Risk Factors for Assault and Physical Aggression Among Medically Hospitalized Adult Patients Who Had a Behavioral Emergency Call: A Descriptive Study

2021 ◽  
pp. 107839032098344
Author(s):  
Della J. Derscheid ◽  
Judith E. Arnetz ◽  
Christine Lohse
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Emergency Response ◽  
Physical Aggression ◽  
Descriptive Study ◽  
Health Conditions ◽  
Care Providers ◽  
Mental Health Conditions ◽  
Behavioral Emergencies

BACKGROUND: Health care settings are a primary location for workplace violence that involves clients, but risk factors for behavioral emergencies in medical settings are largely unknown. AIM: This study proposed to identify risk factors for assault and physical aggression among medically hospitalized patients who needed a behavior emergency response team. METHOD: This descriptive study, conducted at a large Midwestern academic medical center, used univariable and multivariable logistic regression to assess relationships between demographic, medical, mental health, and contextual variables with assault and physical aggression. Predictive ability was summarized using area under the receiver operating characteristic curve. RESULTS: Among patients who received a behavior emergency response ( N = 820), 86 (10%) were assaultive. Physical aggression was the most significant predictor of assault. Physical aggression was predicted by older age, male gender, and verbal threats to others. Conversely, internalizing mental health conditions of anxiety, depression, and suicidal ideation were significant for decreased risk of assault and/or physical aggression. Contextual factors, identified as wanting to smoke or leave the hospital, were significantly associated with decreased risk of both assault and physical aggression. CONCLUSION: Health care providers are encouraged to (1) consider the demonstration of physical aggression as a sign to urgently implement precautionary measures for safety, (2) avoid predicting violent situations based on particular medical or mental health conditions alone, and (3) understand that not all disruptive behavior leads to violent situations.

On the same page or in a different book? A pilot project on the perceptions of educational needs in an era of shifting mental health care to primary care (Preprint)

2021 ◽  
Author(s):  
Stephanie Sutherland ◽  
Dahn Jeong ◽  
Michael Cheng ◽  
Mireille St-Jean ◽  
Alireza Jalali
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Medical Management ◽  
Family Physicians ◽  
Educational Needs ◽  
Health Conditions ◽  
Care Providers ◽  
Mental Health Conditions

BACKGROUND There is an unmet need for mental health care in Canada. Seventy-five percent of visits for mental health services are related to mood and anxiety disorder, which occur most frequently in the primary care setting. Primary care providers such as general practitioners and family physicians are essential part of mental health care services. However, it is currently not well known what is needed to increase care providers’ willingness, comfort and skills to adequately provide care. OBJECTIVE The aim of this study was to understand the caregiver and family physician needs regarding the care and medical management of individuals with mental health conditions. METHODS A needs assessment was designed to understand the educational needs of caregivers and family physicians with regard to the provision of mental health care, specifically, to seek advice of the format and delivery mode for an educational curriculum to be accessed by both stakeholder groups. Exploratory qualitative interviews were conducted and data was collected and analysed iteratively until thematic saturation was achieved. RESULTS Caregivers of individuals with mental health conditions (n=24) and family physicians (n=10) were interviewed. Both caregivers and family physicians expressed dissatisfaction with the status quo regarding the provision of mental health care at the family physician’s office. They stated that there was a need for more educational materials as well as additional supports. Caregivers expressed a general lack of confidence in family physicians to manage their son/daughter’s mental health condition, while family physicians sought more networking opportunities to improve and facilitate provision of mental health care. CONCLUSIONS Robust qualitative studies are necessary to identify the educational and medical management needs of caregivers and family physicians. Understanding each other’s perspectives is an essential first step to collaboratively designing, implementing, and the subsequent evaluation of community-based mental health care. Fortunately, there are initiatives underway already to address these need areas (e.g. websites such as eMentalHealth.ca/PrimaryCare as well as mentorship and collaborative care network) and information from this study can help inform the gaps in those existing initiatives. CLINICALTRIAL NA

scholarly journals Disruptions in the management and care of university students with preexisting mental health conditions during the COVID-19 pandemic

2021 ◽  
Vol 11 (3) ◽  
pp. 802-807
Author(s):  
Kaleigh Ligus ◽  
Emily Fritzson ◽  
Emily A Hennessy ◽  
Rebecca L Acabchuk ◽  
Keith Bellizzi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Self Efficacy ◽  
Well Being ◽  
Health Conditions ◽  
Care Providers ◽  
Psychological Well Being ◽  
Mediation Analyses ◽  
Mental Health Conditions ◽  
Linear Regressions

Abstract Students with preexisting mental health conditions or disabilities may fair worse due to virus mitigation strategies during the COVID-19 pandemic. This study was conducted to understand the experiences of students with preexisting mental health conditions or disabilities at a public university during COVID-19. We examined disruptions in the management of preexisting mental health conditions or disabilities and its impact on psychological well-being. Students were surveyed about their health care experiences during the COVID-19 pandemic between June and September 2020. Linear regressions and mediation analyses were conducted to examine the relationships between disruption to care, mental health self-efficacy, and four psychological well-being outcomes (stress, anxiety, depression, and overall distress). Of the total (N = 1,082) study participants, 258 (24%) reported having a preexisting mental health condition(s) or disabilities (81% female; Mage = 23.47). Of those, 155 (61%) reported that COVID-19 disrupted health care delivery and management of their conditions or disabilities. Of those who reported this disruption, 51% (n = 109) of participants reported a disruption in their ability to see a health care professional and 58% (n = 69) reported either that they lost care or that the quality of the new telemedicine care was not sufficient. A series of linear regressions revealed significant relationships between disruption to care and the four psychological outcomes. Mediation analyses revealed that depression, stress, anxiety, and overall distress were mediated by self-efficacy in managing mental health. University administrators and health care providers should evaluate the scope of mental health care and telemedicine services for students to help long-term psychological effects of COVID-19.

scholarly journals Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

2020 ◽  
Author(s):  
Steven Gillard ◽  
Ceri Dare ◽  
Jackie Hardy ◽  
Patrick Nyikavaranda ◽  
Rachel Rowan Olive ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Connectedness ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Qualitative Interview Study ◽  
The Impact

AbstractPurposeResearch is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time.MethodsWe used qualitative interviews (N=49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team.ResultsExisting mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health.ConclusionThere is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

scholarly journals Challenges to peer support in low- and middle-income countries during COVID-19

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Global Mental Health ◽  
Health Conditions ◽  
Middle Income ◽  
Low Resource Settings ◽  
Mental Health Conditions ◽  
Middle Income Countries

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

Impact of a Usual Source of Care on Health Care Use, Spending, and Quality Among Adults With Mental Health Conditions

2017 ◽  
Vol 45 (3) ◽  
pp. 462-471 ◽  
Author(s):  
Catherine A. Fullerton ◽  
Whitney P. Witt ◽  
Clifton M. Chow ◽  
Manjusha Gokhale ◽  
Christine E. Walsh ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Use ◽  
Health Conditions ◽  
Usual Source Of Care ◽  
Mental Health Conditions ◽  
Usual Source ◽  
Source Of Care

scholarly journals Outcomes of mental health pharmacist-managed electronic consults at a Veterans Affairs health care system

2017 ◽  
Vol 7 (3) ◽  
pp. 131-136 ◽  
Author(s):  
Christina Herbert ◽  
Holly Winkler ◽  
Troy A. Moore
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Health Conditions ◽  
Veterans Health ◽  
Improvement Project ◽  
Mental Health Conditions ◽  
The Impact ◽  
Care System

Abstract Introduction: The demand for mental health services has increased as more veterans have been diagnosed with—and sought care for—one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. Methods: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. Results: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. Discussion: This service improves mental health care—and patient access—by promoting successful management and maintenance of less complicated patients in primary care.

scholarly journals Nigerian cultural beliefs about mental health conditions and traditional healing: a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dung Ezekiel Jidong ◽  
Di Bailey ◽  
Tholene Sodi ◽  
Linda Gibson ◽  
Natéwindé Sawadogo ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Cultural Beliefs ◽  
Traditional Healing ◽  
Health Conditions ◽  
Future Research ◽  
Mental Health Systems ◽  
Content Type ◽  
Mental Health Conditions

Purpose This study aims to explore how cultural beliefs and traditions are integral to understanding indigenous mental health conditions (MHCs) and traditional healing (TH). However, Nigerian cultural beliefs about MHCs and TH are under-researched. Design/methodology/approach This study adopted a qualitative design using critical realist and social constructionist perspectives to explore Nigerian mental health-care practitioners (MHCPs) and lay participants’ (LPs) views regarding MHCs and TH. Purposive and snowball sampling techniques were used to select 53 participants (MHCPs = 26; LPs = 27; male = 32; female = 21) in four Nigerian cities (Ado-Ekiti, Enugu, Jos and Zaria). Data were collected using semi-structured interviews and analysed through thematic analyses. Findings The data sets revealed three overarching themes, namely, existing cultural beliefs about MHCs as spiritual curse; description of TH as the first treatment modality for MHCs; and perceived stigma associated with MHCs and help-seeking behaviours. Originality/value A study on Nigerian cultural beliefs and TH contributes meaningfully to mental health systems. Future research and policy initiatives could explore ways of optimising TH practices and community awareness programmes to increase access to mental health care in Nigeria.

scholarly journals Worry from contracting COVID-19 infection and its stigma among Egyptian health care providers

2022 ◽  
Vol 97 (1) ◽  
Author(s):  
Doaa Mohamed Osman ◽  
Fatma R. Khalaf ◽  
Gellan K. Ahmed ◽  
Ahmed Y. Abdelbadee ◽  
Ahmed M. Abbas ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
High Risk ◽  
Health Care Providers ◽  
High Impact ◽  
Severe Illness ◽  
Care Providers ◽  
Internalized Shame ◽  
High Discrimination

Abstract Backgrounds Healthcare providers (HCPs) in COVID-19 epidemic face stressful workload of disease management, shortage of protective equipment and high risk of infection and mortality. These stressors affect greatly their mental health. The aim is to identify working conditions among Egyptian HCPs during COVID-19 epidemic as well as stigma and worry perceptions from contracting COVID-19 infection and their predictors. Methods A cross-sectional study was conducted among 565 HCPs. Data was collected through Google online self-administered questionnaire comprised seven parts: demographics characteristics, knowledge and attitude of COVID-19, working condition, worry of contracting COVID-19 at work, discrimination intention at work for COVID-19 patients, stigma assessment using impact stigma, and internalized shame scales. Results The vast majority of HCPs (94.7%) were worried from contracting COVID-19 at work. Risk factors for perceiving severe worry from contracting COVID-19 were expecting infection as a severe illness, believing that infection will not be successfully controlled, improbability to continue working during the pandemic even if in a well/fit health, high discrimination intention and impact stigma scales. Significantly high impact stigma scores were detected among those aged < 30 years, females, workers primarily in sites susceptible for contracting COVID-19 infection, those had severe worry from contracting infection at work, and high internalized shame scale. The risk factors for perceiving higher internalized shame scores were not having a previous experience in working during a pandemic, high discrimination intention towards COVID-19 patients and high impact stigma scale. Conclusions Considerable levels of worry and stigma were detected among Egyptian HCPs during COVID-19 outbreak. The psychological aspect of health care providers should not be overlooked during epidemic; appropriate institutional mental health support should be provided especially for young HCPs, those without previous work experience in epidemic and those who work in high-risk units. Raising the community awareness about contribution of HCPs in fighting the epidemic might decrease stigmatization action toward HCPs.

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review (Preprint)

2021 ◽  
Author(s):  
Tristan J Philippe ◽  
Naureen Sikder ◽  
Anna Jackson ◽  
Maya E Koblanski ◽  
Eric Liow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mobile Communications ◽  
Digital Health ◽  
Health Interventions ◽  
Stress Disorders ◽  
Health Conditions ◽  
Rapid Review ◽  
Mental Health Conditions

BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, video conferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a rapid review of the literature to assess the state of digital health interventions for the treatment of several mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010-2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Sixty percent (60%) of research involved the treatment of substance use disorders, 25% focused on mood, anxiety and traumatic stress disorders and 5% or less on other mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective, but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and online forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients, who are marginalized, and may lack access to digital health interventions.

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