Mental Facilities Research Articles

Reexamination of the relationships among neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in a sample of patients diagnosed with chronic schizophrenia and schizoaffective disorder

PurposeThis study proposed and evaluated a theoretical model for exploring the relationships between neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in individuals with chronic schizophrenia.MethodThe study recruited 229 individuals given a diagnosis of schizophrenia and schizoaffective disorders from outpatient clinics and the day ward of a mental health hospital. After informed consent was obtained, the participants underwent assessments using the backward digit span, the digit symbol, and measures of self-defeatist beliefs, experiential negative symptoms, and social functioning. A structural equation model was applied to assess the fitness of the hypothesized model, with indices such as the goodness-of-fit index, comparative fit index, root mean square error of approximation, and standardized root mean square residual being used for model evaluation.ResultsThe hypothesized model had an adequate fit. The study findings indicated that neurocognition might indirectly influence self-defeatist beliefs through its effect on experiential negative symptoms. Contrary to expectations, the study did not observe a direct influence of neurocognition, self-defeatist beliefs, or negative symptoms on social functioning. The revised model revealed the role of experiential negative symptoms in mediating the association between neurocognition and social functioning. However, self-defeatist beliefs did not significantly affect social functioning.DiscussionBefore modifying negative thoughts, enhancement of self-awareness ability can help improve negative symptoms and thereby improve the performance of social functions. Future research should develop a hierarchical program of negative symptoms, from cognition rehabilitation to enhancement of self-awareness, and end with modifying maladaptive beliefs.

De-escalating aggression in acute inpatient mental health settings: a behaviour change theory-informed, secondary qualitative analysis of staff and patient perspectives

BackgroundDe-escalation is often advocated to reduce harm associated with violence and use of restrictive interventions, but there is insufficient understanding of factors that influence de-escalation behaviour in practice. For the first time, using behaviour change and implementation science methodology, this paper aims to identify the drivers that will enhance de-escalation in acute inpatient and psychiatric intensive care mental health settings.MethodsSecondary analysis of 46 qualitative interviews with ward staff (n = 20) and patients (n = 26) informed by the Theoretical Domains Framework.ResultsCapabilities for de-escalation included knowledge (impact of trauma on memory and self-regulation and the aetiology and experience of voice hearing) and skills (emotional self-regulation, distress validation, reducing social distance, confirming autonomy, setting limits and problem-solving). Opportunities for de-escalation were limited by dysfunctional risk management cultures/ relationships between ward staff and clinical leadership, and a lack of patient involvement in safety maintenance. Motivation to engage in de-escalation was limited by negative emotion associated with moral formulations of patients and internal attributions for behaviour.ConclusionIn addition to training that enhances knowledge and skills, interventions to enhance de-escalation should target ward and organisational cultures, as well as making fundamental changes to the social and physical structure of inpatient mental health wards. Psychological interventions targeting negative emotion in staff are needed to increase motivation. This paper provides a new evidence-based framework of indicative changes that will enhance de-escalation in adult acute mental health inpatient and PICU settings.

Women’s Experiences With a Pregnancy Relapse Prevention Plan to Prevent Mental Health Symptom Relapse

ObjectiveTo describe the experiences of women with a mental health diagnosis with making and using a pregnancy relapse prevention plan (PRPP) in an effort to prevent mental health symptom relapse during the period of pregnancy, birth, and postpartum. DesignQualitative design with a phenomenological approach. SettingParticipants were recruited from an outpatient clinic within a “psychiatry and pregnancy” mental health institute in the Netherlands. ParticipantsTwelve women with a mental health diagnosis who gave birth. MeasurementsData were collected by individual semistructured interviews supported by a topic list. ResultsFour categories/themes of findings emerged from the data: Making and Advantage of the PRPP, Using the PRPP, Cooperation, and Care After Childbirth. ConclusionMaking and using a PRPP provided pregnant women with overview, predictability, and feelings of tranquility on all aspects related to pregnancy, childbirth, and the postpartum period. Participants appreciated the support and recognition the PRPP provided. The signal function of the PRPP for all who were involved (professional and nonprofessional caregivers) was described as an added value. Involvement of women’s partners and caretakers was essential. An evaluation afterward is recommended.

Strengthening Youth Emotional and Behavioral Well-Being Through Community-Academic Partnership: The EMPOWER Project.

The onset of mental health issues frequently starts during adolescence, where one third of adolescents who are 14 years and younger receive a mental health diagnosis. The state of youth mental health is a major public health concern. The EMPOWER project was developed during the COVID-19 pandemic to address youth mental health. The EMPOWER project is a partnership between two after-school programs and an academic mental health hospital in Toronto, Canada, that aims to bolster youth mental well-being. In this Practice Note, we share our community-based participatory research process of how we built the EMPOWER partnership and highlight our lessons learned so far. Through EMPOWER, we aim to codesign, deliver, and evaluate a scalable, evidence-based, and community-informed youth mental wellness curriculum that will be implemented in after-school programs.

Testing asymptomatic mental health patients for COVID-19 overburdens hospital resources

BackgroundInpatient mental health facilities required COVID-19 testing for all patients, including asymptomatic ones, due to perceived high susceptibility.AimThis study examined how the policy affected patient care and hospital resources.MethodA retrospective review was conducted on asymptomatic psychiatric patients admitted to the psychiatric emergency room between July and December 2020, analyzing COVID-19 test results, conversion rate, length of stay (LOS), and demographic variables.ResultsAmong asymptomatic patients (N = 2020), 2.5% (n = 51) tested positive, with 7.8% (n = 4) experiencing mild symptoms. The average hospital length of stay was 8 days, with 90.2% discharged home and 9.8% transferred to outside mental health inpatient facilities. Chi-square testing found no significant differences in age, gender, or housing status between positive and negative patients (p’s > 0.05), except for a significant difference in positivity rates among Hispanic patients (p < 0.05).ConclusionThe positivity rate among asymptomatic mental health patients was low. The policy of universal testing increased hospital spending and resource utilization, including unnecessary testing and hospital admissions, leading to longer stays. These findings underscore the need to assess the efficacy of COVID-19 testing policies and reconsider resource allocation based on evidence.

A Pilot Implementation and Evaluation of Speech Recognition Technology for Nurses and Health Disciplines.

This pilot study addresses the pervasive issue of burnout among nurses and health disciplines, often exacerbated by the use of electronic health record (EHR) systems. Recognizing the potential of dictation to alleviate documentation burden, the study focuses on the adoption of speech recognition technology (SRT) in a large Canadian urban mental health and addiction teaching hospital. Clinicians who participated in the pilot provided feedback on their experiences via a survey, and analytics data were examined to measure usage and adoption patterns. Preliminary feedback reveals a subset of participants rapidly embracing the technology, reporting decreased documentation times and increased efficiency. However, some clinicians experienced challenges related to initial setup time and the effort of adjusting to a novel documentation approach.

Nutrition Care Practices in Mental Health Nursing Services: Insights from a Preliminary Study from Pune, Maharashtra, India.

To assess nutrition care practices in selected mental health care facilities in Pune, Maharashtra, India. A preliminary cross-sectional study was conducted in individuals (N = 100) residing in five private mental health care facilities. Data were collected on diet quality, nutritional status, and health status of adult patients with mild to moderate mental health disorders. Food safety practices of the care facilities were also investigated. Of 100 recruited participants, 68% were over-nourished (body mass index >23 kg/m2), 32% were given vitamin B complex supplements, 81% used antipsychotic drugs, and 72% reported drug-induced gastric issues. Most participants (n = 71; 71%) consumed medium-quality diets (four to five food groups per day). Food sanitation and hygiene scores indicated fair standards (range = 46% to 51%) at these facilities. Further, partial compliance with World Health Organization guidelines was observed. Findings underscore the need for induction of nutritionists or, in their absence, additional nutrition training for mental health nurses to enhance diet quality, nutritional and health status of patients, and food safety. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

'Safer, Not Safe': Service Users' Experiences of Psychological Safety in Inpatient Mental Health Wards in the United Kingdom.

Research on patient safety in mental health settings is limited compared to physical healthcare settings. Recent qualitative studies have highlighted that patient safety is more than just physical safety but includes psychological safety. Traditionally, psychological safety has been defined as the belief that it is safe to take interpersonal risks, such as speaking up, without a fear of negative consequences. However, to date, it is not clear what constitutes psychological safety for service users of inpatient mental health settings. To understand this, we conducted 12 interviews with former inpatient mental health service users. Interviews were analysed with Reflexive Thematic Analysis, and five themes were developed. All themes had subthemes. Overall, we found that participants were more readily able to draw on situations where they felt psychologically unsafe, rather than safe. Psychological safety in service users was influenced by (1) healthcare staff attitudes and behaviours towards them, (2) their relationships with other service users, (3) whether they felt they had any control over their environment and medical decision-making regarding their care, (4) their experiences of physically safety, feeling listened to and believed and (5) access to meaningful occupation on the wards. These findings suggest that changes are needed to enhance inpatient mental health service users' general experiences of psychological safety. Further research will need to (1) further develop understanding of the concept of psychological safety for service users and (2) identify interventions, and such interventions should be co-designed with service users.

Acoustic design considerations for mental and behavioral healthcare facilities

The acoustic environment in healthcare settings can impact patient comfort and clinical outcomes. Design of mental and behavioral healthcare facilities have the unique challenge of balancing acoustic needs with the considerations of patient safety, maintenance requirements, and cost-effective design. The acoustic quality of these patient care spaces is often overlooked or considered impractical to achieve due to other design constraints. This evaluation reviews the applicable acoustic guidelines and unique design considerations related to mental and behavioral healthcare facilities, current design practices, and developer feedback for recently constructed facilities.

Needs Expressed in Peer-to-Peer Web-Based Interactions Among People With Depression and Anxiety Disorders Hospitalized in a Mental Health Facility: Mixed Methods Study.

Hospitalization in psychiatric wards is a necessary step for many individuals experiencing severe mental health issues. However, being hospitalized can also be a stressful and unsettling experience. It is crucial to understand and address the various needs of hospitalized individuals with psychiatric disorders to promote their overall well-being and support their recovery. Our objectives were to identify and describe individual needs related to mental hospitals through peer-to-peer interactions on Polish web-based forums among individuals with depression and anxiety disorders and to assess whether these needs were addressed by peers. We conducted a search of web-based forums focused on depression and anxiety and selected samples of 160 and 176 posts, respectively, until we reached saturation. A mixed methods analysis that included an in-depth content analysis, the Pearson χ2 test, and φ coefficient was used to evaluate the posts. The most frequently identified needs were the same for depression and anxiety forums and involved informational (105/160, 65.6% and 169/393, 43%, respectively), social life (17/160, 10.6% and 90/393, 22.9%, respectively), and emotional (9/160, 5.6% and 66/393, 16.8%, respectively) needs. The results show that there is no difference in the expression of needs between the analyzed forums. The needs were directly (42/47, 89% vs 98/110, 89.1% of times for depression and anxiety, respectively) and not fully (27/47, 57% vs 86/110, 78.2% of times for depression and anxiety, respectively) addressed by forum users. In quantitative analysis, we found that depression-related forums had more posts about the need for informational support and rectification, the expression of anger, and seeking professional support. By contrast, anxiety-related forums had more posts about the need for emotional support; social life; and information concerning medications, hope, and motivation. The most common co-occurrence of expressed needs was between sharing own experience and the need for professional support, with a strong positive association. The qualitative analysis showed that users join web-based communities to discuss their fears and questions about psychiatric hospitals. The posts revealed 4 mental and emotional representations of psychiatric hospitals: the hospital as an unknown place, the ambivalence of presumptions and needs, the negative representation of psychiatric hospitals, and the people associated with psychiatric hospitals. The tone of the posts was mostly negative, with discussions revolving around negative stereotypes; traumatic experiences; and beliefs that increased anxiety, shock, and fright and deterred users from hospitalization. Our study demonstrates that web-based forums can provide a platform for individuals with depression and anxiety disorders to express a wide range of needs. Most needs were addressed by peers but not sufficiently. Mental health professionals can benefit from these findings by gaining insights into the unique needs and concerns of their patients, thus allowing for more effective treatment and support.

Examination of Cases Who Admitted to the Emergency Department of a Mental Health Hospital in 2020

Objective: This study aimed to retrospectively examine the sociodemographic and clinical characteristics of cases who admitted to the emergency department of a mental health hospital in 2020. Material and Methods: Cases who admitted to the emergency department of XXX Mental Health and Diseases Hospital between 01.01.2020 and 31.12.2020 were included. Sociodemographic and clinical data of the cases were accessed through the patient record system. Results: The total number of applications to the XXX MHDH emergency department between the specified dates was 7071 [5262 (74.4%) male and 1809 (25.6%) female].Sixty-four percent of the cases admitted through the Social Security Institution and 28% through the Ministry of Justice. Seven thousand fifty-five cases (99.7%) were the Republic of Turkey citizens. Three thousand two hundred fifty-four (46.0%) of the cases were evaluated within the scope of medical examination, 1599 (22.6%) were injection, 156 (2.2%) were involuntary hospitalization, and 1887 (26.7%) were judicial illegal substance screening. While 5877 (83.1%) of the cases left the emergency department after examination, 1194 (16.9%) were hospitalized at XXX MHDH. Two thousand one hundred forty-six (30.3%) of the cases were diagnosed with general psychiatric examination, 866 (12.2%) were anxiety spectrum disorders, 1464 (20.7%) were schizophrenia spectrum disorders, and 1658 (23.4%) were bipolar spectrum disorders. A statistically significant difference was found between male and female cases in terms of health insurance (p

Reliability and Factor Structure of the Well-Being and Respect for Human Rights Questionnaire in Measuring Caregivers' Perception.

This study has investigated perceptions of respect for users' rights among informal caregivers in mental healthcare settings, aligning with the guidelines outlined in the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the World Health Organization QualityRights initiative. The study has employed the questionnaire on Well-being at Work and Respect for Human Rights (WWRR) among informal caregivers and tested whether the questionnaire's factor structure among informal caregivers aligns with that of users and health workers. We have hypothesized that informal caregivers prioritize users' needs and rights over the care context's climate. This was a cross-sectional study. The "Well-being at Work and Respect for Human Rights" questionnaire was distributed to 100 caregivers in 4 territorial mental health facilities in Sardinia, Italy. Confirmatory Factor Analysis (CFA) was utilized to assess the participants' responses. Participants reported high satisfaction with their relatives' treatment, perceiving a high level of respect for human rights among users and healthcare professionals. However, they highlighted insufficient resources for services, particularly the need for additional staff. CFA revealed that a scale with the first five items demonstrated good reliability, convergent validity, and discrimination. Mean scores indicated high satisfaction and perception of respect for human rights across the sample, with no significant differences by age or gender. Satisfaction with users' rights is closely correlated with other factors comprising the notion of organizational well-being within a healthcare service.

Certified Community Behavioral Health Clinic Services for Clients With Co-occurring Disorders: A Latent Class Approach.

Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided. The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics. A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes. CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.

Mental Health Hospitalizations in Canadian Children, Adolescents, and Young Adults Over the COVID-19 Pandemic

The COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population. To estimate the incidence of hospitalizations for mental health conditions, stratified by sex, region, and social determinants, in children and adolescents (hereinafter referred to as youths) and young adults comparing the prepandemic and pandemic-prevalent periods. This Canadian population-based repeated ecological cross-sectional study used health administrative data, extending from April 1, 2016, to March 31, 2023. All youths and young adults from 6 to 20 years of age in each of the Canadian provinces and territories were included. Data were provided by the Canadian Institute for Health Information for all provinces except Quebec; the Institut National d'Excellence en Santé et en Services Sociaux provided aggregate data for Quebec. The COVID-19-prevalent period, defined as April 1, 2020, to March 31, 2023. The main outcome measures were the prepandemic and COVID-19-prevalent incidence rates of hospitalizations for anxiety, mood disorders, eating disorders, schizophrenia or psychosis, personality disorders, substance-related disorders, and self-harm. Secondary measures included hospitalization differences by sex, age group, and deprivation as well as emergency department visits for the same mental health conditions. Among Canadian youths and young adults during the study period, there were 218 101 hospitalizations for mental health conditions (ages 6 to 11 years: 5.8%, 12 to 17 years: 66.9%, and 18 to 20 years: 27.3%; 66.0% female). The rate of mental health hospitalizations decreased from 51.6 to 47.9 per 10 000 person-years between the prepandemic and COVID-19-prevalent years. However, the pandemic was associated with a rise in hospitalizations for anxiety (incidence rate ratio [IRR], 1.11; 95% CI, 1.08-1.14), personality disorders (IRR, 1.21; 95% CI, 1.16-1.25), suicide and self-harm (IRR, 1.10; 95% CI, 1.07-1.13), and eating disorders (IRR, 1.66; 95% CI, 1.60-1.73) in females and for eating disorders (IRR, 1.47; 95% CI, 1.31-1.67) in males. In both sexes, there was a decrease in hospitalizations for mood disorders (IRR, 0.84; 95% CI, 0.83-0.86), substance-related disorders (IRR, 0.83; 95% CI, 0.81-0.86), and other mental health disorders (IRR, 0.78; 95% CI, 0.76-0.79). This cross-sectional study of Canadian youths and young adults found a rise in anxiety, personality disorders, and suicidality in females and a rise in eating disorders in both sexes in the COVID-19-prevalent period. These results suggest that in future pandemics, policymakers should support youths and young adults who are particularly vulnerable to deterioration in mental health conditions during public health restrictions, including eating disorders, anxiety, and suicidality.

“Effectiveness Of Nursing Interventions Regarding Homecare Management Of Depressive Patients Among Primary Caregivers In Selected Mental Health Hospitals.”

“Effectiveness Of Nursing Interventions Regarding Homecare Management Of Depressive Patients Among Primary Caregivers In Selected Mental Health Hospitals.”

Adapting of Mental Healthcare Facilities to the COVID-19 Challenges

The healthcare sector is one of the largest in the US economy (generating about 18% of GDP). It is the main employer of American workers. Unfortunately, it has been one of those most affected by the COVID-19 pandemic, as certain medical services had to be suspended under strict quarantine (at least 150 hospitals in the US were forced to send employees on leave or dismiss them, primary care practices reported a 70% decrease in the number of patients). The purpose of the article is to analyse challenges in the US healthcare sector during COVID-19 and to justify ways to overcome these challenges (on the example of the Life Chance Mental Health Medical Group, a leading provider of mental health services in the US with a strong regional network, established good reputation and a wide and loyal customer base). The case of this company was chosen in this context based on the fact that, as the SWOT analysis in the article showed, during the COVID-19 pandemic, the greatest vulnerabilities of medical institutions in the mental health sector are related to the quality of basic services (face-to-face therapy sessions). That is significantly reduced if provided online. In order to operate effectively even during epidemics and pandemics, companies in this specific area should expand partnerships with telemedicine platforms, transform their product portfolio, and ensure that their doctors’ qualification profiles meet the requirements of remote therapy. The article analyses the mechanisms for overcoming pandemic challenges in mental healthcare facilities using the postulates of transformational leadership theory, change management theory, theory of constraints, and organisational culture theory.

Connection, disconnection and reconnection in peer support: a summary of the case of “Christopher”

Purpose The purpose of this service user paper and narrative is to highlight that peer support is not a continuous, easy or uniform process but given to disruption, fragmentation, breakdowns in relationships and hurdles. This is illustrated in a summary of the case of “Christopher”. Design/methodology/approach A reflective journal was kept, and participant observation was conducted for just under a year on the ward where Christopher was under Section. Findings Peer support can be given to fissure, breakages in relationships and discontinuity. This can negatively impact the mental health of peer support workers. With this in mind, it is vitally important to ensure that the people who take up this role are appropriately trained, supported and supervised. There needs to be a focus on “restorative” supervision and supervision by someone with experience of the peer support role as well as buddying between peer workers. Originality/value There is an abundance of literature and research on peer support in the community but little in the inpatient setting, making this paper novel and a contribution to understanding peer support on mental health wards.

P-491 Reproductive mental health empowerment: enhancing mental health literacy among women with reproductive health issues

Abstract Study question What is the role of mental health literacy and its impact on women’s help-seeking when there are reproductive mental health issues? Summary answer Mental health literacy and attitudes toward seeking professional help significantly predict one’s emotional well-being and help-seeking behaviour. What is known already Women who encounter reproductive health issues can experience an array of physical issues as well as emotional hurdles. There are barriers at the societal level that impede women from addressing these reproductive health-related mental health challenges, such as social stigma, lack of attention on mental wellness and a disproportionate amount of focus on the fertility treatments’ outcomes. There is limited understanding regarding the relationship between women’s reproductive mental health literacy and their tendencies to seek help in the literature. Study design, size, duration This study used cross-sectional data from an online questionnaire that explored the participants’ reproductive mental health literacy, attitudes towards seeking professional help and their actual help-seeking behaviour. Data were collected between July and September 2023. Participants/materials, setting, methods Participants were 356 Chinese women (mean age = 32.64±7.15) recruited through community network and social media. Participants answered questions related to their knowledge of mental illness, ability of seeking professional help, recognition of mental illness, acceptance of patients with mental illness, recognition of need for psychotherapeutic help, stigma tolerance, interpersonal openness, confidence in mental health practitioner, knowledge on community resource and their actual help seeking behaviour. Main results and the role of chance 59% of the participants attained a Bachelor’s degree or above and 74% were married. 43.5% of the participants experienced emotional disturbances triggered by reproductive health issues. Among these participants, 52% chose not to seek help from others. Among different types of reproductive problems, participants with fertility and reproductive health problem scored lowest in terms of help-seeking behavior (M = .28, SD = .45, p&amp;lt;.05., reproductive mental health knowledge (M = 27.29, SD = 4.39, p&amp;lt;.01), recognition of mental illness (M = 16.73, SD = 4.0,p&amp;lt;.05), recognition of need for psychotherapeutic help (M = 17.99, SD = 3.63, p&amp;lt;.01), and interpersonal openness (M = 16.85, SD = 3.35, p&amp;lt;.01). In terms of emotional disturbances, the result indicated that acceptance of patients with mental illness (b = -.035, p &amp;lt;.05) and recognition of the need for psychotherapeutic help (b = .068, p &amp;lt;.05) predicted the numbers of emotional disturbances one experienced. In terms of help-seeking behaviour, knowledge of mental illness (B = 1.30, p &amp;lt; .01), recognition of the need for psychotherapeutic help (B = 1.49, p &amp;lt; .01), and knowledge of community resources (B = 2.15, p &amp;lt; .01) significantly predicted one’s actual help-seeking behaviour. Limitations, reasons for caution There may be potential confounding factors that influenced the results, such as previous mental health history and use of mental health facilities. The ability to establish a causal relationship between reproductive mental health literacy, help-seeking attitude, and actual help-seeking is constrained due to the study’s utilization of a cross-sectional design. Wider implications of the findings Providing counseling for infertility plays a crucial role in addressing the emotional and psychological needs of individuals by reducing the stigma surrounding reproductive mental health challenges. Incorporating infertility counseling into fertility treatment empowers women with information and facilitates open and honest communication on mental well-being. Trial registration number Not applicable

Dementia in-patient units in psychiatric hospitals: research priority setting

Aims and method Dementia in-patient units (DIU) are mental health wards that care for people living with dementia (PLWD) whose symptoms are causing severe distress or potential risk. DIUs look after some of the most vulnerable and unwell people in society, yet they are environments that are underresearched: a recent systematic review revealed only 36 articles worldwide relating to DIUs. To better understand research priorities in DIUs, we undertook a two-round online Delphi survey of PLWD with experience of DIUs, their carers and professionals who work in DIUs. Results Ten research priorities were described and ranked. The top three were how to use non-pharmacological techniques to manage non-cognitive symptoms of dementia, supporting families and better understanding of how to discharge PLWD safely and healthily. Clinical implications This is the first Delphi consensus to describe DIU research priorities. This paper will help researchers focus on the areas that matter most to people who use DIUs.

The woman who named God: encountering Hagar in a mental health facility

Set within the biblical narrative of Sarah and Abraham is the figure of Hagar – Sarah’s slave. The significance of Hagar is often overlooked. This article re-examines her story and identifies her own matriarchal status as an intelligent and resourceful woman of faith. Noting that God and Hagar knew each other by name, the author (an experienced hospital chaplain) demonstrates how Hagar’s experience can help both clinicians and patients in a mental health environment. Hagar is a model of transcendence – living above the circumstances that hinder our abilities to flourish.