Geriatric psychiatry education in Canada: the pathway to subspecialty recognition

2010 ◽  
Vol 22 (6) ◽  
pp. 919-926 ◽  
Author(s):  
Melissa H. Andrew ◽  
Catherine Shea
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Professionals ◽  
Primary Care Physicians ◽  
Work Force ◽  
Building Blocks ◽  
Geriatric Psychiatry ◽  
Training Experience ◽  
Care Needs ◽  
The Past

ABSTRACTBackground: This paper outlines the evolution of the training of Canadian physicians and other professionals in the mental health care needs of older adults over the past 2 decades, which has culminated in long-awaited subspecialty recognition by the Royal College of Physicians and Surgeons of Canada (RCPSC). Despite the fact that Canada has more than 4000 psychiatrists officially recognized by RCPSC, and a national body of more than 200 members who practice primarily in geriatric psychiatry, the status of geriatric psychiatry as a subspecialty of psychiatry in Canada remained “unofficial” until 2009.Methods: Early along the pathway toward subspecialization, Canadian educational efforts focused on enhancing the capacity of primary care physicians and other mental health professionals to meet the mental health needs of older adults. Over the past decade, and with the encouragement of RCPSC, Canadian psychiatric educators have carefully and collaboratively defined the competencies necessary for general psychiatrists to practice across the life span, thereby influencing the psychiatry training programs to include dedicated time in geriatric psychiatry, and a more consistently defined training experience.Results: With these two important building blocks in place, Canadian psychiatry was truly ready to move ahead with subspecialization. Three new psychiatric subspecialties – geriatric, child and adolescent, and forensic – were approved at the RCPSC in September 2009.Conclusions: The developments of the past 20 years have paved the way for a subspecialty geriatric psychiatry curriculum that will be well-aligned with a new general psychiatry curriculum, and ready to complement the existing mental health work force with subspecialized skills aimed at caring for the most complex elderly patients.

scholarly journals Challenges in providing ethically competent health care to incarcerated older adults with mental illness: a qualitative study exploring mental health professionals’ perspectives in Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirubel Manyazewal Mussie ◽  
Félix Pageau ◽  
Helene Merkt ◽  
Tenzin Wangmo ◽  
Bernice Simone Elger
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mentally Ill ◽  
Older Persons ◽  
Care Needs ◽  
Competent Health Care

Abstract Background The population of incarcerated older adults is the fastest growing demographic in prisons. Older persons in custody have poorer health as compared with those in the community. The unmet and complex health care needs of incarcerated older adults with mental illness raise justice, safety, dignity and fairness in care as ethical concerns. As there exists research gap to better understand these concerns, the current study aimed at exploring the perspectives of mental health professionals on challenges in delivering ethically competent care to mentally ill incarcerated older adults in Canada. Methods Thirty-four semi-structured interviews were conducted between August 2017 and November 2018 with prison mental health professionals in Canada who were selected using purposive and convenience sampling techniques. The audio recorded interviews were transcribed verbatim and analysed inductively to generate themes. Results The results were distilled into three main categories and seven subcategories that related to ethical issues in the provision of health care for mentally ill incarcerated older adults. The main categories included imprisoned older persons with special care needs, lack of resources, and the peer-support program. Conclusions Results of this study showed that existing practices of care of mentally ill incarcerated older adults are characterised by challenges that increase their vulnerability to worse health conditions. It is imperative for local authorities, policy makers and representatives to prepare for and respond to the challenges that compromise ethically competent health care for, and healthy ageing of, mentally ill incarcerated older adults.

Treatment alliance and needs of care concerning religiousness and spirituality: A follow-up study among psychiatric inpatients

2021 ◽  
pp. 002076402110230
Author(s):  
Joke C van Nieuw Amerongen-Meeuse ◽  
Arjan W Braam ◽  
Christa Anbeek ◽  
Jos WR Twisk ◽  
Hanneke Schaap-Jonker
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Structural Equation ◽  
Treatment Compliance ◽  
Health Clinic ◽  
Care Needs ◽  
Service Engagement ◽  
Treatment Alliance ◽  
Over Time

Background: Patient satisfaction with religious/spiritual (R/S) care during mental health treatment has been associated with a better treatment alliance. Aims: To investigate the longitudinal relations between (un)met R/S care needs and treatment alliance/compliance over a 6-month period. Method: 201 patients in a Christian (CC) and a secular mental health clinic completed a questionnaire (T0) containing an R/S care needs questionnaire, the Working Alliance Inventory (WAI) and the Service Engagement Scale (SES). After 6 months 136 of them took part in a follow-up (T1). Associations were analysed using hybrid linear mixed models and structural equation modelling. Results: R/S care needs decreased over time, but a similar percentage remained unanswered (e.g. 67% of the needs on R/S conversations in a secular setting). Over a 6-month period, met R/S care needs were associated with a higher WAI score (β = .25; p < .001), and unmet R/S care needs with lower WAI score (β = −.36; p < .001), which were mainly between subjects effects. Patients reporting a high score of unmet R/S care at baseline, reported a decrease in SES over time (β = −.13; p < .05). Conclusions: Satisfaction with R/S care among mental health patients is related to a better treatment alliance. When unmet R/S care needs persist, they precede a decrease in treatment compliance. Mental health professionals are recommended to assess the presence of R/S care needs and consider possibilities of R/S care especially in the first weeks of treatment.

Psychological Assessment and Treatment of Older Adults

2021 ◽  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Professionals ◽  
Psychological Assessment ◽  
Health Professionals ◽  
Assessment Tool ◽  
Skill Assessment ◽  
Case Examples ◽  
Assessment And Treatment ◽  
Comprehensive Text

Mental health practitioners are encountering an ever-growing number of older adults and so an up-to-date and comprehensive text addressing the special considerations that arise in the psychological assessment and treatment of this population is vital. This accessible handbook does just that by introducing the key topics that psychologists and other health professionals face when working with older adults. Each area is introduced and then the special considerations for older adults are explored, including specific ethical and healthcare system issues. The use of case examples brings the topics further to life. An important feature of the book is the interweaving of diversity issues (culture, race, sexuality, etc.) within the text to lend an inclusive, contemporary insight into these important practice components. The Pikes Peak Geropsychology Knowledge and Skill Assessment Tool is included in an appendix so readers can test their knowledge, which will be helpful for those aiming for board certification in geropsychology (ABGERO). This an ideal text for mental health professionals transitioning to work with older clients, for those wanting to improve their knowledge for their regular practice, and for trainees or young clinicians just starting out.

International Themes in Psychotherapy Integration

2019 ◽  
pp. 448-473
Author(s):  
Beatriz Gómez ◽  
Shigeru Iwakabe ◽  
Alexandre Vaz
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychotherapy Integration ◽  
Historical Background ◽  
The Past ◽  
Current Climate ◽  
The World ◽  
Training And Research ◽  
Sociopolitical Issues

Interest in psychotherapy integration has steadily expanded over the past decades, reaching most continents of the world and more mental health professionals than ever. Nevertheless, a country’s cultural and historical background significantly influences the nurturance or hindrance of integrative endeavors. This chapter seeks to explicate the current climate of psychotherapy integration in different continents and specific countries. With the aid of local integrative scholars, brief descriptions are presented on integrative practice, training, and research, as well as on cultural and sociopolitical issues that have shaped this movement’s impact around the world.

Urban Mental Health (Oxford Cultural Psychiatry series)

2019 ◽  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Mental Health Professionals ◽  
Internal Migration ◽  
Rural Areas ◽  
Urban Areas ◽  
Help Seeking ◽  
Rapid Urbanization ◽  
Urban Mental Health ◽  
The Past

The internal migration in countries around the globe as a result of rapid urbanization and related to industrialization as a consequence of globalization has been truly remarkable. The past 50 years have seen a massive rise in the numbers of people moving and creating megapolis in many parts of the world. It is inevitable that with such massive internal migration come stressors such as pollution, lack of space, overcrowding, unemployment, and increased likelihood of infectious diseases, all of which contribute to an increase in psychiatric disorders. Furthermore, such migration can also lead to the splintering of social support and the fraying of social networks, which can further contribute to poor help-seeking and poor therapeutic adherence and poor prognosis. This book highlights challenges in managing mental health and psychiatric disorders in urban areas. The contributors include researchers, clinicians, urban planners, urban designers, and others who are interested in the field. The book will appeal to all mental health professionals, whether they are working in urban areas or rural areas.

scholarly journals Religious Hallucinations and Religious Delusions among Older Adults in Treatment for Psychoses in the Netherlands

Religions ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 522
Author(s):  
Annemarie Noort ◽  
Aartjan T. F. Beekman ◽  
Arjan W. Braam
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Mental Health Professionals ◽  
Geriatric Psychiatry ◽  
Psychotic Symptoms ◽  
Psychotic Depression ◽  
Formation Factor ◽  
Existential Suffering ◽  
Diagnostic Interviews ◽  
Significant Difference

Background. Although religious delusions (RDs) are common in geriatric psychiatry, we know little about their frequency and content. Our study examines the prevalence and content of religious hallucinations (RHs) and RDs and how they relate to the diagnosis and the patients’ denominational background and other aspects of religiousness. Methods. Semi-structured diagnostic interviews were conducted with inpatients and outpatients (N = 155, mean age 76.5) at a geriatric psychiatry department in the Netherlands. We used the Schedules for Clinical Assessment in Neuropsychiatry 2.1. Results. The prevalences of RHs and RDs were 19% and 32%, respectively. RHs were mostly auditory. There was no statistically significant difference between the prevalence of RHs in schizophrenia (17.5%) and in psychotic depression (9.4%). Compared to non-affiliated patients and mainline Protestants, RDs were significantly more prevalent in raised and current strict Protestants, especially in those with psychotic depression. RHs were more prevalent in Evangelical (e.g., Pentecostal) and strict Protestant patients. The presence of RDs was associated with several measures of religiousness (e.g., dogmatism, religious coping). Conclusions. Religion is likely to act as a symptom-formation factor for psychotic symptoms in strict Protestant older adults. More detailed research might lead to a fuller understanding of how strict religious beliefs may affect the content of psychotic symptoms and unintentionally add a component of existential suffering. It is important for mental health professionals, especially the predominantly secular professionals in the Netherlands, to recognize and address religious themes.

British psychiatry and homosexuality

1999 ◽  
Vol 175 (2) ◽  
pp. 106-113 ◽  
Author(s):  
Michael King ◽  
Annie Bartlett
Keyword(s):  
Mental Health ◽  
Gay Men ◽  
19Th Century ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Theory And Practice ◽  
Past Century ◽  
The Past ◽  
The 19Th Century ◽  
Behavioural Sciences

BackgroundOpposition to homosexuality in Europe reached a crescendo in the 19th century. What had earlier been regarded as a vice evolved as a perversion or psychological illness. Official reviews of homosexuality as both an illness and (for men) a crime led to discrimination, inhumane treatments and shame, guilt and fear for gay men and lesbians. Only recently has homosexuality been removed from all international diagnostic glossaries.AimsTo review how British psychiatry has regarded homosexuality over the past century.MethodReview of key publications on homosexuality in British psychiatry.ResultsThe literature on homosexuality reflects evolving theories on sexuality over the past century. The assumptions in psychoanalysis and the behavioural sciences that sexuality could be altered led to unscientific theory and practice.ConclusionsMental health professionals in Britain should be aware of the mistakes of the past. Only in that way can we prevent future excesses and heal the gulf between gay and lesbian patients and their psychiatrists.

scholarly journals ‘Offenders, Deviants or Patients’ - Comments on Part Two of the White Paper

2014 ◽  
Vol 1 (5) ◽  
pp. 21
Author(s):  
Herschel Prins
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Good Deal ◽  
Legal Framework ◽  
White Paper ◽  
Green Paper ◽  
Expert Committee ◽  
The Past ◽  
Mental Health Act ◽  
The Government

<p align="LEFT">The Government White Paper Reforming the Mental Health Act follows closely on the heels of the Green Paper - Reform of the Mental Health Act, 1983 which derives from (but also departs from in many respects) the Report of the Expert Committee chaired by Professor Genevra Richardson. One could say, with some justification, that mental health professionals have been ‘deluged’ with paper in this area in the past year or two, so that trying to discern trends has become very difficult. In particular, the material in the White Paper is somewhat closely written and needs to be read with a good deal of care (or, so it seemed to me). To complicate matters further, offender-patients are also discussed in Part I of the White Paper (The Legal Framework) whereas it would have been more logical to have dealt with the proposed provisions for them in Part II. For clarity, I propose to deal with all these matters under one heading.</p>

scholarly journals Resources and Workforce in Top-Tier Psychiatric Hospitals in China: A Nationwide Survey

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Xia ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Yulong Zhang ◽  
Yudong Shi ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Lower Limit ◽  
Mental Health Professionals ◽  
Health Resources ◽  
Psychiatric Hospitals ◽  
Outpatient Services ◽  
The Past ◽  
Psychiatric Staff ◽  
Psychiatric Beds

Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China.Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation.Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio.Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.

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