scholarly journals Suicide in mental health in-patients and within 3 months of discharge

2006 ◽  
Vol 188 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Janet Meehan ◽  
Navneet Kapur ◽  
Isabelle M. Hunt ◽  
Pauline Turnbull ◽  
Jo Robinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
Patient Admission ◽  
Post Discharge ◽  
The Social ◽  
Risk Patients ◽  
Clinical Survey ◽  
Service Priority

BackgroundSuicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.AimsTo describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.MethodA national clinical survey based on a 4-year (1996–2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).ResultsThere were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.ConclusionsSuicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients.

scholarly journals Neonatal outcomes in pregnant women infected with COVID-19 in Babol, North of Iran: retrospective study with short-term follow-up

2021 ◽  
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Short Term ◽  
Post Discharge ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

Abstract During the Coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks post-discharge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 who were admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6 − 40) and 3077.50 ± 697.64 gr (1720–3900) respectively. Apgar score of the first and fifth minutes in all neonates was ≥ 8 and ≥ 9 out of 10 respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP), in three infants, are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results almost similar to those described for non-pregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

scholarly journals Early Post-Discharge Suicide in Mental Health Patients: Findings From a National Clinical Survey

2020 ◽  
Vol 11 ◽  
Author(s):  
Lana Bojanić ◽  
Isabelle M. Hunt ◽  
Alison Baird ◽  
Navneet Kapur ◽  
Louis Appleby ◽  
...  
Keyword(s):  
Mental Health ◽  
Post Discharge ◽  
Mental Health Patients ◽  
Clinical Survey

scholarly journals Outcomes for Treatment of Hypersexual Behavior Provided by Specialized Social Welfare Units

2018 ◽  
Vol 29 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Cecilia Kjellgren
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Social Welfare ◽  
Quantitative Data ◽  
Self Report ◽  
Hypersexual Behavior ◽  
Group Design ◽  
The Social ◽  
Seeking Help

Purpose: This study explores outcomes of treatment provided by specialized units within the social welfare sector in Sweden to clients seeking help with hypersexual behavior. Method: The participants were 27 males and 1 female ( M = 40.3 years) who sought help from one of the three specialized units within social welfare in Sweden. A pretest–posttest group design was used to assess changes after treatment. Quantitative data were collected through interviews and self-report forms. Results: At posttreatment stage (on average a 10-month follow-up), mental health was significantly improved and hypersexual behavior reportedly reduced. The treatment at the specialized units appeared to help the clients. Conclusions: The specialized units seemed to deliver favorable service without shaming and stigmatizing participants. As this study can be considered a pilot study, it needs to be replicated.

Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH)

2015 ◽  
Vol 34 (1) ◽  
pp. 13-18
Author(s):  
B. Masood ◽  
S. O’Ceallaigh ◽  
T. Thekiso ◽  
M. Nichol ◽  
P. Kowalska-Beda ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Involuntary Admission ◽  
Clinical Predictors ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
Admission Status ◽  
Act Assessment

BackgroundFew studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained.AimsThis study aimed to describe all involuntary admissions to St Patrick’s University Hospital (SPUH) (2011–2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.MethodsAll uses of Mental Health Act 2001 within SPUH 2011–2013 were identified. All uses of Section 23(1) during 2011 were reviewed and relevant documents/case-notes examined using a pro forma covering clinical data, factors recognized to influence involuntary admissions and validated scales were used to determine diagnoses, insight, suicide and violence risk.ResultsOver 2011–2013, 2.5–3.8% of all admissions were involuntary with more detained after use of Section 23(1) than Section 14(2). The majority of initiations of Section 23(1) did not result in an involuntary admission (72%), occurred out of hours (52%) and many occurred early after admission (<1 week, 43%). Initiation of Section 23(1) by a consultant psychiatrist (p=0.001), suicide risk (p=0.03) and lack of patient insight into treatment (p=0.007) predicted conversion to involuntary admission.ConclusionThis study predicts a role for patient insight, suicide risk and consultant psychiatrist decision making in the initiation of Mental Health Act assessment of voluntary patients. Further data describing the involuntary admissions process in an Irish setting are needed.

Suicide in recently discharged psychiatric patients: a case-control study

2008 ◽  
Vol 39 (3) ◽  
pp. 443-449 ◽  
Author(s):  
I. M. Hunt ◽  
N. Kapur ◽  
R. Webb ◽  
J. Robinson ◽  
J. Burns ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Suicide Risk ◽  
Case Control Study ◽  
Clinical Symptoms ◽  
Risk Measures ◽  
Psychiatric Patients ◽  
Case Control ◽  
Control Study

BackgroundFew controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge.MethodWe conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls.ResultsForty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide.ConclusionsThe weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

scholarly journals Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Jeanette Finstad ◽  
Olav Røise ◽  
Leiv Arne Rosseland ◽  
Thomas Clausen ◽  
Ingrid Amalia Havnes
Keyword(s):  
Mental Health ◽  
Pain Management ◽  
Trauma Care ◽  
Information Needs ◽  
Trauma Centre ◽  
Trauma Survivors ◽  
Trauma Patients ◽  
Post Discharge ◽  
Physical Trauma

Abstract Background Physical trauma is associated with mortality, long-term pain and morbidity. Effective pain management is fundamental in trauma care and opioids are indispensable for treating acute pain; however, the use and misuse of prescribed opioids is an escalating problem. Despite this, few studies have been directed towards trauma patients in an early phase of rehabilitation with focusing on experiences and perspectives of health and recovery including pain and persistent use of prescribed opioids with abuse potential. To explore pre- and post-discharge trauma care experiences, including exposure to opioids, physical trauma survivors were recruited from a major trauma centre in Norway that provides the highest level of surgical trauma care. Method Qualitative exploratory study. Individual semi-structured interviews were conducted among 13 trauma patients with orthopedic injuries, known to be associated with severe pain, six weeks post-discharge. The interviews were recorded, transcribed verbatim, and thematically analyzed with an interdisciplinary approach. Results The overarching theme was that discharge from the trauma centre and the period that immediately followed were associated with feelings of insecurity. The three main themes that were identified as contributing to this was (a) unmet information needs about the injury, (b) exposure to opioids, and (c) lack of follow-up after discharge from the hospital. Participants experienced to be discharged with prescribed opioids, but without information about their addictive properties or tapering plans. This, and lack of attention to mental health and psychological impact of trauma, gave rise to unmet treatment needs of pain management and mental health problems during hospitalization and following discharge. Conclusion The findings from this study suggest that in addition to delivery of high-quality biomedical trauma care, health professionals should direct more attention to psychosocial health and safe pain management, including post-discharge opioid tapering and individually tailored follow-up plans for physical trauma survivors.

scholarly journals Discharge From the Trauma Hospital as A Transition Into Insecurity, - Experiences Among Physical Trauma Survivors

2020 ◽  
Author(s):  
Jeanette Finstad ◽  
Olav Røise ◽  
Leiv Arne Rosseland ◽  
Thomas Clausen ◽  
Ingrid Amalia Havnes
Keyword(s):  
Mental Health ◽  
Pain Management ◽  
Trauma Care ◽  
Trauma Survivors ◽  
Surgical Trauma ◽  
Trauma Patients ◽  
Treatment Needs ◽  
Post Discharge ◽  
Physical Trauma

Abstract Background: Physical trauma is associated with mortality, long-term pain and morbidity. Effective pain management is fundamental in trauma care and opioids are indispensable for treating acute pain; however, the use and misuse of prescribed opioids is an escalating problem. Despite this, few studies have been directed towards trauma patients in an early phase of rehabilitation with focusing on experiences and perspectives of health and recovery including pain and persistent use of prescribed opioids with abuse potential. To explore pre- and post-discharge trauma care experiences, including exposure to opioids, physical trauma survivors were recruited from a major trauma center in Norway that provides the highest level of surgical trauma care. Method: Qualitative exploratory study. Individual semi-structured interviews were conducted among 13 trauma patients with orthopedic injuries, known to be associated with severe pain, six weeks post-discharge. The interviews were recorded, transcribed verbatim, and thematically analyzed with an interdisciplinary approach. Results: The overarching theme was that discharge from the trauma hospital and the period that immediately followed were associated with feelings of insecurity. The three main themes that were identified as contributing to this was a) unmet information needs about the injury, b) exposure to opioids, and c) lack of follow-up after discharge from the hospital. Participants experienced to be discharged with prescribed opioids, but without information about their addictive properties or tapering plans. This, and lack of attention to mental health and psychological impact of trauma, gave rise to unmet treatment needs of pain management and mental health problems during hospitalization and following discharge. Conclusion: The findings from this study suggest that in addition to delivery of high-quality biomedical trauma care, health professionals should direct more attention to psychosocial health and safe pain management, including post-discharge opioid tapering and individually tailored follow-up plans for physical trauma survivors.

scholarly journals Association between suicide, external-cause and all-cause mortality and irregular mental health discharge among the US veteran population

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Natalie B. Riblet ◽  
Daniel J. Gottlieb ◽  
Bradley V. Watts ◽  
Maxwell Levis ◽  
Brian Shiner
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Post Discharge ◽  
Residential Settings ◽  
Increased Risk ◽  
The Us ◽  
All Cause Mortality ◽  
The Relationship

Background Irregular hospital discharge is highly prevalent among people admitted to hospital for mental health reasons. No study has examined the relationship between irregular discharge, post-discharge mortality and treatment setting (i.e. mortality after patients are discharged from acute in-patient or residential mental health settings). Aims To understand the relationship between irregular discharge and mortality among patients discharged from acute in-patient and residential settings. Method A retrospective study was conducted in members of the US veteran population discharged from acute in-patient or residential settings of the US Department of Veterans Affairs between 2003 and 2018. Multivariate Cox proportional hazards were used to evaluate associations between irregular discharge and suicide, external-cause (as defined by ICD-10 Codes: V01-Y98) and all-cause mortality in the first 30-, 90- and 180-days post-discharge. Results There were over 1.5 million mental health discharges between 2003 and 2018. Patients with an irregular discharge were at increased risk for suicide, external-cause and all-cause mortality in the first 180 days after discharge. In the first 30 days after discharge, patients with irregular discharge had more than three times greater suicide risk than patients with regular discharge (adjusted hazard ratio (HR) = 3.41, 95% CI 2.21–5.25). Suicide risk was higher among patients with irregular discharge in the first 30 days after acute in-patient discharge (adjusted HR = 1.55, 95% CI 1.11–2.16). In both settings, the mortality risk associated with irregular discharge attenuated but remained elevated within 90 and 180 days. Conclusions Irregular discharge after an acute in-patient or residential stay poses a large risk for mortality soon after discharge. Clinicians must identify effective interventions to mitigate harms associated with irregular discharge in these settings.

Knowledge and awareness of Covid 19 and its impact on mental health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 807-815
Author(s):  
Pratheebha C ◽  
Gayatri Devi R ◽  
Gifrina Jayaraj
Keyword(s):  
Mental Health ◽  
Sampling Bias ◽  
Google Docs ◽  
Social Distancing ◽  
The Public ◽  
Daily Routines ◽  
The Social ◽  
Mental Health Support ◽  
Study Population

The coronavirus disease 2019 (COVID-19) pandemic—and the social distancing measures that many countries have implemented—have caused disruptions to daily routines. Mental health support and follow-up should be provided even six months after the release from isolation for those individuals with prior vulnerable mental health status. The main aim of the study is to create awareness and knowledge about COVID – 19 and its impact on the mental health of the public. The self-administered design was designed based on awareness. The questionnaire was distributed through google docs link to 100 numbers of the study population who were in lockdown irrespective of age. Methods of representation of each output variable were represented in the pie chart form. The measure that was taken to minimize the sampling bias was that the validity that was checked both internally and externally. The result was statistically analyzed using SPSS software. The participants were explained about the purpose of the study in detail. From the above Survey conducted, 58% of the total 100 participants' mental health being affected due to lockdown imposed due to COVID -19. This COVID 19 has created stress, anxious and nervous situations for 47% of the total participants. Educated people and health professionals are aware of this infection; they take possible preventive measures. They understand the importance of social distancing. So this lockdown is not affecting their mental health.

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