Psychiatric Hospital Residents Research Articles

Improving the Physical Health of Psychiatric Hospital Residents: An Evaluation of an Obesity Education Program for Mental Health Professionals.

Background: People living with mental health disorders are at increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the obesity rate is 36% in the general population and more than 50% for people living with mental health disorders. Although mental health clinicians concentrate on managing psychiatric disorders, they seldom recognize the gradual increase in body mass index of their patients. The result is a disconnection between the clinical management of psychiatric disorders and the medical management of obesity. Purpose: This study assessed the effectiveness of an evidence-based education program for improving the obesity management practices of mental health clinicians caring for residents at a state psychiatric hospital. Methods: This was a quasi-experimental study design with a pretest and posttest evaluation. Convenience sampling was used to recruit mental health professionals, or clinicians, at a large psychiatric hospital in the Southern region of the United States. Data was collected with the Advising and Treating Overweight and Obese Patient questionnaire (17 items). Data analysis included descriptive and inferential statistics. The findings were reported in accordance with the TREND and GREET guidelines. Results: The education program was completed by 50 MHCs. The pretest indicated that 76% of MHCs were not involved in helping obese residents manage their weight, but the posttest indicated 90% were involved. There was a significant increase in MHC knowledge about obesity management and reported actions 90-days after the program. MHCs were unable to arrange follow-up visits for residents, a task not directly within their control. Conclusions: Mental health clinicians reported increased knowledge and improved clinical practice after an education program. Because the outcomes were reported at 90-days after the program, further research needs to evaluate the longitudinal impact of this type of program, where the reported behaviors are correlated to process and clinical outcome measures for obesity.

Residências Terapêuticas e a cidade: enfrentamentos de normas sociais vigentes

RESUMO O presente artigo propõe um diálogo sobre Residências Terapêuticas e apropriação da cidade a partir do tema da desinstitucionalização de ex-moradores de hospitais psiquiátricos e seu retorno à cidade. O artigo estabelece problematização sobre reparação de danos, além da ruptura da condição de vida desses moradores, o que só parece ser possível quando a loucura ultrapassa a questão da diferença e adentra o âmbito da segregação social, extrapolando em muito o saber psiquiátrico e colocando a existência do louco no interior da realidade compartilhada por todos os fragilizados e segregados das possibilidades de troca social.

Deinstitutionalised patients, homelessness and imprisonment: systematic review.

Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.

The role of intelligence on performance on the Inventory of Legal Knowledge (ILK)

Previous research has shown that individuals with intellectual disabilities perform in the feigning range on malingering measures even when other data suggest that they are performing optimally. However, few studies to date have gone beyond intellectual disabilities and studied the full range of intelligence. Additionally, there are no data available examining the relationship between intelligence and performance on the Inventory of Legal Knowledge (ILK). The relationship between intelligence and performance on malingering tests is important because individuals with intellectual deficits may be incorrectly identified as malingering on these tests. The current study used a sample of state psychiatric hospital residents, adjudicated incompetent to proceed, and a sample of undergraduate university students to examine the relationship between intelligence and performance on the ILK. Results indicated three items on the ILK are correlated with intelligence and total scores were moderately correlated. Participants were further broken into groups using categorical ranges of Intelligence Quotient (IQ). Results were mixed regarding the relationship between ranges of IQ and performance on the ILK. Future directions and implications of this study are discussed.

1183 – Deinstitutionalization and family burden following the psychiatric reform

Deinstitutionalization in Crete and the closure of the only Psychiatric Hospital in 2006, has resulted in a significant shift of treatment options that were available for chronic psychiatric patients. Specifically, psychiatric care shifted from long-term or even lifetime hospitalization, to short-term hospitalization and community-based treatment. To examine the residential/occupational status of the patients discharged from the Psychiatric Hospital after its closure and the profile of residence, psychiatric profile and sociodemographic data of inpatients of the Psychiatric Department of the University Hospital of Crete (PD/UHC). To explore the burden of family members living in the same home with chronic psychiatric patients. We examined the residence status of the patients discharged from the Psychiatric Hospital. Furthermore, we examined the psychiatric profile and sociodemographic data from 400 inpatients that were admitted between Nov 2011 and August 2012 in the PD/UHC. We analyzed the data by using frequencies. Among Psychiatric Hospital residents, 72% returned home after its closure, while 2.5% were referred to community services. Among psychiatric inpatients, 82,9% return home after discharge. From a subset of 212 patients, 64% live with their own/paternal families, while 24.5% live alone, and 63% of patients living with family/relatives, remain unemployed/on welfare. Psychiatric reform and inadequate community-based psychiatric services, has resulted in an increasing family burden, since most psychiatric patients remain unemployed, under the care of their family. There is a need for development of community-based services to provide care and assistance to chronic patients and their families.

Changing Trends in State Psychiatric Hospital Use From 2002 to 2005

Changing Trends in State Psychiatric Hospital Use From 2002 to 2005

The costs of community care for former long-stay psychiatric hospital residents

Support for people with long-term mental health problems is gradually being relocated from hospital to community settings. One of the questions raised by the shifting locus of care concerns the cost implications. This paper describes the cost of supporting people with long-term mental health problems who have moved to the community after many years in hospital. After summarizing the national and local policy contexts, and the methodology, the paper describes the people who have moved to the community, the services they use, and the cost of community care.

System impact and methodological issues in the development of an empirical typology of psychiatric hospital residents.

The identification and categorization of similar objects or individuals into groups is a universal theme that permeates science and provides a conceptual framework to facilitate comprehension. For mental health administrators, a sound methodology to group individuals in a meaningful way would prove useful in the areas of general system understanding, as well as staffing, program planning and evaluation, and service system research, to name a few. Cluster analysis is a set of techniques that approach this grouping process empirically. Within the context of a large psychiatric hospital system, both the methodological processes involved in the application of cluster analysis and the resulting utility of such an analysis are discussed. Issues fundamental to the understanding of such a system are addressed. Special emphasis is placed on methodological issues regarding the application of cluster analytic techniques, which have left such techniques open for criticism. The value of such analyses, when used appropriately, is illustrated by the development of a stable, five-group typology of psychiatric hospital residents whose group characteristics are particularly germane to service system understanding. The implications of such a model for administration, planning, and research in a psychiatric hospital system are also addressed.

Into the unknown: Transitions in psychiatric services as construed by clients and staff

Abstract Mental health policies on resettlement of the long-stay residents of psychiatric hospitals are presenting both the clients and staff of such hospitals with major transitions. In this article, we explore their reactions to these transitions from a personal construct theory perspective by considering the possible effects of hospitalization on a client's construct system, the anxiety with which the client may be confronted by the prospect of discharge, and the threat posed to some staff members by the community care policy. Research findings presented include evidence that clients are more likely to feel dischargeable, and to be considered dischargeable by staff, if their constructs applicable to people outside the psychiatric hospital are relatively highly organized. Evidence is also presented that staff who oppose the community care policy differentiate less between dischargeable and nondischargeable clients, and between nondis-chargeable clients and themselves, than do staff who favor the policy. Implications for the methodology of the study of psychiatric inpatients' views are discussed. The extent of commonality in clients', staff members', and others' constructions of resettlement in the community and quality of life is also considered.

An examination of psychometric properties of the extended scale for dementia in three different populations.

The Extended Scale for Dementia (ESD), a development of the Mattis Dementia Rating Scale, has been used in the evaluation of dementia and aging and has shown substantial clinical utility. We report on analyses of its properties and internal structure in three samples of older people: 153 normals, 101 psychiatric hospital residents, and 114 patients with Alzheimer disease. The results showed good internal consistency in the two clinical samples, with much lower reliability in the normals, for whom the test was too easy. A review of the item statistics led to the use of 17 of the 23 ESD items in item component analyses in the three samples. Use of Horn's parallel analysis criterion led to the retention of three components in the normal group and one in both the hospital and Alzheimer groups. The results are compared with other work and are in accordance with the view that cognitive structure becomes more simple with increasing dementia.

The demography of deinstitutionalization.

AbstractOnce defined as long‐term residents of psychiatric hospitals, the chronically mentally ill today are a heterogeneous population living in a variety of institutional and community settings.

Experience, medication, and the effectiveness of psychotherapy with schizophrenics.

In their article published in this Journal in 1965, May and Tuma (1) suggested that only the use of medication made a difference in the outcome with schizophrenics, and that psychotherapy, whether or not combined with medication, made essentially no difference. Their data, however, as in so many psychotherapy projects, referred only to patients treated by inexperienced therapists, namely psychiatric hospital residents under supervision.