Restraint and confinement of psychiatric patients in community: a scoping review of pasung in Indonesia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dahniar Dahniar ◽  
Rini Asnurianti ◽  
Nurul Amna ◽  
Marthoenis Marthoenis

Purpose The practice of restraint and confinement of patients with mental disorders is common in Indonesia. This practice is known as pasung and is usually carried out by the family or the villagers in community settings. The previous separated studies have investigated the reasons for, methods, duration and consequences of applying pasung to the patients. A scoping review is needed to study the existing practice of restraint and confinement in Indonesian communities. This study aims to review the published studies on the practice of restraint and confinement of people with mental illness (PWMI) in Indonesia. Design/methodology/approach A scoping review method was used to identify studies on the practices of restraint and confinement of PWMI. A search of Science Direct, PubMed database and Google Scholar for articles was conducted. Findings There is an increasing interest in studying the pasung-related aspects among Indonesian mental health practitioners. The studies included the patients, family, caregivers and community as the research subjects. Various elements of pasung; the actors, duration, reason, the consequences and the challenges in releasing pasung have been reported. Stakeholders should consider many factors related to pasung to achieve the free pasung program in Indonesia. Research limitations/implications Pasung is a practice that exists in a significant number in Indonesia. Although researchers have sounded the importance of the pasung as a problem in the community, much has to be done to alleviate the inhuman treatment of PWMI. Originality/value This paper adds to the literature on the research concerning the practice of restraint and confinement of PWMI. The findings could be uses as the basis of the improvement of policy on mental health services, not only in Indonesia but also in other countries where the practice of restraint and confinements of PWMI in the community settings is existing.

Author(s):  
Erin Smith ◽  
Greg Dean ◽  
Lisa Holmes

Abstract Introduction: First responders are at greater risk of mental ill health and compromised well-being compared to the general population. It is important to identify strategies that will be effective in supporting mental health, both during and after the first responder’s career. Methods: A scoping review was conducted using the PubMed database (1966 to October 1, 2020) and the Google Scholar database (October 1, 2020) using relevant search terms, truncation symbols, and Boolean combination functions. The reference lists of all relevant publications were also reviewed to identify further publications. Results: A total of 172 publications were retrieved by the combined search strategies. Of these, 56 met the inclusion criteria and informed the results of this overview paper. These publications identified that strategies supporting first responder mental health and well-being need to break down stigma and build resilience. Normalizing conversations around mental health is integral for increasing help-seeking behaviors, both during a first responder’s career and in retirement. Organizations should consider the implementation of both pre-retirement and post-retirement support strategies to improve mental health and well-being. Conclusion: Strategies for supporting mental health and well-being need to be implemented early in the first responder career and reinforced throughout and into retirement. They should utilize holistic approaches which encourage “reaching in” rather than placing an onus on first responders to “reach out” when they are in crisis.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mayssa Rekhis ◽  
Sami Ouanes ◽  
Abir Ben Hamouda ◽  
Rym Rafrafi

Purpose This study aims to assess the awareness about the rights of people with mental illness in the main psychiatric hospital in Tunisia among the service users, the family members and the staff. Design/methodology/approach The Convention of Rights of People with Disabilities mandates that State Parties initiate and maintain campaigns and human rights training to promote understanding of the rights of people with mental illnesses, considered as a main factor for their fulfillment. Service users, family members and staff evaluated, through a survey, the importance of ten rights for persons with mental illness, stated in the convention. Findings Disparities were found in the perception of the different rights by and between the three groups. The highest levels of awareness were associated with the freedom from torture or degrading treatment and the right to live with dignity and respect, whereas the lower importance were assigned to the right to participation in recovery plans, to give consent and to exercise legal capacity. Originality/value The lack of awareness and the poor perception of rights of people with mental illness is one of the barriers to their achievement. More training and awareness raising is necessary.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen

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.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nada Alattar ◽  
Anne Felton ◽  
Theodore Stickley

Purpose Stigma associated with mental health problems is widespread in the Kingdom of Saudi Arabia (KSA). Consequently, this may prevent many Saudi people from accessing the mental health-care services and support they need. The purpose of this study is to consider how stigma affects people needing to access mental health services in the KSA. To achieve this aim, this study reviews the knowledge base concerning stigma and mental health in KSA and considers specific further research necessary to increase the knowledge and understanding in this important area. Design/methodology/approach This review examines the relevant literature concerning mental health stigma and related issues in KSA using the Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses frameworks. As a scoping review, it has used a systematic approach in literature searching. The results of the search were then thematically analysed and the themes were then discussed in light of the concepts of stigma and mental health. Findings Stigma around mental health impedes access to care, the nature of care and current clinical practice in the KSA. The voices of those with mental health issues in KSA are almost entirely unrepresented in the literature. Originality/value The review identifies that mental health stigma and cultural beliefs about mental health in KSA may act as barriers to accessing services. The voice of mental health service users in KSA remains largely unheard. If public discussion of mental health issues can increase, people’s experiences of accessing services may be improved.


2021 ◽  
Vol 16 (6) ◽  
pp. 468-479
Author(s):  
Helen Woodley

Purpose This study aims to reflect upon the first wave of training of Education Mental Health Practitioners (EMHPs), a new National Health Service role to provide support for Children and Young People (CYP) with low and moderate mental health needs in education settings in England. The study specifically focusses on the training for EMHPs in relation to their support for CYP who identify themselves as Black, Asian or Minority Ethnic (BAME), refugees or from the traveller community. Design/methodology/approach A brief review of the policy and literature on the role and remit of EMHPs was undertaken, including an exploration of the current status of BAME, refugee and traveller community CYP in schools in England. The review was then related to the specific experience of the author within the context of teaching EMHP trainees in a higher educational setting and evaluated as developing outcomes in low-intensity school-based practice. Findings There are benefits for trainee EMHPs to have an understanding of the minority groups of CYP attending schools in the area their Mental Health Support Team (MHST) covers. There are benefits for the MHST to form relationships with minority groups at an early stage in the MHST formation. Adapting the EMHP curriculum at a local level to include specific training on the needs of minority groups supports the development of relationships between schools and the communities they engage with locally. Ongoing training should be provided by services focussing on the specific needs of minority groups in their MHST area. Originality/value Involving minority groups in education in the formation of MHST and the training of EMHPs may improve outcomes in developing therapeutic relationships with CYP. Developing engagement practices in MHSTs with higher education providers, begins the process early in the experience of EMHP trainees, providing a safe environment in which to develop engagement skills.


2018 ◽  
Vol 20 (1) ◽  
pp. 17-32
Author(s):  
Daniel T. Wilcox ◽  
Leam A. Craig ◽  
Marguerite L. Donathy ◽  
Peter MacDonald

Purpose The purpose of this paper is to consider the impact of mental capacity legislation when applied to parents with learning difficulties who lack capacity within childcare and family law proceedings in England and Wales. Design/methodology/approach The paper relies on a range of material including reports published by independent mental health foundations, official inquiries and other public bodies. It also refers to academic and practitioner material in journals and government guidance. Findings The paper critically reviews the application of the guidance when assessing mental capacity legislation as applied in England and Wales and offers by way of illustration several case examples where psychological assessments, and the enhancement of capacity, have assisted parents who were involved in childcare and family law proceedings. Research limitations/implications There has been little published research or governmental reports on the number of cases when parents involved in childcare and family law proceedings have been found to lack capacity. No published prevalence data are available on the times when enhancing capacity has resulted in a change of outcome in childcare and family law proceedings. Practical implications The duty is on the mental health practitioners assessing mental capacity that they do so in a structured and supportive role adhering to good practice guidance and follow the guiding principles of mental capacity legislation assuming that the individual has capacity unless it is established that they lack capacity. Guidance and training is needed to ensure that the interpretation of the Mental Capacity Act (MCA) and its application is applied consistently. Social implications For those who are considered to lack mental capacity to make specific decisions, particularly within childcare and family law proceedings, safeguards are in place to better support such individuals and enhance their capacity in order that they can participate more fully in proceedings. Originality/value While the MCA legislation has now been enacted for over ten years, there is very little analysis of the implications of capacity assessments on parents involved in childcare and family law proceedings. This paper presents an overview and, in places, a critical analysis of the new safeguarding duties of mental health practitioners when assessing for, and enhancing capacity in parents.


2015 ◽  
Vol 14 (4) ◽  
pp. 205-210
Author(s):  
Peter John Huxley

Purpose – The purpose of this paper is to report on the development and results of the Mental Health Inclusion Index. Design/methodology/approach – Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating people with mental illness. Findings – The main findings were: mental illness exacts a substantial human and economic toll on Europe, and there is a substantial treatment gap, especially for people with common mental health problems. Germany’s generous social provision and strong healthcare system put it number one in the Mental Health Integration Index. The UK and Scandinavian states come next. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglect of mental illness and poorly developed community services. One needs to understand that the leading countries are not the only ones providing examples of best practice in integrating those with mental illness. Employment is the field of greatest concern for people with mental illness, but employment is also the area with the most inconsistent policies across Europe. A distinction can be made between countries whose policies are aspirational and those where implantation is support by substantial and most importantly sustained, resource investment. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult, and improvement can only be demonstrated by repeated surveys of this kind, based on more substantial, comprehensive and coherent information. Research limitations/implications – Usual caveats about the use of surveys. Missing data due to non-response and poverty of mental health inclusion data in many European countries. Practical implications – The author reflects on the findings and considers areas for future action. The main implications are: better services result from substantial, but most importantly, sustained investment; and that employment is most important to people with mental health problems, but is one of the most inconsistent policy areas across Europe. Social implications – Supports the need for consistent investment in community mental health services and more consistent employment policies in Europe. Originality/value – This survey is the first of its kind in Europe, and was conducted by the Economist Intelligence Unit in London, and sponsored by Janssen.


2017 ◽  
Vol 21 (3) ◽  
pp. 184-190 ◽  
Author(s):  
David Crepaz-Keay

Purpose The purpose of this paper is to look at peer support in the context of broader communities. Design/methodology/approach It builds on the author’s experience working with the Mental Health Foundation of developing delivering and evaluating several self-management and peer support initiatives in a variety of settings with a range of different peer groups. It will consider what constitutes a peer and a community, and explore the notion of community solutions for community problems. Findings Peer support in community settings has the capacity to address social isolation, build skills and self-esteem and give individuals a better quality of life – it can also add value to whole communities and reframe the way entire groups are considered within them. It has the ability to be both more accessible and less stigmatising and thus reach more people. This also offers community based peer support as a contributor to preventing the deterioration of mental health and potentially reducing the impact of mental ill-health. Social implications The author needs to think more in terms of whole community and get better at improving how the author measures and articulates this community benefit. This will allow us to make better decisions about how best to apply resources for long term whole community gain. Peer support and peer leadership needs to be at the heart of this process. Originality/value This paper places a familiar approach in a different setting placing peer support firmly outside services and within comunities.


2015 ◽  
Vol 19 (4) ◽  
pp. 202-211 ◽  
Author(s):  
Michael Clark ◽  
Charlie Murphy ◽  
Tony Jameson-Allen ◽  
Chris Wilkins

Purpose – Social exclusion and isolation of older people and their mental health are likely to be more significant, interlinked issues for society as countries experience an ageing demographic profile. The authors urgently need to identify effective ways of addressing these challenges that can be easily mobilised to meet diverse needs in different settings. The purpose of this paper is to explore the impact of sporting memories (SM) work as one approach to help meet this need. This SM work entails the use of sports-based reminiscence to engage with older people experiencing mental health problems. To date this has especially focused on people living with dementia in institutional and in community settings. Design/methodology/approach – The paper sets out the SM idea and discusses lessons learnt from case studies of its application to meet the inclusion and mental health needs of different older people in institutional and community settings. Findings – The evidence from the application of SM work to date is that it is an effective and flexible means of engaging people to improve their social inclusion and mental well-being. It can be readily deployed in various care and community settings. Research limitations/implications – The evidence to date is of case studies of the use of SM work, and, although these are now extensive case studies, further research is needed on the costs and impacts of SM work. Practical implications – SM work is a flexible and readily adoptable intervention to engage older people and help improve their social inclusion and mental well-being. Social implications – SM work can be an important part of meeting some of the challenges society faces with an ageing population profile. Originality/value – This is the first paper to set out the SM work.


2014 ◽  
Vol 9 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Susan Patterson ◽  
Pauline Ford

Purpose – The purpose of this paper is to inform education of non-mental health professionals who provide care to people with severe mental illness; to describe dentistry students’ knowledge and views about mental illness, including willingness to engage in various social situations with a person hospitalised for mental illness; and to assess and understand the impact of a targeted lecture on views and attitudes. Design/methodology/approach – The paper employed mixed methods to examine dental students’ knowledge and views about mental disorder before and after a seminar covering mental disorder, disadvantage and oral health. Findings from a bespoke questionnaire administered to third-year dental students were triangulated with qualitative data gathered in interviews with a subsample. Findings – Students understood mental disorder broadly, employing diverse causal models. Although knowledge was typically grounded in media stereotypes, attitudes were benevolent and most students reported willingness to provide dental care to affected individuals. The seminar, especially the consumer delivered section, was valued and associated with increased appreciation of the impact of mental disorder on oral health and need for assertive action to promote access to care. However, students reported being reluctant to disclose their own mental health problems for fear of being considered a professional or personal failure. A minority knew how to seek support if a friend talked of suicide. Research limitations/implications – This study highlights the need for further investigation of the knowledge and attitudes of dentistry students pertinent to provision of care to people with mental illness and to examine the links between attitudes and practice. The paper also provides a useful foundation for development of brief educational interventions, particularly the value in integrating the service user perspective, and their evaluation. Research should also examine the impact of mental health education on practice. Practical implications – A single inexpensive educational session, such as the one the paper developed may support reconsideration of often unconscious views of mental illness which might affect practice. Social implications – If people with mental illness are to receive equitable access to health care, non-mental health professionals should be supported to develop knowledge and attitudes which are conducive to inclusive treatment. An education session such as this could be helpful. Originality/value – There is scant literature examining attitudes of dentistry students and no reports of mental health-specific education with this population.


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