scholarly journals Design and pilot evaluation of an evidence-based worksheet and clinician guide to facilitate nutrition counselling for patients with severe mental illness

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura LaChance ◽  
Monique Aucoin ◽  
Kieran Cooley
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Practice ◽  
Lived Experience ◽  
Premature Mortality ◽  
Mental Illnesses ◽  
Psychiatric Training ◽  
Schizophrenia Spectrum Disorders ◽  
Nutritional Counselling ◽  
Schizophrenia Spectrum

Abstract Background Schizophrenia spectrum disorders (SSD) are severe, persistent mental illnesses resulting in considerable disability and premature mortality. Emerging evidence suggests that diet may be a modifiable risk factor in mental illness; however, use of nutritional counselling as a component of psychiatric clinical practice is limited. The objective of this project is the design and evaluate a worksheet and clinician guide for use in facilitating nutritional counseling in the context of existing mental health care. Methods The worksheet and clinician guide were developed based on the results of a recent scoping review on the relationship between diet and mental health symptoms among individuals with SSD. A feedback process involved a focus group with psychiatrists and interviews with individuals with lived experience with psychosis. Participants were asked a series of structured and open-ended questions. Interviews were transcribed and data units were allocated to categories from an existing framework. The comments were used to guide modifications to the worksheet and clinician guide. A brief interview with all participants was completed to gather feedback on the final version. Results Five psychiatrist participants and six participants with lived experience completed interviews. Participants provided positive comments related to the worksheet design, complexity and inclusion of interactive components. A novel theme emerged relating to the lack of nutritional counselling in psychiatric training and clinical practice. Many constructive comments were provided which resulted in meaningful revisions and improvements to the worksheet and clinician guide design and content. All participants were satisfied with the final versions. Conclusions A worksheet and clinician guide designed to facilitate nutritional counselling with individuals with SSD was found to be acceptable to all participants following a process of feedback and revision. Further research and dissemination efforts aimed at increasing the use of nutritional counselling in psychiatric practice are warranted.

Effective e-health design for those with, and without, mental health disorders: shallow navigation, concentrated contents, modest number of links, one screen area for links. (Preprint)

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Success Rate ◽  
Fractional Factorial ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Design Elements ◽  
Website Usability ◽  
Schizophrenia Spectrum ◽  
Health Applications

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.

scholarly journals Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Jelle Lamsma ◽  
Rongqin Yu ◽  
Seena Fazel ◽  
Therese van Amelsvoort ◽  
Agna Bartels-Velthuis ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Interpersonal Violence ◽  
Brier Score ◽  
Schizophrenia Spectrum Disorders ◽  
Violent Behaviour ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

AbstractOxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.

Culturally Informed Therapy for Schizophrenia

2020 ◽  
Author(s):  
Amy Weisman de Mamani ◽  
Merranda McLaughlin ◽  
Olivia Altamirano ◽  
Daisy Lopez ◽  
Salman Shaheen Ahmad
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cultural Beliefs ◽  
The United States ◽  
Behavioral Approach ◽  
Case Vignette ◽  
Background Information ◽  
Schizophrenia Spectrum Disorders ◽  
Culturally Informed ◽  
Schizophrenia Spectrum

This book is primarily designed for clinicians and researchers interested in learning how to conduct an empirically supported culturally informed therapy for schizophrenia (CIT-S) that integrates core components of evidenced-based family therapy. It is estimated that approximately 1% of adults in the United States will be diagnosed with schizophrenia or a related schizophrenia spectrum disorder. Without treatment, prognosis is generally poor. Fortunately, traditional family therapies have shown increasing promise in reducing relapse rates and improving mental health for this population. As more and more societies become multicultural, however, there is an increasing expectation that mental health providers will also be prepared to meet the needs of unique and culturally diverse clients in an efficient, skillful, and culturally relevant manner. CIT-S is a 15-week, family-focused, cognitive behavioral approach for managing schizophrenia spectrum disorders. The intervention draws upon clients’ cultural beliefs, practices, and traditions to help them conceptualize and manage mental illness. It aims to improve the quality of clients’ lives in a manner that is in line with their values and takes into account their cultural norms when discussing important issues and addressing challenges (such as mental illness) within the family. CIT-S contains five distinct modules: (a) family collectivism, (b) psychoeducation, (c) spirituality, (d) communication training, and (e) problem-solving. For each module, a detailed rationale, background information, therapy instructions, suggested homework assignments, and a sample case vignette are provided in an accessible, easy-to-use manner.

scholarly journals For the Insane in the Insane World

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Celia Ringstrom
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Lived Experience ◽  
Lived Experiences ◽  
Mental Illnesses ◽  
Public Sentiment ◽  
Medical Classification ◽  
Socially Relevant

Because of the COVID-19 pandemic, we are all now living in a world of mass panic, confusion, and isolation that inflicts experiences of mental illness on those not typically considered mentally ill. When, where, and how does identifying “mental illness” come to trap certain people under the stigmatizing identity, while others are able to avoid the problematic medical classification but not the lived experience? As a writer mitigating a long-term struggle between my lived experiences with depression and anxiety, and the outside categorization and medical classification of these “mental illnesses”, I realize the current public sentiment has never been more welcoming of my personal musings on these tensions. I have centered an autoethnographic approach that reflects on mental health experiences and critiques of biomedical ontologies through a reading of My Brilliant Friend (and the associated quadrilogy). By attending to socially relevant story arcs involving mental health, I use the symbol of book character Lila’s “blurred boundaries” to both identify and rethink mental health categorizations and lived experiences that previously differentiated subsets of people prior to COVID-19. My reflection ultimately seeks to address the ways that these once dissimilar groups have converged psychologically through disruptions of time during the current health pandemic.

Prescriptive Power: Biologism, Biopsychiatry and Drug-centred Psychopharmacology

Somatechnics ◽  
2019 ◽  
Vol 9 (2-3) ◽  
pp. 291-309
Author(s):  
Francis Russell
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Justice ◽  
Cultural Theory ◽  
Human Experience ◽  
Mental Illnesses ◽  
False Consciousness ◽  
The Subject ◽  
Biological Ontology ◽  
Health Discourse

This paper looks to make a contribution to the critical project of psychiatrist Joanna Moncrieff, by elucidating her account of ‘drug-centred’ psychiatry, and its relation to critical and cultural theory. Moncrieff's ‘drug-centred’ approach to psychiatry challenges the dominant view of mental illness, and psychopharmacology, as necessitating a strictly biological ontology. Against the mainstream view that mental illnesses have biological causes, and that medications like ‘anti-depressants’ target specific biological abnormalities, Moncrieff looks to connect pharmacotherapy for mental illness to human experience, and to issues of social justice and emancipation. However, Moncrieff's project is complicated by her framing of psychopharmacological politics in classical Marxist notions of ideology and false consciousness. Accordingly, she articulates a political project that would open up psychiatry to the subjugated knowledge of mental health sufferers, whilst also characterising those sufferers as beholden to ideology, and as being effectively without knowledge. Accordingly, in order to contribute to Moncrieff's project, and to help introduce her work to a broader humanities readership, this paper elucidates her account of ‘drug-centred psychiatry’, whilst also connecting her critique of biopsychiatry to notions of biologism, biopolitics, and bio-citizenship. This is done in order to re-describe the subject of mental health discourse, so as to better reveal their capacities and agency. As a result, this paper contends that, once reframed, Moncrieff's work helps us to see value in attending to human experience when considering pharmacotherapy for mental illness.

Sleep and cognition in schizophrenia spectrum disorders: A systematic review protocol.

2020 ◽  
Author(s):  
Sean Carruthers ◽  
Gemma Brunetti ◽  
Susan Rossell
Keyword(s):  
Systematic Review ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Systematic Review Protocol ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Review Protocol ◽  
Spectrum Disorders ◽  
Sleep And Cognition ◽  
The Relationship

Schizophrenia spectrum disorders are chronic and debilitating mental illnesses characterised by both cognitive impairments and sleep deficits. In this systematic review protocol, we outline an approach to examine the available literature investigating the relationship between sleep and cognition in individuals with schizophrenia spectrum disorder.

Development of a suspicion index for secondary schizophrenia using the Delphi method

2021 ◽  
pp. 000486742110257
Author(s):  
Olivier Bonnot ◽  
Jose Luis Insua ◽  
Mark Walterfang ◽  
Juan Vincente Torres ◽  
Stefan Armin Kolb
Keyword(s):  
Clinical Practice ◽  
Sensitivity And Specificity ◽  
Delphi Method ◽  
Schizophrenia Spectrum Disorders ◽  
Differential Distribution ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Aids Diagnosis ◽  
Suspicion Index

Aim: The aim of this study was to develop a suspicion index that aids diagnosis of secondary schizophrenia spectrum disorders in regular clinical practice. Method: We used the Delphi method to rate and refine questionnaire items in consecutive rounds. Differences in mean expert responses for schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders populations allowed to define low/middle/high predictive items, which received different weights. Algorithm performance was tested in 198 disease profiles by means of sensitivity and specificity. Results: Twelve experts completed the Delphi process, and consensus was reached in 19/24 (79.2%) items for schizophrenia spectrum disorders and 17/24 (70.8%) for secondary schizophrenia spectrum disorders. We assigned rounded values to each item category according to their predictive potential. A differential distribution of scores was observed between schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders when applying the suspicion index for validation to 198 disease profiles. Sensitivity and specificity analyses allowed to set a >8/10/16 risk prediction score as a threshold to consider medium/high/very high suspicion of secondary schizophrenia spectrum disorders. Conclusion: Our final outcome was the Secondary Schizophrenia Suspicion Index, the first paper-based and reliable algorithm to discriminate secondary schizophrenia spectrum disorders from schizophrenia spectrum disorders with the potential to help improve the detection of secondary schizophrenia spectrum disorder cases in clinical practice.

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

scholarly journals Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

2020 ◽  
Vol 7 ◽  
pp. 238212051988935 ◽  
Author(s):  
Andrés Martin ◽  
Julie Chilton ◽  
Doron Gothelf ◽  
Doron Amsalem
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Medical Students ◽  
Help Seeking ◽  
Randomized Study ◽  
Role Modeling ◽  
Mental Illnesses ◽  
Control Group ◽  
Health Seeking ◽  
Health Seeking Behaviors

Introduction: Depression and suicidal ideation are common among medical students, a group at higher risk for suicide completion than their age-normed peers. Medical students have health-seeking behaviors that are not commensurate with their mental health needs, a discrepancy likely related to stigma and to limited role-modeling provided by physicians. Methods: We surveyed second-year medical students using the Attitudes to Psychiatry (ATP-30) and Attitudes to Mental Illness (AMI) instruments. In addition, we asked questions about role-modeling and help-seeking attitudes at baseline. We then conducted a randomized trial of an intervention consisting of 2 components: (a) a panel of 2 physicians with personal histories of mental illness speaking about their diagnosis, treatment, and recovery to the students, immediately followed by (b) small-group facilitated discussions. We repeated the ATP-30 and AMI after the active/early group was exposed to the panel, but before the control/late group was similarly exposed. Results: Forty-three medical students participated (53% women). The majority of students (91%) agreed that knowing physicians further along in their careers who struggled with mental health issues, got treatment, and were now doing well would make them more likely to access care if they needed it. Students in the active group (n = 22) had more favorable attitudes on ATP-30 ( P = .01) and AMI ( P = .02) scores, as compared with the control group (n = 21). Conclusion: Medical students can benefit from the availability of, and exposure to physicians with self-disclosed histories of having overcome mental illnesses. Such exposures can favorably improve stigmatized views about psychiatry, or of patients or colleagues affected by psychopathology. This intervention has the potential to enhance medical students’ mental health and their health-seeking behaviors.

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