People Management Strategies Research Articles

Psychiatric Contacts Among Youths Aged 13 Through 24 Years Who Have Made Serious Suicide Attempts

To compare the history of psychiatric contacts among young people who have made medically serious suicide attempts and control subjects. Using a case-control design, the authors contrasted 129 young people who made serious suicide attempts with 153 randomly selected community controls on a series of measures of lifetime, prior year, and prior month contacts with psychiatric services. Of those who made serious suicide attempts, 78.3% had a lifetime history of contact with health services for psychiatric reasons, 72.1% reported contact within the year preceding the suicide attempt 58.9% reported contact within the month preceding the suicide attempt, and 29.5% had a lifetime history of psychiatric hospital admission. Within the year preceding the suicide attempt, 21.7% had been admitted to a psychiatric hospital and 67.4% had outpatient consultations for psychiatric problems. Multiple logistic regression suggested that the best psychiatric service predictors of risk of serious suicide attempt were admission within the preceding year (p < .005) and outpatient consultation within the preceding month (p < .0001). Young people making serious suicide attempts had vastly elevated rates of a range of psychiatric contacts including hospital admissions and outpatient consultations. These findings imply that the development of improved treatment and management strategies for young people with psychiatric morbidity may be a very effective approach to reducing youthful suicidal behaviors.

Natural therapeutic holding: a non-aversive alternative to the use of control and restraint in the management of violence for people with learning disabilities.

For at least the last 10 years, control and restraint (C&R) has gained increased popularity amongst nurses as a safe, professional and legal means to manage violence in health care settings. However, during this period there has been an increased momentum to find non-aversive management strategies for people with learning disabilities and there has been frequent debate on the abolition of practices which do not achieve this. More recently, the main criticisms of C&R have been the professional and ethical objections that the techniques used inflict some degree of pain or discomfort to the client, and the fact that it remains a reactive strategy with no theoretical framework for professional practice. On this basis, alternatives should be sought which seek to address these issues. This paper outlines the development of natural therapeutic holding, an approach which is non-aversive and which provides a theoretical structure for professionals to base their practice on in order to develop clear therapeutic goals for the client. Initial findings within a small community residential service for people with learning disabilities indicate that natural therapeutic holding was a preferred method of intervention strategy by staff, proving as effective as C&R in the management of violent incidents, with interventions being much shorter in duration and non-aversive in nature.

Co‐existent psychiatric illness and drug abuse: A community study

In this paper the authors discuss recent research in Victoria exploring the dimensions of co‐occurring serious I psychiatric disorder and problematic drug or alcohol use. A mutt‐method approach was adopted in the light of I the absence of any previous local studies. The findings highlighted the critical lack of service and care for this most severely disadvantaged group. Of particular importance is the evidence of conflicting conceptualisations of the problem amongst service providers in different health and welfare sectors and the impact of administrative divisions which serve to exacerbate the difficulties of people with these dual problems. The evidence from the research points to a need to develop a common philosophical outlook amongst service providers. It is argued that the social policy of “harm minimisation” may, if developed within the mental heafth domain, provide a crucial first step in addressing the urgent and critical needs for services and management strategies for people with these dual pr...