scholarly journals Suicidal ideation in patients with mental illness and concurrent substance use: analyses of national census data in Norway

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Helle Wessel Andersson ◽  
Solfrid E. Lilleeng ◽  
Torleif Ruud ◽  
Solveig Osborg Ose
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Census Data ◽  
Current Treatment ◽  
Cross Sectional ◽  
Specialized Mental Health

Abstract Background Suicidal ideation may signal potential risk for future suicidal behaviors and death. We examined the prevalence of recent suicidal ideation in patients with mental illness and concurrent substance use and explored the clinical and sociodemographic factors associated with suicidal ideation in this patient subgroup, which represents a particular risk group for adverse psychiatric outcomes. Methods We used national cross-sectional census data in Norway collected from 25,525 patients in specialized mental health services. The analytic sample comprised 3,842 patients with concurrent substance use, defined as having a co-morbid substance use disorder or who reported recent regular alcohol use/occasional illicit drug use. Data included suicidal ideation measured in relation to the current treatment episode, sociodemographic characteristics and ICD-10 diagnoses. Bivariate and multivariate analyses were used to examine differential characteristics between patients with and without suicidal ideation. Results The prevalence of suicidal ideation was 25.8%. The suicidal ideation rates were particularly high for those with personality disorders, posttraumatic stress disorder, and depression, and for alcohol and sedatives compared with other substances. Patients with suicidal ideation were characterized by being younger, having single marital status, and having poorly perceived social relationships with family and friends. Conclusion Suicidal ideation in patients with mental illness and concurrent substance use was associated with a number of distinct characteristics. These results might help contribute to an increased focus on a subgroup of individuals at particular risk for suicidality and support suicide prevention efforts in specialized mental health services.

scholarly journals Prevalence and Correlates of Suicidal Ideation and Deliberate Self-harm in Canadian Adolescents During the Coronavirus Disease 2019 Pandemic

2021 ◽  
pp. 070674372110366
Author(s):  
Brianna J. Turner ◽  
Christina L. Robillard ◽  
Megan E. Ames ◽  
Stephanie G. Craig
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Online Survey ◽  
Warning Signs ◽  
Deliberate Self Harm ◽  
Health Concerns ◽  
Self Harm

Objective In light of recent evidence that the coronavirus disease 2019 (COVID-19) pandemic has resulted in marked increases in depression, anxiety, substance use, and other mental health concerns among Canadian adolescents, we investigated the rates of self-harm thoughts and behaviours in this population. Specifically, this study explored: (1) the demographic and geographic distributions of suicidal ideation (SI) and deliberate self-harm (DSH), and (2) the associations of mental health and substance use with SI and DSH. Method A total of 809 Canadian adolescents, aged 12–18 years, completed an online survey between June 17, 2020 and July 31, 2020. Results 44% of adolescents reported experiencing SI since the pandemic began, while 32% reported engaging in DSH. SI and DSH were more common among youth who: identified as transgender, non-binary or gender fluid; who did not reside with both parents; and who reported psychiatric concerns or frequent cannabis use. Conclusion Canadian adolescents appear to be experiencing higher rates of self-harm thoughts and behaviours relative to before the COVID-19 pandemic. It is important for adults who are likely to interact with distressed youth to be aware of potential warning signs that a youth is struggling with self-harm, and to refer youth to specialty mental health services where appropriate.

scholarly journals Investigating geographical variation in the use of mental health services by area of England: a cross-sectional ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lucy Maconick ◽  
Luke Sheridan Rains ◽  
Rebecca Jones ◽  
Brynmor Lloyd-Evans ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Geographical Variation ◽  
Ecological Study ◽  
Cross Sectional ◽  
Psychological Therapies ◽  
Access To Primary Care

Abstract Background There is evidence of geographical variation in the use of mental health services in the UK and in international settings. It is important to understand whether this variation reflects differences in the prevalence of mental disorders, or if there is evidence of variation related to other factors, such as population socioeconomic status and access to primary care services. Methods This is a cross-sectional ecological study using Public Health England data. The unit of analysis was the population served by clinical commissioning groups (CCGs), National Health Service (NHS) catchment areas. The analysis explored associations between area characteristics and the number of people in contact with mental health services using regression modelling. Explanatory variables included age, gender, prevalence of severe mental illness (SMI), prevalence of common mental disorder (CMD), index of multiple deprivation (IMD), unemployment, proportion of the population who are Black and Minority Ethnic (BAME), population density, access to and recovery in primary care psychological therapies. Unadjusted results are reported, as well as estimates adjusted for age, prevalence of CMD and prevalence of SMI. Results The populations of 194 CCGs were included, clustered within 62 trusts (NHS providers of mental health services). The number of people in contact with mental health services showed wide variation by area (range from 1131 to 5205 per 100,000 population). Unemployment (adjusted IRR 1.11; 95% CI 1.05 to 1.17; p < 0.001) and deprivation (adjusted IRR 1.02 95% CI 1.01 to 1.04; p < 0.001) were associated with more people being in contact with mental health services. Areas with a higher proportion of the population who are BAME (IRR 0.95 95% CI 0.92 to 0.99 p = 0.007) had lower service use per 100,000 population. There was no evidence for association with access to primary care psychological therapies. Conclusions There is substantial variation in the use of mental health services by area of England. Social factors including deprivation, unemployment and population ethnicity continued to be associated with the outcome after controlling for the prevalence of mental illness. This suggests that there are factors that influence the local population use of mental health services in addition to the prevalence of mental disorder.

scholarly journals Determinants of timely access to Specialized Mental Health Services and maintenance of a link with Primary Care: A cross-sectional study.

2021 ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Timely Access ◽  
Specialized Mental Health

Abstract Background: Although it is known that several factors may influence the access to specialized care, the factors related to the maintenance of a link with Primary Care by patients who accessed Specialized Mental Health Services (SMHS) remain unknown. The aim of this study was to evaluate the determinants of timely access to SMHS and maintenance of a link with Primary Care. Methods: This is a cross-sectional study, conducted with 341 users of SMHS at outpatient and community level in a medium-sized city in Brazil. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results: Among the factors associated with the study outcomes, those related to the organization of services and the movement between them were noteworthy. Patients referred by Primary Care were less likely to access specialized services in a timely manner (RR: 0.61; 95% CI: 0.40, 0.93). However, the referral of cases by Primary Care (RR: 1.38; 95% CI: 1.06, 1.79) and follow-up with visits by Community Health Agents (RR: 1.26; 95% CI: 1.04, 1.53) appeared to favor maintenance of the patient-Primary Care link. Conclusion: This study reinforces the idea that integration between Primary Care and SMHS should be strengthened, both to reduce waiting times for between-service referrals and benefit continuity of care.

scholarly journals Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Substance Misuse ◽  
Cross Sectional Study ◽  
Psychoactive Substance ◽  
Cross Sectional ◽  
Timely Access ◽  
Specialized Mental Health

Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients’ admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients’ link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity.

scholarly journals Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial

2017 ◽  
Vol 20 (11) ◽  
pp. 2023-2033 ◽  
Author(s):  
Patricia O’Campo ◽  
Stephen W Hwang ◽  
Agnes Gozdzik ◽  
Andrée Schuler ◽  
Vered Kaufman-Shriqui ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Food Security ◽  
Mental Health Services ◽  
Health Services ◽  
Usual Care ◽  
Homeless Adults ◽  
Adults With Mental Illness ◽  
At Home

AbstractObjectiveIndividuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population.DesignAt Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months).SettingCommunity settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver).SubjectsHomeless adults with mental illness (n2148).ResultsApproximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites.ConclusionsOur large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

scholarly journals Socio-demographic and clinical characteristics of adults under involuntary hospitalization in the acute mental health services of Cyprus

2019 ◽  
Author(s):  
Katerina G. Kaikoushi ◽  
Bella Evanthia ◽  
Middleton Nicos ◽  
Chatzitofis Andreas ◽  
Alevizopoulos George ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Treatment ◽  
Clinical Characteristics ◽  
Demographic Characteristics ◽  
Substance Use Prevention ◽  
Involuntary Hospitalization ◽  
Cross Sectional

Abstract Background: The clinical and demographic characteristics of the adults involuntary admitted for compulsory mental health treatment have not been reported adequately. Purpose: Investigation of the socio-demographic and clinical characteristics of the adults who are involuntary hospitalized in the acute Mental Health Services in Cyprus. Method: A descriptive correlation study with cross-sectional comparisons was applied. Data collection was performed from December 2016 to February 2018 via a structured questionnaire including demographic and clinical variables. Each questionnaire was accompanied by a consent form, which was assigned by the participants before their discharge. Results: The sample consisted of 406 people, of whom 262 were male and 144 were female. The vast majority were Greek-Cypriots. The largest age groups were 45-65 years (33%) and 25-34 years (31.8%), respectively. 172 of the participants reported current substance use and 117 of them fulfilled the criteria of dual diagnosis. The most frequent diagnosis was schizophrenia or a relevant psychotic disorder (86.4%). The main cause of relapse and subsequent admission was medication non-adherence along with lack of insight (57.1%). 52% of the sample had been previously involuntary hospitalized in a psychiatric hospital. Conclusions: A high percentage of involuntary hospitalizations was noted due to non-adherence to pharmacotherapy. Re-evaluation of the effectiveness of relevant community interventions is suggested, as well as implementation of structured educational programs on therapy adherence during hospitalization. The goal is the limitation of the frequency of relapse while being in the community. Also, education on substance use prevention is also suggested for clinical populations. Keywords: demographic characteristics, compulsory hospitalization, involuntary admission, mental illness, neurobiological disorders

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