Mental Facilities Research Articles

COMBINED HIGH-INTENSITY INTERVAL TRAINING FOR PEOPLE WITH DISORDERS OF GUT BRAIN INTERACTION: A CASE REPORT

AIMS The efficacy of high intensity exercise for improving symptoms of chronic idiopathic constipation, a highly prevalent disorder of gut brain interaction (DGBI), remains uncertain. The aim of this case report was to investigate the feasibility, safety, and efficacy of 8-weeks of combined high-intensity interval training (C-HIIT) for a person (female, 23 years old) with chronic constipation. METHODS The participant enrolled in the C-HIIT for DGBI controlled trial that aims to recruit 32 participants with DGBI. Following comprehensive assessments of gastrointestinal symptoms, neuromuscular fitness, cardiorespiratory fitness and mental health, the participant completed an 8-week intervention consisting of thrice weekly 26-minute C-HIIT sessions. These consisted of a 3-minute aerobic warm-up (treadmill; 50-60% peak heart rate [HRpeak]) followed by 4-minutes of high-intensity aerobic exercise at ≥85% HRpeak. After 1-minute rest, eight whole body resistance exercises were performed. These involved continuous repetitions with good technique for 1-minute at an ≥8/10 (very hard) rating of perceived exertion; 1-minute rest separated each exercise. Adverse events were recorded throughout the intervention. RESULTS The participant adhered to the intervention, attending 100% of sessions and reaching the prescribed intensity for 100% of aerobic and 80% of resistance exercises. Efficacy of the exercise training was indicated by a reduction in the severity of gastrointestinal symptoms measured via the irritable bowel syndrome-symptom severity scale (from 111 to 100) and the structured assessment of gastroIntestinal symptoms (39 to 12). There were some improvements in neuromuscular fitness (handgrip strength: 27 to 29.5 kg, 30-second sit to stands: 12 to 10 repetitions) and cardiorespiratory fitness (VO2max: 36.7 to 38.2 mL/kg/min). No changes were observed in mental health (Hospital Anxiety and Depression scale), and one non-serious adverse event (nausea post-eating), which was deemed not related to the intervention. CONCLUSION The C-HIIT intervention in a person with DGBI was feasible, efficacious and safe.

Analysis of oral health status and related factors in hospitalized psychiatric patients

Purpose: The objective of this study is to investigate the oral health of inpatients with mental disorders, providing foun­dational data for future oral health policies.</br>Materials and Methods: Oral examination results obtained from alcohol use disorder and schizophrenia spectrum disorder patients currently residing in mental health facility were used to investigate the decayed, missing and filled teeth (DMFT) index and Community Periodontal Index score. Self-administered questionnaire record was utilized to categorize patients based on survey items, and the DMFT index and Community Periodontal Index results were analyzed.</br>Results: As age increased, both DMFT and MT showed higher values. Schizophrenia spectrum disorder patients exhibited higher DMFT and MT results compared to those with alcohol use disorder. Longer duration of illness and hospitalization were associated with poorer oral health conditions. Significant differences were observed in oral health-related indices based on toothbrushing frequency, post-meal brushing, and time spent per brushing session. Individuals who had received dental treatment in the past 6 months and regular dental check-ups before admission demonstrated significantly lower DMFT and MT results.</br>Conclusion: In mental health facility inpatients, oral health conditions varied based on age, types of mental disorders, illness and hospitalization duration, oral care habits, and dental visits. Overall, their oral health status was less favorable than that of the general population. Regular oral exams, oral health education, and hygiene management training for facility personnel are believed to significantly improve oral health in these patients.

Changes in the Clinical Practice of Mental Health Service Providers Throughout the COVID-19 Pandemic: Longitudinal Questionnaire Study.

The COVID-19 pandemic impacted the practices of most mental health providers and resulted in a rapid transition to providing telemental health services, changes that were likely related to stay-at-home policies as well as increased need for services. The aim of this study was to examine whether these changes to practice have been sustained over time throughout the course of the COVID-19 pandemic and whether there are differences among mental health provider type and setting. We hypothesized that there would be an increase in the number of patients seen in person after the initial surge of the pandemic in spring 2020 and subsequent discontinuation of stay-at-home policies, though with continued implementation of telemental health services across settings. This study surveyed 235 of the 903 mental health providers who responded to a survey in spring 2020 (Time point 1) and at a 1-year follow-up in spring 2021 (Time point 2). Differences in practice adjustments, factors related to telemental health, and number of patients seen were examined across provider type (social worker, psychologist, neuropsychologist) and setting (academic medical center [AMC], community mental health, private practice, and Veterans Affairs hospital). From Time point 1 to Time point 2, there was a small but significant increase in the overall number of providers who were implementing telehealth (191/235, 81% to 204/235, 87%, P=.01) and there was a significant decline in canceled or rescheduled appointments (25%-50% in 2020 to 3%-7% in 2021, P<.001). Psychologists and providers working at AMCs reported decreased difficulty with telehealth implementation (P<.001), and providers working at AMCs and in private practice settings indicated they were more likely to continue telehealth services beyond spring 2021 (P<.001). The percent of time working remotely decreased overall (78% to 59%, P<.001), which was most notable among neuropsychologists and providers working at an AMC. There was an overall increase in the average number of patients seen in person per week compared with earlier in the pandemic (mean 4.3 to 8.7, P<.001), with no change in the number of patients seen via telehealth (mean 9.7 to 9.9, P=.66). These results show that the rapid transition to telemental health at the onset of the COVID-19 pandemic in spring 2020 was sustained over the next year, despite an overall increase in the number of patients seen in person. Although more providers reported returning to working on-site, over 50% of providers continued to use a hybrid model, and many providers reported they would be more likely to continue telemental health beyond spring 2021. This suggests the continued importance and reliance on telemental health services beyond the acute pandemic phase and has implications for future policies regulating the availability of telemental health services to patients.

Severe Maternal Morbidity and Mental Health Hospitalizations or Emergency Department Visits

Severe maternal morbidity (SMM) can have long-term health consequences for the affected mother. The association between SMM and future maternal mental health conditions has not been well studied. To assess the association between SMM in the first recorded birth and the risk of hospitalization or emergency department (ED) visits for a mental health condition over a 13-year period. This population-based retrospective cohort study used data from postpartum individuals aged 18 to 55 years with a first hospital delivery between 2008 and 2021 in 11 provinces and territories in Canada, except Québec. Data were analyzed from January to June 2023. SMM, defined as a composite of conditions, such as septic shock, severe preeclampsia or eclampsia, severe hemorrhage with intervention, or other complications, occurring after 20 weeks' gestation and up to 42 days after a first delivery. The main outcome was a hospitalization or ED visit for a mental health condition, including mood and anxiety disorders, substance use, schizophrenia, and other psychotic disorder, or suicidality or self-harm event, arising at least 43 days after the first birth hospitalization. Cox regression models generated hazard ratios with 95% CIs, adjusted for baseline maternal comorbidities, maternal age at delivery, income quintile, type of residence, hospital type, and delivery year. Of 2 026 594 individuals with a first hospital delivery, 1 579 392 individuals (mean [SD] age, 30.0 [5.4] years) had complete ED and hospital records and were included in analyses; among these, 35 825 individuals (2.3%) had SMM. Compared with individuals without SMM, those with SMM were older (mean [SD] age, 29.9 [5.4] years vs 30.7 [6.0] years), were more likely to deliver in a teaching tertiary care hospital (40.8% vs 51.1%), and to have preexisting conditions (eg, ≥2 conditions: 1.2% vs 5.3%), gestational diabetes (8.2% vs 11.7%), stillbirth (0.5% vs 1.6%), preterm birth (7.7% vs 25.0%), or cesarean delivery (31.0% vs 54.3%). After a median (IQR) duration of 2.6 (1.3-6.4) years, 1287 (96.1 per 10 000) individuals with SMM had a mental health hospitalization or ED visit, compared with 41 779 (73.2 per 10 000) individuals without SMM (adjusted hazard ratio, 1.26 [95% CI, 1.19-1.34]). In this cohort study of postpartum individuals with and without SMM in pregnancy and delivery, there was an increased risk of mental health hospitalizations or ED visits up to 13 years after a delivery complicated by SMM. Enhanced surveillance and provision of postpartum mental health resources may be especially important after SMM.

The attitudes of nurses towards seclusion: A New Zealand in-patient mental health setting.

Seclusion is a form of restraint practised in mental health services world-wide, and has been criticised as unethical and traumatising to patients. Several countries have committed to reducing or eliminating seclusion. In New Zealand, there has been a focus on reducing seclusion of the indigenous Māori population, who experience particularly high rates. Nurses typically lead decisions to place patients in seclusion and their attitudes towards seclusion likely influence this process. This study aimed to address the primary question: what are the attitudes of registered nurses towards the use of seclusion? A mixed methods pragmatic approach was used involving qualitative interviews of nurses working in a high seclusion mental health ward located in the North Island of New Zealand, and a quantitative analysis of the seclusion data from this ward. This report is adherent with COREQ and STROBE. Thirteen nurses were interviewed and four main themes were identified: seclusion is necessary; seclusion is being used unnecessarily; nurse characteristics influence the use of seclusion; nurses perceived their ward culture to be improving in the use of seclusion. However, analysis of seclusion data indicated that rates had been increasing for this ward prior to this study, and the rates for indigenous Māori patients were especially elevated. This pattern of increasing rates was congruent with the 'supportive' attitudes of nurses towards seclusion. Interestingly, during the time of this study, the seclusion rates began to decline, including for Māori patients. This decline may have been partially due to the increased awareness prompted by the study.

0980 Circadian Patterns of Aggressive Behaviors in a Mental Health Care Facility

0980 Circadian Patterns of Aggressive Behaviors in a Mental Health Care Facility

570 Adult Self-Inflicted Burn Demographics in West Texas

Abstract Introduction Self-inflicted burns (SIB) are a subset of burns defined based on self-injury, sometimes also referred to as self-immolation. The United States generally reports SIB in the context of psychiatric ailment. However, due to the difference in geographic locations, the West Texas burn coverage has never been checked for SIB patients. We hypothesize that patients with SIB have higher rates of psychiatric disorders and are generally older men. Methods We obtained a list of all patients admitted to the burn intensive care unit (BICU) with a Second/Third-degree burn. After, we verified the inclusion of patients meeting the study criteria from July 01, 2011, to July 01, 2021, ages between 18 and 89, and a completed Lund-Browder Chart. Data was collected from a mix of manual chart review from electronic health records and electronic data retrieval. Patients were split into two groups, SIB and non-intentional burns (NIB). Bivariate analysis was conducted using Mann Whitney U test and either Fisher’s exact test or Chi-square test when independent variables were categorical. Results The initial data set (n=2,875) decreased due to missing burn documentation, burn intensive care unit admission, and incomplete records and was split into two groups: SIB (n=49) and NIB (n=1,243). The average age and percentage of male patients compared between NIB and SIB were not significant (p=0.32, p=0.39). However, TBSA, frequency of inhalation injury, burn symmetry, suicidal ideation, history of drug abuse, history of self-harm, history of mental illness, past mental health hospitalization, and mortality were all significantly higher in the SIB group (p&amp;lt; 0.001). There was also a statistically significant higher frequency of psychological disorders in the SIB group for depression, acute schizophrenia, borderline personality disorder, bipolar disorder (p&amp;gt;0.001), anxiety disorders (p=0.02), post-traumatic stress disorder (p=0.006), atypical psychosis, drug-induced psychosis, and delirium (p=0.04). Conclusions The demographics of the West Texas SIB population are comparable to that of the United States, predominantly older male patients. Similarly, many psychiatric disorders occur at a higher frequency in SIB patients than NIB: depression, acute schizophrenia, borderline personality disorder, anxiety disorder, post—traumatic stress disorder, bipolar disorder, atypical psychosis, drug-induced psychosis, and delirium. Applicability of Research to Practice While SIB patients make a small portion of the total burn population, there burns are often associated with worse outcomes – mortality, larger burns, and length of stay. The severity of their injuries begs the need for further analysis and hopefully prevention of SIB. Addressing psychiatric facilities and preventing these incidents from occurring may offer preventative methods.

Insights into the Impact of Organizational Factors and Burnout on the Employees of a For-Profit Psychiatric Hospital during the Third Wave of the COVID-19 Pandemic.

In this paper, we provide insights into the interplay among the organizational, job, and attitudinal factors and employees' intentions to resign during the third wave of the COVID-19 pandemic at a mental health hospital. We point out shortcomings in the relationship dynamics between executive administration and operational staff and propose a pathway to develop more effective leadership frameworks to increase job satisfaction. We integrate qualitative data from case information and open-ended questions posed to employees at a mental health hospital and quantitative data from a small-scale survey (n = 19). We highlight that the ability to achieve objectives, work autonomy, burnout, affective commitment, distributive and procedural justice, and job satisfaction are critical in determining individuals' intentions to resign. Individuals identified disconnectedness and moral distress as critical aspects, while highlighting empathy, compassion, satisfaction, and confidence as pivotal elements. Mental healthcare settings could benefit from enhancing the staff's ability to achieve objectives, work autonomy, affective commitment, and both distributive and procedural justice. Addressing burnout and implementing measures to increase job satisfaction are equally vital. Efficiently restructuring dynamics between various leadership levels and staff can significantly improve employee retention.

Pharmaceutical company ranks best, worst states to live in for MH

In an analysis published last month, the online pharmacy company, Universal Drugstore, ranked the best and worst states to live in for mental health after evaluating various data points, including the prevalence of mental illness and the cost of care, FortuneWell, reported on April 8. Montana topped the list of best places to live for mental health, scoring 8.06 out of 10. The state had the lowest number by population of “mentally unhealthy adults” who cannot afford care, and residents took the second‐fewest mental health sick days in 2022. By contrast, Nevada ranked as the worst state for mental health, with a score of 2.06 out of 10. The Silver State placed in the top five for several measurements, including the highest number of mental health sick days taken and the most youth reporting depressive episodes. Nevada also had one of the lowest ratios of psychologists to residents across the nation. Breaking the data down further, South Dakota, ranked fourth as the best state for mental health with the fewest reported mental health sick days (three), while West Virginia and Louisiana, ranked 34th and 44th, reported the most (six). Adults in New Jersey, ranked 16th, had the lowest rates of mental illness diagnoses (16%), while adults residing in Utah, ranked 25th, had the highest rates of mental illness (27%). Oregon, in 50th place, ranked as the second‐worst state for mental health with a score of 2.89 out of 10, tied with New Mexico, ranked 42nd, for the nation's highest percentage of youth experiencing depressive episodes (19%); the lowest is in Washington, D.C. (11%). The nation's capital, which ranked 13th, is also home to the highest proportion of psychologists compared to Alabama, Maine, Georgia, and Louisiana. Researchers used data from the U.S. Bureau of Labor Statistics, the Kaiser Family Foundation, Mental Health America, the U.S. Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration to compile the rankings. They compared each state's ratio of psychologists to residents, the average number of mental health sick days taken, the prevalence of mental illness for adults and youth, the number of beds available in mental health facilities and the cost of prescription drugs.

Promoting a Patient-Centered Understanding of Safety in Acute Mental Health Wards: A User-Centered Design Approach to Develop a Real-Time Digital Monitoring Tool.

Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need. This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory. The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool. We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, "getting worse" or "getting better"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code. Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.

Legal Identity and Socio-Political Inclusion for Persons in Long-Stay Mental Health Facilities

Legal Identity and Socio-Political Inclusion for Persons in Long-Stay Mental Health Facilities

Providing peer support on a men’s mental health ward: a service user narrative

Purpose The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems. Design/methodology/approach This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work. Findings Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support. Originality/value Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.

Healing Architecture in Mental Health Facilities in the New European Bauhaus Context

The processes of health building design issues overlap, like the complexity of architecture, technology, and protection of human well-being. It becomes necessary to use a holistic and empathized approach. They meet the concept of the New European Bauhaus (NEB) in terms of attention to the aspects of comprehensive design with a focus on humans and their environment. The investigation focused on psychiatric hospitals with an ever-growing demand for treatment places. Accordingly, this article shows the healing architecture’s examination and the environment in healthcare facilities. The POE method was used by investigating the examples. Research contained the technical, functional, spatial, and behavioral qualities of existing psychiatric hospitals. By presenting elements that positively affect the well-being of users, we indicate good practices that bring psycho-physical benefits.

Factors Associated With Prolonged Mental Health Admissions at US Children's Hospitals.

Mental health (MH) hospitalizations at medical hospitals are associated with longer length of stay (LOS) compared with non-MH hospitalizations, but patient factors and costs associated with prolonged MH hospitalizations are unknown. The objective of this paper is to assess patient clinical and demographic factors associated with prolonged MH hospitalizations and describe variation in MH LOS across US children's hospitals. We studied children aged 5 to 20 years hospitalized with a primary MH diagnosis during 2021 and 2022 across 46 children's hospitals using the Pediatric Health Information System database. Generalized estimating equations, clustered on hospital, tested associations between patient characteristics with prolonged MH hospitalization, defined as those in the 95th percentile or above (>14 days). Among 42 654 primary MH hospitalizations, most were aged 14 to 18 (62.4%), female (68.5%), and non-Hispanic white (53.8%). The most common primary MH diagnoses were suicide/self-injury (37.4%), depressive disorders (16.6%), and eating disorders (10.9%). The median (interquartile range) LOS was 2 days (1-5), but 2169 (5.1%) experienced a hospitalization >14 days. In adjusted analyses, race and ethnicity, category of MH diagnosis, and increasing medical and MH complexity were associated with prolonged hospitalization. Our results emphasize several diagnoses and clinical descriptors for targeted interventions, such as behavioral and inpatient MH resources and discharge planning. Expanded investment in both community and inpatient MH supports have the potential to improve health equity and reduce prolonged MH hospitalizations.

Implementation of an Electronic Clinical Decision Support System for the Early Recognition and Management of Dysglycemia in an Inpatient Mental Health Setting Using CogStack: Protocol for a Pilot Hybrid Type 3 Effectiveness-Implementation Randomized Controlled Cluster Trial.

Severe mental illnesses (SMIs), including schizophrenia, bipolar affective disorder, and major depressive disorder, are associated with an increased risk of physical health comorbidities and premature mortality from conditions including cardiovascular disease and diabetes. Digital technologies such as electronic clinical decision support systems (eCDSSs) could play a crucial role in improving the clinician-led management of conditions such as dysglycemia (deranged blood sugar levels) and associated conditions such as diabetes in people with a diagnosis of SMI in mental health settings. We have developed a real-time eCDSS using CogStack, an information retrieval and extraction platform, to automatically alert clinicians with National Health Service Trust-approved, guideline-based recommendations for dysglycemia monitoring and management in secondary mental health care. This novel system aims to improve the management of dysglycemia and associated conditions, such as diabetes, in SMI. This protocol describes a pilot study to explore the acceptability, feasibility, and evaluation of its implementation in a mental health inpatient setting. This will be a pilot hybrid type 3 effectiveness-implementation randomized controlled cluster trial in inpatient mental health wards. A ward will be the unit of recruitment, where it will be randomly allocated to receive either access to the eCDSS plus usual care or usual care alone over a 4-month period. We will measure implementation outcomes, including the feasibility and acceptability of the eCDSS to clinicians, as primary outcomes, alongside secondary outcomes relating to the process of care measures such as dysglycemia screening rates. An evaluation of other implementation outcomes relating to the eCDSS will be conducted, identifying facilitators and barriers based on established implementation science frameworks. Enrollment of wards began in April 2022, after which clinical staff were recruited to take part in surveys and interviews. The intervention period of the trial began in February 2023, and subsequent data collection was completed in August 2023. Data are currently being analyzed, and results are expected to be available in June 2024. An eCDSS can have the potential to improve clinician-led management of dysglycemia in inpatient mental health settings. If found to be feasible and acceptable, then, in combination with the results of the implementation evaluation, the system can be refined and improved to support future successful implementation. A larger and more definitive effectiveness trial should then be conducted to assess its impact on clinical outcomes and to inform scalability and application to other conditions in wider mental health care settings. ClinicalTrials.gov NCT04792268; https://clinicaltrials.gov/study/NCT04792268. DERR1-10.2196/49548.

The Impact of Resilience on Workplace Violence Experienced by Mental Health Nurses: A Cross-Sectional Survey

Background. Violence at work against healthcare professionals is a frequent and pervasive problem. There are growing data that indicate nurses are especially susceptible to experiencing violent acts at work. Resilience helps strengthen nursing competency in the proper management of stressful circumstances, like being exposed to workplace violence. Aim. The aim of the study is to assess the impact of resilience on workplace violence among mental health nurses. Method. A cross-sectional research design was used to conduct this study with a convenience sample of 361 nurses recruited from a governmental psychiatric hospital in Saudi Arabia. Tools. Data were collected using two tools: the first tool was the workplace violence questionnaire, which collected nurses’ demographic, job, and workplace violence data, and the second was the resilience at work scale to assess nurses’ resilience. Results. This survey found that 70.4% of nurses experienced workplace violence in the last year, and fewer than half were resilient at work. Close to one-third (33.5%) of nurses were terrified and confused after workplace violence. The most violent repercussions were psychological (46.8%): dread, tension, and worry. Additionally, 48.8% of nurses exhibited high work resilience. Conclusion. A considerable percentage of mental health nurses encountered instances of violence during the provision of care inside mental health hospital settings. The variables of nationality (non-Saudi nurses), rotating work shift, educational levels, and exhibiting a lower level of resilience were found to have a statistically significant correlation with instances of workplace violence. Recommendation. Training programs and educational initiatives should be developed and implemented to equip nurses with the necessary knowledge and skills to effectively respond to and prevent workplace violence incidents. By providing comprehensive training, healthcare organizations can empower nurses to address and mitigate workplace violence, ultimately creating a safer and more supportive work environment.

„Nie daję łajbie żadnych szans”. Depresja: choroba czy rozczarowanie?

The subject of depression, often driven by personal experience, has lately become very prominent in the public sphere. Olga Hund's Psy ras drobnych [Dogs of Smaller Breeds] (2018) is a novel about depression, though unlike many European films and novels, it does not blame the condition on the individual – the main character of the story. Her book is memoir of sorts, a series of dramatic scenes from a mental ward of the Kobierzyn Psychiatric Hospital in Cracow. The whole is written, we may assume, to provoke out-rage: it is an accusation of the health care system, yet the blame for the mental condition rather than the wrong therapy, is put squarely on the structures and socio-economic mechanisms of the neoliberal society. The book makes two points. First, the psychiatric hospital by its very nature is a total institution that’s totally indispensable; and second – as seen from the interface of the ‘normal’ people and the mental patients – the social, economic and ideological factors have a significant role in generating suffering and the mental illness itself.

REVIEW OF MEDICATION INCIDENTS IN MENTAL HEALTH SERVICE

IntroductionIn this review, medication incidents accross different mental health care facilities was reviewed and nuances, challenges, and advancements in the administration and management of psychiatric medications was noted. Through gaining a better understanding of the complexities surrounding these incidents, valuable information can be gathered that will enhance patient safety, improving healthcare practices, and fostering a deeper understanding of the critical intersection between mental health care and medication management.ObjectivesTo identify the most frequent types of medication errors or patterns of medication errors in a mental health service accross different settings including inpatient, outpatient, liaison and long term residential unitMethodsThis is a multicentre project as it covers medication incidents in mental health care in a regianal area in Ireland. It includes an acute psychiatric Unit, the General Hospital and patients admitted in medical and surgical wards and as well long term residential care. Using the National Incident Management System we collected National Incident Report Forms (NIRF) relating mental health care provided and medication prescribed within a region in Ireland. From these we selected the ones were medication hazard was noted. Data collection happened between July 2020 and July 2021. A statuystical analysis was then performed to identify any patterns to medication errors.ResultsA total of 22 incidents were included. On review of these, it was noted, among other findings, that here was a significant increase in the frequency of medication errors during the month of December. It was also noted errors ranged from medication being given to the wrong patient, medication being given twice and medication being missed.ConclusionsMinimising medication errors requires a comprehensive, multidisciplinary approach that involves healthcare providers, patients, and healthcare systems. Healthcare organizations should foster a culture of safety where medication errors are seen as preventable and where providers are encouraged to report errors without fear of retaliation.Disclosure of InterestNone Declared

Post-traumatic stress disorder in crack/cocaine users

IntroductionCocaine use has become popular in the form of crack and has spread throughout the world. Crack/cocaine use is often linked to serious social and psychiatric disorders, including post-traumatic stress disorder, and users appear to be at increased risk of physical and mental illness and social harm.ObjectivesTo determine the prevalence of post-traumatic stress disorder in patients followed and hospitalized in the addictology department at the Arrazi psychiatric hospital in Salé for management of crack/cocaine use disorder.MethodsThis is a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria and a post-traumatic stress scale (PCLS) to investigate the existence of post-traumatic stress disorder in patients monitored and hospitalized for crack/cocaine use disorder in the addictology department at the Arrazi psychiatric hospital in Salé.ResultsWe collected 77 participants. The majority of patients were born in the city The average age of the participants was 27, with a male predominance (67%). The majority were unemployed at the time of the study, single, separated or divorced. For more than 50%, the start of drug use was more than 4 years ago. The smoked route (crack) is the most predominant, followed by the inhaled route and 1% for the injectable route. Some 37% were hospitalized in an addictology unit. Almost 65% of participants had a history of post-traumatic stress disorder.ConclusionsCo-morbidity between crack/cocaine use disorder and post-traumatic stress disorder is frequent among patients monitored and hospitalized in the addictology department at the Arrazi psychiatric hospital in Salé. There seems to be a need to develop new therapeutic strategies and to adapt existing programs to patients’ needs. In addition, understanding the profiles of patients suffering from this comorbidity in mental health facilities could help clinical staff to better accept their problems and behaviours, thus promoting treatment adherence and better outcomes.Disclosure of InterestNone Declared

Dimensions of Psychological Resilience Among Mental Health Professionals in Greece: A Postdoctoral-based Literature Review

IntroductionResilience is defined as the process and outcome of successfully adapting to difficult or challenging life experiences, and adjustment to external and internal demands, including challenges in family or relationship dynamics, serious health concerns, financial pressure or work-related stress. Employees’ creative self-sufficiency, work environment, as well as the interpersonal relationships developing in the workplace which constitute basic parameters of professional satisfaction can potentially affect both psychosomatic resilience of the employees as well as their performance at work. Exploring the available bibliography, it was revealed that the mental health professionals’ community has not been sufficiently examined in terms of emotional resilience.ObjectivesTo examine the dimensions of psychological resilience among mental health professionals.MethodsIn the context of a postdoctoral research which is conducted on a sample of the Greek population- personnel working in mental health hospital and community-based settings -a review of 35 articles from 1985 to 2023 on PubMed and Google Scholar was proceeded regarding psychological resilience among mental health professionals.ResultsCreative self-sufficiency and professional satisfaction were found to be positively correlated with resilience among mental health professionals. Additional factors have been found to influence mental resilience among mental health professionals, such as individual personality traits, coping style, perceived social support, a sense of security, and organizational support.ConclusionsThis review contributes to the evolving understanding of resilience, particularly regarding mental health prοviders. The positive correlation between creative self-sufficiency and professional satisfaction highlights the importance of fostering these dimensions to enhance mental resilience through implementing emotional capacity-building practices, social skills counseling, as well as mindfulness-based interventions.Disclosure of InterestNone Declared