“Just be a light”: Experiences of peers working on acute inpatient psychiatric units – 2017

Objective: The study aimed to clarify the potential role and impact of behavioral health peer support providers on community hospital acute inpatient psychiatric units. Method: Qualitative interviews were conducted to examine perspectives of peer support providers (peers) and individuals who initially received peer services (recipients) during an inpatient stay on

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1st International Experts’ Meeting on Agitation: Conclusions Regarding the Current and Ideal Management Paradigm of Agitation – 2018

Agitation is a heterogeneous concept without a uniformly accepted definition, however, it is generally considered as a state of cognitive and motor hyperactivity characterized by excessive or inappropriate motor or verbal activity with marked emotional arousal. Not only the definition but also other aspects of agitated patients’ care are still

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A pilot study of “post‐seclusion and/or restraint review” intervention with patients and staff in a mental health setting – 2018

Abstract 1 Purpose To develop and evaluate a “post‐seclusion and/or restraint review” (PSRR) intervention implemented in an acute psychiatric care unit. 2 Design and Methods Twelve staff members and three patients were enrolled in a participatory case study. To evaluate PSRR intervention, qualitative analysis was carried out. Seclusion and restraint

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A Survey of Hospital Ethics Structures in Ontario

In response to the growing recognition of the prevalence of ethical issues in clinical care, hospitals in Canada began forming ethics committees in the 1980s. Studies showed significant growth in the prevalence of ethics committees over the ensuing decade. Although the limited studies available suggest that ethics committees have become

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Acute Care Use for Ambulatory Care–Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions – 2018-01-18

Objective: The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care–sensitive conditions (ACSCs) among high-cost

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Adverse events occurring on mental health units – 2018-01

Objective While the study of suicide on mental health units has a long history, the study of patient safety more generally is relatively new. Our objective was to determine the type and relative frequency of adverse events occurring on Veterans Health Administration (VHA) mental health units; the primary root causes

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An algorithm for managing adults who refuse medical treatment in New South Wales – 2018-02

Objectives: The assessment and management of a patient who refuses medical treatment requires clinical skill, and consideration of the relevant law and the patient’s decision-making capacity. Psychiatrists are often asked to advise in these situations. We aimed to develop an algorithm describing the relevant legal pathways to assist clinicians, especially

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An audit of patient aggression in an adult psychiatric unit: 2013–2014 – 2018

Objectives: The aim of this study was to determine the rates of patient aggression in a psychiatric unit over 12 months and to determine underlying causes, notably the role of substances. Methods: A retrospective file audit was undertaken of all patients admitted to St Vincent’s psychiatric unit (Melbourne, Australia) in

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An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings – 2018

In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has

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Anger and aggression treatments: a review of meta-analyses – 2018-02

Highlights • There is considerable variability in the effectiveness of anger treatments. • Cognitive-behavioral interventions are the most commonly studied treatment of anger. • Court-mandated anger management classes are underrepresented in the literature. • Behavioral rehearsal may be more effective than therapy targeting cognitive changes. • Future research will benefit from a

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Applications of Yoga in Psychiatry: What We Know – 2018

Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering

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Association between alcohol and substance use disorders and psychiatric service use in patients with severe mental illness: a nationwide Danish register-based cohort study – 2018-02

Substance use disorder is highly prevalent in people with psychiatric disorders, and known to impede the psychiatric treatment. Some studies show increased rates of service use, while others show a decrease. These conflicting results are further hampered by a lack of large-scale studies. The aim of this study was to

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Association of Childhood Blood Lead Levels With Criminal Offending – 2017-12-26

Key Points Question Is childhood lead exposure associated with criminal offending in a setting where the degree of lead exposure was not confounded by socioeconomic status? Findings In this cohort study of 553 New Zealanders observed for 38 years, lead exposure in childhood was weakly associated with official criminal conviction

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Coercion in Outpatients under Community Treatment Orders: A Matched Comparison Study – 2018

Objective: Since the deinstitutionalization of psychiatric services around the world, the scope of outpatient psychiatric care has also increased to better support treatment access and adherence. For those with serious mental illness who may lack insight into their own illness, available interventions include coercive community practices such as mandated community

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Cognitive-behavioral programming and the value of failed interventions: A propensity score evaluation – 2018-01

Recent scholarship suggests treatment effects from cognitive behavioral therapy (CBT) based interventions can significantly reduce rates of prison misconduct. However, these findings may overestimate CBT treatment effects due to publication bias towards positive results and limitations of nonexperimental methodologies. This study used propensity score matching (PSM) to evaluate the effectiveness

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Correlates of Treatment Retention Among Persons with Serious Mental Illness Receiving Integrated Care in a Community Mental Health Setting – 2018

Knowledge about methods to retain community mental health (CMH) clients in integrated primary and behavioral health care (PBHC) programs is needed to address longstanding health disparities. A preexisting data set that contained the clinical records of 446 PBHC program participants was used to examine whether baseline sociodemographic, health, and psychosocial

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Culturally Competent Commissioning; Meeting the Needs of Canada’s Diverse Communities: The Road Map to a Culturally Competent Mental Health System for All – 2018

Cultural competence has proven to be a very efficient tool in reducing healthcare disparities and improving healthcare experiences, compliance with therapy, and reducing incidents of misdiagnosis. This effect is because professionals are recognizing the value and significance of including the person in need of services in their assessment and decision

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Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit – 2018

The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national

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Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit – 2018-02

The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national

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Empathic processes during nurse–consumer conflict situations in psychiatric inpatient units: A qualitative study – 2016-12

Empathy is a central component of nurse–consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13)

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Emptying the ‘New Asylums’: A Beds Capacity Model to Reduce Mental Illness Behind Bars – 2017-01

In 2016, an estimated 90,000 US jail inmates were pretrial defendants with serious mental illness who had been found incompetent to stand trial (IST). IST services most commonly take place in state hospitals. Most state hospitals maintain waitlists of IST inmates because they do not have enough beds to meet

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Ethical challenges when using coercion in mental healthcare: A systematic literature review – 2016

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was

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Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada – 2018

Background: The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. Methods: The study population was derived from the Canadian Community Health

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Evaluating psychiatric readmissions in the emergency department of a large public hospital – 2018

Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients

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Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK – 2017

The purpose of this research was to identify factors associated with lengthy stays in psychiatric hospital in a UK mental health trust. A multiple regression using a multiple imputation method to deal with missing data was performed on inpatient admissions data over a four-year period for 7653 individuals. Factors associated

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