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1.
Psychiatr Serv ; : appips20230028, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38369884

RESUMO

Previous evaluations of interventions for borderline personality disorder have focused on psychotherapies. This study (N=42 patients), conducted in Liverpool, United Kingdom, reviewed the effect on out-of-area treatments (OATs) and hospital admissions of establishing a local case management team and a combined day treatment and crisis service for patients who are too dysregulated to access typical office-based psychotherapy. Data from 12, 24, and 36 months postintervention were compared with baseline data. All patients in OATs were repatriated to the local community. No new patients were sent to OATs. Admissions decreased (at 12 months, 49%; 24 months, 64%; 36 months, 74%), achieving savings in hospitalization costs. Moderate increases in the use and costs of some other services were observed.

2.
Psychiatr Serv ; : appips20230157, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38347813

RESUMO

Stressful events can exacerbate symptoms of psychiatric disorders among primary care patients, putting them at increased risk for suicide. In a pilot study that ran from August to December of 2020, researchers evaluated the acceptability and implementation of Managing Emotions in Disaster and Crisis (MEDIC), a self-help intervention designed to assist at-risk primary care patients. A total of 108 at-risk veterans completed baseline and 6-week assessments. Results were promising, with high patient acceptability and engagement along with improvement in all measures of mental illness symptoms from baseline to posttreatment. Self-help interventions like MEDIC may offer a low-burden way for primary care providers to support more patients.

3.
J Interpers Violence ; : 8862605231222902, 2024 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-38243761

RESUMO

Bystanders play a crucial role in assisting and rescuing victims of intimate partner violence (IPV) or sexual assault, thereby preventing further harm. Consequently, an increasing amount of research has focused on improving bystander interventions in such situations. While many existing scales that measure bystanders' willingness to intervene and their behaviors are likely tailored to Western settings and primarily focused on preventing sexual assaults, pursuing diversity to make these scales applicable to a variety of contexts is necessary. This study aimed to develop and validate a scale from South Korean samples that measure the likely level of bystander engagement in witnessed IPV situations, named the Bystander Engagement Scale for Witnessed Intimate Partner Violence (BESW-IPV). Preliminary items, developed to describe various IPV situations that a bystander might witness, underwent content validity testing through expert review and cognitive focus group interviews. Afterward, the scale was administered to 311 participants from the target population in South Korea. The scale's factor structure was assessed through exploratory factor analysis (EFA) and confirmed through confirmatory factor analysis (CFA). The reliability and validity were rigorously assessed. The final version of the BESW-IPV comprised 28 items. Through EFA, "direct IPV indicators" and "indirect IPV indicators" were identified. Together, these factors accounted for 76.10% of the total variance. CFA affirmed that the final model offers an acceptable fit. The scale's convergent and discriminant validities were also well established. The Cronbach's alpha and the McDonald's omega values were 0.98 and 0.99, respectively. In contrast to many existing tools that measure bystander intervention predominantly within the confines of Western educational settings, we believe that the BESW-IPV can be applied in broader contexts, especially in patriarchal environments. Further research is required to translate and validate this tool in different cultural contexts.

4.
Arch Psychiatr Nurs ; 47: 47-49, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38070997

RESUMO

The 988 Suicide and Crisis Lifeline (hereinafter referred to as The Lifeline) is a national effort to provide mental health crisis support for individuals or 3rd parties (requesting help for others) via a three-digit phone number. Since July 2022, the Lifeline is part of a national effort to assist individuals who are suicidal, homicidal, or distressed. Over half of suicides in the United States are completed with a gun, hence the need for an effort to focus on prevention related to a growing tragic loss of life. Psychiatric mental health nurses can be part of the prevention focus by promoting and discussing The Lifeline resource with patients, families, and colleagues. The majority of individuals requiring psychiatric-mental health services are living in the community and not institutionalized; therefore, The Lifeline is an invaluable resource to support wellness and well-being.

5.
Rev. latinoam. enferm. (Online) ; 31: e3848, ene.-dic. 2023. tab
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1442000

RESUMO

Objetivo: evaluar la capacidad de los Centros de Atención Psicosocial de Alcohol y Otras Drogas 24 horas para manejar situaciones de crisis de las personas que consumen AOD en la atención integral. Método: estudio cuantitativo, evaluativo y longitudinal, realizado de febrero a noviembre de 2019. La muestra inicial estuvo compuesta por 121 personas que consumen AOD, que recibieron atención integral en situaciones de crisis en dos Centros de Atención Psicosocial para Alcohol y Otras Drogas 24 horas en el centro de São Paulo. Los mismos fueron reevaluados después de 14 días de atención. La capacidad para manejar la crisis se evaluó mediante un indicador validado. Los datos se analizaron utilizando estadísticas descriptivas y modelos de regresión de efectos mixtos. Resultados: sesenta y siete personas que consumen AOD completaron el follow-up (54,9%). Durante la atención de las situaciones de crisis, nueve personas que consumen AOD (13,4%; p=0,470) fueron derivadas a otros servicios de la red de salud: siete por complicaciones clínicas, una por intento de suicidio y una por hospitalización psiquiátrica. La capacidad de los servicios para manejar situaciones de crisis fue del 86,6%, fue considerada positiva. Conclusión: los dos servicios evaluados fueron capaces de manejar situaciones de crisis en su área de influencia, evitando internaciones y contando con el apoyo de la red cuando fue necesario, logrando así los objetivos de desinstitucionalización.


Objective: to assess the ability of 24-hour Psychosocial Care Centers specialized in Alcohol and Other Drugs to handle the users' crises in comprehensive care. Method: a quantitative, evaluative, and longitudinal study was conducted from February to November 2019. The initial sample consisted of 121 users, who were part of the comprehensibly care in crises by two 24-hour Psychosocial Care Centers specialized in Alcohol and other Drugs in downtown São Paulo. These users were re-evaluated 14 days after admission. The ability to handle the crisis was assessed using a validated indicator. The data were analyzed using descriptive statistics and regression of mixed-effects models. Results: 67 users (54.9%) finished the follow-up period. During crises, nine users (13.4%; p=0.470) were referred to other services from the health network: seven due to clinical complications, one due to a suicide attempt, and another for psychiatric hospitalization. The ability to handle the crisis in the services was 86.6%, which was evaluated as positive. Conclusion: both of the services analyzed were able to handle crises in their territory, avoiding hospitalizations and enjoying network support when necessary, thus achieving the de-institutionalization objectives.


Objetivo: avaliar a capacidade dos Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas em manejar situações de crise dos usuários no acolhimento integral. Método: estudo quantitativo, avaliativo e longitudinal, realizado de fevereiro a novembro de 2019. A amostra inicial foi composta por 121 usuários, acolhidos integralmente em situações de crise por dois Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas do centro de São Paulo. Estes foram reavaliados após 14 dias de acolhimento. A capacidade de manejar a crise foi avaliada por um indicador validado. Os dados foram analisados por estatística descritiva e por regressão de modelos de efeitos mistos. Resultados: sessenta e sete usuários concluíram o follow-up (54,9%). Durante o acolhimento às situações de crise, nove usuários (13,4%; p=0,470) foram encaminhados para outros serviços da rede de saúde: sete por complicações clínicas, um por tentativa de suicídio e um para internação psiquiátrica. A capacidade de manejo das situações de crise pelos serviços foi de 86,6%, avaliada como positiva. Conclusão: os dois serviços avaliados foram capazes de manejar situações de crise no próprio território, evitando internações e tendo apoio da rede quando necessário, atingindo assim, os objetivos da desinstitucionalização.


Assuntos
Humanos , Brasil , Estudos Longitudinais , Transtornos Relacionados ao Uso de Substâncias/terapia , Intervenção na Crise , Reabilitação Psiquiátrica , Hospitais Psiquiátricos
6.
Aust N Z J Psychiatry ; : 48674231216348, 2023 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-38140961

RESUMO

OBJECTIVE: Heterogeneous brief non-pharmacological interventions and guidelines exist to treat the burgeoning presentations to both emergency department and inpatient settings, for those in a crisis of mental ill-health. We systematically reviewed the literature to create a taxonomy of these brief non-pharmacological interventions, and review their evaluation methods and effectiveness. METHOD: We conducted a systematic review across Cochrane, CINAHL, DARE, Embase, MEDLINE, PsycINFO databases. Studies meeting quality criteria, using Joanna Briggs Institute tools, were eligible. Interventions were categorised, and outcomes synthesised. RESULTS: Thirty-nine studies were included: 8 randomised controlled trials, 17 quasi-experimental, 11 qualitative studies, and 3 file audits. Taxonomy produced six coherent intervention types: Skills-focussed, Environment-focussed, Special Observation, Psychoeducation, Multicomponent Group and Multicomponent Individual. Despite this, a broad and inconsistent range of outcome measures reflected different outcome priorities and prevented systematic comparison of different types of intervention or meta-analysis. Few brief non-pharmacological interventions had consistent evidential support: sensory modulation rooms consistently improved distress in inpatient settings. Short admissions may reduce suicide attempts and readmission, if accompanied by psychotherapy. Suicide-specific interventions in emergency departments may improve depressive symptoms, but not suicide attempt rates. There was evidence that brief non-pharmacological interventions did not reduce incidence of self-harm on inpatient wards. We found no evidence for frequently used interventions such as no-suicide contracting, special observation or inpatient self-harm interventions. CONCLUSION: Categorising brief non-pharmacological interventions is feasible, but an evidence base for many is severely limited if not missing. Even when there is evidence, the inconsistency in outcomes often precludes clinicians from making inferences, although some interventions show promise.

7.
Healthcare (Basel) ; 11(24)2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38132048

RESUMO

Background: Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Methods: Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients (n = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Results: Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Conclusions: Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.

8.
Australas Psychiatry ; 31(6): 771-775, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37965756

RESUMO

OBJECTIVE: The study aimed to highlight principles of Dialectical Behaviour Therapy (DBT) that can provide a framework in the management of patients with borderline personality disorder (BPD) and outline some guiding principles in the effective management of these patients on a busy acute inpatient ward. CONCLUSIONS: The inpatient environment is often a place where invalidating experiences can occur. These include feeling ignored, misunderstood and where private experiences are trivialised or denied. Patients with BPD are extremely sensitive to these experiences and are likely to decompensate if strategies are not in place to facilitate a more validating experience during admission. The proposed guidelines are feasible to implement and support a cohesive treatment team and collaborative patient-centred care which is likely to improve patient outcomes.

9.
Front Psychol ; 14: 1253179, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38022932

RESUMO

Introduction: Despite the propagation of virtual mental health services for vulnerable groups during COVID-19 pandemic, the implementation and evaluation of remote evidence-based practices (EBP) to manage them in low- and middle-income countries remains scarce. In the current study, we describe and evaluate the implementation process and clinical impact of brief, remote, manualized EBP for crisis intervention and suicide risk management among healthcare workers attending patients with COVID-19 (COVID-19-HCWs) in Mexico. Methods: The implementation process comprised community engagement of volunteer mental health specialists, creation of new clinical teams with different disciplines and skills, intervention systematization through manuals and education through 4-h remote training as main strategies. Mexican COVID-19-HCWs who had used a free 24-h helpline rated their pre- and post-intervention emotional distress. Therapists recorded patients' pre-intervention diagnosis, severity, and suicide risk, the techniques used in each case, and their post-treatment perception of COVID-19-HCWs' improvement at the end of the intervention. Results: All techniques included in the intervention manual were employed at least in one case (n = 51). At the beginning of the intervention, 65.9% of the COVID-19-HCWs were considered moderately ill or worse according to Clinical Global Impression-Severity (CGI-S) scores, whereas at the end, 79.4% of them were perceived as much or very much improved according to CGI-Improvement scores (CGI-I), and their emotional distress had been significantly reduced (p < 0.001). Discussion: This prospective study provides evidence that implementation of remote EBP is feasible and useful to reduce emotional distress and suicide risk among COVID-19-HCWs from a middle-income country. However, this study was limited by lack of a control group, improvement ratings provided by therapists and non-anonymous satisfaction ratings.

10.
Arch Suicide Res ; : 1-14, 2023 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-37970867

RESUMO

OBJECTIVE: Suicide ideation (SI) is prevalent among college students, and suicide disclosure (SD) is critical for crisis intervention. However, students with SI may worry about stigmatizing responses to their disclosure. To better understand the mechanism of stigmatizing responses to SD, we investigated the effects of a hypothetical classmate's SD on college students' emotions and reasoning when providing advice to a distressed classmate. METHOD: In a randomized controlled experiment, students wrote advice to a hypothetical classmate who recently failed in his pursuit of a romantic relationship with a peer. The experimental/control group also learned he wanted to either commit suicide/quit school. When typing the advice, participants' facial expressions were recorded and analyzed by Facereader7.1. After advising, participants reported their sadness, joy, fear, anger, surprise, and disgust when advising. Finally, trained coders coded the common themes of their advice and rated the wise reasoning involved. Additionally, two experts in suicide prevention rated the helpfulness of their advice for the classmate. RESULTS: The experimental group showed significantly fewer facial expressions of happiness, reported higher sadness and fear, provided less helpful advice, and mentioned "confronting reality" less during advising. The difference in disgust and wise reasoning was nonsignificant. CONCLUSION: Learning of a classmate's SI may increase fear and sadness among recipients and reduce the helpfulness of their advice. Increased psychoeducation for students that focuses on improving emotional regulation (especially facial expressions) during SI may reduce the stigma surrounding SI and prevent perceived burdensomeness among individuals with SI after SD.


Hearing a peer's SI reduced listeners' happiness and increased sadness and fear.Listeners' disgust did not change significantly after learning of a classmate's SI.Learning of a classmate's SI reduced the helpfulness of listeners' advice.

12.
Psychiatr Serv ; : 0, 2023 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-37855097

RESUMO

Certified community behavioral health centers (CCBHCs) were established under section 223 of the Protecting Access to Medicare Act of 2014. CCBHCs had the goal of expanding access to care for people with behavioral health needs "regardless of ability to pay and place of residence." The authors used descriptive tables and a heat map to compare the geographic distribution of CCBHCs with county-level rates of mental illness, poverty, and population density. Regression models were employed to determine which county-level characteristics are most strongly associated with the establishment of a CCBHC. The authors found that population density is a stronger predictor of CCBHC presence than are rates of poverty or serious mental illness. Holding all other local characteristics constant, the authors observed that going from the population density typical of the most rural counties to that of the most urban counties was associated with an approximately 28-percentage-point increase (from 7% to 35%) in the likelihood of being served by a CCBHC. Expanding CCBHC services to areas with lower population densities likely requires an approach that is different from the current method of allocation of grant funds by the Substance Abuse and Mental Health Services Administration (SAMHSA). Two features of the program might be modified. The first would build on flexibilities incorporated into the most recent round of SAMHSA grantmaking, which explicitly aim to build infrastructure and capacity to develop a CCBHC. A second modification might seek to identify which certification requirements are essential to supporting CCBHC quality and access and eliminate nonessential requirements.

13.
Gen Psychiatr ; 36(5): e101133, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37859750

RESUMO

Background: Youth suicide has been a pressing public mental health concern in China, yet there is a lack of gatekeeper intervention programmes developed locally to prevent suicide among Chinese adolescents. Aims: The current Delphi study was the first step in the systematic development of the Life Gatekeeper programme, the first gatekeeper programme to be developed locally in China that aims to equip teachers and parents with the knowledge, skills and ability to identify and intervene with students at high risk of suicide. Methods: The Delphi method was used to elicit a consensus of experts who were invited to evaluate the importance of training content, the feasibility of the training delivery method, the possibility of achieving the training goals and, finally, the appropriateness of the training materials. Two Delphi rounds were conducted among local experts with diversified professional backgrounds in suicide research and practice. Statements were accepted for inclusion in the adjusted training programme if they were endorsed by at least 80% of the panel. Results: Consensus was achieved on 201 out of 207 statements for inclusion into the adapted guidelines for the gatekeeper programme, with 151 from the original questionnaire and 50 generated from comments of the panel members. These endorsed statements were synthesised to develop the content of the Life Gatekeeper training programme. Conclusions: This Delphi study provided an evidence base for developing the first gatekeeper training programme systematically and locally in China. We hope that the current study can pave the way for more evidence-based suicide prevention programmes in China. Further study is warranted to evaluate the effectiveness of the Life Gatekeeper training programme.

14.
BMC Geriatr ; 23(1): 631, 2023 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-37803286

RESUMO

BACKGROUND: More than 55 million people are currently affected by dementia worldwide and over 144 thousand in Switzerland. In Swiss nursing homes, 47.6% of the residents had a medical diagnosis of dementia in 2014. Due to cognitive impairment, they have difficulties remembering hygiene measures or placing them in the epidemic context. This results in a higher infection risk. There are COVID-19-associated recommendations focused on dementia care management but studies simultaneously surveying and correlating perspectives of health professionals as well as people with dementia across care settings are largely lacking. This study is focused on COVID-19-associated perspectives and needs of health professionals and people with dementia across different care settings. Lessons learned from the pandemic shall be pointed out. METHODS: We conducted a mixed-methods approach based on an exploratory sequential design. Two qualitative interview rounds (n = 15 participants) and a quantitative online survey (n = 148 participants) with people with dementia, caring relatives, Advanced Practice Nurses and nursing home managers (health professionals) were performed. Data collected was performed in nursing home and home-care settings. The SQRQ checklist was used. RESULTS: Fear and uncertainty were highest at the beginning of the pandemic among the interviewed nursing professionals and nursing home managers. As a positive side effect of the pandemic, increased cohesion in care teams was reported. Some people with dementia experienced the decelerated outside world as pleasant and less challenging to master. Particularly during the first wave, nursing home managers rated political decision-making processes as being too slow, partly non-transparent, inconsistent, and sometimes inappropriate for people with dementia. CONCLUSIONS: Although the identified emotional and physical consequences of the COVID-19 pandemic are mostly negative for health professionals and people with dementia, research should also investigate potential positive side effects. Furthermore, political decisions should be passed on to care institutions as promptly, transparently, and comprehensibly as possible. The results provide guidance on dementia-focused COVID-19 management interventions incorporating lessons learned and considering the emotional impact of the pandemic in Switzerland and beyond.


Assuntos
COVID-19 , Demência , Humanos , Suíça/epidemiologia , COVID-19/epidemiologia , Pandemias , Motivação , Demência/diagnóstico , Demência/epidemiologia , Demência/terapia , Emoções
15.
Aust Crit Care ; 2023 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-37537123

RESUMO

BACKGROUND: Intensive care unit (ICU) nurses are exposed to critical incidents daily at their workplace, which may have long-term physical and psychological impacts. Despite the growing evidence supporting clinical debriefing in health care to prevent these impacts, a scarcity of literature exists to support its use in the adult intensive care setting. OBJECTIVES: The objective of this study was to explore nurses' perceptions of clinical debriefing after critical incidents in an adult ICU. METHODS: A qualitative descriptive design was utilised. Thematic analysis of data from individual semistructured interviews with six ICU nurses was undertaken. FINDINGS: In this study, two themes were identified. Firstly, participants valued hot debriefing after critical incidents for the key reasons of having an opportunity to reflect on and learn from a critical incident and reduce normalisation of stressful situations. Secondly, when logistical factors such as communication, timing, and location were not considered, the attendance at debriefings was negatively influenced. Participants identified that ICU nurses commonly prioritised patient tasks over attending a debrief; therefore, teamwork and flexibility with logistics was crucial. CONCLUSIONS: Hot debriefing, of a short duration and close to the time of the event, was valued and played an important role in staff wellbeing and self-care, contributing to preventing self-blame and normalisation of stressful situations. A clearer definition of the term along with greater recognition of types of events that could be considered critical incidents is required for staff support after critical incidents in the complex intensive care setting.

16.
Int J Integr Care ; 23(3): 4, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37577140

RESUMO

Introduction: As the number of children and young people (CYP) presenting to Emergency Departments (ED) with acute mental health (MH) presentations has been steadily increasing over the years and further accelerated by the pandemic, there is an urgent need to develop and evaluate innovative solutions to respond to this growing challenge. Description: The evaluation of the Safeguards Teams Program (STP) aims to ascertain the impact, implementation and economic analysis of this acute rapid response recovery-focused, trauma-informed assessment and brief intervention for CYP (aged 0-17 years) presenting in acute MH crisis and their families/caregivers.The STP will support consumers (patients) and their families/caregivers to navigate the complex and often fragmented child and adolescent MH services (CAMHS) landscape, thereby avoiding unnecessary ED presentations or hospitalisations, and facilitating comprehensive assessment and appropriate care pathways for those who present in crisis. Discussion: The STP is expected to provide CYP in MH crisis and their support networks with early access to evidence-based specialist care at the right place and time. Conclusion: Implementation of the STP will assist with identifying and addressing gaps in acute care for CYP and provide the necessary evidence for service redesign in collaboration with consumers, service providers and other stakeholders.

17.
Int J Ment Health Nurs ; 32(6): 1636-1653, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37574714

RESUMO

Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, for whom and in what circumstances community mental health crisis services for adults work to resolve crises and is reported according to RAMESES guidelines. Using realist methodology, initial programme theories were identified and then tested through iterative evidence searching across 10 electronic databases, four expert stakeholder consultations and n = 20 individual interviews. 45 relevant records informed the three initial programme theories, and 77 documents, were included in programme theory testing. 39 context, mechanism, outcome configurations were meta-synthesized into three themes: (1) The gateway to urgent support; (2) Values based crisis interventions and (3) Leadership and organizational values. Fragmented cross-agency responses exacerbated staff stress and created barriers to access. Services should focus on evaluating interagency working to improve staff role clarity and ensure boundaries between services are planned for. Organizations experienced as compassionate contributed positively to perceived accessibility but relied on compassionate leadership. Attending to the support needs of staff and the proximity of leaders to the front line of crisis care are key. Designing interventions that are easy to navigate, prioritize shared decision-making and reduce the risk of re-traumatizing people is a priority.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Avaliação de Processos e Resultados em Cuidados de Saúde , Adulto , Humanos
18.
Community Ment Health J ; 59(8): 1601-1609, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37273010

RESUMO

Brief interventions increase access to and engagement with care for people who are discharged presentation to emergency departments or inpatient care due to suicidal behavior. This study was to investigate the effectiveness of the Allied Health Brief Therapies (AHBT) clinic interventions on suicide ideation, health service utilization, negative emotional states, and functioning and well-being in consumers in suicidal crisis. This research was designed as pre-post study. Three AHBT clinics were established to provide brief interventions in Queensland Australia. Repeated measures ANOVA and McNemar's test were used to measure the impact of the interventions. Sensitivity analysis was conducted to ensure the robustness and appropriate interpretation of the results. Among the 141 consumers who accepted the referral, 106 (75.2%) attended the AHBT sessions, and 35 (24.8%) did not start the interventions. The AHBT clinic interventions reduced consumers' presence and frequency of suicide ideation, emergency department presentations, and negative emotional states (depression, anxiety, and stress), and increased their functioning and well-being with large effect sizes. Change in the frequency of inpatient admission after the AHBT clinic interventions was statistically non-significant. This study provides evidence that the AHBT clinics can reduce suicidal risk factors, decrease health service utilization, and increase functioning and well-being in consumers in suicidal crisis. Future research should consider the use of a control group to increase confidence in the findings.

19.
Crisis ; 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37278001

RESUMO

Background: While crisis intervention frameworks have indicated the importance of clients in suicidal crisis better understanding their distress to decrease suicidality, it is unclear how clients in suicidal crisis process their distress. Aims: To develop (Study 1) and validate (Study 2) a sequential distress-processing model for clients in suicidal crisis. Methods: Applying task analysis, Study 1 consisted of three phases, which resulted in a theoretically and empirically informed model. In Study 2, we examined the distress-processing model's validity using a longitudinal design. In both studies, data were online crisis chats with adults in suicidal crisis. Results: In Study 1, we developed a sequential five-stage distress-processing model: (Stage 1) unengaged with distress, (Stage 2) distress awareness, (Stage 3) distress clarity, (Stage 4) distress insight, and (Stage 5) applying distress insight. In Study 2, the model's validity was supported via evidence that (H1) progression through the processing stages was sequential and (H2) clients with good outcomes had greater progression in their processing than clients with poor outcomes. Limitation: Clients who were suicidal but did not disclose their suicidality were not included. Conclusion: Our findings provide a framework for conceptualizing and operationalizing how clients move through suicidal crises, which can facilitate intervention and research developments.

20.
J Am Psychiatr Nurses Assoc ; : 10783903231184200, 2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37382297

RESUMO

OBJECTIVE: The purpose of this discussion paper is to summarize the 2022 updates to the American Psychiatric Nurses Association's (APNA) Seclusion and Restraint Position Statement and Seclusion and Restraint Standards of Practice. METHOD: Both documents were the work of the APNA 2022 Seclusion and Restraint Task Force that consisted of APNA nurses with expertise in the use of Seclusion and Restraint, who practice across a wide range of clinical settings. RESULTS: The 2022 Updates to the APNA Position Statement and Standards were guided by evidence-based information found in the review of seclusion and restraint literature and clinical expertise from the 2022 Seclusion and Restraint Task Force. CONCLUSIONS: Updates were evidence-based and in line with APNA's core values and initiatives in diversity, equity, and inclusion.

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