Analysis of Suicides Reported as Adverse Events in Psychiatry Resulted in Nine Quality Improvement Initiatives

Crisis ◽  
2021 ◽  
Author(s):  
Julie Mackenhauer ◽  
Jan-Henrik Winsløv ◽  
Jens Holmskov ◽  
Inger Brødsgaard ◽  
Tina Gram Larsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Adverse Events ◽  
Mental Disorder ◽  
Suicide Attempts ◽  
Clinical Care ◽  
Health Facilities ◽  
Risk Assessments ◽  
Medical Chart Review ◽  
Mental Health Facilities

Abstract. Background: The majority of persons who die by suicide have a mental disorder. Preventive strategies should include addressing social and psychological factors and the treatment of the mental disorder. Aim: We aimed to identify breaches in clinical care and identify areas for quality improvement initiatives. Method: An aggregate analysis of suicides reported as adverse events during 2012–2016 to Psychiatry, North Denmark Region was carried out. We developed an audit chart and identified items through (a) medical chart review and (b) consensus meetings in an expert panel. Results: A total of 35 cases were analyzed. Suicide risk assessments were adequately documented in the medial chart in six of 35 cases. Risk assessments emphasized suicidal ideation rather than well-known risk factors such as previous suicide attempts, substance abuse, physical illness, or job loss. Relatives were involved in four of 35 of the risk assessments. The panel suggested nine areas for quality improvement. Limitations: Most people who die by suicide are not seen in mental health facilities prior to suicide, and hence conclusions can only be generalized to these patients. Information on the gap between “Work-as-Done” and “Work-As-Imagined” was not recognized. Conclusion: Most of the risk assessments among suicides reported as adverse events to our mental health facilities were insufficient. Quality improvement initiatives focusing on training, documentation, involving relatives, communication, and data sharing must be planned to improve clinical care.

scholarly journals Impact of arthritis on the perceived need and use of mental healthcare among Canadians with mental disorders: nationally representative cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041371
Author(s):  
Alyssa Howren ◽  
J Antonio Aviña-Zubieta ◽  
Deborah Da Costa ◽  
Joseph H Puyat ◽  
Hui Xie ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Clinical Care ◽  
Mental Healthcare ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Perceived Need ◽  
Mental Health Support ◽  
Health Support

ObjectiveTo evaluate the association between having arthritis and the perceived need for mental healthcare and use of mental health support among individuals with mental disorders.DesignA cross-sectional analysis using data from Canadian Community Health Survey—Mental Health (2012).SettingThe survey was administered across Canada’s 10 provinces using multistage cluster sampling.ParticipantsThe study sample consisted of individuals reporting depression, anxiety or bipolar disorder.Study variables and analysisThe explanatory variable was self-reported doctor-diagnosed arthritis, and outcomes were perceived need for mental healthcare and use of mental health support. We computed overall and gender-stratified multivariable binomial logistic regression models adjusted for age, gender, race/ethnicity, income and geographical region.ResultsAmong 1774 individuals with a mental disorder in the study sample, 436 (20.4%) reported having arthritis. Arthritis was associated with increased odds of having a perceived need for mental healthcare (adjusted OR (aOR) 1.71, 95% CI 1.06 to 2.77). In the gender-stratified models, this association was increased among men (aOR 2.69, 95% CI 1.32 to 5.49) but not women (aOR 1.48, 95% CI 0.78 to 2.82). Evaluation of the association between arthritis and use of mental health support resulted in an aOR of 1.50 (95% CI 0.89 to 2.51). Individuals with arthritis tended to use medications and professional services as opposed to non-professional support.ConclusionComorbid arthritis among individuals with a mental disorder was associated with an increased perceived need for mental healthcare, especially in men, underscoring the importance of understanding the role of masculinity in health seeking. Assessing the mental health of patients with arthritis continues to be essential for clinical care.

scholarly journals Profiling persons reported missing from hospitals versus mental health facilities

2021 ◽  
pp. 146135572110218
Author(s):  
Lorna Ferguson
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Logistic Regression ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Significant Issue ◽  
Missing Persons ◽  
Mental Health Facilities ◽  
Municipal Police ◽  
Location Type

Missing person reports from hospitals and mental health facilities are a significant issue impacting patients, communities, and health and police sectors. Research on missing persons seldom considers the type of location from where people go missing, which can be troublesome due to the increased chances for experiencing harm during an episode from hospitals and mental health facilities. When location type is studied, these often remarkably different places are frequently blended together in analyses and discussions. This conflation has implications for research and the development of effective police preventive responses. To begin to address this gap, this study uses descriptive analysis and logistic regression to examine the descriptive and predictive profiles of those reported missing from hospitals versus those reported missing from mental health units. For this, data are taken from a sample of 916 closed missing person cases reported to a Canadian municipal police service over five years. Results suggest there are significant differences in both the descriptive and predictive profiles of individuals reported missing from these two location types, such as individuals with varying mental health and cognitive issues going missing from each place, respectively. Given the findings, the implications for research, policing, and risk management are discussed.

scholarly journals Design features that reduce the use of seclusion and restraint in mental health facilities: a rapid systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046647
Author(s):  
Sanne Oostermeijer ◽  
Catherine Brasier ◽  
Carol Harvey ◽  
Bridget Hamilton ◽  
Cath Roper ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Environment ◽  
Critical Appraisal ◽  
Physical Restraint ◽  
Health Facilities ◽  
Rapid Review ◽  
Cochrane Library ◽  
Design Features ◽  
Mental Health Facilities

Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint.DesignA rapid review of peer-reviewed literature.MethodsPeer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute’s critical appraisal tool was used to assess the quality of included studies.ResultsWe identified 35 peer-reviewed studies. The findings revealed several overarching themes in design efforts to reduce the use of seclusion and restraint: a beneficial physical environment (eg, access to gardens or recreational facilities); sensory or comfort rooms; and private, uncrowded and calm spaces. The critical appraisal indicated that the overall quality of studies was low, as such the findings should be interpreted with caution.ConclusionThis study found preliminary evidence that the physical environment has a role in supporting the reduction in the use of seclusion and restraint. This is likely to be achieved through a multilayered approach, founded on good design features and building towards specific design features which may reduce occurrences of seclusion and restraint. Future designs should include consumers in a codesign process to maximise the potential for change and innovation that is genuinely guided by the insights of lived experience expertise.

Investigating Sources of Inefficiency in Residential Mental Health Facilities

2006 ◽  
Vol 30 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Nick Kontodimopoulos ◽  
Thalia Bellali ◽  
Georgios Labiris ◽  
Dimitris Niakas
Keyword(s):  
Mental Health ◽  
Health Facilities ◽  
Mental Health Facilities

scholarly journals Overtime working patterns and adverse events in work-related suicide cases: hierarchical cluster analysis of national compensation data in Japan (fiscal year 2015–2016)

2021 ◽  
Author(s):  
Yuki Nishimura ◽  
Takashi Yamauchi ◽  
Takeshi Sasaki ◽  
Toru Yoshikawa ◽  
Masaya Takahashi
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Adverse Events ◽  
Mental Disorder ◽  
Working Hours ◽  
Hierarchical Cluster ◽  
Fiscal Year ◽  
Long Working Hours ◽  
Interpersonal Conflicts ◽  
Work Related

Abstract Background Although various work-related adverse events affect workers’ mental health, the association between long working hours and mental disorders remains unclear. We investigated the characteristics of overtime work and work-related adverse events among all cases of compensated work-related suicide in Japan to empirically reveal the context of the serious consequences. Methods We analysed all 167 cases of mental disorders resulting in suicide that were compensated in fiscal year 2015–2016. Hierarchical clustering was applied to the overtime working history. Work-related adverse events were also evaluated as the qualitative aspects of their jobs. Results More than half of the cases committed suicide within a month of developing a mental disorder. The Administrative and professional or engineering workers had a higher suicide rate. The clustering analysis revealed chronic long working hours (19%), gradual increase (27%), or rapid increase (25%) in working hours before the onset of a mental disorder. A group of cases with less overwork experienced more interpersonal conflicts. Conclusion This is the first study to employ a clustering technique to objectively reveal the actual working patterns behind suicide. The patterns of working overtime before the onset of mental disorders varied considerably among the cases. Taking the transition of working overtime into account may provide clearer insight into the relationship between long working hours and workers’ mental health. These results highlight the need for countermeasures especially for causes of chronic overworking, drastic increases in working hours, and interpersonal conflicts to prevent work-related suicide.

An Experientially- and Community-Oriented Graduate Course in Mental Health Administration

1987 ◽  
Vol 14 (1) ◽  
pp. 51-53
Author(s):  
David S. Glenwick
Keyword(s):  
Mental Health ◽  
Course Evaluation ◽  
Health Facilities ◽  
Health Administration ◽  
Graduate Course ◽  
Evaluation Data ◽  
Mental Health Administration ◽  
Mental Health Facilities

A graduate course in mental health administration that combines classroom, field visit, and practicum components is described. The course provides students with an overview of the major responsibilities, concerns, and issues in the management of mental health facilities. Course evaluation data indicate that the course has been meeting its goal of stimulating students' interest in this area of increasing involvement by psychologists.

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