Integrated Drug and Alcohol Intervention: Development of an Opportunistic Intervention Program to Reduce Alcohol and other Substance use among Psychiatric Patients

1999 ◽  
Vol 33 (5) ◽  
pp. 676-683 ◽  
Author(s):  
Thiagarajan Sitharthan ◽  
Subba Singh ◽  
Paul Kranitis ◽  
Jon Currie ◽  
Pauline Freeman ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Intervention Program ◽  
Psychiatric Patients ◽  
Clinical Care ◽  
Psychiatric Hospitals ◽  
Alcohol Problems ◽  
Health Staff ◽  
Alcohol Intervention ◽  
Drug And Alcohol

Objective: This paper describes the rationale, aims and processes involved in developing and implementing an opportunistic intervention program to reduce substance misuse detected among psychiatric patients. Method: In this randomised, opportunistic intervention program, eligible patients recruited from a large psychiatric hospital and its associated community mental health centres are assigned to receive an integrated drug and alcohol intervention (IDAI) or alternatively allocated to a minimal intervention condition (MI). The IDAI is based on motivational enhancement and cognitive-behavioural principles, and incorporates harm-reduction approaches. This clinical program is based on the research findings and recommendations of the mental health and the drug and alcohol literature. Results: A collaborative partnership between the Mental Health Services and the Drug and Alcohol Services was formed. Following a relatively short training period, mental health staff were trained to opportunistically detect drug and alcohol problems among psychiatric patients and offer appropriate integrated clinical care. Conclusion: The process of implementing an integrated opportunistic intervention program is achievable and can be readily incorporated in psychiatric hospitals and community mental health clinics.

Experience, Knowledge and Attitudes of Mental Health Staff Regarding Patients' Problematic Drug and Alcohol Use

1999 ◽  
Vol 33 (2) ◽  
pp. 267-273 ◽  
Author(s):  
Nandi Siegfried ◽  
Joanne Ferguson ◽  
Michelle Cleary ◽  
Garry Walter ◽  
Joseph M. Rey
Keyword(s):  
Mental Health ◽  
Work Experience ◽  
Education And Training ◽  
Alcohol Problems ◽  
Health Staff ◽  
Mental Health Staff ◽  
Alcohol Education ◽  
Problematic Drug ◽  
Drug And Alcohol ◽  
And Training

Objective: The aim of this study was to assess the experience, knowledge and attitudes of mental health staff regarding patients' problematic drug and alcohol use in order to provide direction for planned drug and alcohol education. Method: A 47-item questionnaire was developed and individually posted to all mental health staff employed by Central Sydney Area Health Service (n == 536). Results: Three hundred and thirty-eight (63%) staff members completed the questionnaire. Thirty-six percent of respondents had received drug and alcohol training and 41% had drug and alcohol work experience. Drug and alcohol training and work experience were associated with increased drug and alcohol knowledge. Respondents' perception of their knowledge and competence was positively correlated with their actual knowledge. Most staff reported having regular contact with patients with psychotic illnesses and drug and alcohol problems. The majority considered the management of this patient group difficult and currently inadequate. Seventy percent believed that as mental health professionals they had a role to play in the management of their patients' drug and alcohol problems. Almost all (95%) were willing to participate in further education and training in this area. Conclusions: Mental health staff are often confronted with drug and alcohol problems in patients with psychotic illnesses. They perceive a need for drug and alcohol education and training specific to the management of these patients. Future research will need to evaluate outcomes of education and training programs for both staff and patients.

The Yantai Model of Community Care for Rural Psychiatric Patients

1994 ◽  
Vol 165 (S24) ◽  
pp. 107-113 ◽  
Author(s):  
Qingtong Wang ◽  
Yuzhu Gong ◽  
Kezhen Niu
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Health Workers ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Home Care Services ◽  
Mental Illnesses ◽  
Mental Health Workers ◽  
Advisory Group ◽  
Community Mental Health Workers

The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics (‘village doctors’) who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.

Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States

2020 ◽  
pp. 084456212090462
Author(s):  
Ifeoma E. Ezeobele ◽  
Ardell Mock ◽  
Rachel McBride ◽  
Arslee Mackey-Godine ◽  
Dorothy Harris ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Psychological Trauma ◽  
Environmental Safety ◽  
The United States ◽  
Health Staff ◽  
Professional Lives ◽  
Mental Health Staff ◽  
Job Functions

Introduction Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. Purpose To explore MHS perspectives of assault by psychiatric patients. Methods A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants’ age ranged from 22 to 63 years (mean age = 32.4). Moustakas’ theoretical underpinnings guided the study. Results Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes—increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes—unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. Discussion Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient’s behavior. Conclusion The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

The Practice of Community Psychiatric Nursing and Mental Health Social Work in Salford Some Implications for Community Care

1988 ◽  
Vol 152 (6) ◽  
pp. 783-792 ◽  
Author(s):  
K. Wooff ◽  
D. P. Goldberg ◽  
T. Fryers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Health Staff ◽  
Mental Health Staff ◽  
Term Care ◽  
Community Psychiatric ◽  
Wide Range

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

scholarly journals Development of hospital treatment of persons with mental disorders

2011 ◽  
Vol 139 (suppl. 1) ◽  
pp. 6-9 ◽  
Author(s):  
Milutin Nenadovic
Keyword(s):  
Mental Health ◽  
19Th Century ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Hospital Treatment ◽  
Social Community ◽  
Mental Patients ◽  
The Past ◽  
15Th Century ◽  
The 19Th Century

Discordances of harmonic mental functioning are as old as the human kind. Psychopathological behaviour of an individual in the past was not treated as an illness. That means that psychopathology was not considered an illness. In all past civilizations discordance of mental harmony of an individual is interpreted from the physiological aspect. Psychopathologic expression was not considered an illness, so social attitudes about psychiatric patients in the past were non-medical and generally speaking inhuman. Hospitals did not follow development of medicine for admission of psychiatric patients in past civilizations, not even in the antique era. According to historic sources, the first hospital that was meant for mental patients only was established in the 15th century, 1409 in Valencia (Spain). Therefore mental patients were isolated in a special institution-hospital, and social community rejected them. Only in the new era psychopathological behavior begins to be treated as an illness. Therefore during the 19th century psychiatry is developed as a special branch of medicine, and mental disorder is more and more seen according to the principals of interpretation of physical illnesses. By the middle of the 19th century psychiatric hospitals are humanized, and patients are being less physically restricted. Deinstitutialisation in protection of mental health is the heritage of reforms from the beginning of the 19th century which regarded the prevention of mental health protection. It was necessary to develop institutions of the prevention of protection in the community which would primarily have social support and characteristics.

Spain

2020 ◽  
pp. 147-160
Author(s):  
Victor Aparicio Basauri
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychiatric Hospitals ◽  
Psychiatric Reform ◽  
The Relationship ◽  
Critical Movement

This chapter analyses the influence of Franco Basaglia and the organization ‘Psichiatria Democrática’ on the Spanish critical movements. These movements appeared in 1971 and were organized through a clandestine group known as the ‘Psychiatric Coordinator’. This organization linked professionals (mainly young psychiatrists) who had initiated innovative experiences in various psychiatric hospitals. These developments generated conflict when opposing the norms of the dictatorship. From 1975, and especially after the approval of the 1978 Constitution, the critical movement was a force for change in mental health structures in Spain, through the established organization, the Spanish Association of Neuropsychiatry. This effort made it possible to generate the psychiatric reform in 1985 that advocated community mental health and deinstitutionalization policies. Franco Basaglia began his contacts with the Spanish critical professionals in 1970, and the relationship was maintained periodically until 1980, the year of his death.

Privacy and Access to Electronic Health Records

2011 ◽  
pp. 1997-2005
Author(s):  
Dick Whiddett
Keyword(s):  
Mental Health ◽  
Personal Information ◽  
Hippocratic Oath ◽  
Alcohol Problems ◽  
Sensitive Information ◽  
Correct Treatment ◽  
Health Records ◽  
Release Of Information ◽  
Relationship Of ◽  
Drug And Alcohol

The special relationship of trust that needs to exist between a patient and his or her physician has been recognized since the origins of the profession, and the need for doctors to keep confidential any information disclosed to them is codified in the Hippocratic Oath. A distinctive feature of the health records which arises from this relationship is the intimate nature of the information that they may contain; consequently, it is vitally important to maintain the confidentiality of the records and to protect the privacy of the patients. Privacy has long been recognized as a fundamental right in most western societies (Westin, 2003), and unless a patient can be sure that personal information will not be distributed against his or her wishes, the patient may be reluctant to disclose information that may in fact be crucial to his or her correct treatment (Ford, Bearman, & Moody, 1999; NZHIS, 1995), or he or she may refrain from seeking treatment (Sankar, Moran, Merz, & Jones, 2003). This is particularly true when health records contain sensitive information concerning issues like drug and alcohol problems, sexual behavior, mental health, or a genetic predisposition towards certain diseases. In such circumstances, the consequences of the inappropriate release of information could be extensive and might impact on many aspects of a person’s life, such as the ability to gain employment, to maintain a marriage, or to obtain loans or life insurance (Chadwick, 1999; Woodward, 1995).

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