Effect of Brain Damages on Logical Inferences of Depressive Adults

Objective: To examine the immediate and mediate inferences among depressive adults with and without brain damage. Methods: The descriptive, comparative study was conducted from November 6 to June 19, 2019, in Sargodha, Pakistan, and comprised depressive adults of either gender enrolled from various local mental health facilities. After applying Stroop test to identify brain damage, the subjects were divided into adults with brain damage in group A, and adults without brain damage in group B. Logical inferences of both groups were identified using three decision situations, and the findings were compared between the groups. Results: Of the 170 individuals approached, 120(70.5%) were included; 60(50%) in each of the two groups. Overall, there were 76(63%) males and 44(37%) females. The overall age range 18-60 years, with 105(88%) being young adults aged 18-49 years. Chi-Square Test was applied to test the hypotheses. Findings revealed that Group A exhibited higher frequency of immediate inferences on three conditions of certainty (55, 53, 58) as compared to Group B (23, 21, 20) while group B exhibited higher frequency on mediate inferences on the conditions of certainty (37, 39, 40) as compared to Group A (5, 7, 2). Group A exhibited higher frequency of immediate inferences on three conditions of risk (54, 55, 56) as compared to Group B (14, 23, 22) ----Continue

The current state of mental healthcare in Bangladesh: part 2 – setting priorities

This is the second of a two-part profile on mental healthcare in Bangladesh. It describes the state of mental health research in the country and presents a set of priorities for addressing improvements to the fundamental gaps in mental healthcare highlighted in part 1. Focus on building infrastructure for public mental health facilities, training skilled mental health professionals, adequate distribution of financial resources and addressing stigma are all priorities that will contribute to significantly improving mental healthcare in Bangladesh.

Situational Analysis of Mental Health System in The West Region of Cameroon Using The World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS)

Background The burden of mental illnesses is increasing in Cameroon and there is no available published work on the mechanisms put in place to address this issue. The government recognizes this burden and tries to feel the gap. In line to this, this study aimed at describing the mental health services available in West Cameroon to provide an evidence based support to this process. Method We used the world health organization assessment instrument for mental health systems (WHO-AIMS) version 2.2 to collect, analyze, and report, data on mental health services offered in 2020 in the west region of Cameroon. We extracted our data from the registers of the different mental health facilities of the region and we interviewed staffs in these facilities and at the ministry of public health. Results The region is divided into 20 health districts, of which 06 offered mental health services. As a whole, Cameroon had a mental health policy, mental health plan, but no mental health legislation and emergency plan. There was no specific budget for mental health in the country. In the west region of Cameroon, there was no psychiatrist. Mental health services were offered by nurses, psychologists, general practitioner and neurologists; representing 1.87 human resources in mental health facilities per 100,000 population, of which 1.4 were nurses. 1 in 1.4 of these nurses worked in the main city. There was no formal link of mental health services with other sectors and no publication in the previous 5 years about mental health in the region referenced on PubMed. Conclusion In 2020, access too mental health services in the west region of Cameroon was unequitable, and was not supported by scientific evidence.

Profiling persons reported missing from hospitals versus mental health facilities

Missing person reports from hospitals and mental health facilities are a significant issue impacting patients, communities, and health and police sectors. Research on missing persons seldom considers the type of location from where people go missing, which can be troublesome due to the increased chances for experiencing harm during an episode from hospitals and mental health facilities. When location type is studied, these often remarkably different places are frequently blended together in analyses and discussions. This conflation has implications for research and the development of effective police preventive responses. To begin to address this gap, this study uses descriptive analysis and logistic regression to examine the descriptive and predictive profiles of those reported missing from hospitals versus those reported missing from mental health units. For this, data are taken from a sample of 916 closed missing person cases reported to a Canadian municipal police service over five years. Results suggest there are significant differences in both the descriptive and predictive profiles of individuals reported missing from these two location types, such as individuals with varying mental health and cognitive issues going missing from each place, respectively. Given the findings, the implications for research, policing, and risk management are discussed.

Design features that reduce the use of seclusion and restraint in mental health facilities: a rapid systematic review

Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint.DesignA rapid review of peer-reviewed literature.MethodsPeer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute’s critical appraisal tool was used to assess the quality of included studies.ResultsWe identified 35 peer-reviewed studies. The findings revealed several overarching themes in design efforts to reduce the use of seclusion and restraint: a beneficial physical environment (eg, access to gardens or recreational facilities); sensory or comfort rooms; and private, uncrowded and calm spaces. The critical appraisal indicated that the overall quality of studies was low, as such the findings should be interpreted with caution.ConclusionThis study found preliminary evidence that the physical environment has a role in supporting the reduction in the use of seclusion and restraint. This is likely to be achieved through a multilayered approach, founded on good design features and building towards specific design features which may reduce occurrences of seclusion and restraint. Future designs should include consumers in a codesign process to maximise the potential for change and innovation that is genuinely guided by the insights of lived experience expertise.

Analysis of Suicides Reported as Adverse Events in Psychiatry Resulted in Nine Quality Improvement Initiatives

Background: The majority of persons who die by suicide have a mental disorder. Preventive strategies should include addressing social and psychological factors and the treatment of the mental disorder. Aim: We aimed to identify breaches in clinical care and identify areas for quality improvement initiatives. Method: An aggregate analysis of suicides reported as adverse events during 2012–2016 to Psychiatry, North Denmark Region was carried out. We developed an audit chart and identified items through (a) medical chart review and (b) consensus meetings in an expert panel. Results: A total of 35 cases were analyzed. Suicide risk assessments were adequately documented in the medial chart in six of 35 cases. Risk assessments emphasized suicidal ideation rather than well-known risk factors such as previous suicide attempts, substance abuse, physical illness, or job loss. Relatives were involved in four of 35 of the risk assessments. The panel suggested nine areas for quality improvement. Limitations: Most people who die by suicide are not seen in mental health facilities prior to suicide, and hence conclusions can only be generalized to these patients. Information on the gap between “Work-as-Done” and “Work-As-Imagined” was not recognized. Conclusion: Most of the risk assessments among suicides reported as adverse events to our mental health facilities were insufficient. Quality improvement initiatives focusing on training, documentation, involving relatives, communication, and data sharing must be planned to improve clinical care.