scholarly journals DEVELOPING DEMENTIA-SPECIFIC PROVIDER TRAINING IN MENTAL HEALTH: WHAT IS THE TARGET?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S379-S379
Author(s):  
Mary F Wyman ◽  
Corrine I Voils ◽  
Ranak B Trivedi ◽  
Carey E Gleason
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Outpatient Setting ◽  
Dementia Care ◽  
Care Staff ◽  
System Level ◽  
Health Providers ◽  
Provider Training ◽  
Outpatient Mental Health ◽  
Managing Risk

Abstract Most persons with dementia (PwD) live in the community and receive mental health care in the outpatient setting, making these providers an important target for education to improve dementia care. To inform the development of training curricula, we surveyed 65 mental health providers in a Veterans Affairs outpatient clinic on perceived barriers and training needs related to service delivery to PwD and caregivers. We used an adapted version of the Sense of Competence in Dementia Care Staff scale to assess domain-specific competencies. Respondents rated this work as highly important and wanted dementia-related training. They reported low competency in person-centered care approaches and challenging clinical situations, e.g., managing risk of harm. System-level barriers affecting services for PwD were noted. Findings suggest that outpatient mental health professionals are an underutilized resource in dementia care. This work can inform the development of provider training and identification of system-level barriers in this setting.

scholarly journals The Emergency Assessment and Management of Non-Suicidal Self-Injury in Adolescents

2020 ◽  
Vol 9 (2) ◽  
pp. 92-99
Author(s):  
Sindhu A. Idicula ◽  
Amy Vyas ◽  
Nicole Garber
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Outpatient Clinics ◽  
Psychiatric Diagnoses ◽  
Mental Health Providers ◽  
Health Providers ◽  
Levels Of Care ◽  
Self Injury ◽  
History Of ◽  
Inpatient Units

Background and Goals: Non-suicidal self-injury (NSSI) is a common presenting issue mental health providers experience in all levels of care from outpatient clinics to inpatient units. It is common among adolescents seen in emergency settings, either as a presenting problem or as a covert condition that may not be detected unless specifically assessed for. The presence of NSSI increases the risk of suicide. This article aims to help the clinician develop a better understanding of NSSI – what it may entail, the prevalence, and the motivations for why young people engage in it. Methods: We review the reasons adolescents injure themselves, the link between NSSI and psychiatric diagnoses and suicide, the assessment of NSSI, and treatment planning, with emphasis on ways to screen for NSSI and interventions that can be implemented in the Emergency Department. We illustrate the complexity of NSSI with the case of a young patient with a complex psychiatric history and an extensive history of self-injury. Results and Discussion: Despite the seeming intractability of NSSI, a number of evidencebased treatments exist. Treatment primarily involves specialized forms of psychotherapy, but interventions can be implemented in the ED that will reduce the immediate risk of NSSI while more definitive intervention is awaited. Conclusion: Mental health consultations in the ED should always include screening for NSSI. Mental health professionals in the ED can play an important role in the detection and treatment of this condition..

Cultural Diversity in Psychiatry

2017 ◽  
Author(s):  
Joanna Chambers ◽  
Mary Guerriero Austrom ◽  
Ryan Harris ◽  
Danielle Patterson
Keyword(s):  
Mental Health ◽  
Cultural Identity ◽  
Cultural Diversity ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Key Words Aging ◽  
Health Providers ◽  
Manage Care ◽  
Starting Point ◽  
Key Aspects

This purpose of this review is to provide general guidelines to practicing psychiatrists and psychologists on cultural diversity in the discipline. Diversity and mental health is a complex topic in a complex discipline, and our goal is to contribute to an understanding of how cultural identity affects our work. This review does not explicitly state how to treat any one cultural group. Rather, it is a tool for psychiatrists and other mental health providers to begin a sensitive and helpful conversation with patients of all backgrounds and a way to explore their own cultural identities. As our nation becomes increasingly diverse, providers are expected to understand how a patient’s cultural identity impacts the presenting problem and, ultimately, treatment. In addition, an ever-present opportunity remains for mental health professionals to explore their own cultural identity and how it may be involved in conscious and unconscious biases, which, in turn, also impact how they interpret, treat, and manage care. We explore key aspects of diversity with the goal of cultivating a deeper level of insight and awareness among psychiatrists in training and those currently in practice when caring for patients with diverse backgrounds. The guidelines offer a starting point toward delivering culturally competent care and, coupled with a commitment to lifelong learning from psychiatrists and other mental health professionals, can help minimize the stigma of traditionally marginalized groups.  This review contains 7 tables, and 67 references.  Key words: aging, diversity, LGBTQ, psychiatry, race, religion 

scholarly journals DEMENTIA CARE AND BEHAVIORAL HEALTH WORKFORCE DEVELOPMENT: INNOVATIONS IN TRAINING ACROSS SETTINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S379-S379
Author(s):  
Mary F Wyman ◽  
Verena R Cimarolli ◽  
Robyn Stone
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Behavioral Health ◽  
Workforce Development ◽  
Health Care Professionals ◽  
Professional Training ◽  
Outpatient Setting ◽  
Direct Care ◽  
Care Staff ◽  
Health Care Staff

Abstract It is well-established that there is a critical shortage of trained health care staff who can deliver high-quality behavioral health services to persons with dementia. The development of innovative professional training curricula, and effectively implementing and sustaining such programs, is a key element in addressing this workforce crisis. This symposium highlights cutting-edge efforts being conducted across the continuum of care, to train health care professionals to support optimal behavioral health for persons with dementia. In the outpatient setting, Wyman et al. present data from a survey of mental health clinicians on their perspectives about working with persons with dementia and caregivers, revealing critical gaps in knowledge and skills to target in continuing education programming. Wray and colleagues focus on integrated behavioral health in primary care, discussing how geriatric experts can most effectively contribute to improved assessment and treatment within this setting. Koepp presents an innovative program to transform outpatient mental health care for persons with dementia through provider training and consultation. In the residential care setting, Reinhardt and colleagues report on the implementation of a comprehensive approach to the alleviation of behavioral health problems through training direct care staff in person-directed care in nursing homes. Finally, Karel et al share how VA interprofessional nursing home teams learn and sustain an evidence-based program to address behavioral concerns among residents with dementia. The discussant will lend a deep expertise in research and policy related to the geriatric workforce to her remarks on the presentations.

Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities

2001 ◽  
Vol 16 (3) ◽  
pp. 162-166 ◽  
Author(s):  
A.C. Schrier ◽  
B.J.M. van de Wetering ◽  
P.G.H. Mulder ◽  
J.P. Selten
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
The Netherlands ◽  
Hospital Admission ◽  
Mental Health Professionals ◽  
Point Prevalence ◽  
Outpatient Mental Health ◽  
Netherlands Antilles ◽  
Female Immigrants

SummaryObjectiveReports of an increased incidence of schizophrenia in some immigrant groups to The Netherlands are based exclusively on hospital data. The aims of our study were: 1) to determine the treated point prevalence of schizophrenia at outpatient mental health services in Rotterdam and to compare the results for immigrants to those for natives; and 2) to compare groups born in The Netherlands and immigrant groups in terms of the proportions of patients with a previous hospital admission.MethodWe included all patients aged between 20 and 64 who were treated for a non-affective psychosis at any of the outpatient mental health services in Rotterdam on October 1, 1994. The mental health professionals responsible reported on the socio-demographic and clinical characteristics of each patient.ResultsSeven hundred and thirteen patients with a diagnosis of schizophrenia (DSM-III-R) were identified (rate: 2.1 per 1000). The (treated) prevalence of schizophrenia in male immigrants from Surinam and Morocco and in female immigrants from Surinam, the Netherlands Antilles and Cape Verde was significantly higher than that in their native-born counterparts (odds ratios between 2 and 3). The (treated) prevalence was not significantly higher in immigrants from Turkey, female immigrants from Morocco or male immigrants from the Antilles. Proportions of patients with a previous hospital admission were similar in each ethnic group (81–93%).ConclusionThese findings are generally in line with earlier studies, based on the Dutch psychiatric registry, which has reported an increase in the (treated) incidence of schizophrenia in immigrants from Surinam and the Netherlands Antilles and in male immigrants from Morocco, and no increase in the (treated) incidence in immigrants from Turkey or female immigrants from Morocco.

scholarly journals Putting meaning into medicine: why context matters in psychiatry

2015 ◽  
Vol 24 (4) ◽  
pp. 292-295 ◽  
Author(s):  
E. Carpenter-Song
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Medication Management ◽  
Symptom Control ◽  
Mental Health Providers ◽  
Health Providers ◽  
Illness Experiences ◽  
Care Demands

Mainstream psychiatry emphasises controlling symptoms by taking medications. This approach ignores the role of context in shaping illness experiences and how people engage with mental health professionals. The focus on symptom control and medication management also narrows the function of the psychiatrist. This editorial argues that knowledge of patients’ lives is important for providing empathic care that is oriented to the outcomes that matter to patients. In addition, care that attends to the person-in-context motivates and sustains mental health providers by putting meaning back into medicine. Truly patient-centred care demands pushing back against the reductionism of contemporary psychiatry to thoughtfully engage with the complexities of patients’ lives.

scholarly journals TRANSFORMING DEMENTIA SERVICE DELIVERY: THE MENTAL HEALTH GERO-CHAMPIONS PROGRAM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S380-S380
Author(s):  
Regina M Koepp
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Medical Center ◽  
Neurocognitive Disorders ◽  
Mental Health Providers ◽  
Health Providers ◽  
Mental Health Clinics ◽  
Outpatient Mental Health ◽  
Health Clinics ◽  
Clinical Support

Abstract In order to provide effective mental health care to older adults with major neurocognitive disorders (e.g., Alzheimer’s disease and related dementias) within outpatient mental health clinics, mental health practitioners must possess a basic understanding of these disorders, the needs of and challenges faced by people living with dementia and their families, and effective treatment approaches for this population. The Mental Health Gero-Champions Program was established in 2015 at a large Veterans Affairs medical center with the aim of providing clinical support and opportunities for training to multidisciplinary mental health providers to enhance skills in assessing and treating older adults with neurocognitive disorders. This presentation will provide an overview of the Mental Health Gero-Champions Program, describe the development and implementation of this program, and discuss challenges and successes in sustaining this transformative initiative over time.

The Limitations and Strengths of the Evidence-Based Practice Attitude Scale as a Measure of Correctional Employees’ Attitudes: A Psychometric Evaluation

2017 ◽  
Vol 62 (12) ◽  
pp. 3947-3964 ◽  
Author(s):  
Breanna Boppre ◽  
Jody Sundt ◽  
Emily J. Salisbury
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Evidence Based Practice ◽  
Psychometric Evaluation ◽  
Attitude Scale ◽  
Evidence Based ◽  
Correctional Staff ◽  
Mental Health Providers ◽  
Health Providers ◽  
Evidence Based Practices

Evidence-based practices (EBPs) hold tremendous potential for improving the outcomes of corrections interventions. The implementation of EBPs requires support from staff at all levels of an organization; however, the study of correctional staff attitudes toward organizational change and EBPs is in its infancy. The current study examines the psychometric properties of the Evidence-Based Practice Attitude Scale (EBPAS), an instrument originally designed for mental health professionals, to measure correctional employees’ readiness to implement EBPs. The results indicate mixed conclusions regarding the use of the EBPAS with correctional staff. We found that the total scale and subscales are reliable and exhibit high internal consistency. However, the results of an exploratory and confirmatory factor analysis failed to replicate the factor structure from previous research with mental health providers. The findings indicate potential drawbacks regarding the construct validity of the EBPAS for use with correctional personnel.

Integrating mental health professionals into the care team to better recognize and manage delirium in hospitalized oncology patients.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 83-83
Author(s):  
Joseph Hooley ◽  
Laurel Ralston ◽  
Joel Daniel Marcus ◽  
Carolyn Best ◽  
Diana Karius ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Unit Length ◽  
Care Team ◽  
Clinical Social Workers ◽  
Health Providers ◽  
Front Line ◽  
Order Set

83 Background: Delirium is a common neuropsychiatric condition associated with increased morbidity and mortality, length of hospitalization, and distress. The prevalence of delirium in cancer ranges from 10% to 30% in hospitalized patients and up to 85% in terminally ill cancer patients. Rates of delirium on Cleveland Clinic’s inpatient oncology units were lower than expected. Our goal was to integrate mental health professionals into the care team to assist with better recognition and management of delirium. Methods: Education was developed for a range of caregivers, including physicians, nurses, and advanced practice providers. It was facilitated by a psychiatrist, psychologist, and clinical social workers, and included proper identification of both hyper- and hypoactive delirium through use of the Brief Confusion Assessment Method (bCAM) and use of a delirium order set to treat and manage patients identified as positive for delirium. An important component of this education included a proper assessment and comparison of patients’ current mental status compared to their true baseline prior to hospitalization. Additional integration directly into the care team included participation of the psychiatrist, psychologist, and clinical social workers into each team’s multidisciplinary rounds to facilitate discussions around delirium and its appropriate management, and separate targeted rounding which included one-to-one education with front-line caregivers. Results: During the first year of integration, substantial improvements were noted. The percentage of patients identified as positive for delirium through bCAM screening increased from 3.4% to 15.8% after 12 months, and utilization of the delirium order set increased from 11.1% to 58.3%. Additionally, the average nursing unit length of stay (LOS) for delirium-positive patients decreased by more than 2 days compared to baseline. Conclusions: Integration of mental health providers into the care team to assist with recognizing and managing patients with delirium and to provide direct education to front-line caregivers has helped to rapidly improve delirium identification and management for oncology inpatients.

Geriatric Forensic Psychiatry

2017 ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Forensic Psychiatry ◽  
Mental Health Training ◽  
Older Population ◽  
Geriatric Population ◽  
Term Care ◽  
Training And Research ◽  
Managing Risk

Geriatric Forensic Psychiatry: Principles and Practice is one of the first texts to provide a comprehensive review of important topics in the intersection of geriatric psychiatry, medicine, clinical neuroscience, forensic psychiatry, and law. It will speak to a broad audience among varied fields, including clinical and forensic psychiatry and mental health professionals, geriatricians and internists, attorneys and courts, regulators, and other professionals working with the older population. Topics addressed in this text, applied to the geriatric population, include clinical forensic evaluation, regulations and laws, civil commitment, different forms of capacity, guardianship, patient rights, medical-legal issues related to treatment, long term care and telemedicine, risk management, patient safety and error reduction, elder driving, sociopathy and aggression, offenders and the adjudication process, criminal evaluations, corrections, ethics, culture, cognitive impairment, substance abuse, trauma, older professionals, high risk behavior, and forensic mental health training and research. Understanding the relationship between clinical issues, laws and regulations, and managing risk and improving safety, will help to serve the growing older population.

scholarly journals The experiences of spirituality among adults with mental health difficulties: a qualitative systematic review

2019 ◽  
Vol 29 ◽  
Author(s):  
K. Milner ◽  
P. Crawford ◽  
A. Edgley ◽  
L. Hare-Duke ◽  
M. Slade
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Professionals ◽  
Meaning Making ◽  
Holistic Approach ◽  
Spiritual Needs ◽  
Health Providers ◽  
Qualitative Systematic Review ◽  
Mental Health Difficulties ◽  
Spiritual Struggles

Abstract Aims Despite an increasing awareness of the importance of spirituality in mental health contexts, a ‘religiosity gap’ exists in the difference in the value placed on spirituality and religion by professionals compared with service users. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts, and can result in people's spiritual needs being neglected, dismissed or pathologised within clinical practice. The aim of this qualitative systematic review is to characterise the experiences of spirituality among adults with mental health difficulties in published qualitative research. Methods An electronic search of seven databases was conducted along with forward and backward citation searching, expert consultation and hand-searching of journals. Thirty-eight studies were included from 4944 reviewed papers. The review protocol was pre-registered (PROSPERO:CRD42017080566). Results A thematic synthesis identified six key themes: Meaning-making (sub-themes: Multiple explanations; Developmental journey; Destiny v. autonomy), Identity, Service-provision, Talk about it, Interaction with symptoms (sub-themes: Interactive meaning-making; Spiritual disruption) and Coping (sub-themes: Spiritual practices; Spiritual relationship; Spiritual struggles; Preventing suicide), giving the acronym MISTIC. Conclusions This qualitative systematic review provides evidence of the significant role spirituality plays in the lives of many people who experience mental health difficulties. It indicates the importance of mental health professionals being aware of and prepared to support the spiritual dimension of people using services. The production of a theory-based framework can inform efforts by health providers to understand and address people's spiritual needs as part of an integrated holistic approach towards care.

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