scholarly journals Reducing the use of oral psychotropic PRN medication in acute mental health inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S210-S210
Author(s):  
Zoe Moore ◽  
Rachel Morrow ◽  
Meta McGee
Keyword(s):  
Mental Health ◽  
Median Number ◽  
Hospital Environment ◽  
Process Time ◽  
List Type ◽  
Type Number ◽  
Negative Consequences ◽  
Nursing Administration ◽  
Pro Re Nata ◽  
The Impact

AimsProject aim:To reduce the use of oral psychotropic PRN* medication on Ward 3 AMHIC (Acute Mental Health Inpatient Centre) by 20% by May 2020(*PRN = Pro re nata/As required)On Ward 3, we identified a number of unintended negative consequences of PRN medication to both patients and staff.These included issues with over-use, dependence and side effects; as well as loss of staff ownership and challenging interactions with patients, (including escalation to aggression).Following the success of our Child and Adolescent Mental Health Inpatient colleagues in this area, we decided to embark on a project to change practice within our ward.MethodIn order to quantify the problem, we first collected baseline data on current use of psychotropic PRN medication.As a multidisciplinary project team, we then brainstormed potential contributory factors and displayed these visually as a driver diagram.This divided our project into 3 main areas: 1)Safe prescribing2)Safe administration,3)Safety culture.Project measures were also agreed as follows:Outcome: Number of doses of oral psychotropic PRN medication administered per weekBalancing: Violent incidents; IM administrations of psychotropic medicationProcess: Time taken to complete interventions; Patient and staff satisfaction. Change ideas were selected and implemented sequentially, using Plan-Do-Study- Act methodology.These included: 1)Weekly review of PRN prescribing2)Nursing administration sheetData were collected weekly and plotted on our run chart.ResultBy the end of May 2020, we had exceeded our initial goal, reducing the weekly median number of doses of oral psychotropic PRN medication administered by over 30%.Our balancing measures remained stable and we gained useful insights and development ideas from a staff survey.Further change ideas were planned for implementation over the months that followed, however, the impact of the COVID-19 pandemic meant that the project lost some momentum.ConclusionDespite running into some difficulty over recent months, the team remain motivated to maintain and build upon our previous success.In the past few weeks, “Calm Cards”, (a patient-centred intervention promoting use of individualised alternative coping strategies), have been introduced.We hope that the outcomes of this intervention will be positive, both in terms of further reducing use of PRN medication and encouraging development of skills which can be utilised beyond the hospital environment.We also intend to share our learning with colleagues and explore the possibility of introducing the project to other wards within the hospital.

The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

2020 ◽  
pp. 089826432097523
Author(s):  
Stephanie Ureña ◽  
Miles G. Taylor ◽  
Dawn C. Carr
Keyword(s):  
Mental Health ◽  
Depressive Symptom ◽  
Military Service ◽  
Later Life ◽  
Traumatic Experiences ◽  
Psychological Resilience ◽  
Previous Exposure ◽  
Negative Consequences ◽  
Symptom Trajectories ◽  
The Impact

Objectives: We examine the impact of exposure to the dead, dying, and wounded (DDW) during military service on the later-life depressive symptom trajectories of male United States veterans, using psychological resilience as an internal resource that potentially moderates negative consequences. Methods: The Health and Retirement Study (2006–2014) and linked Veteran Mail Survey were used to estimate latent growth curve models of depressive symptom trajectories, beginning at respondents’ first report of resilience. Results: Veterans with higher levels of resilience do not have increased depressive symptoms in later life, despite previous exposure to DDW. Those with lower levels of resilience and previous exposure to DDW experience poorer mental health in later life. Discussion: Psychological resilience is important for later-life mental health, particularly for veterans who endured potentially traumatic experiences. We discuss the importance acknowledging the role individual resources play in shaping adaptation to adverse life events and implications for mental health service needs.

scholarly journals The impact of COVID-19 restriction measures on loneliness among older adults in Austria

2020 ◽  
Author(s):  
Erwin Stolz ◽  
Hannes Mayerl ◽  
Wolfgang Freidl
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Positive Association ◽  
Health Issues ◽  
Negative Consequences ◽  
Cross Sectional ◽  
Social Contacts ◽  
Mental Health Issues ◽  
The Impact ◽  
Opening Phase

Abstract Background To halt the spread of COVID-19, Austria implemented a 7-week ’lockdown’ in March/April 2020. We assess whether the ensuing reduction in social contacts led to increased loneliness among older adults (60+). Methods Three analyses were conducted: (1) A comparison between pre-pandemic (SHARE: 2013-2017) and pandemic (May 2020) levels of loneliness (UCLA-3 scale), (2) an assessment of the cross-sectional correlation between being affected by COVID-19 restriction measures and loneliness (May 2020), and (3) a longitudinal analysis of weekly changes (March-June 2020) in loneliness (Corona panel). Results We found (1) increased loneliness in 2020 compared with previous years, (2) a moderate positive association between the number of restriction measures older adults were affected from and their loneliness, and (3) that loneliness was higher during ’lockdown’ compared to the subsequent re-opening phase, particularly among those who live alone. Conclusion We provide evidence that COVID-19 restriction measures in Austria have indeed resulted in increased levels of loneliness among older adults. However, these effects seem to be short-lived, and thus no strong negative consequences for older adults’ mental health are expected. Nonetheless, the effects on loneliness, and subsequent mental health issues, might be both more long-lasting and severe if future restriction measures are enacted repeatedly and/or over longer time periods.

scholarly journals Diversion from custody: An update

2017 ◽  
Vol 23 (6) ◽  
pp. 375-384 ◽  
Author(s):  
Luke Birmingham ◽  
Olusola Awonogun ◽  
Howard Ryland
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Mental Health Problems ◽  
List Type ◽  
Mentally Disordered ◽  
The Past ◽  
Important Landmark ◽  
Justice Process ◽  
Criminal Justice Process ◽  
The Impact

SummaryLiaison and diversion services are concerned with ensuring that individuals with mental health problems and related vulnerabilities who come into contact with the criminal justice system receive appropriate support and treatment. In the past 15 years there have been significant changes in policy, legislation and the broader landscape in community, custodial and hospital settings which have shaped these services. The Bradley Report, published in 2009, represents an important landmark in this field. Bradley made 82 recommendations, from interventions to improve identification of mental illness and vulnerable individuals at risk of offending to effecting speedier transfers of mentally disordered prisoners to hospital. Some progress has been made in achieving these recommendations, and further investment is promised, but at present only half of England is covered by liaison and diversion services.LEARNING OBJECTIVES•Appreciate how services have developed over the past 15 years to provide support and treatment and divert mentally disordered people from custody at all stages in the criminal justice process•Recognise how government policy has shaped the development of liaison and diversion services over the past 15 years•Understand the impact of the 2007 amendments to the Mental Health Act on the diversion of mentally disordered people from custody

Some Characteristics of Employees as Risk Factors for Presenteeism

2014 ◽  
Vol 11 (2) ◽  
pp. 31-55
Author(s):  
Petra Mlakar ◽  
Janez Stare
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Job Security ◽  
Negative Consequences ◽  
Physical And Mental Health ◽  
Sickness Absenteeism ◽  
The World ◽  
Employee Characteristics ◽  
Absence From Work ◽  
The Impact

Presenteeism, or the act of attending work while sick or despite feeling unwell, is a relatively new concept in the sphere of work. It is a phenomenon that has begun to be monitored more intensively around the world in the last decade. Presenteeism can affect an employee’s work in various ways and its consequences mean that it is already a problem in itself. Employers devote too little attention to it or are frequently not even aware of it. The majority of employers are in fact too often focused on the growing problem of absence from work because of sickness (absenteeism) and on eliminating the negative consequences of absenteeism, and do not (yet) see presenteeism as a problem. The research presented in this article deals with the question of the impact of employee characteristics on the phenomenon of presenteeism. The characteristics considered included ambition, financial worries, job security, sick leave and the physical and mental health of employees.

scholarly journals Evaluating mental health services. A world perspective

1997 ◽  
Vol 6 (S1) ◽  
pp. 239-245
Author(s):  
Norman Sartorius
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
World Wide ◽  
List Type ◽  
Type Number ◽  
Evaluative Research ◽  
World Perspective

Evaluations of mental health services are much in demand. Their results are supposed to help in improving the quality of mental health care and in making them economically better viable.Yet, world-wide there is: 1)little agreement about the content of terms such as evaluation, mental health service, outcome of an activity although these and other terms are widely used;2)uncertainty about the best use of results of evaluative research;3)lack of consensus about who should evaluate what and by what method.

scholarly journals The impact on the mental health and well-being of unpaid carers affected by social distancing, self-isolation and shielding during the COVID 19 pandemic in England – a systematic review

2021 ◽  
Author(s):  
Tabo Akafekwa ◽  
Elizabeth Dalgarno ◽  
Arpana Verma
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Well Being ◽  
Poor Mental Health ◽  
List Type ◽  
Digital Platforms ◽  
Health And Wellbeing ◽  
The People ◽  
The Impact ◽  
Health And Well Being

AbstractObjectiveThis study explores the impact of the COVID 19 lockdown measures on the mental health and well-being of unpaid carers, who make up the largest number of the carer population in England.Study designA systematic review research protocol was designed and used to conduct the review along with the Enhancing Transparency in Reporting the synthesis of Qualitative Research - ENTREQ statement [43]. Pre-determined inclusion and exclusion criteria were used. EndNote X9 reference management was used and the search process was represented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram [76]. Appraisal of the included research was carried out using the Critical Appraisal Skills Programme (CASP) [57]. Line by line coding was done using inductive thematic synthesis and EPPI Reviewer 4 software [60].ResultsFour themes emerged; immediate worries or fears, adapting to change, post pandemic fears and use of technology.ConclusionThe measures put in place during the first lockdown period have had detrimental impacts on unpaid carers, putting them at greater risk of burnout. However, use of digital platforms could have a positive impact on well-being. Recommendations for further research are provided.What is new?Key findings?Discontinued or reduced access to activities and services during the first lockdown during the pandemic has had a negative impact on both people who require care and their carers.Carers prioritise the mental health and wellbeing needs of the people they care for over their own.Further qualitative research from different groups of carers would be useful to gain a deeper understanding of the impact of the COVID 19 pandemic measures on unpaid carers.Use of digital technology and digital platforms may be useful tools for carers both during the pandemic and after.What this adds to what is known?There have been very few qualitative studies on the impact of the COVID 19 pandemic on the mental health and wellbeing of unpaid carers, this review has synthesised their findings and will contribute to future research.Unpaid carers are known to be at risk of poor mental health and wellbeing outcomes, this review demonstrates that they are even more at risk due to the increased reliance on them during the pandemic.What is this implication and what should change?There is limited qualitative data available from a range of different groups of carers for example, spouse carers, parent carers, carers of people who have specific needs or conditions. Therefore, purposeful sample research to determine the needs of groups of carers during the COVID 19 pandemic could be valuable.Unpaid carers who do not have appropriate support are more at risk of poor mental health and wellbeing outcomes. During the pandemic services have had to adapt to the various rules implemented. Digital adaptations to the provision of support to both carers and the people they care for could be beneficial both during and after the pandemic.

scholarly journals Mapping population mental health concerns related to COVID-19 and the consequences of physical distancing: a Google trends analysis

2020 ◽  
Vol 5 ◽  
pp. 82 ◽  
Author(s):  
Duleeka Knipe ◽  
Hannah Evans ◽  
Amanda Marchant ◽  
David Gunnell ◽  
Ann John
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Health Treatment ◽  
Google Trends ◽  
Negative Consequences ◽  
Public Health Response ◽  
Social Stressors ◽  
Protection Measures ◽  
Population Mental Health ◽  
The Impact

Background: The 2020 Coronavirus pandemic is a major international public health challenge.  Governments have taken public health protection measures to reduce the spread of the virus through non-pharmalogical measures. The impact of the pandemic and the public health response on individual and population mental health is unknown.  Methods: We used Google Trends data (1 Jan 2020 - 1 Apr 2020) to investigate the impact of the pandemic and government measures to curb it on people’s concerns, as indexed by changes in search frequency for topics indicating mental distress, social and economic stressors and mental health treatment-seeking. We explored the changes of key topics in Google trends in Italy, Spain, USA, UK, and Worldwide in relation to sentinel events during the pandemic. Results: Globally there appears to be significant concerns over the financial and work-related consequences of the pandemic, with some evidence that levels of fear are rising. Conversely searching for topics related to depression and suicide fell after the pandemic was announced, with some evidence that searches for the latter have risen recently. Concerns over education and access to medication appear to be particular social stressors. Whilst searches for face-to-face treatments have declined, those for self-care have risen. Conclusions: Monitoring Google trends shows promise as a means of tracking changing public concerns. In weeks to come it may enable policy makers to assess the impact of their interventions including those aiming to limit negative consequences, such as government funded financial safety nets.

New World of Mental Health Legislation England and Wales David Jolley and Reinhard Heun

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Jolley ◽  
R. Heun
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Mental Illnesses ◽  
Community Treatment ◽  
List Type ◽  
Type Number ◽  
England And Wales ◽  
Use Of Resources ◽  
Mental Health Legislation ◽  
Health Legislation

After eight years of tortured negotiations between government, professional psychiatrists and lay pressure groups, England and Wales will begin to use new Mental Health Legislation November 2008. This will not be a new Mental Health Act, but a substantial modification of the 1983 act. There are nine key changes:1.A single definition of mental disorder: ‘any disorder of mind or brain’.2.Criteria for compulsion: ‘appropriate medical treatment’ test.3.Age-appropriate services: special arrangements for under 18 years.4.Professional roles: approved clinicians and responsible clinicians (non-medical).5.Nearest relative: recognises Civil Partnerships, allows displacement.6.Supervised Community Treatment Orders.7.Mental health Review Tribunal: unified.8.Advocacy: Independent Mental Health Advocates.9.ECT: new safeguards.The Code of Practice identifies five key principles:1.Purpose - to minimise adverse effects of Mental Disorder.2.Least Restriction.3.Respect - diverse needs, values and circumstances.4.Participation - involving patient in planning, developing and reviewing treatment and care.5.Effectiveness, efficiency and equity - optimal use of resources.Earlier drafts had been described as: ‘little more than a Public Oder Bill dressed up as Mental Health legislation’; ‘ethically unworkable and practically unworkable’. Much of the dissent related to suggestions that people with Personality Disorder behaving in a dangerous or antisocial way should be subject to compulsory detention. Fears included breach of liberties and Human Rights and transformation of Mental Health Services disadvantaging people with major mental illnesses.

scholarly journals The impact of beliefs about mental health problems and coping on outcome in schizophrenia

2004 ◽  
Vol 34 (7) ◽  
pp. 1165-1176 ◽  
Author(s):  
F. LOBBAN ◽  
C. BARROWCLOUGH ◽  
S. JONES
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Self Regulation ◽  
Psychosocial Interventions ◽  
Health Problems ◽  
Negative Consequences ◽  
Cross Sectional ◽  
Physical Health Problems ◽  
Regulation Model ◽  
The Impact

Background. Using the theoretical framework of the Self Regulation Model (SRM), many studies have demonstrated that beliefs individuals hold about their physical health problems are important in predicting health outcomes. This study tested the SRM in the context of a mental health problem, schizophrenia.Method. One hundred and twenty-four people with a diagnosis of schizophrenia were assessed on measures of symptom severity, beliefs about their mental health problems, coping and appraisal of outcome at two time points, 6 months apart.Results. Using multivariate analyses and controlling for severity of symptoms, beliefs about mental health were found to be significant predictors of outcome. Beliefs about greater negative consequences were the strongest and most consistent predictors of a poorer outcome in both cross-sectional and longitudinal analyses.Conclusions. These results suggest that the SRM is a promising model for mental health problems and may highlight important areas for development in clinical, and especially psychosocial interventions.

scholarly journals Impact of Parental Personality on Crying Child Behavior and Their Future Mental Health

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Rupali Chandola ◽  
S. C. Tiwari ◽  
Rakesh Kumar Tripathi
Keyword(s):  
Mental Health ◽  
Psychosocial Development ◽  
Parental Education ◽  
Systems Approach ◽  
Child Rearing ◽  
Future Research ◽  
Negative Consequences ◽  
Personality Dimension ◽  
Significant Difference ◽  
The Impact

Background: Crying is an important means of communication for babies. It plays a crucial role in ensuring the survival, health and development of the child. Whether infants cry intensely for a few months or fuss frequently for the first year of life, a systems approach to development would suggest that the impact of extremes in crying on the infant’s immediate environment may have negative consequences for the dynamics of the parent-child relationship, which in turn would have implications for the child’s psychosocial development. Parents have important roles in child rearing, but the influence of their personality on rearing practices and their impact on the behavior of children has received surprisingly little attention. The aim of the current study was to investigate the relationship between parent’s personality and child crying behavior and future mental health. Methods:  Study examined personality dimension of 300 parents of normal and psychiatrically ill male and female subjects selected purposively between 20-25 years age group. A question was asked to all the parents of the subjects, “What was the behavior of the subject during two years from the birth? Was he or she used to ‘cry’ often or not? The study was conducted on the parents of diagnosed 75 indoor and outdoor psychiatric patients and 75 normal controls. GHQ-12 negative subjects from the community formed the normal group.  Dimension Personality Inventory (DPI) was administered on all parents of included subjects. Result: Significant difference was found in all the dimensions of DPI between ‘crying’ and ‘non crying’ child’s parents. Conclusion: The maturity of parent’s character appears to have a key role in reducing the risk of behavior problems in their children. Suggestions are made for parental education and future research.

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