scholarly journals Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding

10.2196/19008 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e19008 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Gabriella Landy ◽  
Michelle Eskinazi ◽  
Andrew Sommerlad ◽  
Nicola Morant ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Internet Use ◽  
Child And Adolescent ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Data Set ◽  
Related Risk

Background The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. Objective This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. Methods We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. Results The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;P=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; P=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; P=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; P=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. Conclusions Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

scholarly journals Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding (Preprint)

2020 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Gabriella Landy ◽  
Michelle Eskinazi ◽  
Andrew Sommerlad ◽  
Nicola Morant ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Internet Use ◽  
Child And Adolescent ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Data Set ◽  
Related Risk

BACKGROUND The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. OBJECTIVE This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. METHODS We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. RESULTS The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;<i>P</i>=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; <i>P</i>=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; <i>P</i>=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; <i>P</i>=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. CONCLUSIONS Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

scholarly journals “I Go up to the Edge of the Valley, and I Talk to God”: Using Mixed Methods to Understand the Relationship between Gender-Based Violence and Mental Health among Lebanese and Syrian Refugee Women Engaged in Psychosocial Programming

2021 ◽  
Vol 18 (9) ◽  
pp. 4500
Author(s):  
Rassil Barada ◽  
Alina Potts ◽  
Angela Bourassa ◽  
Manuel Contreras-Urbina ◽  
Krystel Nasr
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Focus Groups ◽  
Service Providers ◽  
Gender Based Violence ◽  
Community Members ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
International Research Institute ◽  
Gender Based

Lebanon’s intersecting economic and political crises exacerbate complex public health issues among both host and refugee populations. This mixed-methods study by a Lebanese service provider, in partnership with an international research institute, seeks to better understand how experiences of gender-based violence (GBV) and mental health intersect in the lives of Syrian and Lebanese women, and how to better meet these needs. It employs a randomized cross-sectional survey of 969 Abaad service users and focus groups with community members and service providers. There were significant associations between GBV and ill mental health; notably, respondents reporting transactional sex had 4 times the likelihood of severe distress (aOR 4.2; 95% CI 1.2–14.8; p ≤ 0.05). Focus groups emphasized less-visible forms of violence, such as emotional violence, and the importance of environmental factors in one’s ability to cope, noting “it always came back to the economy”. Recommendations include providing a more holistic and coordinated approach between GBV, mental health, livelihood, and basic assistance sectors; and sensitive, accessible, and higher-quality mental health services informed by GBV response actors’ experience putting in place survivor-centered programming and made available to both host and refugee community members.

scholarly journals The Readiness of Psychiatrists to Implement Psychedelic-Assisted Psychotherapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Lisa A. Page ◽  
Ahmad Rehman ◽  
Habib Syed ◽  
Kathryn Forcer ◽  
Graham Campbell
Keyword(s):  
Focus Groups ◽  
Thematic Analysis ◽  
Training Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Methods Approach ◽  
Potential Barriers ◽  
Descriptive Approach ◽  
Attitudes And Knowledge ◽  
Health Trust

Introduction: Psychedelic-assisted psychotherapy is a promising approach in psychiatry; evidence is growing and it may not be long before mainstream services are expected to offer it to selected patients. This pilot study examined the attitudes and knowledge of NHS psychiatrists of all levels towards psychedelic-assisted psychotherapy and explored potential barriers and facilitators to its implementation.Methods: A mixed-methods approach was adopted, using a cross-sectional survey and focus groups. All psychiatrists in one NHS mental health trust were approached by email to participate. The survey was analysed using a simple descriptive approach and thematic analysis was used for the focus groups.Results: Eighty-three (25.7%) psychiatrists participated in the survey. All psychiatrists were familiar with one or more psychedelic substances. Although 77.2% felt that there should be a role for controlled or therapeutic use of psychedelics, trainees appeared better informed than non-training grade psychiatrists. Psychiatrists of all grades did not feel prepared to participate in the delivery of psychedelic-assisted psychotherapy. Thematic analysis of the focus groups identified three main themes in relation to psychedelic-assisted psychotherapy: “need for knowledge,” “openness to change,” and “uncertainty.”Discussion: NHS psychiatrists are positive about the potential for psychedelic-assisted therapy to advance psychiatric practise. However, psychiatrists are lacking in confidence or preparedness to implement this treatment should it become a mainstream option and significant training needs were identified. Thematic analysis highlighted the need for societal shifts as well as professional ones.

A cross-sectional survey among physicians on Internet use for epilepsy-related information (Preprint)

2019 ◽  
Author(s):  
Francesco Brigo ◽  
Simona Lattanzi ◽  
Giorgia Giussani ◽  
Laura Tassi ◽  
Nicola Pietrafusa ◽  
...  
Keyword(s):  
Internet Use ◽  
The Internet ◽  
Online Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Information ◽  
Internet Users ◽  
Therapeutic Decisions ◽  
The Individual ◽  
The Web

BACKGROUND The Internet has become one of the most important sources of health information, accessed daily by an ever-growing number of both patients and physicians, seeking medical advice and clinical guidance. A deeper insight into the current use of the Web as source of information on epilepsy would help in clarifying the individual attitude towards this medium by Internet users. OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to explore factors which explained the influence of information found on the internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8% of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9%) or to confirm a diagnostic or therapeutic decision (37.3%). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95%CI: 1.28-6.76; p=0.011), higher frequency of Internet use (OR: 3.66; 95%CI: 1.56-9.21; p=0.006) and higher confidence in reliability of online information (OR: 2.61; 95%CI: 1.09-6.26; p=0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSIONS Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

The mental health of Australian medical practitioners during Covid-19

2021 ◽  
pp. 103985622110108
Author(s):  
Michelle Anne Adams ◽  
Matthew Brazel ◽  
Richard Thomson ◽  
Hannah Lake
Keyword(s):  
Mental Health ◽  
Junior Doctor ◽  
Demographic Factors ◽  
Cross Sectional Survey ◽  
Mental Health Diagnosis ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Psychological Distress Scale ◽  
Distress Scale ◽  
Health Diagnosis

Objectives: To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress. Methods: Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress. Results: The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred. Conclusions: Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.

scholarly journals Mental Health of COVID-19 Patients—A Cross-Sectional Survey in Saudi Arabia

2021 ◽  
Vol 18 (9) ◽  
pp. 4758
Author(s):  
Hasan Saeed Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Personal Data ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Patients Experience ◽  
Self Administered Questionnaire

Background: This study aims to investigate the mental health of COVID-19 patients in Saudi Arabia. Method: A cross-sectional study was carried out targeting confirmed cases of COVID-19 in Saudi Arabia. Due to travel and time constraints as well as the accessibility of patients, cases were included from East Jeddah Hospital, King Abdulaziz Hospital, and the Oncology Center in Jeddah. The data were collected using a predesigned self-administered questionnaire. The questionnaire addressed COVID-19 cases, personal data, medical history, smoking, traveling abroad, and work-related conditions. Additionally, data regarding contact level with COVID-19 cases were considered. The mental health statuses of the patients were assessed using a validated Arabic version of the Hospital Anxiety and Depression (HAD) scale. The study included 261 COVID-19 patients whose ages ranged from 18 to 65 years. Results: The survey findings revealed that 13% of COVID-19 patients had a borderline level of anxiety, 26.8% were considered anxiety cases, while 60.2% were normal. The findings also revealed that 29.9% had a borderline level of depression, 18.4% were considered depression cases, while 51.7% were normal. Conclusions: This study concluded that COVID-19 patients experience anxiety and depression, and as the COVID-19 epidemic continues to spread, the results of the study are particularly useful in developing a strategy to psychologically support COVID-19 patients.

scholarly journals Potential value of the current mental health monitoring of children in state care in England

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Christine Cocker ◽  
Helen Minnis ◽  
Helen Sweeting
Keyword(s):  
Mental Health ◽  
Missing Data ◽  
Mental Health Problems ◽  
Population Level ◽  
Cross Sectional ◽  
Data Set ◽  
Looked After Children ◽  
Education Data ◽  
Sample Attrition ◽  
Aggregate Population

BackgroundRoutine screening to identify mental health problems in English looked-after children has been conducted since 2009 using the Strengths and Difficulties Questionnaire (SDQ).AimsTo investigate the degree to which data collection achieves screening aims (identifying scale of problem, having an impact on mental health) and the potential analytic value of the data set.MethodDepartment for Education data (2009–2017) were used to examine: aggregate, population-level trends in SDQ scores in 4/5- to 16/17-year-olds; representativeness of the SDQ sample; attrition in this sample.ResultsMean SDQ scores (around 50% ‘abnormal’ or ‘borderline’) were stable over 9 years. Levels of missing data were high (25–30%), as was attrition (28% retained for 4 years). Cross-sectional SDQ samples were not representative and longitudinal samples were biased.ConclusionsMental health screening appears justified and the data set has research potential, but the English screening programme falls short because of missing data and inadequate referral routes for those with difficulties.Declaration of interestNone.

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