scholarly journals First line in psychiatric emergency: Pre-hospital emergency protocol for mental disorders in Iran

2020 ◽  
Author(s):  
Fatemeh Shirzad ◽  
Fateme Hadi ◽  
Seyede Salehe Mortazavi ◽  
Maryam Biglari ◽  
Hassan Noori Sari ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Relevant Literature ◽  
Hospital Setting ◽  
Access To Medicines ◽  
Rapid Review ◽  
Treatment Center ◽  
Security Issues ◽  
Patient Status ◽  
Status Assessment ◽  
Implementation Problems

Abstract Introduction: This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands.Methods: The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. Results: Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center). Discussion: This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposing a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues are different.

scholarly journals First line in psychiatric emergency: Pre-hospital emergency protocol for mental disorders in Iran

2019 ◽  
Author(s):  
Fatemeh Shirzad ◽  
Fateme Hadi ◽  
Seyede Salehe Mortazavi ◽  
Maryam Biglari ◽  
Hassan Noori Sari ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Relevant Literature ◽  
Hospital Setting ◽  
Access To Medicines ◽  
Rapid Review ◽  
Treatment Center ◽  
Security Issues ◽  
Patient Status ◽  
Status Assessment ◽  
Implementation Problems

Abstract Introduction: This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands. Methods: The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. Result s : Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center). Discussion: This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposing a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues are different.

scholarly journals First line in psychiatric emergency: Pre-hospital emergency protocol for mental disorders in Iran

2020 ◽  
Author(s):  
Fatemeh Shirzad ◽  
Fateme Hadi ◽  
Seyede Salehe Mortazavi ◽  
Maryam Biglari ◽  
Hassan Noori Sari ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Relevant Literature ◽  
Hospital Setting ◽  
Access To Medicines ◽  
Rapid Review ◽  
Treatment Center ◽  
Security Issues ◽  
Patient Status ◽  
Status Assessment ◽  
Implementation Problems

Abstract Introduction : This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands. Methods: The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. Result s : Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center). Discussion: This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposing a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues are different.

scholarly journals First line in psychiatric emergency: Pre-hospital emergency protocol for mental disorders in Iran

2019 ◽  
Author(s):  
Fatemeh Shirzad ◽  
Fateme Hadi ◽  
Seyede Salehe Mortazavi ◽  
Maryam Biglari ◽  
Hassan Noori Sari ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Relevant Literature ◽  
Hospital Setting ◽  
Access To Medicines ◽  
Rapid Review ◽  
Treatment Center ◽  
Behavioral Management ◽  
Security Issues ◽  
Patient Status ◽  
Status Assessment

Abstract Introduction This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands.Methods The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems.Result Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center).Discussion This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposure to a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues (For instant, access to medications) are different.

Psychiatric patients' behavior and adjustment as appraised in the community and hospital setting

1967 ◽  
Author(s):  
Robert Ellsworth ◽  
Gilbert Arthur ◽  
Duane Kroeker ◽  
Barry Childers
Keyword(s):  
Psychiatric Patients ◽  
Hospital Setting

Psychological/psychiatric impact of the novel coronavirus outbreak: lessons learnt from China and call for timely crisis interventions in Italy

2020 ◽  
Author(s):  
Patrizia Zeppegno ◽  
Carla Gramaglia ◽  
Chiara Guerriero ◽  
Fabio Madeddu ◽  
Raffaella Calati
Keyword(s):  
Mental Health ◽  
Migrant Workers ◽  
Mental Health Problems ◽  
Virus Disease ◽  
Selection Process ◽  
Psychiatric Patients ◽  
Homeless People ◽  
World Health ◽  
Rapid Review ◽  
Post Traumatic Stress

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.

Utilization of Emergency Departments for Psychiatric Treatment

1978 ◽  
Vol 23 (3) ◽  
pp. 143-148 ◽  
Author(s):  
G.D. Watson
Keyword(s):  
Emergency Department ◽  
Emergency Services ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Relevant Literature ◽  
Emergency Department Utilization ◽  
Annual Number ◽  
Personal Distress ◽  
Clinical Records

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.

Severe Personality Disorder

1996 ◽  
Vol 168 (6) ◽  
pp. 723-731 ◽  
Author(s):  
Kingsley Norton ◽  
R. D. Hinshelwood
Keyword(s):  
Personality Disorder ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Relevant Literature ◽  
Term Treatment ◽  
Successful Outcome ◽  
Post Discharge ◽  
Long Term Treatment ◽  
Severe Personality Disorder

BackgroundSevere personality disorder (SPD) is an imprecise but useful term referring to some notoriously difficult to treat psychiatric patients. Their long-term psychiatric treatment is often unsuccessful, in spite of hospitalisation. The specialist expertise of in-patient psychotherapy units (IPUs) can successfully meet some of SPD patients' needs.MethodRelevant literature on the subject is summarised and integrated with the authors' specialist clinical experience.ResultsMany clinical problems with SPD patients are interpersonal and prevent any effective therapeutic alliance, which is necessary for successful treatment. With in-patients, inconsistencies in treatment delivery and issues surrounding compulsory treatment reinforce patients' mistrust of professionals, compromising accurate diagnosis and an assessment of the need for specialist IPU referral.ConclusionsGeneral psychiatric teams are well-placed to plan long-term treatment for SPD patients which may include IPU treatment. Timely referral of selected SPD patients to an IPU maximises a successful outcome, especially if there is appropriate post-discharge collaboration with general psychiatric teams to consolidate gains made.

A National Audit of New Long-Stay Psychiatric Patients

1994 ◽  
Vol 165 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Paul Lelliott ◽  
John Wing
Keyword(s):  
Northern Ireland ◽  
Psychiatric Patients ◽  
Hospital Setting ◽  
Residential Setting ◽  
National Audit ◽  
Community Based ◽  
Community Placement ◽  
Lengths Of Stay ◽  
Psychiatric Beds ◽  
Rate Of Accumulation

Background.This second report of a national audit of new long-stay (NLS) psychiatric patients describes the services caring for the patients and the reasons why patients were still in hospital.Method.Data analyses addressed the prevalence of NLS patients, the residential resources available to services, the distributions of patients within services, clinicians' views as to the appropriateness of current placement and the reasons for any inappropriate placements.Results.The average point prevalence was 6.1 per 100 000 population; it was significantly lower in England and Wales (5.6, s.d. = 3.2) than in Scotland and Northern Ireland (10.7, s.d. = 6.4, ANOVA F ratio = 10.9, P < 0.01). The estimated rate of accumulation was 1.3 per 100 000 population per year. Many English services had very few non-acute psychiatric beds and 31 % of English NLS patients, despite their protracted lengths of stay, were housed on acute wards. Assessors thought that 61 % of patients would be better placed in a non-hospital setting; 47% were thought to require a community-based residential setting, and of these over one-half were still in hospital because no suitable community placement was available.Conclusions.Many NLS patients remain in hospital because their residential needs are not met by existing community provision.

Intensive Psychotherapy for Acute Psychiatric Patients in a Day Hospital Setting in Israel

1972 ◽  
Vol 121 (565) ◽  
pp. 635-639 ◽  
Author(s):  
Y. Fried ◽  
F. Brüll
Keyword(s):  
Psychiatric Patients ◽  
Hospital Setting ◽  
Health Clinic ◽  
Day Hospital ◽  
Professional Literature ◽  
Sick Fund ◽  
Day Hospitals ◽  
Type Of Institution ◽  
Autonomous Service ◽  
Intensive Psychotherapy

The psychiatric services in the field of community psychiatry in Israel have developed in a number of directions over the past decade. Following the establishment by the Workers' Sick Fund (Kupat Holim) of a Rehabilitation Unit for chronic psychiatric patients (Wijsenbeek and Lindner (53)) and the opening of a Day Hospital for acute cases in conjunction with a psychiatric hospital (Ramot and Jaffe (45)), a Day Hospital was established in October 1968, at the Out-Patient Mental Health Clinic (Ramat Chen), to serve acute psychiatric patients. This represented the first attempt of its kind in Israel. The professional literature on Day Hospitals, which in the main describes a ‘half-way out’ type of hospital (Farndale (16); Epps and Hanes (14); Kramer (32)), also reports the existence of a ‘half-way in’ type of institution, operating as an autonomous service catering to a particular geographical region, without being attached directly to a mental hospital. This kind of Day Hospital, specifically designed for acute cases, has not yet been tried in Israel.

Exposure, Relaxation, and Rescripting Therapy for Trauma-Related Nightmares With Psychiatric Inpatients: A Case Series

2020 ◽  
Vol 20 (1) ◽  
pp. 3-21
Author(s):  
Helen Reiter ◽  
Leanne Humphreys
Keyword(s):  
Acute Care ◽  
Psychiatric Hospital ◽  
Psychological Symptoms ◽  
Psychiatric Patients ◽  
Hospital Setting ◽  
Case Series ◽  
Psychiatric Inpatients ◽  
Empirically Supported ◽  
Individualized Care

Research has shown that posttraumatic stress disorder (PTSD) is a highly prevalent diagnosis for psychiatric patients, yet individualized care and treatment is limited in the inpatient acute care sector. Two case studies are presented which examine the use of Exposure, Relaxation, and Rescripting Therapy (ERRT) for chronic trauma-related nightmares, within a private acute care inpatient psychiatric hospital setting. ERRT is empirically supported with efficacy for veteran and civilian populations, however no research to date has been conducted with psychiatric inpatients. Two participants diagnosed with PTSD, suffering distressing trauma-related nightmares, completed ERRT over three sessions during their psychiatric hospital admission, with the aim of reducing the frequency and severity of nightmares and related psychological symptoms. PTSD, depression, sleep quality and quantity, and nightmare frequency and related distress, were measured pre-treatment, during treatment, and follow-up at one, 3 and 6 months. Only one participant reported ongoing nightmares by the third week of the intervention, with both participants reporting an absence of nightmares at the one and 3-month follow-ups, but mixed results by the 6-month follow-up. One participant also reported a reduction in PTSD symptoms and a mild improvement in depression. The results offer some preliminary support for the provision of ERRT for the treatment of trauma-related nightmares for psychiatric inpatients.

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