Screening for serious mental illness in a correctional setting.

BACKGROUND: Serious mental illness (SMI) is more common among adults in correctional settings than in the general population. No standard exists for SMI screening across correctional settings; SMI therefore often goes undetected in these facilities. Placing individuals with unidentified SMI who are incarcerated in general population cells increases their risk for self-harming behaviors, suicide, and for being victims or perpetrators of exploitation and violence. METHODS: This article describes a quantitative, descriptive study conducted to evaluate the use of the Brief Jail Mental Health Screen (BJMHS) tool to screen for possible SMI among individuals in a jail setting. RESULTS: A total of 89 individuals who were incarcerated in one jail setting were screened either with the facility's internally developed standard medical questionnaire (SMQ) or with the BJMHS. Findings showed that 28% screened positive for possible SMI using the BJMHS as compared with only 3% using the SMQ. CONCLUSION: The BJMHS flagged a higher number of possible instances of SMI than the jail's SMQ, potentially signifying its screening superiority. Identification of SMI leads to better care for individuals who are incarcerated, and it increases safety for the individual with SMI, the greater jail population, and jail staff. Findings from this study were shared with system leadership, which has replaced other screening tools with the BJMHS in at least 250 correctional facilities throughout the US.

Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies.

OBJECTIVE: to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services. METHOD: a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents. RESULTS: 229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate. FINAL CONSIDERATIONS: nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.

Terapia ocupacional y rehabilitación psicosocial: estudio descriptivo de la situación actual en España / Occupational therapy and psychosocial rehabilitation: Descriptive study of the current situation in Spain

Objetivos: recoger datos de la situación, funciones y metodología de trabajo de los y las terapeutas ocupacionales en los diferentes dispositivos de rehabilitación psicosocial en salud mental en España. Metodología: estudio descriptivo con una muestra final de 176 terapeutas ocupacionales que trabajan en rehabilitación psicosocial, y que a través de un cuestionario, reflejan información sobre la ubicación, condiciones y desempeño laboral Resultados: la mayoría de los y las participantes en el estudio, trabajan en estos dispositivos a jornada completa, donde el diagnóstico principal de las personas atendidas es esquizofrenia, trastorno esquizotípico, trastorno delirante y otros trastornos psicóticos no relacionados con el estado de ánimo. El modelo de terapia ocupacional más frecuente es el Modelo de la Ocupación Humana, siendo las escalas de evaluación más asiduas el Listado de Intereses y los registros elaborados por ellos y ellas mismas. Las ocupaciones en las que más se interviene son las actividades instrumentales de la vida diaria, ocio y participación social. Conclusiones: la unificación de modelos y escalas ayudarían a reforzar el papel de la terapia ocupacional en la rehabilitación psicosocial, así como a seguir evolucionando hacia una intervención de calidad y basada en la evidencia de esta área en general.(AU)

Objective: To collect data on the situation, functions, and work methodology of occupational therapists in the different mental health psychosocial rehabilitation devices in Spain. Methodology: Descriptive study with a final sample of 176 occupational therapists working in psychosocial rehabilitation, and through a questionnaire, it reflects information on the location, conditions, and work performance. Results: Most of the participants in the study work on these devices full-time, where the main diagnosis of the people treated is schizophrenia, schizotypal disorder, delusional disorder and other psychotic disorders unrelated to mood. The most frequent occupational therapy model is the Model of Human Occupations (MOHO), the most frequent evaluation scales being the List of Interests and the records prepared by themselves, and the occupations in which more intervention is made are instrumental activities of daily life (IADLS), leisure and social participation. Conclusions: The unification of models and scales would help to reinforce the role of occupational therapy in psychosocial rehabilitation, as well as to continue evolving towards a quality and evidence-based intervention in this area in general.(AU)

Percepções da equipe de enfermagem sobre cuidados de crianças e adolescentes internados com transtornos mentais / Percepciones del equipo de enfermería sobre la atención a niños y adolescentes hospitalizados con trastornos mentales / Nursing team's perceptions on care for children and adolescents hospitalized with mental disorders

Resumo Objetivo conhecer as percepções da equipe de enfermagem ante o cuidado de crianças e adolescentes com transtornos mentais internados. Método estudo qualitativo fenomenológico social cuja coleta de dados foi realizada com 12 membros das equipes de enfermagem por meio de entrevista fenomenológica. Resultados "Motivos porque" descritos em duas categorias: a percepção da equipe de enfermagem em face dos cuidados prestados e ações e cuidados da equipe de enfermagem da criança com transtornos mentais. "Motivos para" expressos na categoria: a recuperação da criança com transtorno mental e o seu retorno para casa. Conclusões e Implicações para a prática a possibilidade do estabelecimento da relação face a face entre equipe, família e criança como forma de apreender a situação biográfica e o acervo de conhecimento dos sujeitos envolvidos e, então, entender as suas reais necessidades e demandas promovem um cuidado integral. Através da fenomenologia social de Alfred Schutz, traz-se como implicação para a prática a possibilidade de compreender a percepção da equipe de enfermagem sobre a relevância da relação face a face no cuidado de crianças e adolescentes com transtornos mentais.

Resumen Objetivo conocer las percepciones del equipo de enfermería sobre los cuidados prestados a los niños y adolescentes hospitalizados con trastornos mentales. Método estudio cualitativo fenomenológico social cuya recogida de datos se realizó con 12 miembros de los equipos de enfermería mediante entrevista fenomenológica. Resultados "Motivos-por qué" se describen en dos categorías: la percepción del equipo de enfermería ante los cuidados prestados y las acciones y cuidados del equipo de enfermería del niño con trastornos mentales. "Motivos-para" expresadas en la categoría: la recuperación del niño con trastorno mental y su regreso a casa. Conclusiones e Implicaciones para la práctica La posibilidad de establecer una relación cara a cara entre el equipo, la familia y el niño como una forma de aprehender la situación biográfica y el cuerpo de conocimiento de los sujetos involucrados y luego comprender sus necesidades y demandas reales, promueve la atención integral. A través de la fenomenología social de Alfred Schutz, aporta como implicaciones para la práctica la posibilidad de entender la percepción del equipo de enfermería sobre la relevancia de la relación cara a cara en el cuidado de niños y adolescentes con trastornos mentales.

Abstract Objective to know the perceptions of the nursing team about the care of hospitalized children and adolescents with mental disorders. Method social phenomenological qualitative study whose data collection was carried out with 12 members of the nursing teams by means of phenomenological interviews. Results "Reasons why" described in two categories: the perception of the nursing team in view of the care provided and actions and care of the nursing team of the child with mental disorders. "Reasons for" expressed in the category: the recovery of the child with mental disorder and his return home. Conclusions and Implications for practice The possibility of establishing a face-to-face relationship between the team, the family, and the child to apprehend the biographical situation and the body of knowledge of the subjects involved, and then understand their real needs and demands promotes comprehensive care. Through Alfred Schutz's social phenomenology, it brings as implications for practice the possibility of understanding the perception of the nursing staff about the relevance of the face-to-face relationship in caring for children and adolescents with mental disorders.

Association of Psychiatric Diagnoses and Medicaid Coverage with Length of Stay Among Inpatients Discharged to Skilled Nursing Facilities.

BACKGROUND: Inpatients with psychiatric diagnoses often require higher levels of care in skilled nursing facilities (SNFs) and are more likely to be covered by Medicaid, which reimburses SNFs at significantly lower rates than Medicare and commercial payors. OBJECTIVE: To characterize factors affecting length of stay in inpatients discharged to SNFs. DESIGN: A retrospective cross-sectional study design using 2016-2018 data from National Inpatient Sample. PARTICIPANTS: Inpatients aged ≥ 40 who were discharged to SNFs. EXPOSURES: Primary discharge diagnosis (medical, psychiatric, or substance use) and primary payor. MAIN OUTCOMES AND MEASURES: Length of stay, categorized non-exclusively as >3 days, >7 days, or > 14 days. RESULTS: Among 9,821,155 inpatient discharges to SNFs between 2016 and 2018, 95.7% had medical primary discharge diagnoses, 3.3% psychiatric diagnoses, and 1.0% substance use diagnoses; Medicare was the most common primary payor (83.3%), followed by private insurance (7.9%), Medicaid (6.6%), and others (2.2%). Median length of stay for all patients was 5.0 days (interquartile range [IQR], 3.0-8.0), 5.0 (IQR, 3.0-8.0) for those with medical diagnoses, 8.0 (IQR, 4.0-15.0) for psychiatric diagnoses, and 5.0 (IQR, 3.0-8.0) for substance use diagnoses. After multivariable adjustment, compared to patients with medical diagnoses, patients with psychiatric diagnoses were more likely to have hospital stays > 3, > 7, and > 14 days, respectively (p < 0.001). Compared to Medicare patients, Medicaid patients were more likely to have hospital stays > 3, > 7, and > 14 days, respectively (p < 0.001). Compared to patients with medical diagnoses, those with psychiatric diagnoses were also more likely to have lengths of stay 1 times, 1.5 times, and 2 times greater than the national geometric mean length of stay for that diagnosis-related group (p < 0.001). CONCLUSIONS: Patients discharged to SNFs after inpatient hospitalization for psychiatric diagnoses and with Medicaid coverage were more likely to have longer lengths of stay than patients with medical diagnoses and those with Medicare coverage, respectively.

Percepção de gestores municipais diante da implementação da política de saúde mental / Percepción de los gestores municipales ante la implementación de la política de salud mental / Perception of municipal managers in the face of the implementation of the mental health policy

RESUMO Objetivo: apreender a percepção dos gestores de saúde sobre a implementação da Política de Saúde Mental nos municípios pertencentes a 5ª Regional de Saúde do Estado do Paraná. Métodos: estudo de abordagem qualitativa e caráter exploratório, realizado nos meses de fevereiro e março de 2015. Foram entrevistados 20 gestores de saúde da 5° Regional de Saúde, por meio de entrevistas semiestruturadas. A análise dos dados foi desenvolvida segundo o método de análise de conteúdo de Bardin, modalidade temática. Resultados: emergiram duas categorias: "A percepção dos gestores sobre aSM nos municípios" e "Dificuldades para a implementação da PNSM". Os gestores de saúde destacam a necessidade da melhor implementação da Política de Saúde Mental em seus municípios e a adequação da Rede de Atenção Psicossocial. As dificuldades enfrentadas são a falta de recursos financeiros, capacitação profissional e preconceitos. Considerações finais: é perceptível a falta de visibilidade entre os gestores em saúdesobre o papel dos serviços que compõem a Rede de Atenção àSaúde Mental, especialmente a atenção primária, pois é a principal responsável pelas ações de acolhimento e de promoção e prevenção aos transtornos mentais.

RESUMEN Objetivo: comprender la percepción de los gestores de salud sobre la implementación de la Política de Salud Mental en los municipios pertenecientes a la 5ª Regional de Salud del Estado de Paraná-Brasil. Método: estudio de enfoque cualitativo y carácter exploratorio, realizado en los meses de febrero y marzo de 2015. Se entrevistaron a 20 gestores de salud de la 5ª Regional de Salud, mediante entrevistas semiestructuradas. El análisis de datos se desarrolló según el método de análisis de contenido de Bardin, modalidad temática. Resultados: surgieron dos categorías: "La percepción de los gestores sobre la SM en los municipios" y "Dificultades para la implementación de la PNSM". Los gestores de salud señalan la necesidad de una mejor aplicación de la Política de Salud Mental en sus municipios y la adecuación de la Red de Atención Psicosocial. Las dificultades a las que se enfrentan son la falta de recursos financieros, la formación profesional y los prejuicios. Consideraciones finales: es perceptible la falta de visibilidad entre los gestores de salud sobre el rol de los servicios que componen la Red de Atención a la Salud Mental, especialmente la atención primaria, por ser la principal responsable de las acciones de acogida y de promoción y prevención de los trastornos mentales.

ABSTRACT Objective: to understand the perception of health managers about the implementation of the Mental Health Policy in municipalities belonging to the 5th Health Regional Unit of the State of Paraná. Methods: study with a qualitative approach and an exploratory nature, conducted in the months of February and March 2015. Twenty health managers from the 5th Health Regional Unit were interviewed, through semi-structured interviews. Data analysis was developed according to Bardin's content analysis method, thematic modality. Results: two categories emerged: "The perception of managers about MH in the municipalities" and "Difficulties in implementing PNSM". Health managers highlight the need for better implementation of the Mental Health Policy in their municipalities and the adequacy of the Psychosocial Care Network. The difficulties faced are the lack of financial resources, professional training and prejudice. Final considerations: the lack of visibility among health managers about the role of the services that make up the Mental Health Care Network is noticeable, especially primary care, as it is primarily responsible for the actions of welcoming and promotion/prevention of mental disorders.

Os primeiros passos para a institucionalização da loucura em Alagoas na segunda meta de do século XIX ao estabelecimento do Asylo Santa Leopoldina: inserção de enfermeiros e tratamento / Los primeros pasos hacia la institucionalización de la locura en Alagoas en la segunda mitad del siglo XIX hasta la instauración del Asilo Santa Leopoldina: inserción de enfermeras y tratamiento / The first steps towards the institutionalization of madness in Alagoas in the second half of the 19th century to the establishment of Asylo Santa Leopoldina: insertion of nurses and treatment

A partir de 1850 Alagoas começou a discutir sobre as primeiras medidas sanitárias para conter as epidemias no estado. Foi nesse contexto que a comissão de higiene pública passou a propor medidas sanitárias coletivas e/ou individuais, como a limpeza das ruas e pântanos, orientações à população, controle na criação de porcos, construção do hospital de caridade, cemitério público de Maceió, lazareto do porto do Francês, abertura de enfermarias provisórias e adaptações à cadeia pública, este último abrigando o primeiro local para os alienados no Estado [Fragmento de texto] (AU)

Therapeutic alliance in mental health care: When language issues challenge provider-patient relationships.

ABSTRACT: The field of psychiatric nursing provides unique opportunities for nurse-patient interactions. Nurses working in inpatient psychiatric settings face constant challenges that may hinder the development of meaningful nurse-patient interactions. Peplau's theory of interpersonal relations emphasized the importance of nurse-patient relationships in nursing care. Therapeutic alliance can help promote nurse-patient relationships and may help nurses and patients achieve their goals. This article presents several phases of a concept-building process that illustrates the importance of therapeutic alliance and its application in mental health care.

Improving mental health education in nursing school.

ABSTRACT: Nurses are at the forefront of providing care to individuals with mental illness in various healthcare settings, yet the World Health Organization and others have found that many nurses are inadequately prepared to provide mental health care. This article discusses the nurse's role in providing care to individuals with mental illness and the importance of integrating more mental health education into undergraduate nursing curricula.

Delusional infestation: What nurses should know.

ABSTRACT: Patients with delusional infestation, a rare psychiatric disorder, have a false and fixed belief that insects or other organisms are crawling in or on their skin. This article describes signs and symptoms, available treatments, and appropriate nursing interventions for patients with primary delusional infestation.

Caring for the Mental Health of Youth and Families: What is the Role of the Psychiatric Mental Health Advanced Practice Nurse?

PURPOSE/OBJECTIVES: Children in our nation are experiencing the social, emotional, and physical impacts of an unprecedented time in history. Advanced practice nurses prepared as psychiatric clinical nurse specialists and nurse practitioners bring therapeutic interventions, psychopharmacologic management, and systems thinking to clinical environments of care. Insight into the mental health of youth and families and how clinical nurse specialists may provide solutions for forthcoming challenges is discussed. DESCRIPTION OF THE PROJECT/PROGRAM: Barriers to mental healthcare such as the invisibility of nurses at state and federal levels must be eradicated to mitigate the mental health challenges that youth, families, and communities endure. Contemporary issues such as effects of social media, stigma, and suicide present burdens that can be moderated through nursing interventions. OUTCOME: The psychiatric clinical nurse specialist provides evidence and community-based nursing interventions that, through early identification and advocacy, contribute to positive mental health outcomes for youth and families. CONCLUSION: The need for well-educated advanced practice nurses has never been greater for our vulnerable populations of children, adolescents, and families with mental health challenges. Nurse-delivered programs demonstrate that interventions are necessary for communication, psychoeducation, and prevention of consequences from unacknowledged social media, stigma, and suicide problems.

The impact of an undergraduate students' culture on their learning about mental health: A scoping review.

Mental disorders are highly prevalent. This necessitates undergraduate students in health-related courses are provided with the knowledge, skills, and attitudes to deliver safe care. Research confirms undergraduate health students maintain discriminative, stigmatizing, and inaccurate beliefs and attitudes toward those experiencing mental disorders. However, there is a paucity of research exploring how culture influences these beliefs. This scoping review addressed the question: 'What is the impact of an undergraduate student's culture on their learning about mental health?' A systematic search was undertaken of the MEDLINE, CINAHL, Scopus, PsycINFO, and ERIC databases. Results indicate variance between students' cultural beliefs in their attitudes toward and knowledge of mental disorders and understanding of interventions and treatment. None of the identified studies reviewed the ramifications for pedagogy beyond anecdotal suggestions. Educators need to acknowledge the potential impact that students' cultural beliefs have on their learning about mental health and consider appropriate learning activities to acknowledge the role of culture. Research of the impact of undergraduate students' culture on their learning about mental health will provide an evidence base for the development of these learning activities.

[Nursing clinical judgement in situations of restraint]. / Le jugement clinique infirmier en situation de soins sous contrainte.

Coercive measures such as seclusion and restraint, which are sometimes used in psychiatry, remain current practices. According to literature, these interventions are particularly complex for the nurses implementing them. In situations of seclusion and restraint, these professionals focus in particular on the nurse-patient relationship, the patient's safety and the respect of their humanity. Training is possible to help nurses manage these situations and improve their approach to the clinical judgement.

Mental health problems among youth experiencing sex trafficking.

ABSTRACT: There are an estimated 4.8 million victims of sex trafficking (ST) globally, and 21% of these victims are children or adolescents. Victims of ST are at risk for mental health problems, and it is crucial for healthcare professionals to identify them and provide care.

Opportunities for the advanced practice nurse in improving the wellbeing of older adults during the COVID-19 pandemic.

The prevalence of stress, anxiety, and depression have increased during the coronavirus disease (COVID-19) pandemic across age groups. Older adults may additionally be experiencing accelerated cognitive decline and increased behavioral and psychological symptoms of dementia related to the pandemic and associated isolation precautions. The advanced practice nurse has an opportunity to holistically intervene to mitigate the negative effects of isolation and promote older adults' wellbeing during challenging times.

[From the person receiving care to the subject of care: the I-you relationship in psychiatry]. / De la personne faisant l'objet de soins au sujet de soins : la relation je-tu en psychiatrie.

The subjective recognition by those involved in care, of people with psychiatric disorders, is not self-evident. Caregivers, in the general sense of the term, often find it difficult to recognise the personal freedom and dignity of psychiatric patients. Care is, however, inseparable from the relationship of trust and the mobilisation of the patient's ability to freely express choices and to participate in decisions concerning him; a central ability in the caregiver-patient relationship. Although the objectives of access to care and protection of the patient's rights are clearly stated, the question of the mental patient's freedom of choice, as well as his inner moral freedom, remains open to question, as does the questioning of these same freedoms among care providers.