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1.
Article in English | MEDLINE | ID: mdl-38541282

ABSTRACT

Globally and historically, Indigenous healthcare is efficacious, being rooted in Traditional Healing (TH) practices derived from cosmology and place-based knowledge and practiced on the land. Across Turtle Island, processes of environmental dispossession and colonial oppression have replaced TH practices with a colonial, hospital-based system found to cause added harm to Indigenous Peoples. Growing Indigenous health inequities are compounded by a mental health crisis, which begs reform of healthcare institutions. The implementation of Indigenous knowledge systems in hospital environments has been validated as a critical source of healing for Indigenous patients and communities, prompting many hospitals in Canada to create Traditional Healing Spaces (THSs). After ten years, however, there has been no evaluation of the effectiveness of THSs in Canadian hospitals in supporting healing among Indigenous Peoples. In this paper, our team describes THSs within the Center for Addiction and Mental Health (CAMH), Canada's oldest and largest mental health hospital. Analyses of 22 interviews with hospital staff and physicians describe CAMH's THSs, including what they look like, how they are used, and by whom. The results emphasize the importance of designating spaces with and for Indigenous patients, and they highlight the wholistic benefits of land-based treatment for both clients and staff alike. Transforming hospital spaces by implementing and valuing Indigenous knowledge sparks curiosity, increases education, affirms the efficacy of traditional healing treatments as a standard of care, and enhances the capacity of leaders to support reconciliation efforts.


Subject(s)
Indigenous Canadians , Mental Health , Humans , Canada , Hospitals, Psychiatric , Inuit , Indigenous Canadians/psychology
2.
Article in English | MEDLINE | ID: mdl-36767331

ABSTRACT

INTRODUCTION: Patient participation is a cornerstone of the debate concerning healthcare professionals and patients of mental health centres. It constitutes an objective in government health policy in Scandinavia and other Western countries. However, little is known about the experiences of healthcare professionals in mental healthcare practices involving patients under their treatment and care. OBJECTIVE: This study aimed to explore the experiences of healthcare professionals with patient participation in the context of a mental health centre. METHODOLOGICAL DESIGN: Four focus group interviews with healthcare professionals reflected differing experiences with unfolding patient participation in clinical practices in four wards of a mental health centre. A content analysis developed and framed themes. RESULTS: Patient participation was based on structural conditions, which shows that predetermined structural methods predominantly control involvement. The structural methods are seen as promoting participation from the patient's perspective. At the same time, the methods also enable taking account of the individual patient's wishes and needs for involvement. DISCUSSION AND CONCLUSION: This study illuminates the meaning of patient participation in a mental health centre based on the social interactions among nurses and other healthcare professionals. The approach can contribute to dealing with the challenges of incorporating patient participation as an ideology for all patients in a psychiatric context, which is important knowledge for healthcare professionals.


Subject(s)
Mental Health Services , Patient Participation , Humans , Patients , Hospitals, Psychiatric , Palliative Care , Qualitative Research , Health Personnel/psychology
3.
J Ment Health ; 32(2): 412-423, 2023 Apr.
Article in English | MEDLINE | ID: mdl-35037548

ABSTRACT

BACKGROUND: Team case formulation on acute psychiatric wards aims to support staff to manage significant levels of challenging behaviour. However, there is limited research on staff experience of case formulation in this setting. AIM: This study aimed to investigate staff experience of team case formulation sessions on acute psychiatric wards and their impact on staff wellbeing. METHODS: Eighteen multidisciplinary staff (nurses, doctors, occupational therapists, support workers, activities coordinators) from five acute wards at a South London psychiatric hospital completed a semi-structured interview and visual analogue scales on their experience of attending case formulation. Thematic analysis was employed to analyse qualitative data. RESULTS: Participants reported that case formulation supported staff to develop a holistic understanding of service users, provided a safe space for staff to discuss the impact of challenging behaviour and improved teamwork and communication. Participants reported that these benefits increased their ability to identify and support the needs of service users and improved therapeutic relationships. Challenges with establishing continuity of care were highlighted. CONCLUSION: Team case formulation is an important intervention to support ward staff and has significant benefits to staff wellbeing and quality of care. Greater integration with existing ward practices may benefit both staff and service users.


Subject(s)
Physicians , Psychiatric Department, Hospital , Humans , London , Hospitals, Psychiatric
4.
Int J Ment Health Nurs ; 32(2): 534-543, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36345037

ABSTRACT

Globally, an increasing number of people who Self-Harm (SH) are being treated in mental health hospitals. Incidences of SH are common in secure hospitals, with those using the behaviour being highly dependent on staff for care and support but impacting on often limited resources. While literature related to the lived experiences of people who SH exists, this is in its infancy in African countries. The aim of this study was to explore the lived experiences of people who SH in two secure mental health hospitals in Ghana. Interpretive Phenomenological Analysis (IPA) was used to explore the experiences of people who SH in two secure mental hospitals in Ghana. A convenience sample of nine participants were recruited and face-to-face in-depth semi structured interviews were used to collect data. With the permission of each participant, all interviews were audio recorded and notes were made by the researcher (first author). Each interview was transcribed and analysed using the IPA seven-step approach, with three superordinate and 11 subordinate themes being identified. The superordinate themes were: Being let down; Living with the negative self; Forces of the supernatural and religion. Findings demonstrate that there is a need to develop a collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high-risk behaviours, such as SH. To ensure care is holistic, culturally, and temporally relevant research is needed, particularly in Sub-Saharan Africa.


Subject(s)
Mental Health , Self-Injurious Behavior , Humans , Qualitative Research , Self-Injurious Behavior/psychology , Ghana , Hospitals, Psychiatric
5.
Int J Paleopathol ; 39: 75-84, 2022 12.
Article in English | MEDLINE | ID: mdl-36332399

ABSTRACT

OBJECTIVE: This study employs feminist disability theory and the concept of structural violence to interpret the results of skeletal and documentary analysis of fracture and disease presence (i.e., syphilis and tuberculosis) among a group of institutionalized women who lived and died within 20th-century Missouri state mental hospitals. MATERIALS: The skeletal remains and corresponding death certificates of 52 adult Euro-American women housed in the Robert J. Terry Anatomical Collection at the Smithsonian Museum Support Center. Archival and historical literature concerning state mental hospitals were also utilized. METHODS: Macroscopic skeletal analysis of fracture and disease combined with archival research (i.e., associated death certificates and historical documentation). RESULTS: Approximately 15% of patients demonstrated evidence of perimortem hip fractures with no surgical intervention, most of whom were labeled "psychotic". Death certificates revealed the presence of syphilis (n = 4) and death from TB (n = 5). CONCLUSIONS: Nineteenth and 20th-century patriarchal conditions contributed to the institutionalization of women. Women who were impoverished, spouseless, and perceived as mentally or physically disabled were particularly vulnerable to institutionalization. Once hospitalized, patients were exposed to structurally violent conditions including neglect and abuse that resulted in avoidable harm. SIGNIFICANCE: Historical and documentary data associated with osteological collections is underutilized and can serve to both humanize these individuals and advance our understanding of their intersectional experiences. The implementation of theoretical frameworks within bioarchaeology can also assist in more holistically interpreting the complexities of past life. LIMITATIONS: Small, homogenous sample size limited by macroscopic analysis. FURTHER RESEARCH: Future work should increase sample size, heterogeneity, and conduct other relevant skeletal and documentary analyses.


Subject(s)
Fractures, Bone , Syphilis , Humans , Female , Adult , Hospitals, Psychiatric , Missouri , Violence
6.
Article in English | MEDLINE | ID: mdl-36011927

ABSTRACT

INTRODUCTION: Recovery-oriented practices have become a means of promoting user recovery during hospitalisation, but we do not know much about the concrete means of practicing recovery-orientation for the most vulnerable users with serious mental difficulty and substance use. AIMS: We investigated the concrete means of practicing recovery-orientation in care work and the elements, dimensions, outcomes, or steps of it in a special department of mental health centres. METHOD: Focus group interviews were conducted with 16 health professionals with experience with users with serious mental difficulty and substance use. Qualitative content analysis was undertaken. RESULTS: The main theme was "holistic recovery on structural terms" based on two themes and four subthemes. The first theme was "recovery based on an individual approach" with subthemes "detective-find hope" and "how to do recovery-oriented practice". The next theme was "recovery subject to structural framework" with subthemes "tension between different interests" and "symptoms as a barrier". CONCLUSIONS: recovery-oriented practice is understood as an approach where health professionals emphasise forming relationships based on trust, being hopeful for the users' future, spending time with users, and respecting users' experiences and knowledge from their own life. There are cross-pressures between different interests. The desire to meet the users' perspectives and respect these perspectives but at the same time live up to mental health centre purposes to stabilise the users' health and achieve self-care.


Subject(s)
Mental Disorders , Mental Health Services , Substance-Related Disorders , Delivery of Health Care , Hospitals, Psychiatric , Humans , Mental Disorders/therapy , Mental Health , Qualitative Research
7.
J Pastoral Care Counsel ; 76(2): 139-149, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35435074

ABSTRACT

This project considers two co-occurring studies accounting perceptions of patients (n=8) and staff (n=8) related to assignment of Spiritual Care students as full-time interdisciplinary team members at a Forensic mental health facility. Students on 12-week placements were individually assigned to care units. Qualitative method consistent with Interpretative Phenomenological Analysis was employed. The co-occurring studies identified that enhanced access to Spiritual Care was valued. Staff and patients indicated a desire for more spirituality focused participation.


Subject(s)
Pastoral Care , Spiritual Therapies , Hospitals, Psychiatric , Humans , Mental Health , Patient Care Team , Spirituality
8.
PLoS One ; 17(2): e0264012, 2022.
Article in English | MEDLINE | ID: mdl-35180260

ABSTRACT

Scientific evidence has shown that healthcare clowning can decrease the level of stress and anxiety in pediatric patients. However, little attention has been devoted to the potentially beneficial impact of clown visits in the child and adolescent psychiatry setting. Therefore, this pilot study aims at investigating short-term effects of clown visits by RED NOSES Clowndoctors Austria on stress and mood levels of children and adolescents in psychiatric care. The sample will consist of approximately 50 children and adolescents in inpatient psychiatric wards who receive clown visits on a weekly basis over four consecutive weeks. The examined intervention, i.e., the clown visits, is an integral part within the selected psychiatric institutions. Using a non-controlled pre-/post-test design, the level of salivary cortisol and self-reported stress and mood will be measured as primary outcomes before and immediately after each clown visit. Additionally, self-reported effects on care staff at the health care facilities will be assessed based on a questionnaire after each clown visit within the same time period of four weeks. Secondary outcome measures (i.e., health-related quality of life, emotional and conduct problems, perceived chronic stress) will be assessed at baseline and at close-out assessment after the four intervention weeks. Further control variables and potential moderators are included at baseline. Due to the nested data structure, multilevel modeling will be used to analyze the data. To our knowledge, this is the first study to examine the stress-reducing and mood-improving effects of clown visits on inpatients in child and adolescent psychiatry. Results will be relevant for the design of future large-scale RCTs and might provide valuable implications for the use of healthcare clowning to reduce stress and improve mood in children and adolescents in psychiatric care. The study is registered at ClinicalTrials.gov (Identifier: NCT04844398).


Subject(s)
Affect , Child, Hospitalized/psychology , Hospitals, Psychiatric , Sensory Art Therapies , Stress, Psychological/therapy , Adolescent , Child , Humans , Psychology, Child
9.
J Med Humanit ; 43(1): 95-116, 2022 Mar.
Article in English | MEDLINE | ID: mdl-31907702

ABSTRACT

Nineteenth-century psychiatrists ascribed to a model of health that was predicated on the existence of objective and strictly defined laws of nature. The allegedly "natural" rules governing the production of consumption of food, however, were structured by a set of distinctively bourgeois moral values that demonized over-indulgence and intemperance, encouraged self-discipline and productivity, and treated gentility as an index of social worth. Accordingly, the asylum acted not only as a therapeutic instrument but also as a moral machine that was designed to remake lazy, indolent transgressors into useful, "decorous" citizens. Because the theory and mechanics underlying this machine seemed straightforward and self-evident to psychiatrists, they were confounded when the asylum failed to translate its ideals into reality. While psychiatrists tended to blame this failure on the intractable immorality and weakness of individual patients, particularly paupers and immigrants, a review of the various meanings and uses of food in the hospital reveals the fault lines that ran through the asylum's ideological structure.


Subject(s)
Mental Disorders , Psychiatry , Bread , History, 19th Century , Hospitals, Psychiatric/history , Humans , Tea
10.
Psychiatr Prax ; 49(2): 71-79, 2022 Mar.
Article in German | MEDLINE | ID: mdl-33902127

ABSTRACT

OBJECTIVE: Since 2013, flexible and integrative psychiatric treatment models (FIT64b) have been set up in 22 German hospitals. FIT64b is based on a global treatment budget (GTB) covering costs for all psychiatric hospital services and is related to the number of patients treated. As part of the "PsychCare"-study we are examining incentives, requirements and challenges which relate to the introduction of FIT64b. METHODS: Expert interviews and focus groups (n = 29) were led with management and controlling staff from 7 FIT64b adopting hospitals and 3 statutory health insurance funds (SHI). A thematic analysis was conducted. RESULTS: A central component for the introduction of a GTB is a cooperative relation based on mutual trust between hospitals and SHI. Challenging are, above all, performance documentation and performance control of cross-sectoral treatment as well as the parallel structure of FIT64b and standard care. CONCLUSION: Apart from several surmountable obstacles to implementation, the GTB seems to be a strong driver for the future-oriented transformation of psychiatric hospital services in Germany. In the further development of GTB, the obligation to contract with all SHI should be considered.


Subject(s)
Hospitals, Psychiatric , Motivation , Budgets , Germany , Humans , National Health Programs
11.
J Hist Behav Sci ; 58(2): 147-162, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34674398

ABSTRACT

Drawing on personal testimonials and questions addressed to psychiatric hospital officials, this article explores how patients and their loved ones engaged with the idea of diagnosis in interwar and war-era America. I argue that diagnosis had synergies with intellectual sensibilities of American modernity, among them an enthusiasm for science and newness, a modernist sense of time that could be both forward- and backward-looking, and a knowable, interpreted self. While self-understanding and the creation of life narratives were more often considered the bailiwick of psychoanalysis in this period, understanding subjectivity and self-interpretation were not solely expressed in its conceptual vocabulary. Patient and family dialogs with diagnosis and psychiatric authorities allow for an illumination of the interaction between domestic intuitions, common sense, and folk wisdom, on the one hand, and institutional taxonomy, categorization, and scientific terminology on the other, or more broadly, between dispositions that are ostensibly antimodern and more modern ideas. I suggest that the protean and wide-ranging intellectual origins of the discipline of psychiatry, along with the inherent ambiguity of psychiatric diagnosis during the early 20th century, allowed patients to participate in their own medicalization in the most capacious way possible: by combining biology with diagnostic narrative capacities, as well as broader perceptions of morality and character. In the concluding reflection, I speculate about why it is that late 20th-century American critics and activists have tended to view diagnosis and medicalization as coercive and threatening, in contrast to earlier 20th-century patients and their intimate observers.


Subject(s)
Mental Disorders , Psychiatry , History, 20th Century , Hospitals, Psychiatric , Humans , Medicalization , Mental Disorders/diagnosis , Mental Disorders/history , Morals , Psychiatry/history
12.
Curationis ; 45(1): 1-11, 2022. tables
Article in English | AIM | ID: biblio-1401455

ABSTRACT

Background: Caring for mental healthcare users (MHCUs) with a comorbid disorder of human immunodeficiency virus (HIV) and schizophrenia has always been challenging and requires expertise, skill, intuition and empathy. Objectives: The objective of this study was to explore and describe the experiences of psychiatric nurses caring for MHCUs with a comorbid disorder of HIV and schizophrenia. Method: A qualitative, exploratory, descriptive and contextual research design was used. Eight participants were selected through purposive sampling for individual in-depth interviews to collect data. Thematic analysis was used to analyse data. Results: Three themes emerged from this study. The first theme is that the psychiatric nurses experienced deep frustration because they were capable but unable to manage MHCUs with HIV and schizophrenia because of poor infrastructure and other contributing barriers. The second theme identified that the psychiatric nurses experienced discrimination against MHCUs compromising their holistic recovery. Lastly, the psychiatric nurses identified the need for health care workers in general hospitals and communities and families of MHCUs with a comorbid disorder to be educated in mental health issues to ensure continuous medical care. Conclusion: The results of this study showed that psychiatric nurses became exhausted when trying to cope with difficult nursing situations. The challenges they faced had negative consequences for the mental health of the psychiatric nurses and compromised patient care. Contribution: This study adds knowledge to nursing practice, nursing education and nursing research by implementing recommendations to mitigate the challenges of psychiatric nurses caring for MHCUs with HIV and schizophrenia.


Subject(s)
Humans , Male , Female , Psychiatric Nursing , Schizophrenia , HIV Infections , Mental Health , Education, Nursing , Hospitals, Psychiatric , Comorbidity
13.
Zhonghua Yi Shi Za Zhi ; 51(3): 151-157, 2021 May 28.
Article in Chinese | MEDLINE | ID: mdl-34645199

ABSTRACT

Church General Hospital in Wuchang, China planned to establish a psychiatric hospital in 1930. Chi-liang Kwei, received his PhD at Johns Hopkins Medical School of America and was appointed to be in charge of the preparation. After working out a draft plan for the hospital, Dr. Kwei applied for the Henderson Research Scholarship on Mental Diseases. She planned to study under the guidance of Dr. D.K. Henderson in the Glasgow Mental Royal Hospital for a full year in preparation for the establishment of the hospital. By drawing on the correspondence files of Chi-liang Kwei and psychiatrists Adolf Meyer and David Kennedy Henderson, the paper describes the background conditions and planning for the hospital establishment and interprets the significance and value of Chi-liang Kwei's efforts to establish a psychiatric hospital from the perspective of the historic development of modern psychiatry in China.


Subject(s)
Psychiatry , Psychotic Disorders , China , Female , History, 20th Century , Hospitals, Psychiatric , Humans , Psychiatry/education , Schools, Medical
14.
Tijdschr Psychiatr ; 63(6): 412-418, 2021.
Article in Dutch | MEDLINE | ID: mdl-34231859

ABSTRACT

BACKGROUND Negative symptoms hamper treatment progress of patients with schizophrenia. AIM This study evaluates the effect of a music therapy module on negative symptoms, composed of activating music therapy as usual, augmented by elements of neurologic music therapy on negative symptoms. METHOD A pre- and posttreatment measurement with the Dutch version of the Brief Negative Symptom Scale has been taken from five forensic psychiatric patients and their personal nurses. During the module, sociotherapist scored the Negative Symptom Scale three times a week. Applying the reliable change index and simulation modeling analysis, the quantitative change in negative symptoms was analyzed for each patient, supported by a qualitative analysis of the medical files. RESULTS Four out of five patients showed reduction in negative symptoms. CONCLUSION Music therapy seems to have a positive effect on the reduction of negative symptoms and regaining of activity and treatment motivation in forensic psychiatric patients, who prior to the study were long-lasting inactive and difficult to motivate. Adjusting the music therapy to individual needs, personalized treatment, is in line with the complexity of the target group.


Subject(s)
Music Therapy , Schizophrenia , Hospitals, Psychiatric , Humans , Research Design , Schizophrenia/therapy
15.
J Integr Med ; 19(2): 129-134, 2021 03.
Article in English | MEDLINE | ID: mdl-33317955

ABSTRACT

OBJECTIVE: Patients who are involuntarily committed to a psychiatric facility often experience anxiety or increased anxiety in response to being placed in the institutional environment. The weighted blanket introduced a proactive treatment option. The purpose of this study was to evaluate patients' anxiety symptoms before and after weighted blanket, compared to a group that did not use a weighted blanket to control anxiety. METHODS: This study was conducted in an inpatient mental health facility from June 10, 2019, through November 7, 2019, with psychiatric patients who were not actively psychotic. Participants were offered the choice of weighted or unweighted blankets for a 20-minute intervention. The treatment group was comprised of individuals who had opted to use a 14-pound weighted blanket, 20-pound weighted blanket or 5-pound weighted lap pad. Participants in the comparison group were active in a wider range of settings. Before application of the blankets, pulse rate was measured using a pulse oximeter, and anxiety was measured using the Spielberger State-Trait Anxiety Inventory shortened form (STAI: Y-6). Both measures were taken again after the intervention. A two-way mixed analysis of variance (ANOVA) was run to examine the interaction effects between time (pre/post) and group (comparison/weighted blanket). Simple main effects were then further examined for the comparison/weighted blanket groups using a repeated measures ANOVA. Within the weighted blanket group, additional two-way mixed ANOVA was run to determine if gender or blanket weight made a statistically significant difference. RESULTS: There was a statistically significant difference (P < 0.05) among those who used weighted blankets (n = 61) and those who did not (n = 61) based on the pre/post data for both the STAI: Y-6 inventory and the patients' pulse rates. The results of two-way ANOVA indicated a significant interaction effect between intervention time and group (P < 0.001). Repeated measures ANOVA indicated a change between pre/post for the weighted blanket group only, and showed significant reductions in both the STAI: Y-6 (P < 0.001) and pulse rates (P = 0.040). Within the weighted blanket group, additional two-way mixed ANOVA showed that neither gender nor blanket weight had significant difference for either the STAI: Y-6 or the pulse measures. CONCLUSION: The use of weighted blankets is a safe and potentially effective way to help individuals in a psychiatric facility manage anxiety. This study found a statistically significant drop in anxiety for adults at an inpatient facility, as shown by the STAI: Y-6 scores and drop in pulse rates among patients using weighted blankets. This study suggests a possible alternative to medications, seclusion and physical restraints, which are not patient-centered or trauma-supported.


Subject(s)
Hospitals, Psychiatric , Inpatients , Adult , Anxiety/prevention & control , Bedding and Linens , Humans
16.
Int J Soc Psychiatry ; 67(6): 788-800, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33100119

ABSTRACT

BACKGROUND: Recovery-oriented intersectoral care is described as an aim in mental healthcare to create a holistic framework for planning that provides integration of treatment and rehabilitation. Existing studies show that nurses and other professionals do not take responsibility for the collaborative element of intersectoral care between mental health hospitals and community mental health services. The users of mental healthcare do not experience their patient journey as a cohesive process when they are discharged from a mental health hospital to community mental health services. AIM: The integrative review aims to examine the professionals' experience with recovery-oriented intersectoral care between mental health hospitals and community mental health services. DESIGN: Since the aim was to review user experience, we chose an integrative review as an obvious choice for design. ETHICAL APPROVAL: Not applicable. FINDINGS: Seven studies met the inclusion criteria. The interactive inductive and deductive analysis generated four themes, which clarify the experience of professionals with recovery-oriented intersectoral care between the mental health hospitals and community mental health services, namely 'structurally routine care', 'unequal balance of power between the sectors', 'bureaucracy as a barrier to recovery-oriented intersectoral care' and 'flexible mental healthcare approaches'. CONCLUSION: This review achieves specific knowledge of recovery-oriented intersectoral care. The studies included show that recovery-oriented intersectoral care is not clearly defined. It is challenging to transfer intersectoral care to an organisation with different structural and linguistic barriers.


Subject(s)
Community Mental Health Services , Mental Disorders , Mental Health Services , Delivery of Health Care , Hospitals, Psychiatric , Humans , Mental Disorders/therapy , Mental Health
17.
J Dual Diagn ; 17(1): 4-12, 2021.
Article in English | MEDLINE | ID: mdl-33308058

ABSTRACT

OBJECTIVE: The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. Methods: This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Results: Out of 152 patients who participated in this study, 51.3% (n = 78) had comorbid alcohol use disorder, and 29.6% (n = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations (p < .001 and p = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; p < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high (p = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness (p < .001). Conclusions: The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.


Subject(s)
Mental Disorders , Substance-Related Disorders , Comorbidity , Cross-Sectional Studies , Diagnosis, Dual (Psychiatry) , Hospitals, Psychiatric , Humans , Inpatients , Malaysia/epidemiology , Male , Mental Disorders/complications , Mental Disorders/epidemiology , Prevalence , Severity of Illness Index , Substance-Related Disorders/epidemiology
18.
Int J Psychiatry Clin Pract ; 25(4): 336-343, 2021 Nov.
Article in English | MEDLINE | ID: mdl-32644837

ABSTRACT

OBJECTIVES: To evaluate the prevalence of suicidality among the psychiatric inpatients community in Lebanon, and to elucidate the effect of religiosity and spirituality on suicidal thoughts or behaviours. METHODS: A total sample of 159 patient consecutively admitted to a psychiatric hospital was interviewed. The Ask Suicide-screening Questionnaire (ASQ) was used to assess suicidal risk; the Mature Religiosity Scale (MRS) and the Spirituality Index for Well Being (SIWB) scales were used to assess religiosity and spirituality. RESULTS: We found that 45.6% of the participants screened positively on the ASQ, including 37.5% with acute suicidal ideation. A backward logistic regression, taking the negative/positive screening ASQ as the dependent variable, showed that a positive family history of suicide and depression were significantly associated with higher positive suicidal screening, whereas higher spirituality was significantly associated with lower positive suicidal screening. When forcing the mature religiosity scale as an independent variable, the results remained the same. CONCLUSION: Spiritual well-being might be considered an important factor to explore among psychiatric patients. Psychiatric inpatients have a high risk for suicide; the challenge remains for clinicians to identify upon admission patients that are most likely to die from suicide.Key pointsA positive family history of suicide and depression was significantly associated with higher suicidality.Higher spirituality, but not religiosity, was significantly associated with lower suicidality.Spiritual well-being might be considered an important factor to explore among psychiatric patients.The challenge remains for clinicians to identify patients that are most likely to die from suicide upon admission.


Subject(s)
Inpatients , Mental Disorders , Religion and Psychology , Spirituality , Suicidal Ideation , Hospitals, Psychiatric , Humans , Inpatients/psychology , Inpatients/statistics & numerical data , Lebanon/epidemiology , Mass Screening/methods , Mental Disorders/psychology , Mental Disorders/therapy , Risk Assessment , Suicide
19.
J Addict Nurs ; 31(4): 276-286, 2020.
Article in English | MEDLINE | ID: mdl-33264200

ABSTRACT

BACKGROUND: Alcohol dependence is associated with alcohol-related problems and persistent vulnerability to relapse. Despite newer medications, frequent relapses continue to occur. Hence, there is a need to look at holistic approaches to deal with this problem. OBJECTIVE: Evaluate the effectiveness of nurse-led body-mind-spirit (BMS)-based relapse prevention intervention on craving and quantity and frequency of alcohol consumption among alcohol-dependent individuals. METHODS: Randomized control trial was adopted, and the study was conducted at a mental health care setting in India. Sixty individuals with alcohol use disorder were randomly assigned to a BMS group (n = 30) and a treatment-as-usual (TAU) group (n = 30) between June 2017 and March 2018. Subjects of both groups were initially assessed for craving and quantity and frequency of alcohol consumption. BMS subjects received seven sessions of BMS intervention and routine treatment at de-addiction wards. The interventions comprise of body, mind, and spirit strategies that aid in handling triggers, accept responsibility for their own well-being and take charge of self health. TAU group subjects received only routine treatment. All the participants were followed up over 3 months postdischarge. RESULTS: Over 3 months of follow-up, BMS group subjects (vs. TAU group) reported significantly lesser quantity of alcohol consumption (F = 9.74, p < .001, η = .144), fewer drinking days (F = 14.04, p < .001, η = .195), lower relapse rates (14 vs. 28), and lesser craving (F = 14.01, p < .001, η = .195). Regression analysis showed that number of previous attempts (>1) and increased baseline drinking were associated with relapse. CONCLUSION: Findings provide evidence of BMS intervention in reducing craving and drinking outcomes among alcohol-dependent individuals in India.


Subject(s)
Alcoholism/therapy , Hospitals, Psychiatric/statistics & numerical data , Hospitals, State/statistics & numerical data , Mind-Body Therapies/nursing , Secondary Prevention/methods , Adolescent , Adult , Aftercare , Alcohol Drinking/prevention & control , Humans , India , Male , Mental Health , Middle Aged , Patient Discharge , Pilot Projects , Young Adult
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