scholarly journals The impact of the Emergency Department target upon the discharge decision for people who self-harm

2019 ◽  
Vol 19 (2) ◽  
pp. 89-97
Author(s):  
Michael Brian Haslam ◽  
Emma S. Jones
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Wait Time ◽  
Adverse Outcomes ◽  
Patient Journey ◽  
Content Type ◽  
Target Time ◽  
Starting Point ◽  
Self Harm ◽  
The Impact

Purpose The purpose of this paper is to consider the influence of the Emergency Department (ED) target wait time upon the discharge decision in ED, specifically for patients who have self-harmed. Pressures to discharge patients to avoid breaching the 4-h target wait time, potentially increase the risk of adverse responses from clinicians. For the patient who has self-harmed, such interactions may be experienced as invalidating and may result in adverse outcomes. Design/methodology/approach Secondary data analysis was applied to the retrospective referral data of a Mental Health Liaison Team (MHLT), collected over a period of 11 months from a single hospital in the North of England. In total, 734 episodes of care were referred to the team from ED, where the primary presentation was recorded as self-harm. Findings Over half of patients referred to the MHLT from ED having self-harmed were seen after already breaching the target and the potential for a more restrictive outcome reduced. Of those patients seen within 4 h, the potential for a more restrictive treatment option was increased. Practical implications Recommendations to improve the patient journey for those who have self-harmed include mental health triage and treatment in clinical areas outside of the target. Social implications This study challenges the concept of the target as being realistic and attainable for patients who have self-harmed. Originality/value This exploratory study provides a starting point from which to explore the impact of the target time upon discharge decisions and clinical outcomes specifically for those who have self-harmed.

scholarly journals The PARALLEL Study (imPAct of expeRiencing Another’s seLf harm and suicidaL bEhaviour in hospitaL)

2017 ◽  
Vol 19 (4) ◽  
pp. 258-268
Author(s):  
Rebecca Hargate ◽  
Sharon Howden ◽  
Emma Tarpey ◽  
Tammi Walker
Keyword(s):  
Mental Health ◽  
Suicidal Behaviour ◽  
Interpretative Phenomenological Analysis ◽  
Health Unit ◽  
Structured Interviews ◽  
Content Type ◽  
The North ◽  
Self Harm ◽  
The Impact ◽  
Mental Health Unit

Purpose The purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support. Design/methodology/approach Semi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines. Findings Three dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted. Originality/value This paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms.

scholarly journals Coping with mental health conditions at work and its impact on self-perceived job performance

2020 ◽  
Vol 42 (3) ◽  
pp. 626-645
Author(s):  
Sophie Hennekam ◽  
Sarah Richard ◽  
François Grima
Keyword(s):  
Mental Health ◽  
Job Performance ◽  
Coping Strategies ◽  
Health Conditions ◽  
Content Type ◽  
Mental Health Conditions ◽  
Work Strategies ◽  
Self Harm ◽  
The Impact ◽  
Number Of Individuals

PurposeThis exploratory qualitative study examines both the impact of mental health conditions on self-perceived job performance and how individuals with mental health conditions cope with their conditions at work.Design/methodology/approachA total of 257 responses to a qualitative questionnaire and 17 in-depth interviews with individuals with mental health conditions are analyzed.FindingsThe findings show that mental health conditions can negatively impact self-perceived job performance in the form of lower quality of one's work, slower pace, and more mistakes. In addition, the findings reveal coping strategies that positively and negatively affect one’s performance at work. Strategies that negatively influence one’s performance include substance abuse and self-harm, suppressing and hiding one's symptoms, and forcing oneself to continue to work when feeling unwell. Coping strategies that tend to positively affect their performance include accepting one's condition and taking time off, medication and counseling, mindfulness activities, transparent communication, humor, and a compensation strategy.Originality/valueA growing number of individuals struggle with mental health conditions at work, impacting both organizations and employees. However, little is known about the influence of mental health conditions on one's performance at work, how individuals cope with their mental health conditions at work, and what effect those coping strategies have on organization-relevant outcomes.

scholarly journals Impact of the COVID-19 pandemic on suicide and self-harm among patients presenting to the emergency department of a teaching hospital in Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250706
Author(s):  
Roshana Shrestha ◽  
Shisir Siwakoti ◽  
Saumya Singh ◽  
Anmol Purna Shrestha
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Significant Degree ◽  
Organophosphate Poisoning ◽  
Mental Health Crisis ◽  
Record System ◽  
Cross Sectional ◽  
Health Crisis ◽  
Self Harm ◽  
The Impact

The COVID-19 pandemic is a global challenge that is not just limited to the physical consequences but also a significant degree of a mental health crisis. Self-harm and suicide are its extreme effects. We aim to explore the impact of this pandemic on suicide and self-harm in our Emergency Department. A cross-sectional study was conducted including all fatal and nonfatal self-harm patients presenting to the emergency department during the lockdown period (March 24-June 23, 2020; Period1), matching periods in the previous year (March 24-June 23,2019; Period 2) and 3 months period prior (December 24 2019-March 23, 2020; Period 3) were included through the electronic medical record system. The prevalence and the clinical profile were compared between these three periods. A total of 125 (periods 1 = 55, 2 = 38, and 3 = 32) suicide and self-harm cases were analyzed. Suicide and self-harm had increased by 44% and 71.9% during the lockdown in comparison to periods 2 and 3. Organophosphate poisoning was the most common mode. Females were predominant in all three periods with a mean age of 32 (95%CI: 29.3–34.7). There was a significant delay in arrival of the patients in period 1 (p = 0.045) with increased hospital admission (p = 0.003) and in-hospital mortality (18.2% vs 2.6% and 3.1%) (p<0.001). Our study showed an increase in suicide and self-harm cases in the emergency department during the initial phase of the COVID-19 pandemic which may reflect the increased mental health crisis in the community in low resource settings like Nepal. This study highlights the importance of priming all mental health care stakeholders to initiate mental health screening and intervention for the vulnerable population during this period of crisis.

Impact of PlayerUnknown’s Battlegrounds (PUBG) on mental health

2021 ◽  
pp. 002581722098181
Author(s):  
Shweta Sunil ◽  
Manoj Kumar Sharma ◽  
Nitin Anand
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Professionals ◽  
Online Gaming ◽  
Anxiety And Depression ◽  
Self Harm ◽  
Aggressive Behaviours ◽  
Causal Patterns ◽  
The Impact

Online gaming has become a concern for health professionals due to its dysfunctional effects. This study aimed to conceptualise and summarise the impact that gaming platforms like PUBG can have on an individual’s mental health. A systematic review was conducted using the PRISMA model. A total of five papers were shortlisted and reviewed for the purpose of this study. The results indicated the use of gaming platforms like PUBG by players to address and cope with anxiety and depression, and it also highly influences the presence of other concerns like ADHD and suicidality, self-harm and aggressive behaviours. While the literature points to the detrimental effects of PUBG, this study highlights the importance of undertaking more research to establish the causal patterns in PUBG use and how to address the issues posed from both psychological and legal perspectives.

Health, happiness and your future: using a “men’s group” format to work with homeless men in London

2017 ◽  
Vol 13 (4) ◽  
pp. 403-418
Author(s):  
Kate Thompson ◽  
Pippa Brown ◽  
Stephanie Vieira
Keyword(s):  
Mental Health ◽  
Psychosocial Issues ◽  
Horn Of Africa ◽  
Content Type ◽  
Health And Wellbeing ◽  
Care Services ◽  
Homeless Men ◽  
Group Members ◽  
Future Work ◽  
The Impact

Purpose The purpose of this paper is to describe an intervention with a group of homeless men from the Horn of Africa, service users of the Horn of Africa Health and Wellbeing Project in London. The group was conceived by the second author who noted the presence of significant psychosocial issues for her clients, but equally their reluctance to access mainstream mental health or social care services. Design/methodology/approach Designing the group and introducing it to the men involved threw up some challenges which are explored, and the impact of the group on participants is evaluated. Findings Overall both the participants and the facilitators evaluated the group positively and it appeared to have led to lasting change for some of the group members, and this is described. The authors argue that this sort of group may be a more acceptable way to work on psychosocial issues than something more directly focused on mental health intervention. The group protocol is outlined along with suggestions for future work in this area. Originality/value This intervention represents a creative alternative to more mainstream psychological interventions for homeless or exiled men.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Social Care ◽  
The Body ◽  
Bibliographic Databases ◽  
Service Users ◽  
Content Type ◽  
Practitioner Attitudes ◽  
Health And Social Care ◽  
The Impact

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Inequalities in women’s medium or low secure mental health settings: a scoping review

2021 ◽  
Vol 23 (3) ◽  
pp. 254-271
Author(s):  
Aile Trumm ◽  
Kristina Brenisin ◽  
Kieran Breen
Keyword(s):  
Mental Health ◽  
Sexual Orientation ◽  
Gender Identity ◽  
High Quality Research ◽  
Dysfunctional Family ◽  
Health Service Provision ◽  
Content Type ◽  
Mental Health Settings ◽  
Health Need ◽  
The Impact

Purpose The more disadvantaged members of society generally experience poorer outcomes following the development of mental ill-health. The purpose of this paper is to scope the literature and synthesise findings on the inequalities and mental health within secure mental health settings. Design/methodology/approach Six electronic databases were searched to identify relevant studies. These were included if they examined the association between inequalities and mental health in women’s secure mental health settings. Findings Of the 608 studies reviewed, 14 met the inclusion criteria. In these papers, violence and/or abuse were described as the most prevalent inequalities. The second most frequent group of inequalities identified were socio-economic. Only three published studies researched the impact of ethnicities. Physical health, alcohol abuse and a dysfunctional family upbringing were only mentioned in one of the studies. Gender identity, transitioning and sexual orientation was not considered in any papers. These are areas, which require further investigation to determine their specific impact in this setting. Research limitations/implications This review highlights the dearth of high-quality research-based evidence underpinning an understanding of the impact of inequalities on women in secure mental health settings. The existing studies suggest that inequalities have a very particular impact and that intersectionality plays a key role. Further research is required to further understand how inequalities impact the lives of women in secure mental health settings. Practical implications The inequalities that women experience in relation to mental health need to be further researched in the context of intersectionality. There are also research gaps in terms of gender identity, sexual orientation and socio-economic background. Further primary research using a more complex methodological paradigm is required to explore these factors and their impact on mental health service provision. Social implications The role of inequalities should be considered as part of an overall care package, including the experiences of adverse childhood experiences and this should contribute towards the development of a trauma-based care approach. Originality/value To the best of the authors’ knowledge, this is the first study to scope literature about inequalities experienced in women’s secure psychiatric settings considering intersectionality.

Impact of perceived social support and parental bonding in predicting suicidal intent among self-harm patients

2021 ◽  
pp. 1-11
Author(s):  
Naila Yaqoob ◽  
Sadaf Ahsan
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Perceived Social Support ◽  
Demographic Variable ◽  
Parental Bonding ◽  
Cross Sectional ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Self Harm ◽  
The Impact

Objective: The present study investigated the impact of perceived social-support and parental-bonding in predicting suicidal intent among self-harm patients.Methods: Cross-sectional research design was used in current study. Study was conducted at Foundation University, Rawalpindi from February, 2019 to September, 2019. A purposive sample of 50 self-harm patients was collected from different mental health departments of hospitals of Rawalpindi, Jhelum and Peshawar. Participants were administered Multidimensional Scale of Perceived Social Support (MSPSS), Parental-Bonding Instrument (PBI) and Beck Suicide Intention Scale (BSIS). Data was analyzed through SPSS using correlation, t test and regression. Differences on the basis of demographic variable were also studied.Results: The main results of the study specified that social support and parental bonding’ factor ‘care’ had significant negative correlation with suicide intent. Moreover, it negatively predicted suicide intent. Whereas, parental boding’ factor ‘overprotectiveness’ had significant positive correlation with suicide intent and significantly positively predicted suicide intent. Conclusion: The outcomes of present study emphasized that social-support and parental bonding both can play substantial roles in saving lives. Researchers and mental health experts will be able to start examine about the factors that distinguish deliberate self-harm from attempted suicide as well as the characteristics common to both conducts. Continuous...

A systematic review of Karen refugee health

2016 ◽  
Vol 12 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Sarah J. Hoffman ◽  
Cheryl L. Robertson
Keyword(s):  
Mental Health ◽  
Forced Migration ◽  
The Body ◽  
Health Needs ◽  
Health Providers ◽  
Physical And Mental Health ◽  
Content Type ◽  
And Migration ◽  
Karen Refugees ◽  
The Impact

Purpose – The purpose of this paper is to provide a comprehensive perspective of the documented physical and mental health issues Karen refugees from Burma face as a result of war and refugee trauma, and migration. The review will address the question: What is the impact of trauma and migration on the physical and mental health of Karen refugees? Design/methodology/approach – A total of 18 articles were systematically selected for inclusion in the final review. The focal content for included articles includes qualitative and quantitative research representative of the health and migration experiences of Karen refugees. Findings – The findings of this review demonstrate significance for health providers from a public health standpoint as programs and services are targeted to meet the specific health needs of the Karen community. It also highlights the contribution of the Karen forced migration experience to the complexity of individual and community health needs, particularly as a result of the protracted conflict. Originality/value – This critical appraisal of the body of literature describing the health experiences of Karen refugees from Burma, with a particular focus on outcomes relevant to resettlement, demonstrates value as programs are developed with an integrated refugee perspective.

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