Voluntary and involuntary psychiatric admissions in a suburban area: comparison with national rates, diagnosis and other correlates of involuntary admission status.

OBJECTIVES: To establish if the relatively low rate of involuntary psychiatric admission in a suburban area between 2007 and 2011 was maintained in 2014/2015, and explore key correlates of involuntary status. METHODS: We used existing hospital records and data sources to extract rates and selected potential correlates of voluntary and involuntary admission in south west Dublin (catchment area: 273 419 people) over 18 months in 2014/2015 and compared these with published national data from the census and Health Research Board. RESULTS: The rate of involuntary admission in the suburban area studied between 2007 and 2011 was 33.8 involuntary admissions per 100 000 population annually, which was lower than the national rate (48.6). By 2014/2015, the rate of involuntary admission in this area had risen to 46.8 involuntary admissions per 100 000 population annually, similar to the national rate (44.9). Nevertheless, the overall (voluntary and involuntary) admission rate in the suburban area (346.7 admissions per 100 000 population annually) was still lower the national rate (387.9), owing to a lower rate of voluntary admission in the suburban area (299.9) compared to Ireland as a whole (342.9). Multi-variable testing demonstrated that diagnosis was the strongest driver of involuntary admission in the suburban area: this area had 28.5 involuntary admissions per 100 000 population annually with schizophrenia or related disorders, compared to 18.9 nationally. Schizophrenia and related disorders accounted for 60.9% of involuntary admissions in the suburban area compared to 42.1% nationally. CONCLUSIONS: Schizophrenia is the strongest driver of involuntary admission in the suburban area in this study.

Young, Male and Feeling Suicidal in Ireland: Is Help or Harm Just One Click Away?.

Reports suggest an association between internet use and the elevated risk of suicide and self harm. This study examined the resources a suicidal person might find when searching the internet 'front page' for help. Voluntary suicide help websites accounted for 7/12 front page hits. The National Suicide Research Foundation (NSRF) and the National Office for Suicide Prevention (NOSP), a blog and a newspaper article made up the remainder. Sites were difficult to navigate and highly variable in content. Phone credit was required in many cases in order to contact helplines; opening hours and locations were limited. Most statutory websites referred help-seekers to the voluntary sector, mainly the Samaritans. Information on fundraising and volunteering competed with other sources of help. Of concern, the front page also included links to methods to complete suicide. Irish professional medical bodies offered very limited advice. Our findings suggest that online information is variable and potentially harmful. There is an opportunity for all agencies and providers to generate a co-ordinated internet front page tailored for at-risk groups.

Abuse among pregnant adolescents: differences by developmental age.

PURPOSE: The purpose of this study was to describe the incidence of abuse among pregnant teens in the three developmental stages of adolescence and to determine if abuse was related to pregnancy planning, high school participation, substance use during pregnancy, pregnancy complications, and infant birth weight. DESIGN: Prospective survey. METHODS: A total of 559 pregnant adolescents between the ages of 13 and 19 were interviewed. Abuse was measured by the Abuse Assessment Screen. Substance use was measured by self-report. Birth weights were obtained from hospital records. RESULTS: Abuse was reported by 37% of the adolescents. In every age group, the incidence of low birth weight was higher in those who had been abused. CLINICAL IMPLICATIONS: The high rates of abuse reported by both adolescent and adult women in this study emphasize the need for nurses in every setting to incorporate routine screening for abuse into their nursing assessments.

PIP: 72 pregnant female adolescents aged 13-15 years, 166 aged 16-17, and 341 aged 18-19 attending prenatal clinics in the greater metropolitan area of a northwestern city participated in a study to assess the incidence of abuse, including physical and sexual abuse, in that subpopulation and to determine whether such abuse is related to pregnancy planning, high school participation, substance use during pregnancy, pregnancy complications, and infant birth weight. 52% of the subjects were White, 30% were Black, 4% Native American, 4% Hispanic, 3% Asian, and 6% other. They had completed an average of 10.7 years of education, although 47% had dropped out of high school. 8.6% were married and living with their partner, 28% reported being single and cohabiting with a partner, and this was the first pregnancy for 57%. Abuse was measured using the Abuse Assessment Screen, substance abuse was measured by self-report, and birth weights were obtained from hospital records. More than 37% reported abuse, with the middle adolescents reporting the highest incidence and the oldest adolescents the least. In every age group, the incidence of low birth weight was higher among subjects who had been abused, although that difference was not statistically significant. Compared to nonabused subjects, those abused were significantly more likely to be high school dropouts, to smoke, and to have experienced bleeding during the second trimester. No differences were observed between the abused and nonabused subjects in pregnancy planning and reported use of marijuana, alcohol, or other drugs.