scholarly journals Substance misuse in personality disorder and schizophrenia: findings and clinical implications from a high secure hospital

2017 ◽  
Vol 19 (3) ◽  
pp. 217-226
Author(s):  
Alessandra Cappai ◽  
Jodie Wells ◽  
James Tapp ◽  
Derek Perkins ◽  
Anna Manners ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mentally Disordered Offenders ◽  
Treatment Needs ◽  
Content Type ◽  
Mentally Disordered ◽  
History Of ◽  
Offending Behaviour ◽  
The Relationship

Purpose Substance misuse (SMU) is widely prevalent in mentally disordered offenders and is linked with violence and offending behaviour. There is however, a scarcity of literature dedicated to investigating SMU and its clinical correlates in relation to patients detained within high secure hospital settings. The purpose of this paper is to investigate the extent and severity of SMU and corresponding treatment needs in patients with a primary diagnosis of personality disorder (PD) in comparison with mental illness (MI) in a high secure hospital. Design/methodology/approach The responsible clinicians of all patients (n=240) detained in a high secure hospital were asked to record information using a SMU screening questionnaire over a ten-month period. Details requested included substance type, history of past use and assessment and treatment needs. Data were recorded and then analysed: descriptive statistics were conducted to report historical use of substances, cross tabulations and χ2 analysis explored the relationship between SMU and treatment status and diagnosis and offending behaviour and a means comparison analysis was employed to explore length of stay and treatment of SMU. Findings A total of 230 questionnaires were returned (95 per cent of the patient population). A history of SMU was reported in 88.6 per cent of the sample, with alcohol and cannabis misuse being the most prevalent. At least one substance had been abused by 74.3 per cent of the sample. In two-thirds of the sample, SMU was linked with the onset of mental health problems and symptom exacerbation, including violence. Interestingly, patients with a diagnosis of MI as compared with PD were more likely to have used substances (93.3 per cent compared to 81.9 per cent) and were more likely to need treatment for SMU (64.3 per cent compared to 36.8 per cent). In those with an MI diagnosis, SMU was more likely to be linked with violence and index offence (74.3 per cent compared to 59.0 per cent). Practical implications SMU is significantly prevalent in high risk mentally disordered offenders and linked to onset of mental health problems and offending. Patients with schizophrenia have a higher prevalence of SMU than PD and are likely to be more in need of treatment. Violence and offending are more likely to be related to SMU in schizophrenia than in PD. Originality/value This study substantiates existing evidence that SMU contributes to mental health problems and criminogenic behaviour. Furthermore, the study reports new findings that characterize differences of the relationship of SMU to offending in schizophrenia and PD in forensic psychiatric patients presenting to a high secure hospital.

Socioeconomic status and primary health service use for mental health problems among immigrants with short and long lengths of stay

2016 ◽  
Vol 12 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Melanie Lindsay Straiton ◽  
Anne Reneflot ◽  
Esperanza Diaz
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Services ◽  
Service Use ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
Care Services ◽  
Primary Health ◽  
The Relationship

Purpose – High socioeconomic status (SES) is associated with better health and lower use of health care services in the general population. Among immigrants, the relationship appears less consistent. The purpose of this paper is to determine if the relationship between income level (a proxy for SES) and use of primary health care services for mental health problems differs for natives and five immigrant groups in Norway. It also explores the moderating effect of length of stay (LoS) among immigrants. Design/methodology/approach – Using data from two registers with national-level coverage, logistic regression analyses with interactions were carried out to determine the association between income level and having used primary health care services for mental health problems. Findings – For Norwegian men and women there was a clear negative relationship between income and service use. Interaction analyses suggested that the relationship differed for all immigrant groups compared with Norwegians. When stratifying by LoS, income was not associated with service use among recently arrived immigrants but was negatively associated among immigrants staying more than two years (with the exception of Pakistani and Iraqi women). Research limitations/implications – Country of origin and LoS should be considered when applying measures of SES in immigrant health research. Social implications – There may be an initial transition period for recently arrived immigrants where competing factors mask the association between SES and service use. Originality/value – This study benefits from nationwide coverage, eliminating self-selection biases. It demonstrates the complexity of the relationship between SES and health care use.

scholarly journals Substance use amongst mentally disordered offenders in medium security: prevalence and relationship to offending behaviour

2013 ◽  
Vol 15 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Calem De Burca ◽  
Helen Louise Miles ◽  
Eduardo Antonio Vasquez
Keyword(s):  
Substance Use ◽  
Mental Health Problems ◽  
Small Sample ◽  
Case Note ◽  
Self Report ◽  
Mentally Disordered Offenders ◽  
Research Attention ◽  
Content Type ◽  
Mentally Disordered ◽  
Offending Behaviour

Purpose – Substance use contributes to the development of criminogenic behaviour and mental health problems. However, the extent and severity of substance use and the relationship to offending in mentally disordered offenders (MDOs) admitted to regional medium secure units has received relatively limited research attention. Design/methodology/approach – Case note reviews (n=57) and semi-structured interviews (n=21) of past substance use levels, substance use problems and forensic history were conducted at a medium secure unit in South East England. Findings – Results highlighted the high prevalence of substance use among MDOs, especially when determined by self-report. At least one-third (case note review) or almost half (self-report) used alcohol at the time of their index offence, although many failed to recognise use as problematic. Significant correlations were found between heavy past use of alcohol and use of alcohol at time of offending. Past heavy use of alcohol significantly predicted whether or not the individual was convicted of a violent offence. Research limitations/implications – The small sample from one area limits the generalisability of findings as substance use demographics vary. Methodological shortcomings were noted when comparing data from self-report and case note information. Retrospective recall bias may influence past perceptions of substance use. Practical implications – These preliminary findings indicate the importance of assessing substance use in MDOs and considering its relationship to offending behaviour in treatment and risk management. Originality/value – Although anecdotally substance use is known to be high and likely to be related to offending behaviour amongst MDOs, there is little previous research highlighting this.

Attachment to God and Quest as Moderators of the Relationship between Religious Doubt and Mental Health

2021 ◽  
pp. 009164712199240
Author(s):  
Noah S. Love ◽  
Cassidy A. Merlo ◽  
M. Elizabeth Lewis Hall ◽  
Peter C. Hill
Keyword(s):  
Mental Health ◽  
Positive Relationship ◽  
Mental Health Problems ◽  
Negative Relationship ◽  
Health Problems ◽  
Positive Mental Health ◽  
Attachment To God ◽  
Religious Doubt ◽  
Avoidant Attachment ◽  
The Relationship

The present study examined attachment to God and quest as potential moderators of the relationship between religious doubt and mental health. A sample of Christian participants ( N = 235) completed a survey which included measures of attachment to God, quest, religious doubt, and mental health. As hypothesized, attachment to God and quest significantly moderated an individual’s experience of religious doubt. Low avoidant attachment to God (i.e., a more secure attachment) was associated with a more negative relationship between cognitive religious doubt and positive mental health than high avoidant attachment. In contrast, low avoidant attachment to God also ameliorated the positive relationship between affective religious doubt and mental health problems. Low anxious attachment was associated with a stronger negative relationship between both measures of religious doubt (i.e., cognitive and affective) and positive mental health. In addition, high soft quest weakened all four of the relationships between measures of religious doubt and mental health. High hard quest ameliorated the positive relationship between both measures of religious doubt and mental health problems. These results indicate that an individual’s attachment to God and the way an individual is oriented toward religion each play a role in the mental health outcomes associated with religious doubt.

scholarly journals Trauma, Sleep and Mental Health Problems in Low-Income Young Adults

2021 ◽  
Vol 18 (3) ◽  
pp. 1145
Author(s):  
Rachel A. Fusco ◽  
Yan Yuan ◽  
Hyunji Lee ◽  
Christina E. Newhill
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Low Income ◽  
Mental Health Problems ◽  
Trauma Exposure ◽  
Health Problems ◽  
Equation Modeling ◽  
Poor Sleep ◽  
Depression And Anxiety ◽  
The Relationship

Low-income young adults are more likely to have exposure to trauma, which increases risk for mental health problems. Although adequate sleep promotes good health, people with histories of trauma are more likely to have sleep problems. The current study explored whether poor sleep mediated the relationship between trauma exposure and mental health. A sample of 143 low-income 18–24-year-old young adults completed depression, anxiety, and trauma exposure measures and wore sleep monitors for four nights. Structural equation modeling (SEM) was used to examine both direct and indirect effects of variables. Results showed that higher trauma exposure was associated with depression and anxiety. Mean sleep hours per night was fewer than six, far below recommended guidelines for optimal health and functioning. Fewer sleep hours partially mediated the relationship between both trauma exposure and depression and anxiety, and the direct effect from trauma remained significant after adjusting for the partial mediation from sleep.

scholarly journals Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Clinical Deterioration ◽  
Care Services ◽  
Increased Risk ◽  
Remote Assessment ◽  
History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

scholarly journals Relationships Among the Internal Health Locus of Control, Mental Health Problems, and Subjective Well-Being of Adults in South Korea

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1588
Author(s):  
Sunhwa Shin ◽  
Eunhye Lee
Keyword(s):  
Mental Health ◽  
Locus Of Control ◽  
South Korea ◽  
Mental Health Problems ◽  
Health Locus Of Control ◽  
Well Being ◽  
Health Problems ◽  
Mediating Effect ◽  
Subjective Well Being ◽  
The Relationship

The purpose of this study was to confirm the relationship between internal health locus of control, mental health problems, and subjective well-being in adults during the prolonged COVID-19 pandemic. In particular, the mediating effect of mental health problems on the relationship between internal health locus of control and subjective well-being was examined. A cross-sectional descriptive design was conducted via online survey. The participants were 600 adults over 20 years of age living in South Korea. The collected data were analyzed using hierarchical regression analysis and SPSS Process Macro (Model 4). As a result of the study, the internal health locus of control had a significant negative effect on mental health problems. In addition, in the process of the internal health locus of control affecting subjective well-being, the mediating effect of mental health problems was significantly shown. In the period of an infectious disease pandemic such as COVID-19, it is necessary to establish a strong internal health locus of control of individuals and to promote monitoring and treatment introduction for those with a low internal health locus of control. In addition, it was discussed that controlling mental health problems can improve subjective well-being, which is life satisfaction and happiness.

The History, Justification, and Purpose of Mental Health Law

2021 ◽  
pp. 34-52
Author(s):  
Kay Wilson
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Common Law ◽  
Health Problems ◽  
Systemic Reform ◽  
Health Law ◽  
Mental Health Law ◽  
Incremental Change ◽  
History Of ◽  
The Common

Chapter 2 examines the historical development of mental health law in England (which is similar to the rest of the common law world, including America, Canada, and Australia) and uses that history to consider the justification, purpose, and need for mental health law from Ancient Greece to the present. Contrary to the claims of abolitionists that mental health law has essentially always stayed the same, it demonstrates a history of continuous legal and systemic reform in mental health law. Rather than an over-zealous and interfering state keen to exercise social control over persons with mental impairment, it instead depicts a state which for the most part reluctantly only became involved in the care of persons with mental health problems when informal care by family and friends failed or was non-existent, to prevent abuses by private operators, and as an incident of its administration of the criminal law. When set against the background of the fashions, cycles, and recurring themes of mental health law, the call of abolition can be conceptualized as simply the latest fad in its evolution. Further, many of the issues which arise from mental health problems will continue to exist even without mental health law. Mental health law can be positive and negative, including defining and protecting rights and allocating resources. The chapter cautions against being too optimistic about the promises of sweeping revolutionary changes which have never really delivered (deinstitutionalization or the ‘abolition’ of the asylum being the most poignant example), in favour of solid incremental change.

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