scholarly journals Implementation of smoke-free policies in mental health in-patient settings in England

2009 ◽  
Vol 194 (6) ◽  
pp. 547-551 ◽  
Author(s):  
Elena Ratschen ◽  
John Britton ◽  
Ann McNeill
Keyword(s):  
Mental Health ◽  
Policy Enforcement ◽  
Convenience Sample ◽  
Telephone Interviews ◽  
Smoke Free Policy ◽  
Safety Risks ◽  
Mental Health Settings ◽  
High Smoking Prevalence ◽  
Systematic Sample ◽  
The Impact

BackgroundMental health units in England had to become smoke-free by law from July 2008. Concerns regarding the implementation and enforcement of smoke-free policies in these settings have been raised.AimsTo study difficulties and challenges associated with smoke-free policy implementation in English National Health Service (NHS) mental health settings.MethodQuestionnaire survey of all 72 English NHS trusts providing mental health in-patient services and facilities, supplemented by semi-structured telephone interviews at a systematic sample of 7 trusts and site visits at a convenience sample of 5 trusts.ResultsQuestionnaires were returned by 79% of the trusts, all of whom had implemented smoke-free policies. Most respondents (91%) believed that mental health settings faced particular challenges, arising from the high smoking prevalence among patients (81%), related safety risks (70%), adverse effects on the clinician–patient relationship (36%), and potential interactions with antipsychotic medication (34%). Interviews indicated that sustained policy enforcement was perceived as difficult, but that despite challenges and concerns, the impact of the policy was regarded as beneficial, with some evidence of positive behavioural changes occurring in people.ConclusionsMany mental health trusts across England have implemented comprehensive smoke-free policies but the majority state that they are facing specific difficulties. Challenges and concerns need to be explored in depth and addressed to ensure that smoke-free policies implemented under the terms of the Health Act in July 2008 are not undermined.

scholarly journals Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries

2021 ◽  
Vol 33 (2) ◽  
pp. 130-136
Author(s):  
William Cabin
Keyword(s):  
Mental Health ◽  
New York ◽  
Home Care ◽  
Population Based ◽  
Home Health ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Medicare Population ◽  
Home Health Agencies ◽  
The Impact

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.

What is the impact of staff wearing uniforms in psychiatric inpatient settings?

2021 ◽  
Author(s):  
Sophie Collingwood ◽  
Laura McKenzie-Smith
Keyword(s):  
Mental Health ◽  
Thematic Analysis ◽  
Negative Impact ◽  
Psychiatric Inpatient ◽  
Ideal Self ◽  
Search Terms ◽  
Mental Health Settings ◽  
Inpatient Settings ◽  
The Impact

Background: Uniform has traditionally been worn in psychiatric inpatient and other mental health settings, but there has been a move to non-uniform in recent years. Some services have made the change back to uniform, raising questionsabout the potential impact on patients and staff.Aim: To review the impact of uniform within a psychiatric inpatient or mental health setting.Method: Databases were searched for articles exploring the impact of uniform use using specified search terms. Articles were assessed for suitability with inclusion and exclusion criteria, critically appraised, then analysed for themes using thematic analysis.Results: 17 papers were included in the review. Thematic analysis identified five main themes and 29 subthemes. Main themes were Attitudes and interactions, A freer environment, Are you both nurses?, The ‘ideal self’ and There are more important things. A critical appraisal of the articles suggested issues with validityand reliability, which are discussed.Discussion: Studies identified that wearing non-uniform facilitated positive changes in both patients and staff. This raises the potential negative impact of uniform on both patients and staff, and the role of power imbalance in these settings is discussed. Further themes around identification of staff out of uniform were considered.Implications for practice: The use of uniform in mental health and psychiatric inpatient settings should be considered carefully, due to the potential negative impact, whilst also recognising the importance of staff identification and supporting professional identity.

Inequalities in women’s medium or low secure mental health settings: a scoping review

2021 ◽  
Vol 23 (3) ◽  
pp. 254-271
Author(s):  
Aile Trumm ◽  
Kristina Brenisin ◽  
Kieran Breen
Keyword(s):  
Mental Health ◽  
Sexual Orientation ◽  
Gender Identity ◽  
High Quality Research ◽  
Dysfunctional Family ◽  
Health Service Provision ◽  
Content Type ◽  
Mental Health Settings ◽  
Health Need ◽  
The Impact

Purpose The more disadvantaged members of society generally experience poorer outcomes following the development of mental ill-health. The purpose of this paper is to scope the literature and synthesise findings on the inequalities and mental health within secure mental health settings. Design/methodology/approach Six electronic databases were searched to identify relevant studies. These were included if they examined the association between inequalities and mental health in women’s secure mental health settings. Findings Of the 608 studies reviewed, 14 met the inclusion criteria. In these papers, violence and/or abuse were described as the most prevalent inequalities. The second most frequent group of inequalities identified were socio-economic. Only three published studies researched the impact of ethnicities. Physical health, alcohol abuse and a dysfunctional family upbringing were only mentioned in one of the studies. Gender identity, transitioning and sexual orientation was not considered in any papers. These are areas, which require further investigation to determine their specific impact in this setting. Research limitations/implications This review highlights the dearth of high-quality research-based evidence underpinning an understanding of the impact of inequalities on women in secure mental health settings. The existing studies suggest that inequalities have a very particular impact and that intersectionality plays a key role. Further research is required to further understand how inequalities impact the lives of women in secure mental health settings. Practical implications The inequalities that women experience in relation to mental health need to be further researched in the context of intersectionality. There are also research gaps in terms of gender identity, sexual orientation and socio-economic background. Further primary research using a more complex methodological paradigm is required to explore these factors and their impact on mental health service provision. Social implications The role of inequalities should be considered as part of an overall care package, including the experiences of adverse childhood experiences and this should contribute towards the development of a trauma-based care approach. Originality/value To the best of the authors’ knowledge, this is the first study to scope literature about inequalities experienced in women’s secure psychiatric settings considering intersectionality.

The impact of working conditions on the health of taxi drivers in an urban metropolis

2020 ◽  
Vol 13 (6) ◽  
pp. 671-686
Author(s):  
Husayn Marani ◽  
Brenda Roche ◽  
Laura Anderson ◽  
Minnie Rai ◽  
Payal Agarwal ◽  
...  
Keyword(s):  
Mental Health ◽  
Working Conditions ◽  
Health Management ◽  
Primary Care Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Content Type ◽  
Taxi Drivers ◽  
Targeted Interventions ◽  
The Impact

PurposeThis descriptive qualitative study explores how working conditions impact the health of taxi drivers in Toronto, Canada.Design/methodology/approachDrivers were recruited between September 2016 and March 2017. A total of 14 semi-structured qualitative interviews and one focus group (n = 11) were conducted. Transcripts were analyzed inductively through a socioecological lens.FindingsThe findings of this study are as follows: drivers acknowledged that job precariousness (represented by unstable employment, long hours and low wages) and challenging workplace conditions (sitting all day and limited breaks) contribute to poor physical/mental health. Also, these conditions undermine opportunities to engage in health-protective behaviors (healthy eating, regularly exercising and taking breaks). Drivers do not receive health-enabling reinforcements from religious/cultural networks, colleagues or their taxi brokerage. Drivers do seek support from their primary care providers and family for their physical health but remain discreet about their mental health.Research limitations/implicationsAs this study relied on a convenience sample, the sample did not represent all Toronto taxi drivers. All interviews were completed in English and all drivers were male, thus limiting commentary on other experiences and any gender differences in health management approaches among drivers.Practical implicationsGiven the global ubiquity of taxi driving and an evolving workplace environment characterized by growing competition, findings are generalizable across settings and may resonate with other precarious professions, including long-haul truck operators and Uber/Lyft drivers. Findings also expose areas for targeted intervention outside the workplace setting.Originality/valueHealth management among taxi drivers is understudied. A fulsome, socioecological understanding of how working conditions (both within and outside the workplace) impact their health is essential in developing targeted interventions to improve health outcomes.

Displacement during Hurricane Sandy: The impact on mental health

2018 ◽  
Vol 16 (1) ◽  
pp. 17 ◽  
Author(s):  
Rebecca M. Schwartz, PhD ◽  
Rehana Rasul, MA ◽  
Samantha M. Kerath, MS ◽  
Alexis R. Watson, BS ◽  
Wil Lieberman-Cribbin, MPH ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Perceived Stress ◽  
Hurricane Sandy ◽  
Mental Health Outcomes ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Convenience Sample ◽  
Illicit Substance ◽  
The Impact

Objective: To assess the effect of displacement due to Hurricane Sandy on mental health outcomes among residents of the greater New York City (NYC) area.Design: Prospective, cross sectional.Setting: NYC area residents, including Queens, Staten Island, and Long Island.Participants: In a 4.25 year period (June 2012 to September 2016), a convenience sample of 1,615 adult residents from the greater NYC area completed validated measures of hurricane exposure (including displacement), perceived stress, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms as well as indicators of alcohol, illicit substance, and tobacco use.Main Outcome Measures: Perceived stress, depression, anxiety and PTSD symptoms and alcohol, illicit substance, and tobacco use.Results: Multivariable analyses indicated that displaced participants were more likely to have PTSD (adjusted Odds Ratio (AOR): 2.21, 95%CI: 1.73-2.82), depression (AOR: 1.37, 95%CI: 1.05-1.79) and anxiety symptoms (AOR: 1.30, 95%CI: 1.01-1.67) and had a 1.16 unit increase in perceived stress score (SE = 0.38) compared to nondisplaced participants. Staying with friends/family vs. at a shelter was significantly associated with a 48 percent decreased odds of having PTSD symptoms (AOR: 0.52, 95%CI: 0.31-0.88) and of being a current tobacco user (AOR: 0.52, 95%CI: 0.30-0.92).Conclusions: Displacement is associated with negative mental health outcomes, particularly displacement to shelters. Disaster preparedness efforts should involve increasing mental health resources to those who are displaced and providing support services within the shelter setting.

scholarly journals Investigating the impact of COVID-19 on performance and image enhancing drug use

2021 ◽  
Author(s):  
Matthew Dunn ◽  
Timothy Piatkowski
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Online Survey ◽  
High Dose ◽  
Convenience Sample ◽  
Health Concerns ◽  
Exercise Habits ◽  
Mental Health Concerns ◽  
Image Enhancing ◽  
The Impact

Abstract Background Emerging research has suggested that the COVID-19 pandemic has had some impact on substance use patterns. The aim of the study was to conduct a rapid survey to assess the impact of COVID-19 on performance and image enhancing drug (PIED) use and training, and any subsequent negative physical or mental health outcomes. Methods During 2020, a convenience sample of 60 PIED consumers (mean age = 26.69; 68.3% located outside Australia) completed a quantitative anonymous online survey exploring how the coronavirus pandemic impacted patterns of PIED use and associated exercise habits. The survey was administered via the Qualtrics platform and distributed online through PIED forums as well as through the investigator's networks. Participants were asked about their PIED use and exercise habits prior to and during restricted movement ‘lockdowns’. Results Pre-COVID, the majority of the sample opted to ‘blast-cruise’ (an initial high dose, followed by a lower maintenance dose; 71.7%, n = 43). During lockdown, (45%, n = 27) reported a change in PIED use as a result of the restrictions. In light of health concerns during COVID-19, a majority of men (60%, n = 36) did not take any extra precautions relating to their PIED use. A subgroup of men ceased using PIEDs completely (16.7%, n = 10) with the majority (80%, n = 8) of that subgroup following post-cycle therapy (PCT) of some kind. Conclusions This study contributes to the emerging literature of the impact of the COVID-19 pandemic on substance use, specifically PIED use among men. The results suggest that the pandemic did influence the choice of PIEDs that participants consumed, although there was little disruption to patterns of exercise, an important aspect of PIED use. Of the men who did cease use completely, the majority reported little issue with PCT access; those who reported difficulty accessing PCT compounds indicated experience some mental health concerns related to ceasing their PIED use. Clinicians and those who come into contact with this group should be alert for any negative physical or mental health concerns resulting from disrupted or ceased PIED use.

scholarly journals Current Practices of Suicide Risk Management Protocols in Research

Crisis ◽  
2010 ◽  
Vol 31 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Steven Vannoy ◽  
Ursula Whiteside ◽  
Jürgen Unützer
Keyword(s):  
Mental Health ◽  
United States ◽  
Risk Management ◽  
Suicide Risk ◽  
Qualitative Methodology ◽  
Descriptive Analysis ◽  
The United States ◽  
Convenience Sample ◽  
Wide Range ◽  
The Impact

Background: Participant safety is an important concern in mental-health-oriented research. Investigators conducting studies in the United States that include potentially suicidal individuals are often required to develop written suicide risk management (SRM) protocols. But little is known about these protocols. It is possible that such protocols could serve as templates for suicide risk management in clinical settings. Aims: To elucidate common (best) practices from mental health intervention researchers. Methods: We conducted a systematic descriptive analysis of written SRM protocols. A convenience sample of studies funded by the United States’ National Institute of Mental Health in 2005 were scanned to discover projects in which investigators were likely to identify and take responsibility for suicide risk in their participant pool. Qualitative methodology was used to create a checklist of tasks perceived to be operationally significant for insuring the safety of suicidal participants. The checklist was applied to all protocols to determine the variability of patient safety tasks across protocols. Results: We identified 45 candidate studies, whereof 38 investigators were contacted, resulting in the review of 21 SRM protocols. Three main categories emerged: overview, entry/exit, and process. Overall, 19 specific tasks were identified. Task frequency varied from 7% to 95% across protocols. Conclusions: The SRM checklist provides a framework for comparing the content of SRM protocols. This checklist may assist in developing SRM protocols in a wide range of settings. Developing guidelines and standard methodologies is an important step to further development of suicide prevention strategies. More research is necessary to determine the impact of SRM protocols on participant safety.

Troubled beginnings: the adverse childhood experiences and placement histories of a detained adolescent population with developmental disorders

2020 ◽  
Vol 14 (6) ◽  
pp. 181-197
Author(s):  
Deborah J. Morris ◽  
Elanor Lucy Webb ◽  
Emma Parmar ◽  
Grace Trundle ◽  
Anne McLean
Keyword(s):  
Mental Health ◽  
Adverse Childhood Experiences ◽  
Developmental Disorders ◽  
Developmental Disorder ◽  
Convenience Sample ◽  
Childhood Experiences ◽  
Content Type ◽  
Adolescent Population ◽  
Adverse Childhood ◽  
The Impact

Purpose People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service. Design/methodology/approach A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years). Findings A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses. Practical implications Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care. Originality/value This study explored the early-life and placement experiences of a marginalised and understudied population.

Working alliance and its relationship with treatment outcome

2016 ◽  
Vol 33 (S1) ◽  
pp. s277-s277
Author(s):  
A. Cardoso ◽  
P. Aguiar ◽  
M. Byrne ◽  
M. Xavier
Keyword(s):  
Mental Health ◽  
Treatment Outcome ◽  
Therapeutic Alliance ◽  
Treatment Adherence ◽  
Mental Health Professionals ◽  
Clinical Skills ◽  
Skills Training ◽  
Future Research ◽  
Convenience Sample ◽  
The Impact

IntroductionThe therapeutic alliance might be the most important part of beginning clinical relationship and may have an important impact in treatment adherence. In fact, many studies indicate that the therapeutic alliance is the best predictor of treatment outcome.ObjectivesTo assess clinical skills and attitudes in mental health professionals(MHP).AimsThis study explore the impact of clinical skills and socio-demographic factors related MHP may have on treatment adherence of patients with mental health disorders (MHD).MethodsIn this cross sectional study, we use a convenience sample of MHP working in the mental health departments of three general hospitals in Lisbon great area. Data is being collected through individual interviews. We used a optimism scale (ETOS), Medication Alliance Beliefs Questionnaire (MABQ), and socio-demographic and clinical questionnaire.ResultsA convenience sample composed of sixty-five mental health clinician working in a variety of settings is being collected. We don’t found statistically significant differences between the therapeutic optimism and the socio-demographic and clinical characteristics of MHP. The average values of optimism found in MHP with additional training in skills training it was higher (t test = 1,64). The results demonstrate that the most of clinicians (n = 42; agree 64,6%; strongly agree, n = 19; 29,2%) believe that have the capacity to positively influence outcomes for people with mental disorders.ConclusionThis topic, along with a detailed examination of the relationship between therapeutic alliance and treatment adherence, will be the subject of future research projects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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