Psychiatric Inpatient Settings Research Articles

'It's a Horrible Place to Have a Period': A Survivor-Led Investigation of Experiences of Menstrual Health in Psychiatric Inpatient Settings in England.

This study examined patients' experiences of menstrual health in psychiatric inpatient settings in England as reported by staff and patients. Questionnaires were conducted with 67 staff members and 101 people with lived experience of menstruation and treatment on a psychiatric ward. 10 semi-structured interviews were conducted with people with lived experience. Data were analysed using reflexive thematic analysis. Grouped into overarching themes of institutional and interpersonal environments, four themes were identified: access to menstrual materials; the lack of privacy when menstruating in psychiatric inpatient settings; attitudes and approaches to menstruation; and menstrual support needs and care provision. There was variation among the experiences reported, with some patients receiving dignified care, whilst others described facing 'degrading' and 'dehumanising' treatments and enhanced feelings of shame and embarrassment around menstruation, in comparison with what they usually experience. This appeared to arise due to the interplay between mental health services overlooking menstruation and the overreliance on restrictive practices. These experiences may be understood as menstrual injustices, period poverty,potentially amounting to neglect and posing iatrogenic harms. Participants also discussed how their mental illness and distress, particularly within the context of trauma and/or eating disorders, shaped their menstrual experiences. However, many patients did not receive adequate support in relation to this. Patients' pain and disorder related to menstruation, or gynaecological conditions, was often described as being dismissed by staff or being viewed as beyond the responsibility of mental health services. This study highlighted the urgency for actions to be taken to provide greater support for patients who menstruate in psychiatric inpatient settings.

Great Expectations: Semaglutide as Antidiabetic Weight Management in a Psychiatric Hospital.

This report explores the potential role of glucagon-like peptide 1 (GLP-1) receptor agonists in minimizing the metabolic side effects of psychotropic medications in patients with underlying type 2 diabetes (T2D) in inpatient psychiatric settings. The introduction of novel antidiabetic medications such as GLP-1 receptor agonists has broadened the options for managing metabolic disorders, particularly T2D. These medications not only offer effective glycemic control but also provide cardiovascular and renal benefits and help with weight management. Given the tendency of psychotropic medications to cause weight gain and metabolic complications, this report presents 2 cases where weekly doses of semaglutide improved blood glucose levels and prevented weight gain in patients receiving chronic psychotropic medications. Integrating GLP-1 receptor agonists into inpatient psychiatric care can help mitigate the metabolic adverse effects of psychotropic medications. However, considerations such as cost, accessibility, and institutional formulary restrictions are essential to ensure comprehensive patient care.

Lesbian, Gay, Bisexual, Transgender and Queer People's Experiences of Stigma Across the Spectrum of Inpatient Psychiatric Care: A Systematic Review.

Lesbian, gay, bisexual, transgender, queer and other diverse sexual orientations and gender identity groups (LGBTQ+) face high rates of poor mental health. In the most severe and emergent of instances, inpatient psychiatric care may be required. LGBTQ+ people report experiences of mistreatment in healthcare settings broadly, such as denial of healthcare services and harassment from healthcare providers and other patients. However, little is known about the experiences of LGBTQ+ people in inpatient psychiatric care settings, specifically. The purpose of this review was to assess the existing literature for descriptions of LGBTQ+ people's experiences within inpatient psychiatric care. We searched multiple databases (i.e., PubMed, PsychINFO, CINAHL, Web of Science and Google Scholar) for peer-reviewed articles that described the experiences of LGBTQ+ people within inpatient psychiatric care that were published in English. The included articles (N = 14) were analysed using a conceptual model of stigma and organised within those strata (structural, interpersonal and individual stigma) across the inpatient experience, (admission, inpatient unit, and discharge). Themes identified included: noninclusive intake tools and pervasive misgendering during the admission process; lack of healthcare infrastructure, inadequate training and lack of cultural humility, pervasive discrimination and victimization, silencing of LGBTQ+ patients, and feelings of fear and shame while on inpatient units, and lack of community resources during the discharge process. Clinicians should consider the perspectives and experiences of LGBTQ+ people to enact identity-affirming care practices that may increase mental healthcare engagement and improve long-term mental health outcomes.

Patients' and health professionals' perspectives regarding shared decision making in the psychiatric inpatient setting – A multiple qualitative case study

ObjectiveShared decision-making is one promising approach to promoting recovery and person-centred care but seems challenging for implementation in clinical practice. This study aimed to explore how patients and health professionals experience shared decision-making and its facilitators and barriers. MethodsA multiple qualitative case study design was chosen, using a constant comparative method. Multiple data sources were used, including individual interviews, observation, document analysis and a focus group. ResultsThrough first a within-case analysis and then second a cross-case analysis, four patient profiles and their potential for shared decision-making were constructed. The results indicate that in the daily routine of the psychiatric inpatient setting different forms of decision making are used, even though health professionals advocate shared decision-making as the favored approach. Patients also have varying expectations and perceptions regarding shared decision-making, which is reflected in the degree of their involvement. ConclusionShared decision-making could be enhanced in the future by a more proactive communication style and the proactive provision of information on the part of health professionals, in order to enhance patient participation in decision-making. InnovationThe study identified different forms of decision-making within the acute psychiatric inpatient setting, highlighting the gap between the advocated SDM approach and its practical implementation. This divergence is a key aspect, as it underlines the complexity of implementing SDM in real clinical settings.

Exploring the Safewards Programme to Reduce Restrictive Practices in Residential Aged Care: Protocol for a Pilot and Feasibility Study.

Restrictive practice use in residential aged care homes internationally is unacceptably high. Although policies and legislation mandate the reduction or elimination of restrictive practices, there remains a gap in knowledge regarding strategies that have been effective in achieving a sustained reduction in restraint use. There is an urgent need to identify effective and feasible interventions that aged care staff can implement in everyday practice to reduce restraint use. Safewards is an evidence-based programme that has demonstrated effectiveness in reducing conflict and restrictive practice use in inpatient psychiatric settings and has the potential to address the issue of restraint use in aged care homes. This study aims to evaluate the feasibility of Safewards in reducing restrictive practices in residential aged care homes. This pilot and feasibility study will adopt a mixed methods process and outcomes evaluation. Safewards will be implemented in two Australian residential aged care homes. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework will be used to evaluate implementation outcomes. Additionally, the Consolidated Framework for Implementation Research will be used to guide qualitative data collection (including semi-structured interviews with residents/family members, aged care leaders and staff) and explain the facilitators and barriers to effective implementation. This study will provide pilot evidence on the feasibility of the Safewards programme in residential aged care homes. Understanding the processes and adaptations for implementing and evaluating Safewards in residential aged care will inform a future trial in aged care to assess its effectiveness. More broadly, the findings will support the implementation of an international aged care policy of reducing restrictive practices in residential aged care. A person with lived experience of caring for someone with dementia is employed as a Safewards facilitator and is a member of the steering committee. Residents and family members will be invited to participate in the project steering committee and provide feedback on their experience of Safewards. ACTRN12624000044527.

A qualitative study examining medical students′ expectations of psychiatric inpatient and intensive care settings

Background There is limited literature to date regarding medical students’ expectations of the psychiatric inpatient environment. This study aims to explore what medical students expect from psychiatric wards and psychiatric intensive care units prior to their placement. Psychiatric intensive care, arguably the most intense experience students will have in psychiatry, was used to highlight the full extent of student preconceptions. Methodology: Students were invited to complete a semi-structured questionnaire over a six-month period, from July to December 2021. Questions explored emotions prior to placement, expectations of the ward atmosphere, layout, patient behaviour and care strategies. 37 responses were received. Analysis followed the well-recognised six stages of thematic analysis. Results: Five themes emerged from the data: (1) Mixed feelings about placement; (2) Varied views about patient behaviour and illness; (3) Restrictive and controlled practice; (4) Similarities to acute general hospital care; (5) Care with empathy and compassion. Some of the expectations of students were markedly different to the reality of psychiatric inpatient and intensive care settings, with ideas of patients being physically restrained, unconscious and attached to ventilators. Conclusion: This study offers a unique insight into what medical students expect from psychiatry inpatient and intensive care settings, an issue that all clinicians who have student contact should be aware of. Results can better inform student preparation and placement supervision, leading to more meaningful learning and improved wellbeing.

The Mediating Role of Insomnia Severity in the Relationship Between Anxiety Symptoms and Suicidal Ideation: A Real-World Study in a Psychiatric Inpatient Setting.

Insomnia and anxiety symptoms are independent clinical variables involved in suicidal ideation in psychiatric inpatients. In this article, we investigated the relationship among insomnia severity, severity of anxiety symptoms, and suicidal ideation in a sample of psychiatric inpatients with severe mental disorders. We used a mediation model considering insomnia severity as the possible mediator of the relationship between anxiety severity and suicidal ideation. We administered the Columbia Suicide Severity Rating Scale, the Insomnia Severity Index, and the Hamilton Anxiety Rating Scale to 116 consecutive inpatients to the psychiatric unit of Sant'Andrea Hospital in Rome. The effect of anxiety symptoms was mediated by insomnia severity; patients who perceive higher anxiety symptoms were more likely to experience higher levels of insomnia and, thus, higher suicidal ideation intensity. Results showed the importance of assessing and treating both insomnia and anxiety in clinical practice.

Electroconvulsive Therapy for Psychogenic Polydipsia and Hyponatremia in Chronic Schizophrenia: A Case Report and Literature Review.

Compulsive drinking of excessive quantities of water, called psychogenic polydipsia (PP), is a challenging complication of chronic psychotic disorders, which can lead to hyponatremia and downstream morbidity or mortality. Treatments include behavioral modifications such as free water restriction, medications to modify free water excretion, and psychotropic medications to target psychotic symptoms. However, in many cases, these options remain ineffective and/or intolerable, necessitating chronic institutionalization with poor patient quality of life. Here we report the use of an acute course of 8 sessions of bilateral electroconvulsive therapy (ECT) in a 57-year-old man with chronic schizophrenia, PP, and moderate hyponatremia refractory to standard treatments in an inpatient psychiatric setting. Serum sodium normalized and remained stable during and immediately following his ECT course, despite chronic hyponatremia with high variability for months prior to ECT initiation. A literature review found remarkably few reported cases of ECT for PP in chronic schizophrenia, a surprising result given the use of this modality for patients with psychotic illness in many countries. Our findings support future investigation into the clinical utility and mechanism of ECT for PP in this patient population.

2159 Feasibility study: the use of the Edmonton frail scale in a psychiatric inpatient facility

Abstract Introduction Frailty is an important consideration in the health and wellbeing of older adults, particularly as it is associated with a risk of falls, and mental health difficulties such as depression. There has been no validation of frailty assessment tools among older adults with Psychiatric disorders. This was a feasibility study exploring the use of the Edmonton frail scale (EFS) among patients with highly complex mental health needs within a Psychiatric Inpatient Setting with a view to develop a service integration process leading to further research. Methods 45 participants were recruited from 8 older adult wards across Neuropsychiatry and Medium Secure divisions. EFS assessments were completed every six months by trained members of Multidisciplinary Teams over a 12-month period. Results: About 118 assessments were administered to approximately 45 patients, regardless of a patient’s length of stay at the hospital during the 12-month period. There was a 55% assessment completion rate. This was largely the result of difficulties in administering the cognitive domain of the EFS (Clock Drwing test) to patients with highly complex mental health needs, as the completion rate was 32%. It was also quite challenging for patients to understand and comply with the assessment instructions in the Functional Performance Domain (Timed Get Up and Go Test). As a result, many assessments in this domain were conducted through covert observation of patients’ movement during the course of the day. 29 of the 45 patients were found to have at least moderate level of frailty. Conclusion Older adults with psychiatric disorders may benefit from having an adapted assessment of the cognitive domain to promote complete administration of assessments. Prevalence of frailty is high in this setting. Continuous support towards staff engagement and education would be beneficial in promoting EFS use in determining frailty and integrating it into care planning.

Implementation of a practice model for inpatient psychiatric clinical pharmacist practitioners with prescriptive authority at a veterans health care facility.

Clinical pharmacists play a valuable role on collaborative health care teams, especially in the field of mental health. However, there is a need to explore innovative practice models that optimize their potential in providing comprehensive medication management in inpatient psychiatric settings. This report aims to describe the implementation of a practice model using an inpatient psychiatric clinical pharmacist practitioner performing comprehensive medication management. The implementation of a practice model using a psychiatric clinical pharmacist practitioner was a feasible way to deliver comprehensive medication management and other clinical services in an inpatient psychiatric setting amid staffing challenges. Whereas limitations such as resource constraints must be considered, the success of this model highlights the value of a versatile psychiatric clinical pharmacist practitioner. These findings might offer insight to other health care facilities considering a similar approach to provide mental health care through the use of a psychiatric clinical pharmacist practitioner.

All paths do not lead to Rome or adherence: Innovative antipsychotic prescribing in partnership with people in recovery as they define.

Though the psychiatric field has primarily focused on medication and symptom amelioration via medication "adherence," contemporary approaches that incorporate recovery-oriented care and shared decision-making (SDM) could provide a more holistic and effective approach to serving individuals experiencing psychosis. This article explores the implementation of such innovative and collaborative practices while highlighting their benefits and challenges. Furthermore, it aims to offer practical implementations of SDM in prescribing practices. This article presents innovative strategies for prescribing antipsychotics utilizing SDM and recovery-oriented care approaches for those who experience psychosis. The study explores the clinical applications of these approaches within an inpatient psychiatric setting. The article emphasizes the numerous challenges for those who experience psychosis in adhering to antipsychotic medication and proposes a recovery-oriented approach facilitated by SDM. It emphasizes the importance of therapeutic alliance and collaboration while providing practical clinical applications of this approach. The article advocates for collaborative approaches in antipsychotic prescribing, such as SDM and recovery-oriented care, to support those experiencing psychosis in constructing a life of meaning as they define it, including in how they choose to take medications. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Patient's Experiences of a Cognitive Behaviour Therapy Informed Crisis Intervention for Psychosis Delivered in Inpatient Settings: A Qualitative Exploration.

Cognitive behaviour therapy for psychosis (CBTp) should be offered to patients receiving psychiatric inpatient care, yet very little is known about patients' perspectives on this. The aim of this study was to examine patients' experiences of a CBTp-informed intervention delivered in inpatient settings. We recruited 10 participants from the intervention arm of a randomised controlled trial examining the feasibility and acceptability of a CBTp-informed intervention for psychiatric inpatient settings. We undertook semistructured interviews examining their experiences of the intervention and analysed them using thematic analysis. The study was conducted in partnership with a coproduction group of key stakeholders (people with lived experience, family and carers,and clinicians). The intervention was found helpful by almost all participants, and all participants would recommend it to others in similar situations to themselves. The results demonstrated that participants valued the therapist's professionalism and emphasised the importance of the therapeutic relationship. Participants highlighted the importance of the therapy focusing on navigating admission and developing skills to manage the crisis experience so they could return to their normal lives. Participants described challenges to having psychological therapy in the acute crisis context including therapy interruptions and ongoing distressing experiences of psychosis. The study demonstrated the importance of prioritising the therapeutic relationship, that therapy was a valued process to navigate admission and discharge, but that some environmental and patient-level challenges were present. Further research is needed to explore inpatients' experiences of psychological interventions in this setting. TRIAL REGISTRATION: ISRCTN trial registry: ISRCTN59055607.

Saudi Arabian Nurses' Motivations and Barriers to Employment in Inpatient Mental Health Facilities: A Qualitative Investigation.

The shortage of inpatient psychiatric mental health care nurses in Saudi Arabia represents an important health care challenge. The aim of this study was to illuminate perspectives of psychiatric mental health nurses employed in psychiatric inpatient settings about their employment experiences. This study adopted an exploratory qualitative approach using thematic content analysis. Ten professional nurses with psychiatric inpatient caring experience participated in two focus groups composed of Master of Nursing students. Four main themes emerged: inadequate professional skills and knowledge for psychiatric mental health care practice, negative public attitudes toward psychiatric/mental health nurses, concerns for personal safety, and alternatives and advantages. The findings of this study suggest that nurses' lack of interest in working in psychiatric units is not merely personal but also social and organizational. The study findings may encourage managers and authorities to develop measures to attract more mental health nurses to work in psychiatric units. Such strategies may include modification of nurses' skills, training, and professional knowledge, collegial supervision, mentoring, and working conditions and environment.

The “Team Tree” Professional Tree of Life intervention: development and evaluation within the acute inpatient psychiatric setting

PurposeMental health staff often experience significant levels of stress working in the acute psychiatric inpatient setting. Team-building interventions can mitigate stress in health-care settings, via improvements in team-cohesion, staff interactions and communication skills. The “Tree of Life” (ToL) is a specific narrative therapy approach which uses the metaphor of a tree to facilitate the construction and sharing of strength-based stories. This study aims to describe the development of and evaluate the feasibility, acceptability and staff experiences of the “Team Tree”, an adapted Professional ToL (PToL) intervention.Design/methodology/approachA one-hour, Professional ToL intervention was designed for multidisciplinary acute inpatient staff teams working within a psychiatric hospital in London, UK. A mixed methods approach was used to evaluate the feasibility, acceptability and staff experiences of the session.FindingsParticipants were 46 multidisciplinary staff (33 women; 13 men) working across four acute psychiatric wards. The intervention was feasible to deliver and was acceptable to participants. Results showed significant improvements in self-reported mental well-being and team-cohesiveness scores post-session.Practical implicationsPsychologists face myriad barriers in working with staff teams in the acute inpatient setting. The “Team Tree” intervention was both well received by staff and practical to deliver within the challenging environment of the acute ward.Originality/valueThis adaptation of the original PToL emerged from the author’s work with distressed inpatient teams with limited time resources. To the best of the authors’ knowledge, this is the first description of this intervention using a single tree metaphor to facilitate a reflective and creative session with health-care teams.

Facility-Level and Racial Disparities in Access to Inpatient Psychiatric Occupational Therapy Services in the Veterans Health Administration.

Veterans receiving inpatient psychiatric services with limitations in activities of daily living (ADLs) benefit from occupational therapy, yet disparities in access are unknown. To investigate whether ADL limitations, an indicator of occupational therapy need, was associated with inpatient psychiatric occupational therapy utilization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. Secondary analysis of VHA data. Modified Poisson regression modeled occupational therapy utilization as a function of ADL limitations, facility characteristics, and covariates. Interactions estimated whether the relationship between ADL limitations and occupational therapy utilization differed across facility characteristics. VHA inpatient psychiatric setting. Veterans receiving VHA inpatient psychiatric care from 2015 to 2020 (N = 133,844). Occupational therapy utilization. Veterans with ADL limitations were more likely to receive occupational therapy. Veterans receiving care in facilities with higher complexity and greater inpatient psychiatric care quality were more likely to receive occupational therapy. Additionally, Black veterans were less likely to receive occupational therapy relative to their White, non-Hispanic counterparts. Interactions indicated that the extent to which ADL limitations drove access to occupational therapy utilization was weaker within facilities with higher complexity and care quality. Veterans with ADL limitations were more likely to access inpatient psychiatric occupational therapy, suggesting that such services are generally allocated to veterans in need. However, findings indicate disparities in access across patient-level (e.g., Black race) and facility-level (e.g., facility complexity) factors, informing efforts to eliminate barriers to accessing these valuable services. Plain-Language Summary: This is the first study, to our knowledge, to examine disparities in access to inpatient psychiatric occupational therapy in the Veterans Health Administration (VHA). The study findings show that access to inpatient psychiatric occupational therapy is partly driven by the needs of the patient. However, nonclinical factors, such as a patient's race and the characteristics of the facility at which they receive care (complexity, number of psychiatric beds available, and the quality of psychiatric care), are also important drivers of access. Identifying factors influencing access to these valuable services is the first step in developing strategies that reduce barriers to access for veterans in need.

Attitudes of nurses and nurse managers towards violence risk assessment and management: A cross-sectional study in psychiatric inpatient settings.

Workplace violence is a significant challenge in psychiatric hospital care. Some existing practices of violence risk assessment and management are based on nurses' intuition and clinical experience instead of structured tools. Nurses and nurse managers consider violence risk assessment and management their responsibility. Still, nurses and nurse managers have mixed attitudes towards the use of validated risk assessment tools. The attitudes towards service users' positive risk-taking in nurses and nurse managers vary, with some nurses and nurse managers supporting its importance. Change in nurses' and nurse managers' attitudes towards risk assessment tools is required before their implementation into practice. More profound change in practices towards recovery-oriented care is required also in risk assessment. INTRODUCTION: Workplace violence is a prevalent issue in psychiatric inpatient care. Prevention efforts require the identification of at-risk service users using validated violence risk assessment tools. The shift in violence prevention emphasises preventive measures and collaborative risk assessment together with service users. Nurses have a central role in this process. Therefore, their attitudes are crucial when implementing evidence-based methods. To assess the attitudes of nurses and nurse managers towards violence risk assessment and management. A cross-sectional online survey in Finnish psychiatric inpatient care. Data analysis was conducted with statistical methods. The STROBE guideline was used in reporting. Nurses (n = 142) valued risk assessment and felt that it was their responsibility. Attitudes towards service users' risk-taking as part of their recovery varied. Nurses had mixed attitudes regarding the effectiveness of risk assessment tools. Older participants and nurse managers had more positive attitudes towards risk assessment tools. The study findings highlight a feeling of responsibility of nurses towards violence risk assessment and at the same time their preference towards their own clinical judgement. Understanding nurses' attitudes is crucial in training and implementation processes to address concerns, provide support and enhance positive attitudes.

Promoting Post-Restraint Patient Debriefing in an Acute Psychiatric Inpatient setting

Promoting Post-Restraint Patient Debriefing in an Acute Psychiatric Inpatient setting

Risk assessment for aggressive behaviour in schizophrenia.

Aggressive or violent behaviour is often associated with people with schizophrenia in common perceptions of the disease. Risk assessment methods have been used to identify and evaluate the behaviour of those individuals who are at the greatest risk of perpetrating aggression or violence or characterise the likelihood to commit acts. Although many different interventions have been developed to decrease aggressive or violent incidences in inpatient care, staff working in inpatient settings seek easy-to-use methods to decrease patient aggressive events. However, many of these are time-consuming, and they require intensive training for staff and patient monitoring. It has also been recognised in clinical practice that if staff monitor patients' behaviour in a structured manner, the monitoring itself may result in a reduction of aggressive/violent behaviour and incidents in psychiatric settings. To assess the effects of structured aggression or violence risk assessment methods for people with schizophrenia or schizophrenia-like illnesses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ISRCTN registry, ClinicalTrials.gov, and WHO ICTRP, on 10 February 2021. We also inspected references of all identified studies. We included all randomised controlled trials (RCTs) comparing structured risk assessment methods added to standard professional care with standard professional care for the evaluation of aggressive or violent behaviour among people with schizophrenia. At least two review authors independently inspected citations, selected studies, extracted data, and appraised study quality. For binary outcomes, we calculated a standard estimation of the risk ratio (RR) and its 95% confidence interval (CI). For continuous outcomes, we calculated the mean difference (MD) and its 95% CI. We assessed risk of bias in the included studies and created a summary of findings table using the GRADE approach. We included four studies in the review. The total number of participants was not identifiable, as some studies provided number of participants included, and some only patient days. The studies compared a package of structured assessment methods with a control group that included routine nursing care and drug therapy or unstructured psychiatric observations/treatment based on clinical judgement. In two studies, information about treatment in control care was not available. One study reported results for our primary outcome, clinically important change in aggressive/violent behaviour, measured by the rate of severe aggression events. There was likely a positive effect favouring structured risk assessment over standard professional care (RR 0.59, 95% CI 0.41 to 0.85; 1 RCT; 1852 participants; corrected for cluster design: RR 0.59, 95% CI 0.37 to 0.93; moderate-certainty evidence). One trial reported data for the use of coercive measures (seclusion room). Compared to standard professional care, structured risk assessment may have little or no effect on use of seclusion room as days (corrected for cluster design: RR 0.92, 95% CI 0.27 to 3.07; N = 20; low-certainty evidence) or use of seclusion room as secluded participants (RR 1.83, 95% CI 0.39 to 8.7; 1 RCT; N = 20; low-certainty evidence). However, seclusion room may be used less frequently in the standard professional care group compared to the structured risk assessment group (incidence) (corrected for cluster design: RR 1.63, 95% CI 0.49 to 5.47; 1 RCT; N = 20; substantial heterogeneity, Chi2 = 0.0; df = 0.0; P = 0.0; I2 = 100%; low-certainty evidence). There was no evidence of a clear effect on adverse events of escape (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence); fall down (RR 0.33, 95% CI 0.04 to 3.15; 1 RCT; n = 200; very low-certainty evidence); or choking (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence) when comparing structured risk assessment to standard professional care. There were no useable data for patient-related outcomes such as global state, acceptance of treatment, satisfaction with treatment, quality of life, service use, or costs. Based on the available evidence, it is not possible to conclude that structured aggression or violence risk assessment methods are effective for people with schizophrenia or schizophrenia-like illnesses. Future work should combine the use of interventions and structured risk assessment methods to prevent aggressive incidents in psychiatric inpatient settings.

Cannabis Vaping Is Associated With Past 30-Day Suicide Attempts and Suicidal Ideation Among Adolescents in a Psychiatric Inpatient Setting

Cannabis Vaping Is Associated With Past 30-Day Suicide Attempts and Suicidal Ideation Among Adolescents in a Psychiatric Inpatient Setting

The effectiveness of iso principle mood modulation playlists in inpatient psychiatry: A post-hoc analysis

This post-hoc data analysis study investigates the impact of iso principle-informed mood modulation playlists (MMPLs) on mood ratings using a Likert scale. Pre- and post-listening mood ratings were collected as part of routine music therapy procedures in an inpatient psychiatric setting and de-identified for analysis. The study comprised 125 pairs of mood ratings. The results of the Wilcoxon signed-rank post-hoc analysis revealed a significant improvement in post-test mood ratings compared to pre-test mood ratings (mean rank = 8.34 vs 5.02, respectively, Z = -9.59, p = 0.001). These findings highlight the therapeutic value of individualized MMPLs facilitated by music therapists in enhancing patient mood. The utilization of MMPLs allows patients to purposefully modulate their mood in desirable ways, demonstrating the potential of music therapy as a valuable tool in improving well-being.