Mental Facilities Research Articles

Nursing Students' Attitudes toward Working in Mental Health Facilities in Saudi Arabia: A Cross-Sectional Study.

(1) Background: There is a global demand for more psychiatric nurses, with nursing students' attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health facilities among undergraduate nursing students in Saudi Arabia, both before and after exposure to psychiatry courses, and examine their relationship with perceptions of mental illness. (2) Methods: A quantitative descriptive and correlational cross-sectional design was employed. Nursing students' attitudes toward working in mental health facilities were assessed using the Attitude Toward Psychiatry 18 (ATP-18) questionnaire and the Beliefs Toward Mental Illness (BMI) scale. (3) Results: No significant relationship has been found between the frequency of negative views of both ATP-18 and BMI, and exposure to the psychiatry course. However, nurses who completed the psychiatry course held more positive views towards psychiatrists and found psychiatric patients less demanding, were less likely to view psychological disorders as dangerous, more confident in trusting mentally ill colleagues, and felt less embarrassed by the term "psychological disorder" compared to those who had not taken the course. (4) Conclusion: Based on our findings, it is evident that exposure to psychiatric courses and training enhances the potential of nursing students to contribute effectively to the psychiatric field. Therefore, integrating mental health and illness community services training into nursing education programs can play a pivotal role in raising awareness and attracting students who may hold negative attitudes towards individuals with mental illness.

Economical Impact of Integration of Mental Health Services to Primary Care - A Review.

There are numerous people all across the world who are struggling with mental health (MH) conditions. There is a growing recognition of the significance of MH as a primary cause of disability with substantial effects on daily functioning. The Ministry of Health's financial division oversees money with the Ministry of Finance's approval. Thus, this review explores the economics of integrating MH services in a primary healthcare center (PHC) in Saudi Arabia (SA). The incorporation of MH services into basic medical care is required as it ensures that the general population has access to the necessary MH care and the likelihood of better health outcomes is raised when receiving treatment in PHCs. The majority of funds that are now allocated to the provision of MH care are used to pay the wages of MH professionals and paramedical staff members who are employed in mental hospitals, as well as to invest in the development of infrastructure and education of MH experts. A report found that MH expenditures accounted for 4% of the entire budget for health care. The expenditure for mental hospitals was 22% of the total for MH hospitals. The allocation of funds is integral for the PHCs to perform at their maximum potential in the MH domain. Thus, this review explores the economics of integrating MH services in a PHC in S SA.

Implementing a Hospital Call Center Service for Mental Health in Uganda: User-Centered Design Approach.

Mental health conditions are a significant public health problem globally, responsible for >8 million deaths per year. In addition, they lead to lost productivity, exacerbate physical illness, and are associated with stigma and human rights violations. Uganda, like many low- and middle-income countries, faces a massive treatment gap for mental health conditions, and numerous sociocultural challenges exacerbate the burden of mental health conditions. This study aims to describe the development and formative evaluation of a digital health intervention for improving access to mental health care in Uganda. This qualitative study used user-centered design and design science research principles. Stakeholders, including patients, caregivers, mental health care providers, and implementation experts (N=65), participated in focus group discussions in which we explored participants' experience of mental illness and mental health care, experience with digital interventions, and opinions about a proposed digital mental health service. Data were analyzed using the Consolidated Framework for Implementation Research to derive requirements for the digital solution, which was iteratively cocreated with users and piloted. Several challenges were identified, including a severe shortage of mental health facilities, unmet mental health information needs, heavy burden of caregiving, financial challenges, stigma, and negative beliefs related to mental health. Participants' enthusiasm about digital solutions as a feasible, acceptable, and convenient method for accessing mental health services was also revealed, along with recommendations to make the service user-friendly, affordable, and available 24×7 and to ensure anonymity. A hospital call center service was developed to provide mental health information and advice in 2 languages through interactive voice response and live calls with health care professionals and peer support workers (recovering patients). In the 4 months after launch, 456 calls, from 236 unique numbers, were made to the system, of which 99 (21.7%) calls went to voicemails (out-of-office hours). Of the remaining 357 calls, 80 (22.4%) calls stopped at the interactive voice response, 231 (64.7%) calls were answered by call agents, and 22 (6.2%) calls were not answered. User feedback was positive, with callers appreciating the inclusion of peer support workers who share their recovery journeys. However, some participant recommendations (eg, adding video call options) or individualized needs (eg, prescriptions) could not be accommodated due to resource limitations or technical feasibility. This study demonstrates a systematic and theory-driven approach to developing contextually appropriate digital solutions for improving mental health care in Uganda and similar contexts. The positive reception of the implemented service underscores its potential impact. Future research should address the identified limitations and evaluate clinical outcomes of long-term adoption.

Electroconvulsive therapy in a tertiary Australian mental health facility between 2009 and 2020.

Despite electroconvulsive therapy being one of the most effective treatments in psychiatry, few studies report trends in the provision of electroconvulsive therapy over time. This study aims to investigate the use of electroconvulsive therapy between 2009 and 2020 in an Australian public tertiary mental health facility, and to describe the electroconvulsive therapy patient population and change in courses of treatment. Routinely collected data for 677 patients who received 1669 electroconvulsive therapy courses of treatment at an Australian public tertiary mental health facility between 2009 and 2020 were examined. The provision of acute electroconvulsive therapy was stable across the study period; however, the number of maintenance electroconvulsive therapy courses commenced declined over the study. Schizophrenia was the most common indication for index treatment (37.4%). The majority of patients (85.7%) received acute electroconvulsive therapy only. Voluntary provision of electroconvulsive therapy declined over the study period, reducing from 44.9% in 2009 to 16.3% in 2020. Over the study period, there was a significant reduction in the number of maintenance electroconvulsive therapy courses commenced, and a large increase in involuntary treatment. The provision of electroconvulsive therapy was more likely to occur in males with a diagnosis of schizophrenia. Further studies are needed to generate a greater understanding of the factors influencing the provision of electroconvulsive therapy within differing geographical, social and healthcare landscapes.

SafeVRwards: Designing a complementary virtual reality module to the Safewards framework intended to relax and manage conflict in mental health wards

BackgroundAggression and negative activation in mental health inpatient units pose significant challenges for both patients and staff with severe physical and psychological ramifications. The Safewards model is an evidence-based conflict-containment...

Mental health facilities with ketamine infusion therapy in the United States in 2020: Co-location of dual diagnosis mental health and substance use disorder treatment.

Ketamine is an anesthetic that has been identified as an effective therapy for depressive disorders and related symptoms. Some studies have identified ketamine as having the potential to reduce substance use among individuals with a substance use disorder (SUD)-alongside psychotherapy. Further, SUDs often co-occur with depressive disorders. Using the National Mental Health Services Survey 2020, this study examined a national sample of N = 134 U.S. mental health treatment facilities that provide ketamine infusion therapy (KIT) to identify their geographic locations; availability of individual, couples/family, and group counseling; payment options; and capacity to provide treatment for dually diagnosed mental health (MH) and substance use disorders. Approximately 63% (n = 85) of the facilities in this sample had dual diagnosis MH and SUD treatment. Having group therapy was associated with having dual diagnosis MH and SUD treatment. Alternatively, accepting Medicaid was not associated with having dual diagnosis MH and SUD treatment. This exploratory study estimates dual diagnosis MH and SUD treatment availability among MH treatment facilities offering KIT. Given evidence of KIT's ability to effectively treat depressive disorders and that SUDs often co-occur with them (ketamine's effectiveness in treating substance use disorders warrants further study), the present study's up-to-date information about the distribution salient characteristics of MH facilities that offer this effective treatment can inform future efforts to identify the potential of these facilities to treat co-occurring disorders with ketamine and psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Certified Community Behavioral Health Clinic Demonstration Impact on Health Care Utilization Among Non-Medicaid Patients with Severe Mental Illnesses.

In 2017, the Certified Community Behavioral Health Clinic (CCBHC) demonstration was implemented in New York State to redesign care delivery and financing for behavioral health services. Although CCBHC primarily targeted Medicaid patients, it was hypothesized that the clinic-level benefits of CCBHC were expected to impact even non-Medicaid patients treated in CCBHCs. To test this hypothesis, this study conducted a health insurance claims data analysis of non-Medicaid (ie, commercial and Medicare) patients with severe mental illnesses, comparing a cohort of CCBHC-treated patients with a propensity score-matched comparison cohort of patients treated by non-CCBHC clinics on rates of mental health service utilization, hospitalization, and emergency department (ED) visits. The data suggested CCBHC was associated with more than 10% increase in outpatient mental health service utilization by the patients' second year of CCBHC exposure, accompanied by similarly significant reductions in the rates of all-cause ED visits and non-psychiatric hospitalization. These findings suggest that for behavioral health clinics that serve a sufficiently large population of Medicaid, the impact of innovative clinical redesign attributable to CCBHC is likely to extend to all patients treated by them.

Keeping Up Standards: An Audit of Adherence to Admission Standards on Acute Mental Health Wards in NHS Lanarkshire

Keeping Up Standards: An Audit of Adherence to Admission Standards on Acute Mental Health Wards in NHS Lanarkshire

Experience of violence, social support, nursing practice environment, and burnout on mental health among mental health nurses in South Korea: A structural equation modeling analysis

AimsThis study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses. MethodsStructured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs. ResultsThe total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health. ConclusionThe study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health. ImplementationOur research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.

Optimizing Patient Safety and Security Management in Zambian Mental Health Facility: A PDSA Quality Improvement Study

Delivering specialized and top-tier psychiatric care necessitates an intricate and well-thought-out plan focusing on the safety and security of both healthcare professionals and patients. In the realm of mental health, particularly in specialized clinics and hospitals where patients may require admission and intricate treatment plans, the safety and security of the healthcare environment are paramount. It is crucial to ensure the comprehensive and tailored protection of mental health workers, particularly those operating in shift patterns. A well-devised strategy can significantly enhance the overall safety and security within a healthcare facility, potentially streamlining operational costs while minimizing both immediate and long-term risks associated with breaches in safety and security protocols. The aim of this research was to bolster safety and security protocols within mental health treatment establishments by identifying and addressing operational hurdles faced by ancillary mental health staff. To achieve this, the study implemented the Plan-Do-Study-Act (PDSA) cycle, a cornerstone methodology in quality management systems. The PDSA cycle’s pragmatic ethos encourages a methodical, iterative approach to integrating new methodologies into any process, particularly those aiming to elevate security and safety standards. This model was specifically employed to refine the functioning of the security and safety department at a private mental health facility in Lusaka, Zambia. The anticipated outcome is that this approach will not only safeguard the immediate and future well-being of healthcare personnel and patients but also foster a holistic and efficient operational environment for mental healthcare services.

RETRACTION: Reduced self-harm on acute mental health wards following the implementation of a vision-based patient monitoring system: Evidence from five NHS trusts.

M. Kekic, A. Rose, C. Baker, and D. Bayley, 'Reduced self-harm on acute mental health wards following the implementation of a vision-based patient monitoring system: Evidence from five NHS trusts,' Journal of Psychiatric and Mental Health Nursing (Early View), https://doi.org/10.1111/jpm.13036. The above article, published online on 05 March 2024 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Hugh McKenna, and John Wiley & Sons Ltd. The retraction has been agreed due to an undisclosed conflict of interest by the authors, which was reported in a complaint by a third party. Following an investigation, it was confirmed that, while the authors reported their employment status with Oxehealth Ltd. in their personal affiliations section, they failed to do so in a conflict of interest statement as required by the journal. Because the journal uses a double-blind peer review process, neither the names of the authors nor their affiliations were visible to the reviewers and editors during evaluation of the manuscript. Had an employment status disclosure been made clear in a conflict-of-interest statement in accordance with the journal's submission guidelines, the Editor-in-Chief and all associate editors would have considered author employment by Oxehealth Ltd., the developer of the technology evaluated by the authors, as a major competing interest and would have rejected the manuscript without peer review. Therefore, the article must be retracted. Dr. Kekic disagrees with the retraction, on behalf of all the authors.

Investigating the Associations between Patient-Reported Quality of Care and Perceived Coercion: A Norwegian Cross-Sectional Study

Patient perspectives on the quality of care received are fundamental to mental health care. This study aimed to investigate the association between patient-reported mental health care quality, perceived coercion, and various demographic, clinical, and ward-related factors. Using a cross-sectional design, data were collected from 169 patients in Norwegian mental health wards using the quality in psychiatric care–inpatient (QPC-IP) instrument and experienced coercion scale (ECS). The analysis revealed a consistent pattern in which patients with higher perceived coercion consistently rated lower quality on all QPC-IP dimensions. The significant findings of the multiple regression models further supported this association. Beyond coercion, the factors influencing quality ratings include self-reported treatment results, participation in treatment planning, and knowledge of complaint procedures. Emphasizing the pivotal role of coercion in enhancing mental health care quality, these findings contribute to a nuanced understanding of patient experiences and underscore the importance of patient participation in mental health care improvement efforts.

Antidepressant adherence among outpatients with major depressive disorder

Major Depressive Disorder (MDD) is a global mental health concern, with treatment often involving antidepressant (AD) medications. However, adherence to these medications remains a significant challenge. This study aims to investigate the factors influencing medication adherence among individuals with MDD in Erbil, Iraq. This study was conducted at Erbil Psychiatric Hospital, a leading mental healthcare facility in Erbil city. Participants aged 18 to 65, diagnosed with MDD as per the DSM-5 criteria, were treated with antidepressants. The recruitment of 106 participants was facilitated by their treating psychiatrists at the hospital. Data analysis was conducted using SPSS version 22, standard for social science research. Out of the 106 participants, 64.2% were females, and 35.8% were males. The largest age group was 35–45, comprising 33% of the sample. A vast majority (99.1%) were under regular follow-up, with only 0.9% experiencing relapse. The primary antidepressant used was selective serotonin reuptake inhibitors (SSRIs) (72.6%). Most participants (61.3%) reported very high medication adherence. The notable barriers included treatment duration (13.4%), forgetting to take antidepressants (11.9%), frequent medication refills (17.9%), cultural and religious beliefs (19.3%), stigma (19.3%), travelling issues (42.9%), and lack of hospitals and clinics (30.8%). Healthcare facilitators such as effectiveness of antidepressants (27.5%), patient-provider relationship such as trusting healthcare providers (50.7%), and reminders such as keeping pills in visible places (65.9%) were prominent facilitators aiding adherence. Future research should focus on culturally tailored interventions and collaborative efforts among stakeholders. By addressing socio-cultural nuances and enhancing mental health support, more effective strategies can be developed to tackle medication adherence challenges in Erbil’s unique context.

Artificial Neural Network Analysis Examining Substance Use Problems Co-Occurring with Anxiety and Depressive Disorders Among Adults Receiving Mental Health Treatment

Objective: The co-occurrence of anxiety disorders, depressive disorders, and substance use problems was examined. Methods: The Mental Health Client-Level Data dataset was used to conduct logistic regression models and an artificial neural network analysis. Logistic regression analyses were conducted among adults with anxiety (n = 547,473) or depressive disorders (n = 1,610,601) as their primary diagnosis who received treatment in a community mental health center. The artificial neural network analysis was conducted with the entire sample (N = 2,158,074). Results: Approximately 30% of the sample had co-occurring high-risk substance use or substance use disorder. Characteristics including region of treatment receipt, age, education, gender, race and ethnicity, and the presence of co-occurring anxiety and depressive disorders were associated with the co-occurring high-risk substance use or a substance use disorder. Conclusions: Findings from this study highlight the importance of mental health facilities to screen for and provide integrated treatment for co-occurring disorders.

Retrospective study on the emotional status of healthcare workers in a COVID-19 field hospital in Oman.

To combat the overwhelming demand for medical services and care during the COVID-19 Pandemic, the Sultanate of Oman launched the COVID-19 Field Hospital in 2020, designed to respond and alleviate the burden on the medical infrastructure. Several studies globally and from the Middle East suggested that frontline healthcare workers (HCW) were at risk of developing markers of psychological distress. It was further understood through research findings that HCW were resilient during times of crisis. However, there is a dearth in studies evaluating the emotional status of frontline HCW posted in the COVID-19 field hospitals in Gulf Countries, including Oman. This study attempts to shed light on the emotional status of HCW that were on the frontlines in the field hospital in the Sultanate of Oman. This study aims to quantify and evaluate the emotional status of HCW in the frontline field hospital by screening for symptoms of depression, anxiety, and sleep quality. The data was collected by a local private mental healthcare facility as part of digital feedback to design and implement supportive strategies. Data was collected between September 2021 and October 2021 from 121 HCW in the COVID-19 Field hospital in Oman via 'WhatsApp'. Chi square and binary logistic regression tests were administered to evaluate the data. The participants comprised of 63.6% females and 79.3% were between 30 and 39 years of age. Majority of the participants (65.2%) described themselves as 'financially unstable' and possess an average of 7.5 years of work experience. Of the participants 73.6% of the HCW were based solely in the field hospital for 6-9 months at the time of the survey. Majority of the participants denied the presence of emotional distress expressed through depression (92.6%), anxiety (92.6%) and poor quality of sleep (59.5%). The findings of the present study reflect the HCW ability to cope during challenging situations likely owing to a variety of environmental, social and personal protective factors. The findings of this study can translate into further research on identifying and addressing stressors and targeting the enhancement of protective factors to safeguard the well-being of HCW.

Development and evaluation of a personalised sleep care plan on child and adolescent in-patient mental health wards.

The study evaluated a package of measures to improve sleep on psychiatric wards admitting patients from children and young people's services (CYPS). Sleep disturbance has significant impact on adolescent mental health, and in-patient wards can directly cause sleep disturbance, independent of the problem that led to admission. We developed a CYPS-specific package (TeenSleepWell) that promoted a better sleep environment, enhanced staff education about sleep, screened for sleep disorders, and raised awareness of benefits and side-effects of hypnotics. This included personalised sleep care plans that allowed a protected 8 h sleep period when safe. Evaluation over 2 years showed enhanced in-patient care: 57% of patients were able to have a protected sleep period. There was no increase in adverse events and there was a decrease in hypnotics issued. Improving sleep during in-patient CYPS admissions is possible and personalised sleep care plan should be a care standard.

Depression and anxiety as predictors of performance status and life satisfaction in older adult neurological patients: a cross-sectional cohort study.

Neurological disorders are one of the leading causes of disability globally. Studies emphasise that the course and effectiveness of rehabilitation interventions may be influenced by emotional factors. The aim of the present study was to assess the prevalence of depressive and anxiety symptoms in patients with neurological disorders and examine whether depression and tendency to respond with anxiety are predictors of disability in these patients. The study included 229 individuals with neurological disorders aged over 55. Our findings show that stroke patients are more likely to experience depressive symptoms and are more likely to display trait anxiety as compared with patients with other neurological disorders. Advanced age, female sex, low level of education and the presence of trait anxiety are associated with a higher severity of depressive symptoms. Stroke survivors have significantly poorer ECOG performance scores and are more likely to be incapable for work. Both depression and trait anxiety are significant predictors of neurological patients' performance status, and the presence of depressive symptoms is a determinant of these patients' level of satisfaction with life. An understanding of psychological risk factors for poorer performance status in individuals with neurological disorders will make it possible to plan prophylactic interventions in order to minimise negative health impacts and facilitate access to mental health facilities.

Violence Detection in Jails and Mental Asylums

This research investigates the use of Long- term Recurrent Convolutional Networks (LRCNs) for violence detection in video surveillance systems. LRCNs combine the strengths of Convolutional Neural Networks (CNNs) for capturing spatial information and Long Short-Term Memory (LSTM) networks for modeling temporal sequences. This combination allows the system to learn complex spatiotemporal patterns in video data, improving violence detection accuracy in environments like jails and mental health facilities. The project focuses on the integration of the LRCN model with a Telegram bot for real-time alerting and response. Upon detecting violent incidents in the video streams, the LRCN model triggers alerts through the Telegram bot, providing instant notifications to relevant authorities. The Telegram bot facilitates seamless communication and coordination among stakeholders, enabling swift action to mitigate potential risks and ensure the safety of occupants within these facilities. Through rigorous experimentation and evaluation, the effectiveness and reliability of the LRCN-based violence detection system integrated with the Telegram bot are demonstrated. The research contributes to advancing technology-driven solutions for proactive security measures in high-risk environments, fostering safer and more secure institutional settings

Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial.

Violence in the healthcare workplace has been a global concern for over two decades, with a high prevalence of violence towards healthcare workers reported. Workplace violence has become a healthcare quality indicator and embedded in quality improvement initiatives of many healthcare organizations. The Centre for Addiction and Mental Health (CAMH), Canada's largest mental health hospital, provides all clinical staff with mandated staff safety training for self-protection and team-control skills. These skills are to be used as a last resort when a patient is at imminent risk of harm to self or others. The purpose of this study is to compare the effectiveness of two training methods of this mandated staff safety training for workplace violence in a large psychiatric hospital setting. Using a pragmatic randomized control trial design, this study compares two approaches to teaching safety skills CAMH's training-as-usual (TAU) using the 3D approach (description, demonstration and doing) and behavioural skills training (BST), from the field of applied behaviour analysis, using instruction, modeling, practice and feedback loop. Staff were assessed on three outcome measures (competency, mastery and confidence), across three time points: before training (baseline), immediately after training (post-training) and one month later (follow-up). This study was registered with the ISRCTN registry on 06/09/2023 (ISRCTN18133140). With a sample size of 99 new staff, results indicate that BST was significantly better than TAU in improving observed performance of self-protection and team-control skills. Both methods were associated with improved skills and confidence. However, there was a decrease in skill performance levels at the one-month follow-up for both methods, with BST remaining higher than TAU scores across all three time points. The impact of training improved staff confidence in both training methods and remained high across all three time points. The study findings suggest that BST is more effective than TAU in improving safety skills among healthcare workers. However, the retention of skills over time remains a concern, and therefore a single training session without on-the-job-feedback or booster sessions based on objective assessments of skill may not be sufficient. Further research is needed to confirm and expand upon these findings in different settings.

Predictors of the Availability of Long-Acting Injectable Antipsychotics in US Mental Health Facilities Serving Older Adults.

Older adults are at increased risk of psychotic symptoms and even more at risk of medication nonadherence due to various factors specific to their age including memory impairment. This study aimed to examine the availability of long-acting injectable antipsychotics (LAIs) in US mental health (MH) facilities that serve older adults. This study includes 1,216 MH facilities, using the 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS) data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to evaluate the availability of LAIs in US MHs that provide services to older adults while logistic regression was used to compare facilities that offer the services compared to those that do not. Of the total facilities included, 420 (35%) and 58 (4.8%) offered at least one LAI and all LAIs, respectively. Hospital-based facilities compared to community-based facilities, facilities that provided only MH services compared to those providing SU and MH services, facilities that offer special Alzheimer's programs compared to those that do not, and facilities in Midwest states compared to those in East South Central, New England, and Mountain regions of the US were more likely to offer at least one LAI. Facilities that offer special services for veterans were less likely to have all LAIs examined. Only 43% of the facilities were certified by the Joint Commission. Less than half of US MH facilities that serve older adults have at least one LAI service despite the usefulness of these medications in the studied population.