scholarly journals Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review

2020 ◽  
Author(s):  
Laurie Migliore ◽  
Lisa Braun ◽  
Christopher H Stucky ◽  
Cubby Gardner ◽  
Sarah Huffman ◽  
...  

ABSTRACT Background Although combat stress and psychiatric casualties of war have consistently contributed to the need for deployed patient transport to higher echelons of care, little is known regarding specific evidence-based strategies for providing psychological support and optimal transport interventions for warriors. Study Objective The purpose of this scoping review is to map existing literature related to considerations for deployed mental health patient transport. The review’s primary aims are to identify the existing scientific research evidence, determine research and training gaps, and recommend critical areas for future military research. Methods We used Arksey and O’Malley’s six-stage scoping review methodological framework (identify the research question, identify relevant studies, select studies, chart data, report results, and consultation). Using a systematic search strategy, we evaluated peer-reviewed literature from five databases (PubMed, CINAHL, PsycINFO, Web of Science, and Embase) and gray literature from the Defense Technical Information Center. All publications were independently screened for eligibility by two researchers during three review rounds (title, abstract, and full text). Results We identified 1,384 publications, 61 of which met our inclusion criteria. Most publications and technical reports were level IV evidence and below, primarily retrospective cohort studies and epidemiologic surveillance reports. Few rigorously designed studies were identified. Eight research themes and a variety of research and critical training gaps were derived from the reviewed literature. Themes included (1) characterizing mental health patients aeromedically evacuated from theater; (2) in-flight sedation medications; (3) need for aeromedical evacuation (AE) in-theater education, training, and guidelines for staff; (4) epidemiological surveillance of AE from theater; (5) mental health management in deployed settings; (6) suicide-related event management; (7) transport issues for mental health patients; and (8) psychological stressors of AE. Research is needed to establish clinical practice guidelines for mental health condition management in theater and throughout the continuum of en route care.

Author(s):  
Pawan Gupta

It is estimated that 1 in 4 people in a year will have some kind of mental health problem, and that mixed anxiety and depression is the most common disorder in the UK. There is an increasing number of mental health patients attending the ED, and a new FY doctor in the ED will encounter such patients from their first shift onwards. The approach to a mental health patient is only marginally different from the approach to those presenting under other specialties. The assessment largely depends on careful history taking and attentively listening to the patient’s narrative. There are only a few situations in psychiatry in which a physical examination and investigations are required in the ED to make a diagnosis. As it would not be possible to cover all the areas of psychiatry which come through the doors of the ED in one chapter, only a few questions have been included here to provide a flavour of the common psychiatric situations that FY1/2s may come across in their early training period. The UK has the highest rate of self-harm in Europe and so one of the most important points is to recognize suicidal patients who can harm themselves seriously and manage them appropriately. If such patients are discharged following an inadequate assessment, they may go on to commit suicide and the attending doctors would have missed the opportunity to support and save them. In this category of patients, when they present to the ED, no matter how minimal is the level of their self-mutilation, it is a serious ‘cry’ for help. Our job is to listen to the patient and support them with the maximum help we can provide. As it may be difficult to occasionally get to the bottom of the problem, particularly within the time constraints in the ED, a low level of suspicion should be kept to ask for the assistance of the mental health expert. Self-harm and depression go almost hand in hand. The suicidal rate is higher in depressed patients than in the general population.


2020 ◽  
Vol 17 ◽  
Author(s):  
Alex Parent ◽  
Ryan Smith ◽  
Ruth Townsend ◽  
Tania Johnston

IntroductionMental health represents a growing concern for health services in Australia. Paramedics are increasingly becoming the first point-of-contact for patients experiencing an acute mental health episode. Despite this increasing prevalence of cases there is an established body of literature outlining that paramedics feel inadequately trained to manage these patients. AimThis research aimed to identify how the management of acutely unwell mental health patients is included in paramedic curricula in Australia. MethodsA scoping review methodology was used in association with a thematic analysis of university learning outcomes related to mental health education for Bachelor of Paramedic programs in Australia. It was identified that there are considerable discrepancies between university learning outcomes for mental health education of paramedics. DiscussionMental health management of patients is not integrated throughout curricula, with most students only being exposed to mental health education once in their degree usually as a theoretical subject with no specific mental health practice placement. Further, the existence of discrepancies regarding mental health management education between paramedic courses creates an unequal minimum standard of education among graduating paramedic students. ConclusionGiven the prevalence of mental health cases and the special powers that paramedics have to manage these cases, as well as the fact that mental health does not discriminate between jurisdictions (ie. patients present and should be managed similarly in all states and territories), the authors argue that special consideration by the profession should be given to mandating a consistency in mental health management education across all paramedic Bachelor degree programs.


Crisis ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Suhanthini Farrell ◽  
Nav Kapur ◽  
David While ◽  
Louis Appleby ◽  
Kirsten Windfuhr

Abstract. Background: Entering higher education is a time of transition that coincides with the typical age of onset of serious mental illness. Awareness of the distinguishing characteristics of students with mental illness who die by suicide may inform clinical management. Aim: We aimed to compare the characteristics of mental health patients who died by suicide as students with other young people who died by suicide. Method: UK data were analyzed for individuals aged 18–35 years in contact with mental health services who died by suicide from 1997 to 2012. Univariate analyses examined the sociodemographic, behavioral, and clinical features of those who died as students. Backward stepwise regression analysis identified factors independently associated with student deaths. Results: In all, 214 university students died by suicide within 12 months of mental health service contact. Factors associated with student deaths were: being younger, female, from an ethnic minority group, and a primary diagnosis of affective disorder. Medication nonadherence was less likely to be associated with student deaths. Conclusion: Deaths by suicide are split almost equally between male and female students, unlike the predominance of male suicide in the general population. There are clear differences in the characteristics of the student and nonstudent groups, although causation could not be established.


2020 ◽  
Vol 19 (4) ◽  
pp. 573-602
Author(s):  
Flávia Barreto Tavares Chiavone ◽  
Manacés Santos Bezerril ◽  
Renilly Melo Paiva ◽  
Pétala Tuani Cândido de Oliveira Salvador ◽  
Fernanda Belmiro De Andrade ◽  
...  

Objetivo: Identificar y mapear los Serious Games que son producidos para la enseñanza de enfermería. Método: Se trata de una scoping review. La colecta de datos ocurrió en marzo de 2018, en 14 bases de datos nacionales e internacionales. Para la extracción de los datos se utilizaron los indicadores: año de publicación, país de origen, objetivo del estudio, clasificación de los Serious Games, área temática abordada por los Serious Games y los principales resultados. Resultados: La muestra del estudio estuvo compuesta por siete artículos, publicados entre 2011 y 2017, seis de estos (85,7%) producidos en Brasil. Los contenidos abordados en los serious games, fueron: salud mental, seguridad del paciente, cuidados en neonatología, salud infantil, administración de fármacos y gasometría arterial. Conclusión: Los serious game producidos para la enseñanza de la enfermería abordaron diferentes temáticas relacionadas: la salud mental, salud del niño, neonatología, seguridad del paciente, administración de fármacos y gasometría. Objective: To identify and map the serious games that are produced to teach nursing. Method: This is a scoping review. Data collection took place in March 2017, in 14 national and international databases. The following indicators were used for data extraction: year of publication, country of origin, objective of the study, classification of the serious games, thematic area addressed by the serious games, and main results. Results: The sample consisted of seven articles. The studies were published between 2011 and 2017, and six (85.7%) were produced in Brazil. The subjects addressed by the serious games were mental health, patient safety, neonatology care, child health, drug administration, and arterial gasometry. Conclusion: The serious games produced for teaching nursing addressed different related themes: mental health, child health, neonatology, patient safety, drug administration, and arterial gasometry. Objetivo: Identificar e mapear os Serious Games que são produzidos para o ensino da enfermagem. Método: Trata-se de uma scoping review. A coleta de dados ocorreu em março de 2018, em 14 bases de dados nacionais e internacionais. Para extração dos dados utilizou-se os indicadores: ano de publicação, país de origem, objetivo do estudo, classificação do Serious Games, área temática abordada pelo Serious Games e os principais resultados. Resultados: A amostra do estudo foi composta por sete artigos, publicados entre 2011 e 2017, com seis (85,7%) produzidos no Brasil. Os conteúdos abordados nos serious games, foram: saúde mental, segurança do paciente, cuidados em neonatologia, saúde infantil, administração de fármacos e gasometria arterial. Conclusão: Os serious game produzidos para o ensino da enfermagem abordaram diferentes temáticas relacionadas: a saúde mental, saúde da criança, neonatologia, segurança do paciente, administração de fármacos e gasometria.


2020 ◽  
Author(s):  
Alanna McCrory

UNSTRUCTURED Users of highly visual social media (HVSM), such as Snapchat and Instagram, share their messages through images, rather than relying on words. A significant proportion of people that use these platforms are adolescents. Previous research reveals mixed evidence regarding the impact of online social technologies on this age group’s mental wellbeing, but it is uncertain whether the psychological effects of visual content alone differ from text-driven social media. This scoping review maps existing literature that has published evidence about highly visual social media, specifically its psychological impact on young people. Nine electronic databases and grey literature from 2010 until March 2019 were reviewed for articles describing any aspect of visual social media, young people and their mental health. The screening process retrieved 239 articles. With the application of eligibility criteria, this figure was reduced to 25 articles for analysis. Results indicate a paucity of data that exclusively examines HVSM. The predominance of literature relies on quantitative methods to achieve its objectives. Many findings are inconsistent and lack the richness that qualitative data may provide to explore the reasons for theses mixed findings.


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