those with a younger age of onset. Copyright © 2018 John Wiley & Sons, Ltd. Copyright © 2018 John Wiley & Sons, Ltd.

The attitudes of forensic nurses to substance using service users.

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Foster, J H; Onyeukwu, C

2003-10-01

There is now a body of research that has shown that the attitudes of nurses towards substance misuse in the mentally ill are generally suboptimal and this has an impact on the quality of nursing care provided. Despite this, to date there have been no published studies that have examined the attitudes of forensic nurses towards substance misusing forensic service users. Sixty-three multiethnic registered forensic psychiatric nurses based on an inpatient unit in outer London were surveyed using the Substance Abuse Attitude Survey (SAAS). This has five subscores: Treatment Intervention, Treatment Optimism, Permissiveness, Non-Moralism and Non-Stereotypes. Only Permissiveness scores were at an optimum level and equivalent to other community mental health workers. The Treatment Intervention and Treatment Optimism subscores were well below those of a multidisciplinary group of community mental health workers. Three other findings were of note. Firstly, women had higher Non-Moralism scores than men. Secondly, staff nurses had higher Non-Stereotypes scores than other grades. Finally, Black nurses had higher Treatment Optimism scores than non-Black colleagues. In conclusion, the attitudes of forensic nurses towards substance misuse in forensic clients are more suboptimal than other groups of community mental health workers. Our findings also indicate that gender, staff grading and ethnicity are associated with suboptimal scores.

Improving the physical health of people with severe mental illness in a low secure forensic unit: An uncontrolled evaluation study of staff training and physical health care plans.

Science.gov (United States)

Haddad, Mark; Llewellyn-Jones, Sian; Yarnold, Steve; Simpson, Alan

2016-12-01

The life expectancy of people with severe mental illnesses is substantially reduced, and monitoring and screening for physical health problems is a key part of addressing this health inequality. Inpatient admission presents a window of opportunity for this health-care activity. The present study was conducted in a forensic mental health unit in England. A personal physical health plan incorporating clearly-presented and easily-understood values and targets for health status in different domains was developed. Alongside this, a brief physical education session was delivered to health-care staff (n = 63). Printed learning materials and pedometers and paper tape measures were also provided. The impact was evaluated by a single-group pretest post-test design; follow-up measures were 4 months' post-intervention. The feasibility and acceptability of personal health plans and associated resources were examined by free-text questionnaire responses. Fifty-seven staff provided measures of attitudes and knowledge before training and implementation of the physical health plans. Matched-pairs analysis indicated a modest but statistically-significant improvement in staff knowledge scores and attitudes to involvement in physical health care. Qualitative feedback indicated limited uptake of the care plans and perceived need for additional support for better adoption of this initiative. Inpatient admission is a key setting for assessing physical health and promoting improved management of health problems. Staff training and purpose-designed personalized care plans hold potential to improve practice and outcomes in this area, but further support for such innovations appears necessary for their uptake in inpatient mental health settings. © 2016 Australian College of Mental Health Nurses Inc.

Feeling Safe and Taking on Responsibilities: Newly Graduated Nurses' Perceptions and Evaluations of Their Transition Into a Forensic Mental Health Inpatient Setting.

Science.gov (United States)

Sørensen, Tanja; Tingleff, Ellen B; Gildberg, Frederik A

2018-03-30

Forensic mental health care is faced with serious problems in the recruitment and retention of newly graduated nurses (NGNs). Research into NGNs' experiences of their transition to and evaluations of transition programs in forensic care is sparse, and more studies are called for. This study aimed to investigate the characteristics of NGNs' experiences and perceptions of their transition into a forensic setting and their evaluations of the introduction period. Three focus group interviews were carried out, involving 13 NGNs, lasting 79.68 minutes on average. They were analyzed using thematic analysis. Results show two main themes: "feeling safe" and "taking on responsibilities." If NGNs felt overburdened with clinical responsibilities during their transition, their feeling of safety reduced. The converse also applied; theThe safer they felt, the greater clinical responsibility they felt capable of handling. The more difficult the NGNs perceived the informal transition, the more unsafe they felt, and the more negatively they perceived the responsibilities placed upon them. Tailored programs designed to support both the informal and formal transitions are recommended, along with preceptorship, theoretical training, and role-based support, such as a shift manager, along with early introduction to conflict management and security measures.

An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS

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Cooper Sara

2010-01-01

Full Text Available Abstract Background The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. Methods A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS Version 2.2. Results Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC. The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health, and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population. Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Conclusion Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.

Review of psychiatric services to mentally disordered offenders around the Pacific Rim.

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Every-Palmer, Susanna; Brink, Johann; Chern, Tor P; Choi, Wing-Kit; Hern-Yee, Jerome Goh; Green, Bob; Heffernan, Ed; Johnson, Sarah B; Kachaeva, Margarita; Shiina, Akihiro; Walker, David; Wu, Kevin; Wang, Xiaoping; Mellsop, Graham

2014-03-01

This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in-reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial ("disability") are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Psychiatric/ psychological forensic report writing.

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Young, Gerald

Approaches to forensic report writing in psychiatry, psychology, and related mental health disciplines have moved from an organization, content, and stylistic framework to considering ethical and other codes, evidentiary standards, and practice considerations. The first part of the article surveys different approaches to forensic report writing, including that of forensic mental health assessment and psychiatric ethics. The second part deals especially with psychological ethical approaches. The American Psychological Association's Ethical Principles and Code of Conduct (2002) provide one set of principles on which to base forensic report writing. The U.S. Federal Rules of Evidence (2014) and related state rules provide another basis. The American Psychological Association's Specialty Guidelines for Forensic Psychology (2013) provide a third source. Some work has expanded the principles in ethics codes; and, in the third part of this article, these additions are applied to forensic report writing. Other work that could help with the question of forensic report writing concerns the 4 Ds in psychological injury assessments (e.g., conduct oneself with Dignity, avoid the adversary Divide, get the needed reliable Data, Determine interpretations and conclusions judiciously). One overarching ethical principle that is especially applicable in forensic report writing is to be comprehensive, scientific, and impartial. As applied to forensic report writing, the overall principle that applies is that the work process and product should reflect integrity in its ethics, law, and science. Four principles that derive from this meta-principle concern: Competency and Communication; Procedure and Protection; Dignity and Distance; and Data Collection and Determination. The standards or rules associated with each of these principles are reviewed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

OpenAIRE

Davies, Jacqueline; Heyman, Bob; Godin, Paul; Shaw, M.; Reynolds, L.

2006-01-01

Managers, doctors, nurses, occupational therapists, social workers, psychologists, unqualified staff and service users were interviewed for a qualitative study of risk management and rehabilitation in an inner city medium secure forensic mental health care unit. Different professional orientations to service user problems were identified. Doctors focused primarily on the diagnosis of mental disorder, which they managed mainly through pharmaceutical interventions. Psychologists were principall...

Insane defendants and forensic convicts: before and after the onset of the new forensic psychiatry network and the criminal justice system reform in Chile.

Science.gov (United States)

Cid, Rodrigo D

2010-09-01

Like other Latin American democratic societies, Chile is supposed to respect legal rights of mentally ill people who are in trouble with the law, and provide them protection, treatment and welfare. Therefore, in this decade, the Chilean Criminal Justice and Mental Health System has undergone significant changes. Because this article is related to the recent social features that involve different areas such as justice, mental health assistance and forensic psychiatry systems, and thereby the nonexistence of current literature that reviews this matter from a global perspective and its implications for the mental health population involved in the justice system, its review and analysis seems to be interesting. The 'New Forensic Psychiatry Network' (NFPN) has been putting in relevant efforts to offer proper treatment and forensic assessment taking into account the civil rights of mentally insane people, and the 'Criminal Justice System Reform' (CJSR) is making possible legal conditions for better justice ensuring a more just resolution of insane defendants' and mentally ill convicts' lawsuits. From the author's viewpoint, all these changes are leading to a deep cultural impact on a Chilean's mind, changing their vision of justice and how society should respect insane defendants' and mentally ill convicts' legal rights.

A rapid appraisal of the status of mental health support in post-rape ...

African Journals Online (AJOL)

Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. ... (i.e. clinical care, including forensic management), the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of ...

Factors impacting perceived safety among staff working on mental health wards.

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Haines, Alina; Brown, Andrew; McCabe, Rhiannah; Rogerson, Michelle; Whittington, Richard

2017-09-01

Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

Gender differences in the rate of restriction to room among Ontario forensic patients.

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Mathias, Krista; Hirdes, John P

2015-07-01

Gender can have separate and interacting effects on mental health. Gender-based analysis provides insight into these effects on mental health, and it can provide evidence to inform policy and practice to meet these gender-specific needs among persons in forensic mental health settings. Both individual and facility-level characteristics play a role in restriction to room as a form of control intervention in forensic mental health. Understanding the gender differences associated with the factors that increase a person's risk of restriction to room can allow for more targeted interventions and provide insight into policies that will help reduce these types of control interventions. © 2015 The Canadian College of Health Leaders.

Mental health nurses' attitudes toward self-harm: Curricular implications

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David G. Shaw

2016-10-01

Methods: The study aimed to explore the attitudes of mental health nurses toward service users who self-harm in secure environments, and to inform mental health curriculum development. It was conducted in a large forensic mental health unit, containing medium and low secure facilities, to the west of London, UK. A qualitative multi-method approach was adopted, underpinned by interpretative phenomenological analysis. Data were obtained from mental health nurses using individual interviews and focus groups, and analysis followed a step-by-step thematic approach using interpretative phenomenological analysis. Results: Nurses' attitudes toward self-harm varied but were mainly negative, and this was usually related to limited knowledge and skills. The results of the study, framed by the Theory of Planned Behaviour, led to the development of a proposed educational model entitled ‘Factors Affecting Self-Harming Behaviours’ (FASH. Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.

Ethical issues in perinatal mental health research.

Science.gov (United States)

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

The national trajectory project of individuals found not criminally responsible on account of mental disorder. Part 5: how essential are gender-specific forensic psychiatric services?

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Nicholls, Tonia L; Crocker, Anne G; Seto, Michael C; Wilson, Catherine M; Charette, Yanick; Côté, Gilles

2015-03-01

To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different. Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services.

Concurrent validity and clinical utility of the HCR-20V3 compared with the HCR-20 in forensic mental health nursing: similar tools but improved method.

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Bjørkly, Stål; Eidhammer, Gunnar; Selmer, Lars Erik

2014-01-01

The main scope of this small-scale investigation was to compare clinical application of the HCR-20V3 with its predecessor, the HCR-20. To explore concurrent validity, two experienced nurses assessed 20 forensic mental health service patients with the tools. Estimates of internal consistency for the HCR-20 and the HCR-20V3 were calculated by Cronbach's alpha for two levels of measurement: the H-, C-, and R-scales and the total sum scores. We found moderate (C-scale) to good (H- and R- scales and aggregate scores) estimates of internal consistency and significant differences for the two versions of the HCR. This finding indicates that the two versions reflect common underlying dimensions and that there still appears to be differences between V2 and V3 ratings for the same patients. A case from forensic mental health was used to illustrate similarities and differences in assessment results between the two HCR-20 versions. The case illustration depicts clinical use of the HCR-20V3 and application of two structured nursing interventions pertaining to the risk management part of the tool. According to our experience, Version 3 is superior to Version 2 concerning: (a) item clarity; (b) the distinction between presence and relevance of risk factors; (c) the integration of risk formulation and risk scenario; and (d) the explicit demand to construct a risk management plan as part of the standard assessment procedure.

Forensic Index and Substance Abuse among Psychiatric Patients ...

African Journals Online (AJOL)

Although forensic index and substance use are crucial issues in clinical work among mentally ill patients, studies emanating from psychiatric facilities in nonwestern cultures have been relatively scarce. This paper examines this issue in a tertiary health institution. Participants were 259 mentally ill patients (124 inpatients ...

Effects of Ramadan on Forensic Cases Presenting to Emergency Service

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F. Sarı Doğan

2015-06-01

Full Text Available The term "forensic case" is defined as disruption of physical and/or mental health of an individual due to external factors. Forensic cases are most frequently encountered in emergency services. Ramadan, the ninth month of Islamic calendar, is a month of fasting throughout which Muslims from all around the world worship by observing fasting. There are many studies focusing on the effects of fasting on health. The purpose of this study is to examine the effects of Ramadan on forensic cases presenting to emergency service.

Towards a model for understanding the development of post-traumatic stress and general distress in mental health nurses.

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Lee, Joyce; Daffern, Michael; Ogloff, James R P; Martin, Trish

2015-02-01

In their daily work, mental health nurses (MHN) are often exposed to stressful events, including patient-perpetrated aggression and violence. Personal safety and health concerns, as well as concern for the physical and psychological well-being of patients, dominate; these concerns have a profound impact on nurses. This cross-sectional study explored and compared the psychological well-being of 196 hospital-based MHN (97 forensic and 99 mainstream registered psychiatric nurses or psychiatric state enrolled nurses). The aim was to examine exposure to inpatient aggression and work stress, and identify factors contributing to the development of post-traumatic stress reactions and general distress. Multiple regression analyses indicated that working in a mainstream setting is associated with increased work stress; however, mainstream and forensic nurses experienced similar psychological well-being. As a group, 14-17% of mainstream and forensic nurses met the diagnostic criteria for post-traumatic stress disorder, and 36% scored above the threshold for psychiatric caseness. A tentative model of post-traumatic stress and general distress in nurses was developed, illustrating the impact of aggression and stress on well-being. The present study affirms that mental health nursing is a challenging and stressful occupation. Implications for organizations, managers, and individual nurses are discussed. © 2014 Australian College of Mental Health Nurses Inc.

Malaysia mental health country profile.

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Parameshvara Deva, M

2004-01-01

severe shortages of other professionals such as clinical psychologists and social workers in mental health services. There are a few specialists, and specialized services in child, adolescent, forensic, rehabilitative, liaison or research fields of mental health. In the area of services for women and children, as well as the disabled in the community, there are strong efforts to improve the care and provide services that are in keeping with a caring society. New legislation on these are being passed every year and the setting up of a Ministry for Women's Affairs is one such move in recent years. Mental health in Malaysia has been slow in developing but has in the past decade seen important strides to bring it on par with other branches of medicine.

Revenge Pornography: Mental Health Implications and Related Legislation.

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Kamal, Mudasir; Newman, William J

2016-09-01

Revenge pornography, also known as nonconsensual pornography, is a subtype of cyberharassment/cyberstalking, and a serious problem facing society in the Internet age. Revenge pornography can result in lifelong mental health consequences for victims, damaged relationships, and social isolation. Recently, a growing number of states have recognized the importance of this phenomenon and have enacted legislation that criminalizes it. The technology industry has also taken steps to assist victims of revenge pornography by creating web forms to request removal of links leading to the explicit content. The Cyber Civil Rights Initiative (CCRI) has been instrumental in promoting public awareness of this often overlooked problem and in providing services for victims. Although important steps have been made, greater recognition of the gravity of this problem and the mental health implications of revenge pornography is needed to expand legislation criminalizing such acts. A federal criminal law, in particular, is much overdue. Mental health professionals must understand the dimensions of revenge pornography to be able to identify and address the consequences in both forensic and clinical settings. © 2016 American Academy of Psychiatry and the Law.

Prison mental health in-reach teams, serious mental illness and the Care Programme Approach in England.

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Brooker, Charlie; Webster, Russell

2017-08-01

The delivery of prison mental health services in England is examined over the last 12 years. Resources for services have grown significantly during this period and improved organisational models for the delivery of services are now in place. During this period however the challenges of working in the prison environment have increased. The paper argues that a history of sexual abuse or violence are common amongst prisoners and the Care Programme Approach (CPA) provides the vehicle to assess these histories through the use of routine enquiry. Commissioners of prison mental health services now need to ensure that teams are delivering cogent trauma-based interventions where relevant and the outcomes are measured. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Forensic psychiatry in Africa: prospects and challenges

African Journals Online (AJOL)

mental health professionals burdened with large numbers of patients.6. In most ... by the courts for forensic assessments and testimony in the region. .... A comparison of risk factors for habitual violence in pre- ... Homicide and suicide in Benin-.

Mental health services costs within the Alberta criminal justice system.

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Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

2016-01-01

Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

The risks, needs and stages of recovery of a complete forensic patient cohort in an Australian state.

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Adams, Jonathon; Thomas, Stuart D M; Mackinnon, Tobias; Eggleton, Damien

2018-02-07

Routine outcome measures are increasingly being mandated across mental health services in Australia and overseas. This requirement includes forensic mental health services, but their utility in such specialist services and the inter-relationships between the measures remain unclear. This study sought to characterise the risks, needs and stages of recovery of an entire cohort of forensic patients in one jurisdiction in Australia. Local expert groups, comprising of members of the forensic patient treating teams, were formed to gather information about the status and needs of all forensic patients in the State of New South Wales, Australia. The expert groups provided demographic information and completed three assessment tools concerning the risks, needs and stages of recovery of each forensic patient. The cohort of 327 forensic patients in NSW appears to be typical of forensic mental health service populations internationally when considering factors such as gender, diagnosis, and index offence. A number of important differences across the three structured tools for forensic patients in different levels of secure service provision are presented. The DUNDRUM Quartet demonstrated interesting findings, particularly in terms of the therapeutic security needs, the treatment completion, and the stages of recovery for the forensic patients in the community. The CANFOR highlighted the level of needs across the forensic patient population, whilst the HCR-20 data showed there was no significant difference in the mean clinical and risk management scores between male forensic patients across levels of security. To the authors' knowledge this is the first study of its kind in New South Wales, Australia. We have demonstrated the utility of using a suite of measures to evaluate the risks, needs, and stages of recovery for an entire cohort of forensic patients. The data set helps inform service planning and development, together with providing various avenues for future research.

Forensic nursing and the palliative approach to care: an empirical nursing ethics analysis.

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Wright, David Kenneth; Vanderspank-Wright, Brandi; Holmes, Dave; Skinner, Elise

2017-08-02

A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the values of nurses working in forensic psychiatry, and how these values might influence a palliative approach to care for frail and aging patients. Interviews with four nurses working on one of two forensic units of a university-affiliated mental health hospital in an urban area of eastern Canada. Three specific values were found to guide forensic nurses in their care of aging patients that are commensurate with a palliative approach: hope, inclusivity, and quality of life. When we started this project, we wondered whether the culture of forensic nursing practice was antithetical to the values of a palliative approach. Instead, we found several parallels between forensic nurses' moral identities and palliative philosophy. These findings have implications for how we think about the palliative approach in contexts not typically associated with palliative care, but in which patients will increasingly age and die.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

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Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

2017-12-01

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

Perceptions of diagnostic labels in forensic psychiatric practice: a survey of differences between nurses and other disciplines.

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Mason, Tom; Caulfield, Mike; Hall, Rebecca; Melling, Kat

2010-05-01

This paper reports on a study of nurses' and non-nurses' perceptions of labels of mental illness and personality disorder in forensic services in the UK. The objectives of the study were to establish if differences in perceptions existed within, and between, the two groups of professionals. The research method was a survey design with 1,200 questionnaires distributed to nurses and 300 to other professionals in disciplines on forensic units in the UK, with response rates of 34.6% and 43%, respectively. The target population included clinical health care staff who had patient contact, including nurses, psychiatrists, psychologists, social workers, and occupational therapists. The results indicate that there are statistically significant differences within both nursing and non-nursing groups and also between the groups in relation to a "management" perspective for individuals labelled with a personality disorder and a "clinical" focus for individuals who are labelled as mentally ill. This paper adds research into the arena of forensic mental health in relation to the diagnostic labels of mental illness and personality disorders. It also adds evidence of a clinical response or a management response to such diagnostic labels which may impact on the practice of forensic psychiatry.

Forensic case formulation: theoretical, ethical and practical issues.

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Davies, Jason; Black, Susie; Bentley, Natalie; Nagi, Claire

2013-10-01

Forensic case formulation, of increasing interest to practitioners and researchers raises many ethical, theoretical and practical issues for them. Systemic, contextual and individual factors which need to be considered include the multitude of staff often involved with any one individual, the pressure to 'get it right' because of the range of risk implications that are associated with individuals within forensic mental health settings, and individual parameters, for example reluctance to be engaged with services. Copyright © 2013 John Wiley & Sons, Ltd.

Effects of group metacognitive training (MCT on mental capacity and functioning in patients with psychosis in a secure forensic psychiatric hospital: a prospective-cohort waiting list controlled study

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Naughton Marie

2012-06-01

Full Text Available Abstract Background Metacognitive Training (MCT is a manualised cognitive intervention for psychosis aimed at transferring knowledge of cognitive biases and providing corrective experiences. The aim of MCT is to facilitate symptom reduction and protect against relapse. In a naturalistic audit of clinical effectiveness we examined what effect group MCT has on mental capacity, symptoms of psychosis and global function in patients with a psychotic illness, when compared with a waiting list comparison group. Methods Of 93 patients detained in a forensic mental health hospital under both forensic and civil mental health legislation, 19 were assessed as suitable for MCT and 11 commenced. These were compared with 8 waiting list patients also deemed suitable for group MCT who did not receive it in the study timeframe. The PANSS, GAF, MacArthur Competence Assessment Tool- Treatment (MacCAT-T and MacArthur Competence Assessment Tool-Fitness to Plead (MacCAT-FP were recorded at baseline and repeated after group MCT or following treatment as usual in the waiting list group. Results When baseline functioning was accounted for, patients that attended MCT improved in capacity to consent to treatment as assessed by the MacCAT-T (p = 0.019. The more sessions attended, the greater the improvements in capacity to consent to treatment, mainly due to improvement in MacCAT-T understanding (p = 0.014 and reasoning . The GAF score improved in patients who attended the MCT group when compared to the waiting list group (p = 0.038 but there were no changes in PANSS scores. Conclusion Measures of functional mental capacity and global function can be used as outcome measures for MCT. MCT can be used successfully even in psychotic patients detained in a forensic setting. The restoration of elements of decision making capacity such as understanding and reasoning may be a hither-to unrecognised advantage of such treatment. Because pharmacotherapy can be optimised

Effects of group metacognitive training (MCT) on mental capacity and functioning in patients with psychosis in a secure forensic psychiatric hospital: a prospective-cohort waiting list controlled study.

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Naughton, Marie; Nulty, Andrea; Abidin, Zareena; Davoren, Mary; O'Dwyer, Sarah; Kennedy, Harry G

2012-06-18

Metacognitive Training (MCT) is a manualised cognitive intervention for psychosis aimed at transferring knowledge of cognitive biases and providing corrective experiences. The aim of MCT is to facilitate symptom reduction and protect against relapse. In a naturalistic audit of clinical effectiveness we examined what effect group MCT has on mental capacity, symptoms of psychosis and global function in patients with a psychotic illness, when compared with a waiting list comparison group. Of 93 patients detained in a forensic mental health hospital under both forensic and civil mental health legislation, 19 were assessed as suitable for MCT and 11 commenced. These were compared with 8 waiting list patients also deemed suitable for group MCT who did not receive it in the study timeframe. The PANSS, GAF, MacArthur Competence Assessment Tool- Treatment (MacCAT-T) and MacArthur Competence Assessment Tool-Fitness to Plead (MacCAT-FP) were recorded at baseline and repeated after group MCT or following treatment as usual in the waiting list group. When baseline functioning was accounted for, patients that attended MCT improved in capacity to consent to treatment as assessed by the MacCAT-T (p = 0.019). The more sessions attended, the greater the improvements in capacity to consent to treatment, mainly due to improvement in MacCAT-T understanding (p = 0.014) and reasoning . The GAF score improved in patients who attended the MCT group when compared to the waiting list group (p = 0.038) but there were no changes in PANSS scores. Measures of functional mental capacity and global function can be used as outcome measures for MCT. MCT can be used successfully even in psychotic patients detained in a forensic setting. The restoration of elements of decision making capacity such as understanding and reasoning may be a hither-to unrecognised advantage of such treatment. Because pharmacotherapy can be optimised and there is likely to be enough time to complete the course

Characteristics and motivations of absconders from forensic mental health services: a case-control study.

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Wilkie, Treena; Penney, Stephanie R; Fernane, Stephanie; Simpson, Alexander I F

2014-03-27

Absconding from hospital is a significant health and security issue within psychiatric facilities that can have considerable adverse effects on patients, their family members and care providers, as well as the wider community. Several studies have documented correlates associated with absconding events among general psychiatric samples; however, few studies have examined this phenomenon within samples of forensic patients where the perception of threat to public safety in the event of an unauthorized absence from hospital is often higher. We investigate the frequency, timing, and determinants of absconding events among a sample of forensic psychiatric patients over a 24-month period, and compare patients who abscond to a control group matched along several sociodemographic and clinical dimensions. We explore, in a qualitative manner, patients' motives for absconding. Fifty-seven patients were responsible for 102 incidents of absconding during the two year study window. Forensic patients who absconded from hospital were more likely to have a history of absconding attempts, a diagnosed substance use disorder, as well as score higher on a structured professional violence risk assessment measure. Only one of the absconding events identified included an incident of minor violence, and very few included the commission of other illegal behaviors (with the exception of substance use). The most common reported motive for absconding was a sense of boredom or frustration. Using an inclusive definition of absconding, we found that absconding events were generally of brief duration, and that no member of the public was harmed by patients who absconded. Findings surrounding the motivations of absconders suggest that improvements in therapeutic communication between patients and clinical teams could help to reduce the occurrence of absconding events.

[Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

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Daansen, P J; van Schilt, J

2014-01-01

As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders.

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Völlm, Birgit A; Clarke, Martin; Herrando, Vicenç Tort; Seppänen, Allan O; Gosek, Paweł; Heitzman, Janusz; Bulten, Erik

2018-03-20

Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders (MDOs) are often cared for in secure psychiatric environments or prisons. In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective. We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings: The forensic psychiatrist as expert witness, risk, treatment settings for mentally disordered offenders, and what works for MDOs. We undertook a rapid review of the literature with search terms related to: forensic psychiatry, review articles, randomised controlled trials and best practice. We searched the Medline, Embase, PsycINFO, and Cochrane library databases from 2000 onwards for adult groups only. We scrutinised publications for additional relevant literature, and searched the websites of relevant professional organisations for policies, statements or guidance of interest. We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified. We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only. Practitioners need to follow general psychiatric guidance as well as that for offenders, adapted for the complex needs of this patient group, paying particular attention to long-term detention and ethical issues. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Psychiatric comorbidity in forensic psychiatry.

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Palijan, Tija Zarković; Muzinić, Lana; Radeljak, Sanja

2009-09-01

For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to

[Homicide and major mental disorder: what are the social, clinical, and forensic differences between murderers with a major mental disorder and murderers without any mental disorder?].

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Richard-Devantoy, S; Chocard, A-S; Bourdel, M-C; Gohier, B; Duflot, J-P; Lhuillier, J-P; Garré, J-B

2009-09-01

To establish the social, clinical, and forensic differences between murderers suffering from a major mental disorder and murderers without any psychiatric disorder and, in particular, to compare their respective records of psychiatric symptoms and their respective relationship with their victims. We studied 210 forensic examinations of murderers, the offences related to the murders, and the social and clinical information collected from psychiatric court reports on persons convicted of homicide. Firstly, we identified the socio-demographic, clinical and criminological profiles of 210 murderers from which were distinguished murderers with major mental disorder. Then, we compared the profiles of murderers suffering from a major mental disorder with those of murderers without any mental disease. In other words, we compared 37 persons affected with major mental disorder (schizophrenia, paranoiac delusional disorder, and affective disorder) with 73 persons without any mental disorder. We deliberately excluded subjects with personality disorder or abuse of/dependency on drugs, mental retardation or dementia. With the exception of certain variables, murderers with major mental disorder have the same characteristics as others murderers: young man, living alone, with psychiatric and offence records and substance abuse. Murderers with major mental disorder are older (37.8 versus 31.7 years old) than perpretators without any mental disorder, and the former have a psychiatric record more often than the latter (81 versus 32.9%). In addition, contrary to the latter, the former show clinical symptoms of a psychopathological process. Depression, delusional and suicidal ideas are frequent among murderers with a major mental disorder, whereas the persons without mental disorder quarrel or have a row with their victim just before their crime. The victim was known to the perpetrator significantly more often in the major mental disorder group than in the no mental disorder group (94

Exploring nurses' and patients' perspectives of limit setting in a forensic mental health setting.

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Maguire, Tessa; Daffern, Michael; Martin, Trish

2014-04-01

Limit setting is an intervention that is frequently used by mental health nurses. However, limit setting is poorly conceptualized, its purpose is unclear, and there are few evidence-based guidelines to assist nurses to set limits in a safe and effective manner. What is known is that the manner in which nurses set limits influences patients' perceptions of the interactions and their emotional and behavioural responses. In this qualitative study, 12 nurses and 12 patients participated in personal, semistructured interviews that aimed to explore limit setting and to propose principles to guide practice. The findings suggested that: (i) limit setting is important to safety in mental health hospitals; (ii) engaging patients in an empathic manner is necessary when setting limits (when nurses engage in an empathic manner, the therapeutic relationship is more likely to be preserved and the risk of aggressive responses is reduced); and (iii) an authoritative (fair, respectful, consistent, and knowledgeable), rather than authoritarian (controlling and indifferent), limit-setting style enhances positive outcomes with regards to adherence, reduced likelihood of aggression, and preservation of the therapeutic relationship. In conclusion, a limit-setting style characterized by empathic responding and an authoritative, rather than authoritarian interpersonal, style is recommended. Elucidating the components of this style is critical for effective training and best practice of mental health nurses, and to reduce aggressive responses from limit setting. © 2013 Australian College of Mental Health Nurses Inc.

Measuring relational security in forensic mental health services.

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Chester, Verity; Alexander, Regi T; Morgan, Wendy

2017-12-01

Aims and method Relational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE). Results The STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure. Clinical implications The measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment.

Measuring relational security in forensic mental health services

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Chester, Verity; Alexander, Regi T.; Morgan, Wendy

2017-01-01

Aims and method Relational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE). Results The STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure. Clinical implications The measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment. PMID:29234515

Changes in the provision of institutionalized mental health care in post-communist countries.

Directory of Open Access Journals (Sweden)

Adrian P Mundt

Full Text Available General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that

Changes in the provision of institutionalized mental health care in post-communist countries.

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Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

Factors influencing post-traumatic stress in Korean forensic science investigators.

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Yoo, Yang-Sook; Cho, Ok-Hee; Cha, Kyeong-Sook; Boo, Yun-Jeong

2013-09-01

The aim of this study was to understand factors that influence post-traumatic stress (PTS) in Korean forensic science investigators. A total of 111 forensic science investigators were recruited in Korea. PTS was measured using the tool modified by Choi (2001) from the original developed by Foa, Riggs, Dancu, and Rothbaum (1993) based on DSM-IV. Factors influencing PTS included demographic and job-related characteristics, emotional intelligence, and death anxiety. PTS scores were positively correlated with personality type, fatigue from work, and death anxiety. PTS scores were negatively correlated with length of career as a forensic science investigator and emotional intelligence. The factors that had the greatest influence on PTS were death anxiety, years spent as a forensic science investigator, personality type, emotional intelligence, fatigue, and homicide experience. The explanatory power of these six factors was 44.0%. Therefore, it is necessary to regularly evaluate the mental health of those who are vulnerable to PTS. Based on these results, various interventions could be implemented for promoting overall health of the forensic science investigators. Copyright © 2013. Published by Elsevier B.V.

The approach of prehospital health care personnel working at emergency stations towards forensic cases.

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Asci, Ozlem; Hazar, Guleser; Sercan, Isa

2015-09-01

The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

School Mental Health Resources and Adolescent Mental Health Service Use

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Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Clinical criminology: a bridge between forensic professionals.

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Silfen, P; Ben-David, S

1993-01-01

In recent decades a new profession has developed--clinical criminology. The purpose of this article is to highlight its development. Criminology is defined as a interdisciplinary super-profession. We tend to view criminology as a basic profession with a number of specializations. Clinical criminology is one of these specializations. Forensic psychiatry and clinical criminology have common roots in psychiatry, law and behavioural sciences. They overlap in some fields. Members of both professions work in the same setting and share some of the tasks, but the formal and professional responsibilities differ significantly. We perceive clinical criminology and forensic psychiatry as complementary professions belonging to medicine. The multidisciplinary educated clinical criminologist is the only professional in the forensic system who is qualified to moderate between the mental health and legal expert.

Brain injury in a forensic psychiatry population.

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Colantonio, A; Stamenova, V; Abramowitz, C; Clarke, D; Christensen, B

2007-12-01

The prevalence and profile of adults with a history of traumatic brain injury (TBI) has not been studied in large North American forensic mental health populations. This study investigated how adults with a documented history of TBI differed with the non-TBI forensic population with respect to demographics, psychiatric diagnoses and history of offences. A retrospective chart review of all consecutive admissions to a forensic psychiatry programme in Toronto, Canada was conducted. Information on history of TBI, psychiatric diagnoses, living environments and types of criminal offences were obtained from medical records. History of TBI was ascertained in 23% of 394 eligible patient records. Compared to those without a documented history of TBI, persons with this history were less likely to be diagnosed with schizophrenia but more likely to have alcohol/substance abuse disorder. There were also differences observed with respect to offence profiles. This study provides evidence to support routine screening for a history of TBI in forensic psychiatry.

Preventive risk assessment in forensic child and youth care

NARCIS (Netherlands)

Assink, M.

2017-01-01

Risk assessment is central to the work of forensic mental health professionals, since it serves as a guide for prevention and intervention strategies. For effective risk assessment, knowledge on risk factors and their effects as well as the availability of valid and reliable instruments for risk

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

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Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Teacher Candidate Mental Health and Mental Health Literacy

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Dods, Jennifer

2016-01-01

Providing teacher candidates with a strong foundation in mental health literacy during their teacher education program is crucial in ensuring novice teachers are prepared to support the mental health needs of their students. In addition to responding to students, teacher candidates are typically at an age when mental health disorders are common…

Mental diseases and criminal offences committed by persons placed at the Forensic Department of the Penitentiary in Zenica, Federation of Bosnia and Herzegovina.

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Bjelošević, Edin; Krehmić, Adisa; Hadžikapetanović, Halima; Čoralić, Sanel; Bjelošević, Sonja

2017-08-01

Aim To investigate an impact of various biological, psychological and social factors on perpetration of criminal offences by persons with mental disorders and to examine legal requirements for placement of persons with mental disorders, who committed criminal offences. Methods This retrospective, descriptive study based on the analysis of data collected from records of the Zenica Penitentiary, Forensic Department (age, qualifications, employment status, marital status, mental disorders, information related to earlier treatments, type of committed criminal offense, duration of the security measure of mandatory psychiatric treatment and custody) included 154 examinees. Results The study included 154 male examinees. An average age of the examinees was 34 years. An average duration spent at the Forensic Department was 3 years, murder was committed by 68 (44.15%) examinees, and 34 (22.07%) examinees committed attempted murder. Eighty-five (55. 19 %) examinees suffered from schizophrenia, 30 (19.48%) had delusional disorder, and 19 (12.33%) had mental retardation. Conclusion The highest number of committed crimes was in correlation with schizophrenia, (the highest number of examinees suffered from schizophrenia). It is necessary to work on the establishment of a forensic hospital in the territory of the Federation of Bosnia and Herzegovina in order to create good conditions for rehabilitation of patients with mental disorders who committed criminal offences. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

Assessment of the mental health status of a one year cohort attending a two Sexual Assault Referral Centres in England.

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Brooker, Charlie; Tocque, Karen; Paul, Sheila

2018-02-01

A one year audit was undertaken of the mental health (MH) status of adult attendees to the Thames Valley Sexual Assault Centres (SARC). There were 301 relevant referrals over the twelve month period of whom 126 (42%) either fully or partially completed the mental health assessments. 38% (n = 66) of the population did not consent to the research. Participation in the study was felt inappropriate by the case clinician in the rest of the cases. To summarise the findings: 36% were moderately or severely depressed; 30% experienced moderate to severe anxiety; 28% were drinking at hazardous/harmful levels; and 12% had a drug problem that was moderate to severe. Self harm affected 45% of the sample with the greater majority cutting themselves and self-harming before the age of 17. Admission to a psychiatric in-patient unit was not uncommon and 19% had been admitted an average of three times each. The figure of 19% admitted to a psychiatric hospital is 90 times higher than for the general female population. 42% of the total sample were being prescribed medication for their mental health problem. The paper concludes that: there should be agreement nationally on the use of a standardised set of mental health outcome measures which are used in all assessments; there should be a move towards the commissioning of expert psychological support that is offered in a SARC and the pathways for specialist mental health care out of the SARCs. Finally, forensic physicians and general practitioners needs a greater awareness of the mental health sequalae of sexual assault and they then need to make prompt referrals to the appropriate services. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Electronic Health Record for Forensic Dentistry

Czech Academy of Sciences Publication Activity Database

Zvárová, Jana; Dostálová, T.; Hanzlíček, Petr; Teuberová, Z.; Nagy, Miroslav; Pieš, Martin; Seydlová, M.; Eliášová, H.; Šimková, H.

2008-01-01

Roč. 47, č. 1 (2008), s. 8-13 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * forensic dentistry Subject RIV: IN - Informatics, Computer Science Impact factor: 1.057, year: 2008

Latino Mental Health

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... How Do Mental Health Conditions Affect the Latino Community? Common mental health disorders among Latinos are generalized anxiety disorder , major ... quality care. Lack of Information and Misunderstanding about Mental Health Overall, the Latino community does not talk about mental health issues. There ...

Transformation of children's mental health services: the role of school mental health.

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Stephan, Sharon Hoover; Weist, Mark; Kataoka, Sheryl; Adelsheim, Steven; Mills, Carrie

2007-10-01

The New Freedom Commission has called for a transformation in the delivery of mental health services in this country. The commission's report and recommendations have highlighted the role of school mental health services in transforming mental health care for children and adolescents. This article examines the intersection of school mental health programs and the commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system. Schools are uniquely positioned to play a central role in improving access to child mental health services and in supporting mental health and wellness as well as academic functioning of youths. The New Freedom Commission report articulated several goals related to school mental health: reducing stigma, preventing suicide, improving screening and treating co-occurring disorders, and expanding school mental health programs. The authors suggest strategies for change, including demonstrating relevance to schools, developing consensus among stakeholders, enhancing community mental health-school connections, building quality assessment and improvement, and considering the organizational context of schools.

A Thorn in the Flesh? Forensic Inpatients in General Psychiatry

DEFF Research Database (Denmark)

Møllerhøj, Jette; Stølan, Liv Os; Brandt-Christensen, Anne Mette

2016-01-01

PURPOSE: To illuminate whether and how taking care of forensic inpatients is experienced as a burden among staff and managers in general psychiatry. DESIGN AND METHODS: Qualitative analytical strategies based on interviews and questionnaires. FINDINGS: The interplay between physical environment...... of staff identify the care of mentally disordered offenders in general psychiatric units as either "a parking space" or a very difficult or frightening course, where staff members tend to behave like pleasers in order to avoid risks of conflict or physical violence. Either way, it seems hard to provide...... sufficient mental health care. PRACTICE IMPLICATIONS: Nationwide training and teaching as well as knowledge exchange between specialized forensic psychiatry and general psychiatry are recommended. Further exploration is needed on patient perspectives and on avenues to increase efficiency and decrease...

Mental Health: Keeping Your Emotional Health

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... Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth ... PPD) Home Prevention and Wellness Emotional Well-Being Mental Health Mental Health: Keeping Your Emotional Health Mental Health: ...

A Practical Guide to Forensic Nursing Amar Angela F and Sekula L Kathleen A Practical Guide to Forensic Nursing 392pp £38.85 Sigma Theta Tau International Kindle edition 9781940446349 1940446341 [Formula: see text].

Science.gov (United States)

2016-11-10

This fascinating publication describes in depth the roles and responsibilities of forensic nurses in the US, who are often involved in the scientific investigation of violent and sexual crimes. However, these duties differ from those of nurses in forensic or secure settings in the UK, who work primarily with offenders who have mental health problems and who are in hospital, prison or police cells.

An exploratory study of the role of trust in medication management within mental health services.

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Maidment, Ian D; Brown, Patrick; Calnan, Michael

2011-08-01

To develop understandings of the nature and influence of trust in the safe management of medication within mental health services. Mental health services in the UK. Qualitative methods were applied through focus groups across three different categories of service user--older adult, adults living in the community and forensic services. An inductive thematic analysis was carried out, using the method of constant comparison derived from grounded theory. Participants' views on the key factors influencing trust and the role of trust in safe medication management. The salient factors impacting trust were: the therapeutic relationship; uncertainty and vulnerability; and social control. Users of mental health services may be particularly vulnerable to adverse events and these can damage trust. Safe management of medication is facilitated by trust. However, this trust may be difficult to develop and maintain, exposing service users to adverse events and worsening adherence. Practice and policy should be oriented towards developing trust.

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

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Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

Background General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent

What Is Mental Health?

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... Myths and Facts Recovery Is Possible What Is Mental Health? Mental health includes our emotional, psychological, and social ... mental health problems and where to find help . Mental Health and Wellness Positive mental health allows people to: ...

BIOETHICS AND FORENSIC PSYCHIATRY

Directory of Open Access Journals (Sweden)

Călin SCRIPCARU

2016-03-01

Full Text Available The recent laws on mental health define psychiatric illness as a loss of consciousness and understanding of consequences of self-behavioral acts, evaluated by loss of discernment. As discernment represents the main criteria of responsibility towards personal actions, this study attempts at presenting the ethical issues related to discernment evaluation from the perspective of forensic medicine. We propose a "mint" representation of the content and consequences of one’s own actions as a new criteria of evaluation, taking into account the modern principles of psychology and psychiatry.

MENTAL HEALTH: ISLAMIC PERSPECTIVE

OpenAIRE

Muzdalifah M. Rahman

2015-01-01

The purpose of this paper was to explain the concept of mental health perspective Contemporary Psychology, describes the mental health of an Islamic perspective and describes how mental health recovery. The theory used is the concept of mental health perspective Contemporary Psychology, and the concept of mental health perspective Islamic Psychology Writing is writing method using qualitative research methods. Mental health is avoiding an Islamic perspective of all symptoms, complaints and...

Undergraduate mental health nursing education in Australia: More than Mental Health First Aid.

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Happell, Brenda; Wilson, Rhonda; McNamara, Paul

2015-01-01

Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees' beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a prerequisite of preregistration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.

Personality pathology in a forensic setting : prevalence, assessment, and prognostic value for treatment

NARCIS (Netherlands)

Spaans, M.A.

2016-01-01

Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was carried out within a mainly Dutch forensic mental health setting. Issues such as (dis)simulation and unintentional

Psychiatric care or social defense? The origins of a controversy over the responsibility of the mentally ill in French forensic psychiatry.

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Protais, Caroline

2014-01-01

While some countries like Belgium chose a penal system clearly inspired by social-defense theories for mentally disturbed criminals, the French law hasn't been consistent and varies from the enlightened classical law and social-defense law. Indeed paragraph 1 of article 122-1 states that people whose discernment or control is abolished by a psychiatric disorder are non-responsible respecting the classical logic of law. On the other hand, Paragraph 2 of Article 122-1 allows the mentally ill to be judged responsible whereas no institution exists to take care about them. Then the system of psychiatric care in prisons present as a solution for professionals wishing to promote a system where people are punished and socially rehabilitated. Thus these forensic psychiatrists don't refer to paragraph 1 of article 122-1 and even people presenting serious mental disorders are considered responsible. Moreover, if a controversy has always existed between psychiatrists who argue a large conception of mental irresponsibility and professionals who defend the right to punish and to conclude that responsibility even for mentally disturbed criminals, the controversy becomes more important in French forensic psychiatry after the Second World War. If until the 1970s the practice of imposing responsibility for mentally ill individuals shows itself as a humanism, it occurs more within a security perspective today. © 2013.

[Treatment of offenders with mental disorders: focusing on prison psychiatry].

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Nakatani, Yoji

2011-01-01

Forensic mental health services exist in a nebulous space at the intersection of two different systems-criminal justice and mental health-and the entanglement of these systems poses intricate problems for psychiatrists. This article discusses the present circumstances of forensic mental health services in Japan, focusing on trends in prison psychiatry. In the traditional Japanese system, offenders with mental disorders were treated within general psychiatry as involuntarily admitted patients, or within the prison system as mentally ill inmates. As a consequence of recent legal reform, however, this situation has radically changed. The Medical Treatment and Supervision Act of 2005 aimed to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their reintegration into society. Under the new system, a person who commits a serious criminal offense in a state of insanity or diminished capacity shall be referred by the public prosecutor to the district court; following a treatment order of the court, the person shall be treated in psychiatric facilities established by the law. While the new system is expected to play a role in the context of specialist forensic psychiatry, its distinction from general psychiatry remains unclear. For example, persons who commit serious crimes, such as assault, in an acute psychotic state are occasionally admitted to general psychiatric hospitals, even if they meet the criteria for a treatment order under the Medical Treatment and Supervision Act. The relationship between prison psychiatry and specialist forensic psychiatry is still more problematic. Compared to the intensive, rehabilitation-oriented care provided under the Medical Treatment and Supervision Act, mental health services in penal institutions have a number of disadvantages, and it is unlikely that mentally ill prisoners have benefited from the recent progress in forensic psychiatry. Statistics show that the number of

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

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East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

Public and Private Responsibility for Mental Health: Mental Health's Fourth Revolution.

Science.gov (United States)

Dokecki, Paul R.

Three revolutions in the history of mental health were identified by Nicholas Hobbs: the humane revolution, the scientific and therapeutic revolution, and the public health revolution. The shift of responsibilities for mental health and substance abuse services from the public to the private sector may constitute a fourth mental health revolution.…

The arsonists portrait- as seen by forensic psychiatric examination

Directory of Open Access Journals (Sweden)

Radulescu Simona Delia

2016-12-01

Full Text Available OBJECTIVES The aim of our study is to determine the mental state of the arsonists that have undergone forensic psychiatric evaluation. MATERIALS AND METHODS We have examined the mental health records between years 2014-2015. Only subjects who committed fire setting crimes and were referred to the Legal Medicine Institute from Timișoara for a psychiatric evaluation were selected for the study. We analysed the following data: socio-demographic parameters, psychiatric diagnosis, motivation for the perpetrated crime, alcohol and drug addiction, the applied safety measure, the administrated neuroleptic and complementary treatment and the social support network. RESULTS The portrait of the arsonist is mainly male, young, single, poorly educated, unskilled and unemployed, living mostly in rural areas and with alcohol or drugs additction at the time of comitting the fire setting. Regarding the mental state of the patient, the most common diagnoses among the subjects were: psychoses, toxic substance delusional disorder, mixed personality disorder and intellectual disabilities. In most cases, arsonists lost discerment at the time of comitting the criminal act and they were not held accountable for it. CONCLUSIONS Our study established the most common psychiatric disturbances of arsonists as seen by forensic psychiatric examination. Different reasons for setting up fire have also been discussed. Patients were both delusional and irritated. We attempted to sketch a "portrait" of the arsonist and suggestions were included in order to ensure further "profiling" information gathering. REFERENCES 1. Rasanen P, Hakko H, Vaisanen E. The mental state of arsonists as determined by forensic psychiatric examinations. Bull Am Acad Psychiatry Law. 1995;23:547-553. 2. Tyler N, Gannon TA. Explanations of firesetting in mentally disordered offenders: A review of the literature. Psychiatry: Interpersonal and Biological Processes. 2012;75:150-166. 3. Inciardi JA. The adult

Mental illness and parenthood: being a parent in secure psychiatric care

NARCIS (Netherlands)

Parrott, F.R.; Macinnes, D.I.; Parrott, J.

2015-01-01

Background: Research into parenting and mental illness seldom includes forensic mental health service users, despite its relevance to therapeutic, family work and risk management. Aims: This study aimed to understand the experiences of parents and the variety of parenting roles maintained during

Mental Health

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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel and act as ... stress, relate to others, and make choices. Mental health is important at every stage of life, from ...

Observation of influences of mental health promotion and mental intervention on mental health status of professionals

OpenAIRE

Jiang, Shu-Qiang; Zhang, Jian-Ling

2015-01-01

Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with heal...

How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

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Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

2017-12-01

This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.

2013-01-01

Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel.

Science.gov (United States)

Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E

2016-01-01

Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review

Directory of Open Access Journals (Sweden)

Getinet Ayano

2018-03-01

Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

MENTAL HEALTH: ISLAMIC PERSPECTIVE

Directory of Open Access Journals (Sweden)

Muzdalifah M. Rahman

2015-02-01

of mental health, especially mental health needs to be developed with an Islamic perspective various studies and research, especially the development of mental health recovery means Islamic perspective.

Disaster mental health

DEFF Research Database (Denmark)

Henderson, Silja; Berliner, Peter; Elsass, Peter

2015-01-01

In this chapter we focus on disaster mental health, particularly theoretical and research-based implications for intervention. The field of disaster mental health research is vast and impossible to cover in a single chapter, but we will visit central research, concepts, and understandings within...... disaster mental health and intervention, and refer to further literature where meaningful. We conclude the chapter with recommendations for further research....

[Comparison of sexual murderers in forensic psychiatric hospitals and in prison].

Science.gov (United States)

Ujeyl, M; Habermann, N; Briken, P; Berner, W; Hill, A

2008-05-01

Empirical data are lacking that answer the question of how sexual murderers detained in forensic mental hospitals can be differentiated from those sentenced to prison. Psychiatric court reports and national criminal records on sexual murderers detained in a forensic mental hospital (n=45) were compared with those of prisoners (n=89) regarding diagnostic, criminologic, and prognostic characteristics and criminal recidivism rates after detention. Sexual murderers detained in forensic mental hospitals were characterized by higher psychiatric morbidity and slightly higher risk of future sexual and nonsexual violence. They were released from incarceration less often than the prison inmates but did not show higher sexual or nonsexual violence recidivism rates than those from the prison group.

Consumer attitudes towards evidence based mental health services among American mental health consumers.

Science.gov (United States)

Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

2016-10-01

The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

OpenAIRE

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can pro...

Pakistan mental health country profile.

Science.gov (United States)

Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

2004-01-01

The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

[Mental Health: Concepts, Measures, Determinants].

Science.gov (United States)

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

Mental Health and African Americans

Science.gov (United States)

... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Information in mental health: qualitative study of mental health service users

OpenAIRE

Powell, John; Clarke, Aileen

2006-01-01

Background  Despite the widespread proliferation of consumer health information provision, little is known about information needs or information‐seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users.

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Romantic relationships and mental health.

Science.gov (United States)

Braithwaite, Scott; Holt-Lunstad, Julianne

2017-02-01

This paper reviews the research on relationships and mental health. Individuals who are more mentally healthy are more likely to select into relationships, but relationships are also demonstrably associated with mental health. The type of relationship matters - evidence suggests that more established, committed relationships, such as marriage, are associated with greater benefits than less committed unions such as cohabitation. The association between relationships and mental health is clearly bidirectional, however, stronger effects are observed when mental health is the outcome and relationships are the predictor, suggesting that the causal arrow flows more strongly from relationships to mental health than vice versa. Moreover, improving relationships improves mental health, but improving mental health does not reliably improve relationships. Our review of research corroborates the view that relationships are a keystone component of human functioning that have the potential to influence a broad array of mental health outcomes. Copyright © 2016. Published by Elsevier Ltd.

Acute mental health care according to recent mental health ...

African Journals Online (AJOL)

Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...

Child Mental Health: MedlinePlus Health Topic

Science.gov (United States)

... events and children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Child Mental Health ... in childhood Traumatic events and children Related Health Topics Bullying Child Behavior Disorders Mental Disorders Mental Health ...

The therapeutic use of videogames within secure forensic settings: a review of the literature and application to practice

OpenAIRE

Gooch, P.; Living, R.

2004-01-01

Engagement in leisure pursuits that involves the use of tools and objects and the exploration of a new environment can provide a success experience that leads to increased feelings of competence and mastery. Such experiences are considered important in the rehabilitation of forensic clients. The findings from videogame research within a general population are compared with those among mental health and forensic clients. Within the general population, videogames may provide opportunities for s...

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

Science.gov (United States)

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

Workplace Violence in Mental Health: A Victorian Mental Health Workforce Survey.

Science.gov (United States)

Tonso, Michael A; Prematunga, Roshani Kanchana; Norris, Stephen J; Williams, Lloyd; Sands, Natisha; Elsom, Stephen J

2016-10-01

The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence. © 2016 Australian College of Mental Health Nurses Inc.

Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children

Directory of Open Access Journals (Sweden)

Jing Wu

2016-09-01

Full Text Available Background:Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. Methods:Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. Results:Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7% of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. Conclusion:This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of

Socioeconomic disadvantage and schizophrenia in migrants under mental health detention orders.

Science.gov (United States)

Bulla, Jan; Hoffmann, Klaus; Querengässer, Jan; Ross, Thomas

2017-09-01

Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia. This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders. Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI). For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses. Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.

Community mental health nurses’ experience of decentralised and integrated psychiatric-mental health care services in the Southern mental health region of Botswana (part 1

Directory of Open Access Journals (Sweden)

M.K. Maphorisa

2002-09-01

Full Text Available Since the inception of the decentralisation and integration of psychiatric mental health care services into the general health care delivery system in Botswana, there has never been a study to investigate what community mental health nurses are experiencing due to the policy. Many of these nurses have been leaving the scantily staffed mental health care services in increasing numbers to join other sectors of health or elsewhere since the beginning of the implementation of the policy. During the research study, phenomenological in-depth interviews were conducted with three groups of 12 community mental health nurses altogether. An open central question was posed to each group followed by probing questions to explore and describe these nurses’ experience of the decentralisation and integration of psychiatric-mental health care services. After the data was analysed, related literature was incorporated and guidelines for advanced psychiatric nurses were formulated and described to assist these nurses to cope with the decentralisation and integration of psychiatric-mental health care services. The guidelines were set up for the management of the community mental health nurses who are experiencing obstacles in the quest for mental health which also interfere with their capabilities as mental health care providers.

India mental health country profile.

Science.gov (United States)

Khandelwal, Sudhir K; Jhingan, Harsh P; Ramesh, S; Gupta, Rajesh K; Srivastava, Vinay K

2004-01-01

India, the second most populated country of the world with a population of 1.027 billion, is a country of contrasts. It is characterized as one of the world's largest industrial nations, yet most of the negative characteristics of poor and developing countries define India too. The population is predominantly rural, and 36% of people still live below poverty line. There is a continuous migration of rural people into urban slums creating major health and economic problems. India is one of the pioneer countries in health services planning with a focus on primary health care. Improvement in the health status of the population has been one of the major thrust areas for social development programmes in the country. However, only a small percentage of the total annual budget is spent on health. Mental health is part of the general health services, and carries no separate budget. The National Mental Health Programme serves practically as the mental health policy. Recently, there was an eight-fold increase in budget allocation for the National Mental Health Programme for the Tenth Five-Year Plan (2002-2007). India is a multicultural traditional society where people visit religious and traditional healers for general and mental health related problems. However, wherever modern health services are available, people do come forward. India has a number of public policy and judicial enactments, which may impact on mental health. These have tried to address the issues of stigma attached to the mental illnesses and the rights of mentally ill people in society. A large number of epidemiological surveys done in India on mental disorders have demonstrated the prevalence of mental morbidity in rural and urban areas of the country; these rates are comparable to global rates. Although India is well placed as far as trained manpower in general health services is concerned, the mental health trained personnel are quite limited, and these are mostly based in urban areas. Considering this

Mental Health and Mental Disorder Recommendation Programs.

Science.gov (United States)

Ruchiwit, Manyat

2017-12-01

The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

A rapid appraisal of the status of mental health support in post-rape care services in the Western Cape

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Naeemah Abrahams

2017-01-01

Full Text Available Background: Despite the well-known impact of rape on mental health and the widespread problem of rape in South Africa, mental health services for rape victims are scant and not a priority for acute-phase services. Survivors encounter multiple mental health struggles in this period including adherence to the post-exposure prophylaxis drugs to prevent HIV and finding support from important others. We have little information on what mental health is provided, by whom and how it is integrated into the post-rape package of care. Aim: The aim of the study was to do a rapid appraisal of mental health services for rape survivors to gain a better understanding of the current acute and long-term (secondary mental health services. Method: We conducted a qualitative study using a rapid assessment with a purposive sample of 14 rape survivors and 43 service providers recruited from post-rape sexual assault services in urban and rural Western Cape Province. Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. The data were coded thematically for analysis. Results: Survivors of rape experienced a range of emotional difficulties and presented varying levels of distress and various levels of coping. Receiving support and care from others assisted them, but the poor integration of mental health within post-rape services meant few received formal mental health support or effective referrals. Multiple factors contributed to the poor integration: mental health was not given the same level of priority as other rape services (i.e. clinical care, including forensic management, the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of care, the poor linkages to ongoing mental healthcare, and the mental health challenges caused by vicarious trauma and compassion fatigue. Conclusion: Providing effective

Mental Health staff views on improving burnout and mental toughness

OpenAIRE

Posner, Zoe; Janssen, Jessica; Roddam, Hazel

2017-01-01

Purpose- Burnout in mental health staff is acknowledged as a major problem. The purpose of this paper is to gain an understanding of mental health staff views on improving burnout and mental toughness in mental health staff.\\ud Design/methodology/approach-Ten participants from two mental health rehabilitation units across the North West of England took part in a Nominal Group Technique (NGT). Participants consisted of mental health workers from varied roles in order to\\ud capture views from a...

Malaysian mental health law.

Science.gov (United States)

Khan, Nusrat N; Yahya, Badi'ah; Abu Bakar, Abd Kadir; Ho, Roger C

2015-05-01

The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.

Stigma and Mental Illness: Investigating Attitudes of Mental Health and Non-Mental-Health Professionals and Trainees

Science.gov (United States)

Smith, Allison L.; Cashwell, Craig S.

2010-01-01

The authors explored attitudes toward adults with mental illness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…

Mental health in prisons: A public health agenda.

Science.gov (United States)

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

National Institute of Mental Health

Science.gov (United States)

... to content Home Health Information Health Information Home Mental Health Information Statistics Consumer Health Publications Help for Mental ... signs and symptoms of depression in men. More Mental Health Services Research Conference Register now for the nation’s ...

[Forensic psychiatry. Its relations to clinical psychiatry and criminology].

Science.gov (United States)

Kröber, H-L

2005-11-01

A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Directory of Open Access Journals (Sweden)

Reuben Hendler

Full Text Available Few people with mental disorders in low and middle-income countries (LMICs receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets", what they advocate for ("asks", how advocates reach their targets ("access", how they make their asks ("arguments", and the results of their advocacy ("outcomes".Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Science.gov (United States)

Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya; Jack, Helen

2016-01-01

Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Science.gov (United States)

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Directory of Open Access Journals (Sweden)

Mauricio Toyama

2017-09-01

Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

Mental health in schools and public health

OpenAIRE

Adelman, Howard S; Taylor, Linda

2006-01-01

Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible. Those in the public health field are uniquely positioned to help promote the mental health of young people and to reshape how the nation thinks about and addresses mental health. And schools are essential partners for doing the work.

Forensic neuropsychological assessment: a review of its scope

Directory of Open Access Journals (Sweden)

Antonio De Pádua Serafim

2015-04-01

Full Text Available Background Issues related to the field of mental health and justice require a multifactorial understanding of the possible causes of such issues. Objective To conduct an integrative literature review of controlled studies describing forensic neuropsychological assessment. Methods The articles were compiled and analyzed in two phases: 1 first, we retrieved all papers in PubMed by the keywords “Forensic Neuropsychology” and generated a growth curve for the subject and a cluster-based thematic distribution of publications. 2 We then conducted a curated analysis of all relevant papers indexed in Medline, PubMed and ISI, between 2000 and 2012. Results The evolution of the field during the last 15 years reveals an unstable growth pattern and three main thematic clusters. In terms of our curated analysis, a total of 390 articles were pre-selected, resulting in the selection of 44 fully-relevant studies, which comprise four main categories: cognitive damage in forensic psychiatric patients; imitation of cognitive damage; civil capacity, penal liability and violence risk; and validation of neuropsychological assessment tools. Discussion Two aspects appeared as the most relevant in this study: growth in the use of neuropsychological assessment as a diagnostic tool in the forensic context; and the necessity to enhance conformity in assessments.

Contradictions In Mental Health: Stigma, Mental Health Literacy And Disclosure (Or Not Of A Mental Disorder Diagnosis.

Directory of Open Access Journals (Sweden)

manuel torres cubeiro

2018-05-01

Full Text Available Mental illnesses affect 25% of any given population. The literacy of human population about mental health doesn’t not much the scientific knowledge available about Mental disorders (MDs. Developed countries invest in mental health less than their 9% of their GDPs. There is a contradiction, or discrepancy, between the incidence of MD in human population and how human societies react about them. This discrepancy has long been evident in the literature of medical sociology. In this article we analyze three medical sociology related concepts that have been coined to understand this contradiction: first, mental health literacy; second, stigma of mental ailments; and finally, the disclosure (or not of the diagnosis of a mental illness. With this article we try to solve short use of these concepts in medical sociology in Spanish.

Role of the police in linking individuals experiencing mental health crises with mental health services

Science.gov (United States)

2012-01-01

Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

Public mental health.

Science.gov (United States)

Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Common Mental Health Issues

Science.gov (United States)

Stock, Susan R.; Levine, Heidi

2016-01-01

This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

Forensic psychiatric assessment process and outcome in state ...

African Journals Online (AJOL)

Background: Individuals who were charged with a serious offence may be referred by courts for forensic psychiatric assessment. The court may declare them as state patients if they are found unfit to stand trial or not criminally responsible because of mental illness or defect. In forensic psychiatry practice, there may be ...

Acute mental health care and South African mental health legislation

African Journals Online (AJOL)

information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.

Prospective study of factors influencing conditional discharge from a forensic hospital: the DUNDRUM-3 programme completion and DUNDRUM-4 recovery structured professional judgement instruments and risk.

LENUS (Irish Health Repository)

Davoren, Mary

2013-01-01

We set out to examine whether structured professional judgement instruments DUNDRUM-3 programme completion (D-3) and DUNDRUM-4 recovery (D-4) scales along with measures of risk, mental state and global function could distinguish between those forensic patients detained in a secure forensic hospital (not guilty by reason of insanity or unfit to stand trial) who were subsequently discharged by a mental health review board. We also examined the interaction between these measures and risk, need for therapeutic security and eventual conditional discharge.

Holistic Health: Does It Really Include Mental Health?

Directory of Open Access Journals (Sweden)

Kimberly K. McClanahan

2006-01-01

Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Holistic health: does it really include mental health?

Science.gov (United States)

McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Role of Forensic Pathology in Clinical Practice and Public Health ...

African Journals Online (AJOL)

The request for and performance of autopsy have been on the decline despite its obvious merits to medical practice, the patients and public health. Several surveys have exposed some reasons for this decline. Method: This work is a review of the role of forensic pathology to medical practice and public health. The author ...

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

Science.gov (United States)

Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

2015-09-01

The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

Children's Mental Health

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... Español (Spanish) Recommend on Facebook Tweet Share Compartir Mental health in childhood means reaching developmental and emotional milestones, ... is doing to improve access to care. Children’s Mental Health: What's New Article: U.S. Children with Diagnosed Anxiety ...

Development of Mental Health Indicators in Korea

Science.gov (United States)

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Closing Italian Forensic Psychiatry Hospitals in Favor of Treating Insanity Acquittees in the Community.

Science.gov (United States)

Carabellese, Felice; Felthous, Alan R

2016-03-01

Originally a hedge against the death penalty, the insanity defense came to offer hospitalization as an alternative to imprisonment. In the late 19th century Italy opened inpatient services first for mentally ill prisoners and then for offenders found not guilty by reason of insanity. Within the past decade, a series of decrees has resulted in transferring the responsibility for treating NGRI acquittees and "dangerous" mentally ill prisoners from the Department of Justice to the Department of Health, and their treatment from Italy's high security forensic psychiatric hospitals (OPGs) to community regional facilities (REMSs, Residences for the Execution of Security Measures), community mental health facilities, one of which is located in each region of Italy. Today community REMSs provide the treatment and management of socially dangerous offenders. The dynamic evolution of Italy's progressive mental health system for insanity acquittees, to our knowledge the most libertarian, community oriented approach of any country, is retraced. Discussion includes cautionary concerns as well as potential opportunities for improvements in mental health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Mental Health, Racism, and Sexism.

Science.gov (United States)

Willie, Charles V., Ed.; And Others

This volume, successor to the 1973 volume "Racism and Mental Health," presents a range of perspectives on mental health, prejudice, and discrimination. Contributors are of multiracial, multiethnic, and gender-diverse backgrounds. They use their existential experiences to analyze pressing mental health and mental illness issues. Contributions…

To do good might hurt bad: exploring nurses' understanding and approach to suffering in forensic psychiatric settings.

Science.gov (United States)

Vincze, Mattias; Fredriksson, Lennart; Wiklund Gustin, Lena

2015-04-01

Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients. © 2015 Australian College of Mental Health Nurses Inc.

Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

Science.gov (United States)

Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

2014-01-01

To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Global mental health and the National Institute of Mental Health Research Domain Criteria.

Science.gov (United States)

Weine, Stevan Merill; Langenecker, Scott; Arenliu, Aliriza

2018-05-01

The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project presents innovative ways of investigating mental illness based on behavioral and neurobiological measures of dimensional processes. Although cultural psychiatrists have critiqued RDoC's implications and limitations for its under-developed focus on context and experience, RDoC presents opportunities for synergies with global mental health. It can capture aspects of clinical or sub-clinical behavior which are less dependent upon Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and perhaps better elucidate the role of culture in disease expression and resilience. Aim/Results: This article uses the example of migration to describe several starting points for new research: (1) providing components for building an investigable conceptual framework to understand individual's mental health, resilience and adjustment to migration challenges or social adversities in low- and middle-income countries (LMICs) and (2) identifying measurable factors which determine resilience or vulnerability, to guide development and evaluation of targeted prevention, treatment and recovery strategies for mental health in LMICs. In such ways, RDoC frameworks could help put the new cutting edge neurobiological dimensional scientific advances in a position to contribute to addressing mental health problems amid social adversities in LMICs. However, this would require a much-expanded commitment by both RDoC and global mental health researchers to address contextual and experiential dimensions.

The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

Science.gov (United States)

McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

2018-06-01

Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

Forensic historiography: narratives and science.

Science.gov (United States)

Drukteinis, Albert M

2014-01-01

Psychiatrists function, in part, as historians who rely on patient narratives to help them understand presenting mental disorders and explain their causes. Forensic psychiatrists have been skeptical of using narratives, raising concerns about their lack of objectivity and potential for bias. They also have criticized narratives as being more performative than scientific. Recent authors, however, have pointed out that narratives may be helpful in forming forensic opinions and supporting oral testimony, while stressing that their use must be consistent with the ethics espoused by forensic psychiatry. This article reviews the role of narratives in understanding human events and the ubiquitous presence of narratives in the judicial process. It delves into the inescapability of using explicit or implicit narratives in the course of forensic practice, as well as how they may be meaningfully incorporated into evaluations and find expression alongside scientific principles. © 2014 American Academy of Psychiatry and the Law.

Smartphone Applications for Mental Health

Science.gov (United States)

Vona, Pamela L.; Santostefano, Antonella M.; Ciaravino, Samantha; Miller, Elizabeth; Stein, Bradley D.

2016-01-01

Abstract Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based. PMID:27428034

Forensic Occupational Therapy in Canada: The Current State of Practice.

Science.gov (United States)

Chui, Adora L Y; Wong, Chantal Isabelle; Maraj, Sara A; Fry, Danielle; Jecker, Justine; Jung, Bonny

2016-09-01

Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

Science.gov (United States)

Dixon, Decia Nicole

2009-01-01

Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

Acute mental health care and South African mental health legislation ...

African Journals Online (AJOL)

Objective: This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of ...

The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

NARCIS (Netherlands)

Ploeg, E. van der

2003-01-01

The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

Police and mental health clinician partnership in response to mental health crisis: A qualitative study.

Science.gov (United States)

McKenna, Brian; Furness, Trentham; Oakes, Jane; Brown, Steve

2015-10-01

Police officers as first responders to acute mental health crisis in the community, commonly transport people in mental health crisis to a hospital emergency department. However, emergency departments are not the optimal environments to provide assessment and care to those experiencing mental health crises. In 2012, the Northern Police and Clinician Emergency Response (NPACER) team combining police and mental health clinicians was created to reduce behavioural escalation and provide better outcomes for people with mental health needs through diversion to appropriate mental health and community services. The aim of this study was to describe the perceptions of major stakeholders on the ability of the team to reduce behavioural escalation and improve the service utilization of people in mental health crisis. Responses of a purposive sample of 17 people (carer or consumer advisors, mental health or emergency department staff, and police or ambulance officers) who had knowledge of, or had interfaced with, the NPACER were thematically analyzed after one-to-one semistructured interviews. Themes emerged about the challenge created by a stand-alone police response, with the collaborative strengths of the NPACER (communication, information sharing, and knowledge/skill development) seen as the solution. Themes on improvements in service utilization were revealed at the point of community contact, in police stations, transition through the emergency department, and admission to acute inpatient units. The NPACER enabled emergency department diversion, direct access to inpatient mental health services, reduced police officer 'down-time', improved interagency collaboration and knowledge transfer, and improvements in service utilization and transition. © 2015 Australian College of Mental Health Nurses Inc.

Mental Health and Asian Americans

Science.gov (United States)

... Data > Minority Population Profiles > Asian American > Mental Health Mental Health and Asian Americans Suicide was the 9th leading ... Americans is half that of the White population. MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...

'Everything contradicts in your mind': a qualitative study of experiences of forensic mental health staff in two contrasting services.

Science.gov (United States)

Kurtz, Arabella; Jeffcote, Nikki

2011-10-01

 In the theoretical literature, there is growing recognition of the psychological impact on staff of working in challenging healthcare settings. In forensic mental health (FMH) services, powerful transference and counter-transference reactions in staff-patient relationships may emerge and may even play a role in contributing to incidents of malpractice, but there is little empirical research here.  The exploration of the experiences of FMH staff in two contrasting services.  Thirteen in-depth interviews were carried out with staff from a range of clinical disciplines in a mainstream National Health Service (NHS) medium secure unit (MSU), and 12 interviews were undertaken with such staff from a Personality Disorder Unit (PDU) in an MSU. All interview data were analysed independently using the grounded theory method. To synthesise the two separate analyses, a thematic analysis of both data sets was carried out, in which 'thematic units' were defined as significant points of comparison between the analyses of the two sets of interviews.  The combined analysis yielded six main themes under two main headings. Themes under the first heading Experience of the Clinical Task were: 'difficulty in achieving task integration'; 'motivation to build relationships, work through difficulty and bring about change'; and 'minimal sense of risk and anxiety at the centre'. Themes under the second heading Experience of the Organisation were: 'a distant and difficult relationship with outside'; 'preoccupation with staff relationships'; and 'feeling unsafe'. The overarching concept of the combined analysis was encapsulated in the quotation: 'Everything contradicts in your mind'.  Clinical and organisational aspects of work seemed separate in the minds of staff, with the latter reported to be more stressful; staff support came in the form of close relationships with colleagues, who saw themselves as isolated in the context of the wider environment. Promotion of the well-being and

States Pass Diverse Slate of Mental Health Legislation in 2013. Mental Health: 2013 Legislative Session

Science.gov (United States)

Thomsen, Jennifer

2014-01-01

Recent violence in schools and on college campuses has brought into sharp focus the need to address mental health issues in educational settings. Getting students with mental health problems the help they need, without stigmatizing mental illness, may help prevent future tragedies. Children with mental health problems face a host of challenges,…

Poverty and mental health: What should we know as mental health professionals?

Science.gov (United States)

Lepiéce, Brice; Reynaert, Christine; Jacques, Denis; Zdanowicz, Nicolas

2015-09-01

Social inequality as a social and economic phenomenon has become an issue of common interest in Europe and other societies worldwide, mainly after the recent global financial and economic crisis that occurred in 2008. The increasing gap observed between socioeconomically advantaged and disadvantaged people has caused intensive debates in politics, social sciences and in the field of public health. Today, poverty is considered as a major variable adversely influencing health. In this paper we will discuss the link between poverty and mental health. We conducted a literature search focusing on three main objectives: (I) to investigate the definition of "poverty"; (II) to determine the association between poverty and major mental health problems; and (III) to discuss the extent to which poverty could be both a cause and a consequence of mental health. We identified a total of 142 relevant papers, published between 1995 and 2014, only 32 were retained. Main findings are summarised in this paper. Poverty can be considered as a risk factor for mental illness. Yet the relation between poverty and mental health is complex, without direct causation, and bidirectional. As poverty has severe consequences not only on health but also on the whole society, combating poverty should be placed high on the political agenda.

"A constant struggle to receive mental health care": health care professionals' acquired experience of barriers to mental health care services in Rwanda.

Science.gov (United States)

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-12-16

In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda. A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis. The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance. From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for

Public mental health – using the Mental Health Gap Action Program to put all hands to the pumps

Directory of Open Access Journals (Sweden)

RICHARD eUWAKWE

2014-04-01

Full Text Available Mental ill health constitutes a huge portion of the GBD but the majority of people with mental health problems do not receive any treatment, a scenario much worse in developing countries where mental health personnel are in gross short supply. The mhGAP was launched to address this gap, especially by training non-mental health professionals to deliver effective services for selected priority mental health problems. Especially in developing countries, people with mental health problems consult traditional healers either as a first step in the pathway to biomedical mental health care or as the sole mental health service providers. Bridging the gap between mental health needs and available services in developing countries must incorporate traditional healers, who are ubiquitously available, easily accessible and acceptable to the natives. Although there are barriers in forging collaborations between traditional and biomedical mental health care providers, with mutual respect, understanding and adapted training using the mhGAP guide it should be possible to get some traditional healers to understand the core principles of some priority mental health problems identification, treatment and referral.

Seeking to understand lived experiences of personal recovery in personality disorder in community and forensic settings - a qualitative methods investigation.

Science.gov (United States)

Shepherd, Andrew; Sanders, Caroline; Shaw, Jenny

2017-08-01

Understandings of personal recovery have emerged as an alternative framework to traditional ideas of clinical progression, or symptom remission, in clinical practice. Most research in this field has focussed on the experience of individuals suffering with psychotic disorders and little research has been conducted to explore the experience of individuals with a personality disorder diagnosis, despite the high prevalence of such difficulties. The nature of the personality disorder diagnosis, together with high prevalence rates in forensic settings, renders the understanding of recovery in these contexts particularly problematic. The current study seeks to map out pertinent themes relating to the recovery process in personality disorder as described by individuals accessing care in either community or forensic settings. Individual qualitative interviews were utilised to explore the lived experience of those receiving a personality disorder diagnosis and accessing mental health care in either community or forensic settings. A thematic analysis was conducted to identify shared concepts and understanding between participants. Fourty-one individual participant interviews were conducted across forensic and community settings. Recovery was presented by participants as a developing negotiated understanding of the self, together with looked for change and hope in the future. Four specific themes emerged in relation to this process: 1. Understanding early lived experience as informing sense of self 2. Developing emotional control 3. Diagnosis as linking understanding and hope for change 4. The role of mental health services. Through considering personal recovery in personality disorder as a negotiated understanding between the individual, their social networks and professionals this study illustrates the complexity of working through such a process. Clarity of understanding in this area is essential to avoid developing resistance in the recovery process. Understanding of

Mental health and disorders. Editorial.

Science.gov (United States)

Wittchen, Hans-Ulrich

2014-01-01

Mental health and mental disorders pose a tremendous challenge to the societal, health, and research policies in Europe, and sound advice is needed on a potential strategy for mental health research investment. Toward this goal, the ROAMER initiative ("Roadmap for Mental Health Research in Europe") was launched to map the current state of the art, to identify gaps and to delineate advances needed in various areas and domains of mental health research in Europe. To further stimulate discussions among the scientific community and stakeholders on how to improve mental health research and to promote an improved research agenda for the next decade, this IJMPR topic issue presents the overall ROAMER methodology as well as a series of selected papers highlighting critical issues of psychological approaches and interventions as outcomes of the ROAMER work package 5 "Psychological research and treatments". Copyright © 2013 John Wiley & Sons, Ltd.

Physiotherapy and Mental Health

OpenAIRE

Probst, Michel

2017-01-01

Physiotherapy in mental health care and psychiatry is a recognized specialty within physiotherapy. It offers a rich variety of observational and evaluation tools as well as a range of interventions that are related to the patient’s physical and mental health problems based on evidence-based literature and a 50-year history. Physiotherapy in mental health care addresses human movement, function, physical activity and exercise in individual and group therapeutic settings. Additionally, it conne...

Mental Health - Multiple Languages

Science.gov (United States)

... and Well-Being 1 - Stress - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Health and Well-Being ... Well-Being 2 - Mental Health - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center What Is Mental Distress - ...

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

Science.gov (United States)

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mental health-related discrimination as a predictor of low engagement with mental health services.

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Clement, Sarah; Williams, Paul; Farrelly, Simone; Hatch, Stephani L; Schauman, Oliver; Jeffery, Debra; Henderson, R Claire; Thornicroft, Graham

2015-02-01

This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.

Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools.

Science.gov (United States)

Mcluckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia

2014-12-31

Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.

Mental health triage in emergency medicine.

Science.gov (United States)

Smart, D; Pollard, C; Walpole, B

1999-02-01

The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. A four-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health 'did not waits' showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. A systematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

Cultural diversity and mental health.

Science.gov (United States)

Gopalkrishnan, Narayan; Babacan, Hurriyet

2015-12-01

Cultural diversity and its impact on mental health has become an increasingly important issue in a globalised world where the interactions between cultures continue to grow exponentially. This paper presents critical areas in which culture impacts on mental health, such as how health and illness are perceived, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender, family, stigma and discrimination. While cultural differences provide a number of challenges to mental health policy and practice they also provide a number of opportunities to work in unique and effective ways towards positive mental health. Ethno-specific approaches to mental health that incorporate traditional and community-based systems can provide new avenues for working with culturally diverse populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Teen Mental Health: MedlinePlus Health Topic

Science.gov (United States)

... Trichotillomania (Nemours Foundation) Health Check Tools How's Your Self-Esteem? (Quiz) (Nemours Foundation) Statistics and Research Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults (Substance Abuse and Mental Health Services Administration) ...

Mental health service delivery following health system reform in Colombia.

Science.gov (United States)

Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

2003-12-01

In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

Science.gov (United States)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

D-day for mental health.

Science.gov (United States)

2005-02-16

THERE COULD be no better time for a review of mental health nursing. It is 11 years since the last one, which in itself suggests change must be overdue if professional practice is to keep pace with health service reforms. As the largest professional group in mental health care, nurses will be relied on to deliver the reforms outlined in the Mental Health Bill, as well as the measures to improve race equality in the service. Nurses will also be promoting good mental health as outlined in last autumn's public health white paper. All these initiatives can only benefit from the chance to take stock.

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

Science.gov (United States)

Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

2017-01-01

Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

Holistic Health: Does It Really Include Mental Health?

OpenAIRE

McClanahan, Kimberly K.; Huff, Marlene B.; Omar, Hatim A.

2006-01-01

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate publi...

Inpatient aggression and work stress: comparing civil and forensic psychiatric nursing

OpenAIRE

Lee, Joyce Yan

2017-01-01

In their daily work, psychiatric nurses are subjected to patient-perpetrated verbal and physical aggression. They manage a high level of work stress. As compared to their colleagues working in civil settings, forensic psychiatric nurses may experience different rates of patient aggression and work stress. Such experiences have implications for the mental health and productivity of nursing staff. In inpatient settings, homicide by a patient is a rare event. Representing the most severe f...

Shared decision-making, stigma, and child mental health functioning among families referred for primary care-located mental health services.

Science.gov (United States)

Butler, Ashley M

2014-03-01

There is growing emphasis on shared decision making (SDM) to promote family participation in care and improve the quality of child mental health care. Yet, little is known about the relationship of SDM with parental perceptions of child mental health treatment or child mental health functioning. The objectives of this preliminary study were to examine (a) the frequency of perceived SDM with providers among minority parents of children referred to colocated mental health care in a primary care clinic, (b) associations between parent-reported SDM and mental health treatment stigma and child mental health impairment, and (c) differences in SDM among parents of children with various levels of mental health problem severity. Participants were 36 Latino and African American parents of children (ages 2-7 years) who were referred to colocated mental health care for externalizing mental health problems (disruptive, hyperactive, and aggressive behaviors). Parents completed questions assessing their perceptions of SDM with providers, child mental health treatment stigma, child mental health severity, and level of child mental health impairment. Descriptive statistics demonstrated the majority of the sample reported frequent SDM with providers. Correlation coefficients indicated higher SDM was associated with lower stigma regarding mental health treatment and lower parent-perceived child mental health impairment. Analysis of variance showed no significant difference in SDM among parents of children with different parent-reported levels of child mental health severity. Future research should examine the potential of SDM for addressing child mental health treatment stigma and impairment among minority families.

What does self rated mental health represent

Directory of Open Access Journals (Sweden)

Daphna Levinson

2014-12-01

Full Text Available Background. Unlike the widely used self rated health, the self rated mental health was found unsuitable as a proxy for mental illness. This paper analyses the relationships between the self ratings of physical health, mental health and overall health, and their association of with the objective indicators for physical and mental health. Design and methods. The study is a secondary analysis of data from a nationwide representative sample of the non-institutionalized adult residents of Israel in 2003 that was collected via computer-assisted personal interview methods [n=4859].Results. The self rated physical health and the self rated mental health were strongly related to each other yet the self rated mental health was not related to chronic physical conditions and the self rated physical health was not related to mental disorders. In a multiple logistic regression analysis, those with positive self rated mental health had 93 times the odds of reporting positive overall health whereas those with positive self rated physical health had 40 times the odds of reporting positive overall health. Conclusions. The self rating of mental health presents a qualitatively different dimension from mental illness. The self rated mental health is two times more important than the self rated physical health in predicting the self rated overall health

The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

Science.gov (United States)

Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

2006-04-01

Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

Hawaii's public mental health system.

Science.gov (United States)

VanderVoort, Debra J

2005-03-01

The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

Poverty, social stress & mental health.

Science.gov (United States)

Kuruvilla, A; Jacob, K S

2007-10-01

While there is increasing evidence of an association between poor mental health and the experience of poverty and deprivation, the relationship is complex. We discuss the epidemiological data on mental illness among the different socio-economic groups, look at the cause -effect debate on poverty and mental illness and the nature of mental distress and disorders related to poverty. Issues related to individual versus area-based poverty, relative poverty and the impact of poverty on woman's and child mental health are presented. This review also addresses factors associated with poverty and the difficulties in the measurement of mental health and illness and levels/impact of poverty.

International Student Mental Health

Science.gov (United States)

Prieto-Welch, Susan L.

2016-01-01

This chapter describes the mental health status of international students in institutions of higher education, unique challenges these students face and their impact on mental health, and suggestions for ways to address these challenges.

Mental health, participation and social identity

DEFF Research Database (Denmark)

Johannsen, Gundi Schrötter; Elstad, Toril

2017-01-01

pointed out how people with mental illness protect their identities through consealment in order to avoid stigmatisation. Changes in the organisation of mental health services, from a mainly hospital-based psychiatry towards mental health work in local communities, have highlited issues of participation......, social incluison and integration for people who live with mental health problems. Aiming to support people in daily life, community mental health services that facilitate active participation are encouraged internationally (WHO 2001b, 2005,2013). From these perspectives, we will present our studies from...... a Danish ond Norwegian community mental health service, and relate our findings and the discussion of them to the overall themes of participation, social identity and mental helath....

Art and mental health in Samoa.

Science.gov (United States)

Ryan, Brigid; Goding, Margaret; Fenner, Patricia; Percival, Steven; Percival, Wendy; Latai, Leua; Petaia, Lisi; Pulotu-Endemann, Fuimaono Karl; Parkin, Ian; Tuitama, George; Ng, Chee

2015-12-01

To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma. Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community. The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations. This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

Science.gov (United States)

Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

2011-01-01

Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

Mental health service users' experiences of mental health care: an integrative literature review.

Science.gov (United States)

Newman, D; O'Reilly, P; Lee, S H; Kennedy, C

2015-04-01

A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person-centred practice. The authors completed an in-depth search of the literature to answer the question: What are service users' experiences of the mental health service? Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care. The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support. This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider-service user relationship to facilitate true service-user engagement in their care. The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host (Academic Search Complete, MEDLINE, CINAHL Plus

The promotion of mental health and the prevention of mental health problems in child and adolescent

OpenAIRE

sunmi cho; yunmi shin

2013-01-01

Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term “prevention” for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10&am...

Violence and Personality in Forensic Patients: Is There a Forensic Patient-Specific Personality Profile?

Science.gov (United States)

Stupperich, Alexandra; Ihm, Helga; Strack, Micha

2009-01-01

Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centered on group-specific personality profiles and identifying personality facets…

Retirement and mental health: analysis of the Australian national survey of mental health and well-being.

Science.gov (United States)

Butterworth, Peter; Gill, Sarah C; Rodgers, Bryan; Anstey, Kaarin J; Villamil, Elena; Melzer, David

2006-03-01

Nation-wide research on mental health problems amongst men and women during the transition from employment to retirement is limited. This study sought to explore the relationship between retirement and mental health across older adulthood, whilst considering age and known risk factors for mental disorders. Data were from the 1997 National Survey of Mental Health and Well-being, a cross-sectional survey of 10,641 Australian adults. The prevalence of depression and anxiety disorders was analysed in the sub-sample of men (n = 1928) and women (n = 2261) aged 45-74 years. Mental health was assessed using the Composite International Diagnostic Instrument. Additional measures were used to assess respondents' physical health, demographic and personal characteristics. The prevalence of common mental disorders diminished across increasing age groups of men and women. Women aged 55-59, 65-69, and 70-74 had significantly lower rates of mental disorders than those aged 45-49. In contrast, only men aged 65-69 and 70-74 demonstrated significantly lower prevalence compared with men aged 45-49. Amongst younger men, retirees were significantly more likely to have a common mental disorder relative to men still in the labour force; however, this was not the case for retired men of, or nearing, the traditional retirement age of 65. Men and women with poor physical health were also more likely to have a diagnosable mental disorder. The findings of this study indicate that, for men, the relationship between retirement and mental health varies with age. The poorer mental health of men who retire early is not explained by usual risk factors. Given current policy changes in many countries to curtail early retirement, these findings highlight the need to consider mental health, and its influencing factors, when encouraging continued employment amongst older adults.

Mental Health Insurance Parity and Provider Wages.

Science.gov (United States)

Golberstein, Ezra; Busch, Susan H

2017-06-01

Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; pwages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

VA National Mental Health Statistics - 2015

Data.gov (United States)

Department of Veterans Affairs — VAMC-level statistics on the prevalence, mental health utilization, non-mental health utilization, mental health workload, and psychological testing of Veterans with...

Mental Health Screening Center

Science.gov (United States)

... Releases & Announcements Public Service Announcements Partnering with DBSA Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression Screening for Adult Depression Screening for ...

Disaster Management: Mental Health Perspective.

Science.gov (United States)

Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C

2015-01-01

Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health.

The promotion of mental health and the prevention of mental health problems in child and adolescent

Directory of Open Access Journals (Sweden)

sunmi cho

2013-11-01

Full Text Available Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term “prevention” for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10&#8211;20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability and their long lasting consequences, the mental health needs of children and adolescents are neglected. Early intervention can help reduce the significant impacts that children and adolescents with serious mental health problems may experience. Screening is the first step in early intervention, recognizing emotional and behavioral problems and providing help at an early stage. It is essential to implement early intervention in a sensitive and ethical manner to avoid any of the negative outcomes.

Australian Rotary Health: a major contributor to mental illness research and mental health awareness in Australia.

Science.gov (United States)

Jorm, Anthony; Sawyer, Michael; Gillett, Joy

2012-08-01

Australian Rotary Health (ARH) was established in 1981 with the goal of supporting family health research in Australia. Since 2000, ARH has supported research relevant to mental health and mental illness. This article describes the early history of the fund, the reasons for the move to mental illness research, some examples of research projects that have had a beneficial impact and the branching out into mental health community awareness raising and stigma reduction. ARH has emerged as a major non-government supporter of mental illness research. It has also effectively engaged Rotary clubs at a local level to increase community awareness of mental illness and to reduce stigma.

Forensic nursing. Applications in the occupational health setting.

Science.gov (United States)

Pozzi, C L

1996-11-01

1. Nurses are inherent investigators through the use of observation, data gathering, and documentation techniques. 2. Occupational health nurses may be involved in assisting with or evaluating workplace accidents, injuries, and deaths. These investigations may be the only critical information gathered. 3. Accurate and through investigations are critical for clients, physicians, insurance companies, medical investigators, law enforcement, legal proceedings, and the company. Utilizing improper techniques during accident investigations could potentially dismiss a litigation case or lead to hazardous situations. 4. The occupational health nurse can improve practices related to investigations by understanding and learning more about forensic nursing.

Evolving society and mental health

Directory of Open Access Journals (Sweden)

Dipesh Bhagabati

2016-07-01

Full Text Available Numerous issues related to culture, occupation, gender, caste, and health, to name a few, have faced harshness of society from time immemorial. Reasons are debatable, ranging from somewhat understandable to completely unacceptable. There is no doubt that society is dynamic and it has changed its view on many of the issues with passing time. Mental health is one such issue which society has neglected for quite a long time. Even today, mental health and mentally ill people face stigma and discrimination in their family, society, and at their workplace. People do not feel comfortable talking about mental health, even if they know that there cannot be any health without a healthy mind. But, as Albert Einstein has said “learn from yesterday, live for today, and hope for tomorrow”, everything is not lost. The mentally ill patients who were once abandoned and left on their own have now started to get humane care and attention. This article discusses this very pertinent topic of changing society and mental health.

The 2013 Canadian Forces Mental Health Survey

Science.gov (United States)

Bennett, Rachel E.; Boulos, David; Garber, Bryan G.; Jetly, Rakesh; Sareen, Jitender

2016-01-01

Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings. Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system. The findings of recent population-based CAF mental health research are reviewed, with a focus on findings from the very similar mental health survey done in 2002. Finally, key aspects of the methods of the 2013 CFMHS are presented. Results: The findings of 20 peer-reviewed publications using the 2002 mental health survey data are reviewed, along with those of 25 publications from other major CAF mental health research projects executed over the past decade. Conclusions: More than a decade of population-based mental health research in the CAF has provided a detailed picture of its mental health and use of mental health services. This knowledge base and the homology of the 2013 survey with the 2002 CAF survey and general population surveys in 2002 and 2012 will provide an unusual opportunity to use the CFMHS to situate mental health in the CAF in a historical and societal perspective. PMID:27270738

Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies

Directory of Open Access Journals (Sweden)

Gudde CB

2015-10-01

Full Text Available Camilla Buch Gudde,1,2 Turid Møller Olsø,4 Richard Whittington,1,5,6 Solfrid Vatne,3 1Forensic Department Brøset, Centre for Research and Education in Forensic Psychiatry, St Olavs Hospital, 2Department of Social Work and Health Science, Faculty of Social Science and Technology Management, NTNU, Trondheim, 3Institute of Health and Social Sciences, Molde University College, Molde, 4Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, 5Department of Neuroscience, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; 6Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK Background: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and their respective impact. To date, only a small number of empirical studies include users’ views of relevant factors. The main objective of this review is to identify and synthesize evidence relating to service users’ experiences and views of aggressive situations in mental health settings. Methods: We included qualitative studies of any design reporting on service users’ own experiences of conditions contributing to aggressive situations in mental health care and their views on preventative strategies. Eligible articles were identified through an electronic database search (PsycINFO, PubMed, Ovid Nursing Database, Embase, and CINAHL, hand search, and cross-referencing. Extracted data were combined and interpreted using aspects of thematic synthesis. Results: We reviewed 5,566 records and included 13 studies (ten qualitative and three mixed methods. Service users recognized that both their own mental state and negative aspects of the treatment environment affected the development of aggressive situations

Utilization of Mental Health Services in School-Based Health Centers.

Science.gov (United States)

Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-08-01

We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

Promoting mental health as an essential aspect of health promotion.

Science.gov (United States)

Sturgeon, Shona

2006-12-01

This paper advocates that mental health promotion receive appropriate attention within health promotion. It is of great concern that, in practice, mental health promotion is frequently overlooked in health promotion programmes although the WHO definitions of health and the Ottawa Charter describe mental health as an integral part of health. It is suggested that more attention be given to addressing the determinants of mental health in terms of protective and risk factors for both physical and mental conditions, particularly in developing countries. Examples of evidence-based mental health programmes operating in widely diverse settings are presented to demonstrate that well designed interventions can contribute to the well-being of populations. It is advocated that particular attention be given to the intersectorial cooperation needed for this work.

Understanding the acceptability of e-mental health - attitudes and expectations towards computerised self-help treatments for mental health problems

OpenAIRE

Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

2014-01-01

Background E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of...

Juvenile mental health courts for adjudicated youth: role implications for child and adolescent psychiatric mental health nurses.

Science.gov (United States)

Burriss, F Antoinette; Breland-Noble, Alfiee M; Webster, Joe L; Soto, Jose A

2011-05-01

Juvenile mental health courts for adjudicated youth. To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts. ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000-2010. Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation. © 2011 Wiley Periodicals, Inc.

Mental health promotion in comprehensive schools.

Science.gov (United States)

Onnela, A M; Vuokila-Oikkonen, P; Hurtig, T; Ebeling, H

2014-09-01

The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health. © 2014 John Wiley & Sons Ltd.

Racial Differences in Mental Health Recovery among Veterans with Serious Mental Illness.

Science.gov (United States)

Ali, Mana K; Hack, Samantha M; Brown, Clayton H; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth A; Park, Stephanie G; Dixon, Lisa B; Kreyenbuhl, Julie A

2018-04-01

Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p mental health recovery (p mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients' perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate the effects of psychotic symptomatology.

The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study.

Science.gov (United States)

Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö

2018-05-01

Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format

Attitudes of Chinese community members and psychiatrists towards forensic psychiatric assessments.

Science.gov (United States)

Shaoling, Zhong; Jun, Wang; Graham, Mellsop; Chen, Chen; Simei, Zhang; Qiguang, Li; Qun, Wang; Jiansong, Zhou; Xiaoping, Wang

2017-12-01

The aim of this study was to investigate the attitudes of Chinese community members and psychiatrists towards forensic psychiatric assessments. A questionnaire designed to record attitudes toward the current forensic psychiatric assessment procedures and the disposal of mentally ill offenders was developed and distributed via a mobile App. A total of 134 community members and 132 psychiatrists voluntarily completed the questionnaire. Most of responders agreed that the department of public-security has the right to apply for a forensic psychiatric assessment but should not be held solely by that department. Community members were less significantly confident in the validation of forensic psychiatric opinions than were the psychiatrists. A significantly higher proportion of community members than psychiatrists considered that offenders judged Not Criminally Responsible on Account of Mental Disorder (NCRMD) should be punished as would be sane people. In addition, only a minority of responders supported that NCRMD should not be held criminally responsible. Our results indicate that both groups have comments on the current distribution of right of startup of forensic psychiatric assessments. Compared to psychiatrists, community members have lower confidence in the validation of forensic psychiatric assessment and have stricter attitudes toward the disposal of offenders with psychiatric disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

Partnerships to promote mental health of NSW farmers: the New South Wales Farmers Blueprint for Mental Health.

Science.gov (United States)

Fragar, Lyn; Kelly, Brian; Peters, Mal; Henderson, Amanda; Tonna, Anne

2008-06-01

To describe the process and outcome of development of a framework for planning and implementation of a range of interventions aimed at improving the mental health and wellbeing of farmers and farm families in New South Wales (NSW). In response to a major drought in New South Wales (NSW), key agencies were invited to participate in a longer-term collaborative program aimed at improving the mental health and well-being of the people on NSW farms. These agencies became the NSW Farmers Mental Health Network. The Australian National Action Plan for Promotion, Prevention & Early Intervention for Mental Health 2000 proposed a population health approach base encompassing the range of risk and protective factors that determine mental health at the individual, family and community and society levels. It incorporated three traditional areas of health activity into programs aimed at achieving improved mental health for the Australian population - mental health promotion, prevention activities and early intervention. Although the farming population was not identified as a priority population, research has identified this population to be at high risk of suicide, and of having difficulty in coping with the range of pressures associated with life and work in this industry. Participants were agencies providing services across rural NSW in the fields of farmer and country women's organisations, financial counselling services, government departments of primary industries and health, mental health advisory and support services, charitable organisations and others. The NSW Farmers Blueprint for Mental Health (http://www.aghealth.org.au/blueprint) was developed to be 'a simplified summary of key issues that need to be addressed, and the major actions that we can be confident will be effective in achieving our purpose'. It has identified 'steps' along 'pathways to breakdown' from the range of known mental health and suicide risk factors that are relevant to the NSW farming population

Mental Health Concerns: Veterans & Active Duty

Science.gov (United States)

... dialing 1-800-273-8255 and pressing 1. Mental Health Concerns There are three primary mental health concerns ... care or call 911. How Will Asking for Mental Health Treatment Affect My Career? Military personnel have always ...

Infection Management and Health Practices Among Forensic Science Investigators in South Korea.

Science.gov (United States)

Cha, Kyeong-Sook; Cho, Ok-Hee; Yoo, Yang-Sook

2015-05-01

This study investigated the current status of infection management for forensic science investigators in South Korea. This study included 104 forensic science investigators, of which 97.1% were exposed to the blood or body fluids of corpses during handling. Of these investigators, 98% claimed they wore gloves, and 12.9% used double-layered gloves. A total of 70.6% of the participants with relevant work experience wore masks to reduce infection risk; 43% wore gowns and goggles when at risk of contracting an infection. Furthermore, 59.8% of the investigators with pertinent work experience sought appropriate first aid and treatment when they experienced contaminated skin cuts or stab wounds. Working conditions and other problems should be analyzed consistently with the cooperation of employees, occupational health practitioners, and relevant organizations to prevent work-associated infections among forensic science investigators. © 2015 The Author(s).

Current models of positive mental health

Directory of Open Access Journals (Sweden)

Stanojević Dragana Z.

2012-01-01

Full Text Available The concept of positive mental health represents not merely the absence of mental disease but presence of high level of happiness and well-being. In this paper we mentioned shortly the earliest concept of mental health, presented by Marie Jahoda in the mid-twentieth century. After that, we described two traditions in understanding and researching of subjective well-being: hedonic and eudaimonic approach. First approach focuses on investigation of positive affects and happiness as emotional and life satisfaction as cognitive component of subjective well-being. Second tradition emphasizes potentials and competences that person develops to the highest level, in personal and social area. Both psychological and social well-being are core concept of positive mental health psychology, designated together as positive functioning. The psychological well-being comprises six dimensions: self-acceptance, positive relations with others, environmental mastery, autonomy, purpose of life and personal growth. Social well-being consists of five dimensions: social integration, social acceptance, social contribution, social actualization and social coherence. By integrating hedonic and eudaimonic well-being as well as absence of mental disease, Corey Keyes introduced concept of complete mental health. People with complete mental health have reported absence of disease during past year and presence of high level of emotional, psychological and social well-being (flourishing. People with incomplete mental health have also reported absence of mental disease but low level of positive functioning (languishing. Keyes thought there are people with complete and incomplete mental illness; both groups report presence of mental disease, but second group has high level of positive functioning. Models of positive mental health are widely used in research studies as well as in programs for prevention and promotion of mental health. .

Mental health expectancy--the European perspective

DEFF Research Database (Denmark)

Jagger, C; Ritchie, K; Brønnum-Hansen, Henrik

1998-01-01

The increase in life expectancy observed over the last decade has particular relevance for mental health conditions of old age, such as dementia. Although mental disorders have been estimated to be responsible for 60% of all disabilities, until recently population health indicators such as health...... expectancies have concentrated on calculating disability-free life expectancy based on physical functioning. In 1994, a European Network for the Calculation of Health Expectancies (Euro-REVES) was established, one of its aims being the development and promotion of mental health expectancies. Such indicators...... may have an important role in monitoring future changes in the mental health of populations and predicting service needs. This article summarizes the proceedings and recommendations of the first European Conference on Mental Health Expectancy....

Interactions between youth and mental health professionals: The Youth Aware of Mental health (YAM) program experience

Science.gov (United States)

Wasserman, Camilla; Postuvan, Vita; Herta, Dana; Iosue, Miriam; Värnik, Peeter; Carli, Vladimir

2018-01-01

The Youth Aware of Mental health (YAM) experience Youth stand at the core of much mental health promotion, yet little is written about their experiences of such efforts. We aimed to take this on by interviewing youth after they participated in Youth Aware of Mental Health (YAM), a universal mental health promotion program. YAM has a non-anticipatory methodology that provides youth with a safe space for reflection, role-play, and discussion. Addressing everyday mental health, YAM invites the experiences and issues relevant to the youth present to influence the program in a slightly different direction every time. The YAM instructor guides the participants but does not present the youth with given formulas on how to solve their problems. Like any mental health promotion, YAM appeals to some more than others in its intended audience and individuals engage with the program in many different ways. We set out to learn more about these experiences. Conversations about mental health Thirty-two semi-structured interviews were conducted with 15–17 year olds in Estonia, Italy, Romania and Spain. In these interviews, the researchers made an effort to discuss mental health in terms relevant to youth. Still, wide-ranging levels of motivation, ease with engaging in dialogue with mental health professionals, and comfort with the format and content of YAM were detected. The youth were clustered in five different groups relating to their positioning vis-à-vis the researcher during the interview. The following evocative labels were used: “interested”, “foot in the door”, “respect for authority”, “careful”, and “not my topic”. Corresponding labels were devised for their YAM experience: “engaged”, “initially hesitant”, “cautious”, “eager to please”, or “disengaged”. We also observed that the researchers brought their own expectations and employed a variety of approaches that led to anticipating answers, stating the obvious, or getting along

Cannabis use and mental health

NARCIS (Netherlands)

van Gastel, W.A.

2013-01-01

Cannabis use has been implicated as a risk factor for mental health problems, (subclinical) psychotic symptoms in particular. If cannabis use was a cause of these problems, cessation would lead to improved public mental health. If cannabis use was a mere consequence of a predisposition for mental

Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

Science.gov (United States)

Grundberg, Åke; Hansson, Anna; Religa, Dorota; Hillerås, Pernilla

2016-01-01

Introduction Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health

Policy for better mental health

OpenAIRE

Richard Layard

2014-01-01

Treating mental illness should be a top national priority, especially as proven psychological therapies effectively cost nothing. Richard Layard explains how CEP research has led to a new deal for mental health - but much remains to be done. Mental illness has much greater economic costs than physical illness - but evidence-based ways of treating mental health problems have no net cost to the Exchequer.

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

OpenAIRE

Larson, S; Chapman, S; Spetz, J; Brindis, CD

2017-01-01

Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

Fear and blame in mental health nurses' accounts of restrictive practices: Implications for the elimination of seclusion and restraint.

Science.gov (United States)

Muir-Cochrane, Eimear; O'Kane, Deb; Oster, Candice

2018-03-09

Restrictive practices continue to be used in mental health care despite increasing recognition of their harms and an international effort to reduce and ultimately eliminate their use. The aim of this qualitative study was to explore mental health nurses' views of the potential elimination of these practices. Nine focus groups were conducted with 44 mental health nurses across Australia, and the data analysed using thematic analysis. Overall, the nurses expressed significant fear about the potential elimination of restrictive practices and saw themselves as being blamed for both the use of these practices and the consequences should they be eliminated. Findings detail the conflicts facing staff in balancing the need for ward safety for everyone present while at the same time providing person-centred care. Nurses described the changing role of the mental health nurse in acute settings, being more focussed on risk assessment and medication while at the same time attempting to practise in trauma-informed person-centred ways. The impact on ward safety with increasing acuity of consumers plus the presence of forensic consumers and those affected by methamphetamine was emphasized. Change initiatives need to take into account nurses' deep concerns about the consequences of eliminating all forms of control measures in hospitals and respond to the symptoms and behaviours consumers present with and associated unpredictable and concerning behaviours. Attempts to eliminate restrictive practices should, therefore, be carefully considered and come with a clear articulation of alternatives to ensure the safety of consumers, visitors, and staff. © 2018 Australian College of Mental Health Nurses Inc.

Promoting Mental Health and Preventing Mental Illness in General Practice.

Science.gov (United States)

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

Chicano Aging and Mental Health.

Science.gov (United States)

Miranda, Manuel, Ed.; Ruiz, Rene A., Ed.

Focusing on the direction future research on the Chicano elderly should take, the 10 papers address theory development, methodological approach, social policy and problems, mental health service delivery, and issues of mental illness. The first seven papers discuss: the theoretical perspectives of research pertaining to mental health and the…

Development of forensic medicine in post reform Indonesia.

Science.gov (United States)

Syukriani, Yoni Fuadah; Novita, Nita; Sunjaya, Deni K

2018-05-03

Forensic medicine practice in Indonesia was introduced through the Dutch colonial criminal justice system in the early twentieth century. After more than 70 years of national independence, the development of forensic medicine still faces fundamental challenges, including confusion in the distribution of responsibility with law enforcement agencies, difficulties in managing conflicts of interest, and impediments in scientific practice and professional development. Despite of the golden opportunity from the Indonesian Reform movement in the late 1990s, the impact on forensic medicine development has been less than expected. It is thus important to identify the scope of the problems plaguing the development of forensic medicine, as well as its causes. We conducted a qualitative study to explain the problems and propose solutions. The results show that the standards of practice have developed more slowly than those in many other branches of medicine, despite its increasing popularity from its role in counterterrorism and disaster victim identification. A strong thriving spirit exists in forensic science, although growth in forensic research activities should be facilitated more. The 2009 Health Law has included forensic medicine practice in the health system to cover the role of forensic medicine for health and medical education purposes. It also potentially provides a way to support the justice system without exposing forensic practitioners to possible conflicts of interest, for instance, by utilizing a tiered referral system. To this aim, an alternative is proposed: to place forensic medicine practice within the context of the health system. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Mental Health Consultation Among Ontario's Immigrant Populations.

Science.gov (United States)

Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala

2017-11-16

To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on

Application of TQM to mental health: lessons from ten mental health centers.

Science.gov (United States)

Sluyter, G V

1996-01-01

The principles and techniques of total quality management (TQM) have only recently been applied to the field of mental health. This article reviews issues and offers some preliminary observations, based on the author's consultation and training work with ten state-operated mental health organizations in Missouri (Jul 1, 1994-Jun 30, 1995). Since many mental health organizations have operated in the public sector as part of large, hierarchical state agencies, the legacy of bureaucratic structures and a command and control leadership style may pose additional challenges. Two types of training have proven helpful in the Missouri project: general overview or awareness training for all staff and specialized training for team leaders and facilitators. To be successful with TQM, mental health organizations should clearly delineate their governing ideas, continuously reinforce them with all staff, and use the ideas as a measuring stick for progress. Some of the organizations in the Missouri project link their governing ideas and strategic planning efforts with critical success factors and the measurement methodology to track them. This dimension, which may include a quality council, a quality department, and quality improvement (QI) teams, also extends to the way in which facilities are organized and function. The structure evolving from a team-oriented, time-limited, data-based, and problem-solving approach can facilitate the functioning of the entire organization. The philosophy and techniques of TQM are as applicable to mental health as to health care in general--the question is one more of motivation than of fit.

Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

Directory of Open Access Journals (Sweden)

H. Orpana

2016-01-01

Full Text Available Introduction: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. Methods: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada’s definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. Results: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada’s strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course.

Mental health: More than neurobiology

NARCIS (Netherlands)

Fried, E.; Tuerlinckx, F.; Borsboom, D.

2014-01-01

The decision by the US National Institute of Mental Health (NIMH) to fund only research into the neurobiological roots of mental disorders (Nature 507, 288; 2014) presumes that these all result from brain abnormalities. But this is not the case for many people with mental-health issues and we fear

Workplace mental health: developing an integrated intervention approach

Science.gov (United States)

2014-01-01

Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

Factors for success in mental health advocacy.

Science.gov (United States)

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition - Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings.

Health Problems of Mentally Disabled Individuals

Directory of Open Access Journals (Sweden)

Hatice Yildirim Sari

2010-04-01

Full Text Available Mentally disabled individuals are at risk of health problems. In fact, health problems are more frequent in mentally disabled individuals than in the general population and mentally disabled individuals less frequently use health care facilities. It has been shown that mentally disabled individuals frequently have nutritional problems. They may suffer from low weight, malnutrition, high weight, pica, iron and zinc deficiencies and absorption and eating disorders. Activities can be limited due to motor disability and restricted movements. Depending on insufficient liquid intake and dietary fiber, constipation can be frequent. Another problem is sleep disorders such as irregular sleep hours, short sleep, waking up at night and daytime sleepiness. Visual-hearing losses, epilepsy, motor disability, hepatitis A infection and poor oral hygiene are more frequent in mentally disabled children than in the general population. The mentally disabled have limited health care facilities, poorer health status than the general population and difficulties in demanding for health care and expressing health problems. Therefore, they should be provided with more health promotion services. [TAF Prev Med Bull 2010; 9(2.000: 145-150

Risk assessment and management approaches on mental health units.

Science.gov (United States)

Woods, P

2013-11-01

This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

Dangerousness and mental health policy.

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Hewitt, J L

2008-04-01

Mental health policy development in the UK has become increasingly dominated by the assumed need to prevent violence and alleviate public concerns about the dangers of the mentally ill living in the community. Risk management has become the expected focus of contemporary mental health services, and responsibility has increasingly been devolved to individual service professionals when systems fail to prevent violence. This paper analyses the development of mental health legislation and its impact on services users and mental health professionals at the micro level of service delivery. Historical precedence, media influence and public opinion are explored, and the reification of risk is questioned in practical and ethical terms. The government's newest proposals for compulsory treatment in the community are discussed in terms of practical efficacy and therapeutic impact. Dangerousness is far from being an objectively observable phenomenon arising from clinical pathology, but is a formulation of what is partially knowable through social analysis and unknowable by virtue of its situation in individual psychic motivation. Risk assessment can therefore never be completely accurate, and the solution of a 'better safe than sorry' approach to mental health policy is ethically and pragmatically flawed.

Quick Guide: Mental Health-Secondary Transition

Science.gov (United States)

National Technical Assistance Center on Transition, 2016

2016-01-01

Recently researchers have begun focusing on young adults with mental health disorders transitioning into adulthood. Research exploring the importance of mental health support in secondary transition have yielded positive outcomes. For example, strong collaboration between educational and mental health agencies ensuring academic, employment, and…

Trajectories of mental health problems in children of parents with mental health problems: results of the BELLA study.

Science.gov (United States)

Plass-Christl, Angela; Otto, Christiane; Klasen, Fionna; Wiegand-Grefe, Silke; Barkmann, Claus; Hölling, Heike; Schulte-Markwort, Michael; Ravens-Sieberer, Ulrike

2017-11-24

Children of parents with mental health problems (CPM) have an increased risk for behavioral and psychological problems. This study investigated the age- and gender-specific course as well as predictors of mental health problems in CPM using the longitudinal data (baseline 1- and 2-year follow-ups) of a German general population sample from the BELLA study. Children and adolescents aged 11-17 years (at baseline) who had a parent with mental health problems (n = 325) were analyzed. The mental health problems of the children were assessed by the self-reported version of the strengths and difficulties questionnaire (SDQ). We used individual growth modeling to investigate the age- and gender-specific course, and the effects of risk as well as personal, familial and social protective factors on self-reported mental health problems in CPM. Additionally, data were examined differentiating internalizing and externalizing mental health problems in CPM. Results indicated that female compared to male CPM showed increasing mental health problems with increasing age. Mental health problems in CPM were associated with lower self-efficacy, worse family climate and less social competence over time. Internalizing problems were associated with lower self-efficacy, less social competence and more severe parental mental health problems. Externalizing problems were associated with lower self-efficacy, worse family climate and lower social competence. The main limitations of the study are the short time period (2 years) covered and the report of mental health problems by only one parent. Our findings should be considered in the development of treatment and prevention programs for mental health problems in CPM.

Women and mental health

National Research Council Canada - National Science Library

Kohen, Dora

2000-01-01

... for the individual. Covering issues including perinatal psychiatric disorders, depression, eating disorders, schizophrenia, and alcohol and drug abuse - from a female perspective - Women and Mental Health will prove a valuable tool for all those working in the fields of mental health. Dora Kohen is a Consultant Psychiatrist and an Honorary Senior...

Women and mental health

Directory of Open Access Journals (Sweden)

Unaiza Niaz

2016-07-01

Full Text Available Issues related to the mental health of women are a priority these days. Many international organisations working in the field of psychiatry are having sections on it now. This approach can go a long way in the improvement of the available mental health services for this population.

Reciprocity in global mental health policy

OpenAIRE

White, Ross; Sashidharan, S.P.

2014-01-01

In an attempt to address inequalities and inequities in mental health provision in low\\ud and middle-income countries the WHO commenced the Mental Health Gap Action\\ud Programme (mhGAP) in 2008. Four years on from the commencement of this\\ud programme of work, the WHO has recently adopted the Comprehensive Mental\\ud Health Action Plan 2013-2020. This article will critically appraise the strategic\\ud direction that the WHO has adopted to address mental health difficulties across the\\ud globe. ...

The approach of prehospital health care personnel working at emergency stations towards forensic cases

OpenAIRE

Ozlem Asci; Guleser Hazar; Isa Sercan

2015-01-01

Objectives: The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. Materials and methods: This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 201...

Mental health/illness and prisons as place: frontline clinicians׳ perspectives of mental health work in a penal setting.

Science.gov (United States)

Wright, Nicola; Jordan, Melanie; Kane, Eddie

2014-09-01

This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.

Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems.

Science.gov (United States)

Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

2014-04-11

E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population. An advisory group of service users identified dimensions that potentially influence an individual's decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA. Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants' expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future. Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such

Television and the promotion of mental health

OpenAIRE

Milošević Ljiljana

2011-01-01

Current media campaigns, realized within national campaigns and actions on mental health prevention and promotion, are considered in this paper, in the context of expert public relation, as well as the whole society, towards mental health. Mental health promotion is determined as a range of activities by which individuals, community and society are being enabled to take control over mental health determinants and to improve it, but also as an action for improvement of mental health posi...

Integrating physical and mental health promotion strategies

OpenAIRE

Palma, Jessica Anne

2010-01-01

While health is defined as ‘a state of complete physical, mental and social well-being’, physical and mental health have traditionally been separated. This paper explores the question: How can physical and mental health promotion strategies be integrated and addressed simultaneously? A literature review on why physical and mental health are separated and why these two areas need to be integrated was conducted. A conceptual framework for how to integrate physical and mental health promotion st...

Mental health informatics

CERN Document Server

Song, Insu; Yellowlees, Peter; Diederich, Joachim

2014-01-01

This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).

Cannabis Use and Mental Health Problems

NARCIS (Netherlands)

van Ours, J.C.; Williams, J.

2009-01-01

This paper investigates whether cannabis use leads to worse mental health. To do so, we account for common unobserved factors affecting mental health and cannabis consumption by modeling mental health jointly with the dynamics of cannabis use. Our main finding is that using cannabis increases the

Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

Directory of Open Access Journals (Sweden)

Grundberg Å

2016-02-01

Full Text Available Åke Grundberg,1,2 Anna Hansson,2 Dorota Religa,1 Pernilla Hillerås1,2 1Division of Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, 2Sophiahemmet University, Stockholm, Sweden Introduction: Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs. Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim: To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods: We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results: Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion: The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of

Atheism and mental health.

Science.gov (United States)

Whitley, Rob

2010-01-01

The exploration of the impact of religiosity on mental health is an enduring, if somewhat quiet, tradition. There has been virtually no exploration, however, of the influence of atheism on mental health. Though not a "religion," atheism can be an orienting worldview that is often consciously chosen by its adherents, who firmly believe in the "truth" of atheism-a phenomenon known as "positive atheism." Atheism, especially positive atheism, is currently enjoying something of a renaissance in the Western liberal democracies-a trend often referred to as the "new atheism." I argue that atheism, especially positive atheism, should be treated as a meaningful sociocultural variable in the study of mental health. I argue that atheism (just like theism) is an appropriate domain of study for social and cultural psychiatrists (and allied social scientists) interested in exploring socio-environmental stressors and buffers relating to mental health. Specifically, I argue that (1) atheism needs to be accurately measured as an individual-level exposure variable, with the aim of relating that variable to psychiatric outcomes, (2) there needs to be greater systematic investigation into the influence of atheism on psychiatry as an institution, and (3) the relation of atheism to mental health needs to be explored by examining atheistic theory and its practical application, especially as it relates to the human condition, suffering, and concepts of personhood.

Working Together for Mental Health: Evaluation of a one-day mental health course for human service providers

Science.gov (United States)

Grootemaat, Pam; Gillan, Cathie; Holt, Gillian; Forward, Wayne; Heywood, Narelle; Willis, Sue

2006-01-01

Background The Working Together For Mental Health course is an 8-hour course designed to demystify mental illness and mental health services. The main target group for the course is people working in human service organisations who provide services for people with mental illness. Methods A questionnaire was administered to all participants attending the course during 2003 (n = 165). Participants completed the questionnaire before and immediately after the course, and at three month follow-up. Results A response rate of 69% was achieved with 114 people completing the questionnaire on all three occasions. The responses showed a significant improvement in the self-assessed knowledge and confidence of participants to provide human services to people with a mental health problem or disorder, three months after the course. There was no significant improvement in participants' attitudes or beliefs about people with a mental health problem or disorder at three month follow-up; however, participants' attitudes were largely positive before entering the course. Conclusion The Working Together For Mental Health course was successful in improving participants' confidence and knowledge around providing human services to people with a mental health illness. PMID:17074097

Medicalization of global health 2: The medicalization of global mental health.

Science.gov (United States)

Clark, Jocalyn

2014-01-01

Once an orphan field, 'global mental health' now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives.

Mental health nurses' perspective of workplace violence in Jordanian mental health hospitals.

Science.gov (United States)

Al-Azzam, Manar; Al-Sagarat, Ahmad Yahya; Tawalbeh, Loai; Poedel, Robin J

2017-10-27

The purpose was to assess the mental health nurses' perspectives of workplace violence in mental health departments in Jordan. A cross-sectional correlation study was utilized to address the study's purposes. Data were collected using self-reported questionnaires from nurses working in governmental mental health departments in Jordan. The findings indicated that 80% of the respondents were victims of at least one violent act in the last 2 years. Verbal abuse was the most indicated type of violence. Patients were considered the main source of violence. Policies and legislations addressing workplace violence should be implemented, and nurses should be trained on using such policies. Hospital managers should create a safe work environment by enforcing effective security measures and maintaining adequate staffing. © 2017 Wiley Periodicals, Inc.

Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

Science.gov (United States)

Atilola, Olayinka

2016-06-01

The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

Factors for success in mental health advocacy

Science.gov (United States)

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

Behavioral health leadership: new directions in occupational mental health.

Science.gov (United States)

Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L

2014-10-01

The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

Rural Mental Health

Science.gov (United States)

... social networks While there are drawbacks to small communities when it comes to mental health, there are positives as well. The close-knit ... to refer patients to facilities outside of the community. The Substance Abuse and Mental ... Administration (SAMHSA) maintains the 2016 National Directory ...

Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study.

Science.gov (United States)

Nash, M

2014-10-01

This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi-structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly. © 2014 John Wiley & Sons Ltd.

Undergraduate Nursing Students' Attitudes toward Mental Illness and Mental Health Nursing

Science.gov (United States)

Konzelman, Lois

2017-01-01

Historically, nurses have lacked recognition for the work they do, especially in the area of mental health. There is a shortage of qualified mental health nurses to meet the demand for services. Many rural areas in the United States have few or no mental health services to offer communities. Encouraging positive attitudes toward mental health…

Dual factor model of mental health: Co-occurrence of positive mental health and suicide ideation in inpatients and outpatients.

Science.gov (United States)

Teismann, Tobias; Brailovskaia, Julia; Siegmann, Paula; Nyhuis, Peter; Wolter, Marcus; Willutzki, Ulrike

2017-12-06

Positive and negative mental health are independent but correlated concepts. Yet, it is unknown whether positive mental health does co-occur with suicide ideation. The present study aimed to determine the proportion of patients who have positive mental health as well as suicide ideation. Inpatients (N=100) and outpatients (N=182) completed self-report measures of positive mental health, suicide ideation and lifetime suicide attempts. Eleven outpatients (6%) and ten inpatients (10%) with suicide ideation reported moderate to high levels of positive mental health. Lifetime suicide attempts were less likely in inpatients who suffered from suicide ideation in the presence of positive mental health. Positive mental health does co-occur with suicide ideation and should be considered as a protective factor in suicide risk assessments. Copyright © 2017 Elsevier B.V. All rights reserved.

Positive mental health: is there a cross-cultural definition?

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Vaillant, George E

2012-06-01

SEVEN MODELS FOR CONCEPTUALIZING POSITIVE MENTAL HEALTH ARE REVIEWED: mental health as above normal, epitomized by a DSM-IV's Global Assessment of Functioning (GAF) score of over 80; mental health as the presence of multiple human strengths rather than the absence of weaknesses; mental health conceptualized as maturity; mental health as the dominance of positive emotions; mental health as high socio-emotional intelligence; mental health as subjective well-being; mental health as resilience. Safeguards for the study of mental health are suggested, including the need to define mental health in terms that are culturally sensitive and inclusive, and the need to empirically and longitudinally validate criteria for mental health.

Improving Mental Health in Schools

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Rossen, Eric; Cowan, Katherine C.

2015-01-01

Students do not leave their mental health at the front door when they come to school. From wellness to serious illness, a student's mental health status is integral to how they think, feel, interact, behave, and learn. Decades of research and experience have laid a solid foundation and framework for effectively providing mental health…

Mental health training programmes for non-mental health trained professionals coming into contact with people with mental ill health: a systematic review of effectiveness.

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Booth, Alison; Scantlebury, Arabella; Hughes-Morley, Adwoa; Mitchell, Natasha; Wright, Kath; Scott, William; McDaid, Catriona

2017-05-25

The police and others in occupations where they come into close contact with people experiencing/with mental ill health, often have to manage difficult and complex situations. Training is needed to equip them to recognise and assist when someone has a mental health issue or learning/intellectual disability. We undertook a systematic review of the effectiveness of training programmes aimed at increasing knowledge, changing behaviour and/or attitudes of the trainees with regard to mental ill health, mental vulnerability, and learning disabilities. Databases searched from 1995 onwards included: ASSIA, Cochrane Central Register of Controlled Clinical Trials (CENTRAL), Criminal Justice Abstracts, Embase, ERIC, MEDLINE, PsycINFO, Social Science Citation Index. Courses, training, or learning packages aimed at helping police officers and others who interact with the public in a similar way to deal with people with mental health problems were included. Primary outcomes were change in practice and change in outcomes for the groups of people the trainees come into contact with. Systematic reviews, randomised controlled trials (RCTs) and non- randomised controlled trials (non-RCTs) were included and quality assessed. In addition non-comparative evaluations of training for police in England were included. From 8578 search results, 19 studies met the inclusion criteria: one systematic review, 12 RCTs, three prospective non-RCTs, and three non-comparative studies. The training interventions identified included broad mental health awareness training and packages addressing a variety of specific mental health issues or conditions. Trainees included police officers, teachers and other public sector workers. Some short term positive changes in behaviour were identified for trainees, but for the people the trainees came into contact with there was little or no evidence of benefit. A variety of training programmes exist for non-mental health professionals who come into contact with

[Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy].

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Bruland, Dirk; Kornblum, Katharina; Harsch, Stefanie; Bröder, Janine; Okan, Orkan; Bauer, Ullrich

2017-12-01

Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy Mental health issues of parents of school children often negatively affects the children as well, including their school performance and social behavior in the school setting. Teachers are then required to take actions with regards to supporting children in their coping with and mastering of their home situation and their responds to educational demands. As such, schools' and teachers' actions can either support affected children and fulfill a protective function or respond inappropriately, with negative impact on the affected children. Although the societal discussion about and acceptance of mental illnesses have increased in recent years, scientific knowledge on how well teachers are prepared for meeting the needs of affected students remains insufficient. Therefore, this research study examines teachers' attitudes towards, knowledge about, and competencies regarding children affected by a mentally ill parent. 15 in-depth interviews and 3 focus groups (n = 11) with teachers from primary and secondary schools were conducted and systematically analyzed. Although burdens in the family are perceived as major influences on children's school day and performance, teachers report to not feel sufficiently prepared for and uncertain about supporting and coping with the special needs of affected students. Instead they report to "learn from a case to case" basis. Recognizing the family situation of children with mentally ill parents is reported to be especially difficult for teachers. Responding inadequately and insensitive to the needs of affected children was perceived as a serious burden for teachers themselves. While schools can function as entry points to professional social help systems, teachers frequently reported barriers and challenges in accessing, communicating, and collaborating with these systems. The practical implications of these results regarding the "Mental Health

Mental Health Utilization Among Diverse Parenting Young Couples.

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Albritton, Tashuna; Angley, Meghan; Gibson, Crystal; Sipsma, Heather; Kershaw, Trace

2015-09-01

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.

Perceived barriers on mental health services by the family of patients with mental illness

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Rr Dian Tristiana

2018-01-01

Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.

Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

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Connell, Nadine M.

2014-01-01

Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison. PMID:25322306

Forensic nurses' perceptions of labels of mental illness and personality disorder: clinical versus management issues.

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Mason, T; Hall, R; Caulfied, M; Melling, K

2010-03-01

Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clinical outcomes. This study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant difference across High (z = 9.69; P < or = 0.01), Medium (z = 11.06; P < or = 0.01) and Low (z= 9.57; P= 0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z = 9.69; P < or = 0.01) and Low (z = 9.57; P < or = 0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical-Personality Disorder Management and Mental Illness Clinical-Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.

Mental health among students of pedagogical universities

Directory of Open Access Journals (Sweden)

Malinauskas R.

2010-06-01

Full Text Available This article deals with questions of mental health among students of pedagogical universities. There were analysed differences in the level of mental health among sporting and non-sporting students. Two methods were used in the inquiry. Stepanov's questionnaire was used to estimate the level of mental health, Gundarov's questionnaire was used to evaluate psychical satisfaction. The sample consisted of 263 sporting students (athletes and 288 non-sporting students. Results have shown that the level of mental health among sporting students was higher than the level of mental health among non-sporting students.

Mental Health Services in School-Based Health Centers: Systematic Review

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Bains, Ranbir Mangat; Diallo, Ana F.

2016-01-01

Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

Mental Health

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... well Feeling guilty, worthless, or helpless Thinking about suicide or hurting yourself Other mental health conditions include anxiety disorders, mood disorders, and personality disorders. For a good description ...

The Impact of Mental Health Reform on Mental Illness Stigmas in Israel.

Science.gov (United States)

Ben Natan, Merav; Drori, Tal; Hochman, Ohad

2017-12-01

This study examined public perception of stigmas relating to mental illness six months after a reform, which integrated mental health care into primary care in Israel. The results reveal that the public feels uncomfortable seeking referral to mental health services through the public health system, with Arab Israelis and men expressing lower levels of comfort than did Jewish Israelis. The current reform has not solved the issue of public stigma regarding mental health care. The study suggests that the current reforms must be accompanied over time with appropriate public education regarding mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.

Mental health challenges among adolescents living with HIV.

Science.gov (United States)

Vreeman, Rachel C; McCoy, Brittany M; Lee, Sonia