Public Mental Health Facilities Research Articles

Examining Differences in Substance Use Outcomes and Related Correlates among Transfeminine and Transmasculine Adults Using the 2017 New York State Patient Characteristics Survey

Background: Transgender persons in the U.S. experience high levels of violence and discrimination which have been linked to adverse substance use outcomes. Despite transgender women’s higher exposure to such deleterious events compared to transgender men, studies have often aggregated both transgender women and men, obfuscating potentially unique differences between these groups. The current study, guided by the Minority Stress Model, examines differences in substance use outcomes and related correlates among transfeminine and transmasculine adults. Methods: A secondary data analysis was conducted using the 2017 Patient Characteristics Survey of public mental health facilities in the state of New York (N = 1387). Controlling for theoretically relevant factors, logistic regression models were estimated to examine differences between transfeminine and transmasculine adults in alcohol-related disorder (ARD) and drug use-related disorder (DURD) diagnoses, and tobacco use. Correlates of substance use disparities were also examined within gender identity groups. Results: Overall, 35% of participants were documented as using tobacco products whereas 14 and 19% were diagnosed with ARDs and DURDs, respectively. Transfeminine participants were 1.44-times more likely to be diagnosed with ARDs relative to transmasculine adults. Compared to transmasculine and White participants, transfeminine and Black participants were 1.64- and 1.59-times more likely to be diagnosed with DURDs. Conclusions: Recognizing the observed higher hazardous substance use risk among transfeminine and Black participants, findings indicate the potential role of minority stress in health outcomes of stigmatized communities. Our findings emphasize the need for identifying prevention and treatment strategies aimed at mitigating the implications of minority stress.

Predicting the mental health of rural Bangladeshi children in coronavirus disease 2019

<span>The novel coronavirus disease 2019 (COVID-19) current pandemic is a worldwide health emergency like no other. It is not the only COVID-19 infection in infants, children, and adolescents that is causing concern among their families and professionals; there are also other serious issues that must be carefully detected and addressed. Major things are identified due to COVID-19, some elements are affecting children’s healthcare in direct or indirect ways, affecting them not just from a medical standpoint but also from social, psychological, economic, and educational perspectives. All these factors may have affected children’s mental development, particularly in rural settings. As Bangladesh faces a major challenge such as a lack of public mental health facilities, especially in rural areas. So, we discovered a method to predict the mental development condition of rural children that they are facing at this time of COVID-19 using machine learning technology. This research work can predict whether a rural child is mentally developed or mentally hampered in Bangladesh and this prediction gives nice feedback.</span>

A Clinical Case Report: Schizophrenia

Background: Schizophrenia (SCZ) is a serious mental disorder in which people take reality as abnormally. SCZ may cause in combination of hallucination, delusions, and extremely disorder thinking and behaviour that impairs daily functioning and cannot be disabling. There are different reasons of SCZ this may be as of Genes, Environment or Change in Brain Structures.In India around 3/1000 people were affected due to SCZ
 Aim: The purpose of this case report is to determine the first line approach for a person with SCZ who has been referred to a public mental health facility for treatment.
 Objective: To identifying symptoms of SCZ early, providing treatment and preventing possible complications.
 Methods: Knowledge used to write this case description was gathered from PubMed outlets, search hand, searching college and personal libraries looking for research techniques and case report texts, engaging in or writing many case reports with experience.
 Results: The patient was taken psychopharmacological treatment antipsychotic drugs olanzapine, Risperidone along with antidepressant Sertraline and psycho social therapy, coping strategies, family therapy, yoga, cognitive behavioural therapy, medication. After those symptoms was minimized.
 Conclusion: Patients achieve positive outcomes not only through the support of their treatment management, but also through adaptation and familysupport. subsequently, with appropriate psychophysiological treatment, the patient gave a positive response and gradually all the planned goalswere achieved. Finally, the patient was discharged and she is currently beingmonitored.

A Case Report on Alcohol Dependence Syndrome with Cannabis Addiction

Background: Alcohol dependence syndrome (ADS) and Cannabis use disorder (CUD) are every now and again co-happening or comorbid substance issues in the two young people and grown-ups. Indications of cross-over between ADS and CUD in people as they slowly move from pre-adulthood to adulthood. The researchers reasoned that the two substance-related issues are comorbid, albeit the closeness of their association ordinarily shifts over the long haul.
 Aim and Objective: The purpose of this case report is to determine the first-line approach for a person with alcohol dependence syndrome with cannabis addiction who has been referred to a public mental health facility for treatment. To identifying symptoms of ADS with cannabis addiction early, providing treatment and preventing possible complications.
 Methods: Knowledge used to write this case description was gathered from PubMed outlets, search hand, searching college and personal libraries looking for research techniques and case report texts, engaging in or writing many case reports with experience. 
 Results: The patient was taken psychopharmacological treatment Anti- Anxiety drugs Lorazepam along with Tab. Benalgis, Tab. Neurobion fort and psycho social therapy, coping strategies, family therapy, yoga, cognitive behavioural therapy, medication. After those symptoms was minimized.
 Conclusion: Patients achieve positive outcomes not only through the support of their treatment management, but also through adaptation and family support. Then, with appropriate psychophysiological treatment, the patient gave a positive response and gradually all the planned goals were achieved. Finally, the patient was discharged and he is currently being monitored.

The current state of mental healthcare in Bangladesh: part 2 - setting priorities.

This is the second of a two-part profile on mental healthcare in Bangladesh. It describes the state of mental health research in the country and presents a set of priorities for addressing improvements to the fundamental gaps in mental healthcare highlighted in part 1. Focus on building infrastructure for public mental health facilities, training skilled mental health professionals, adequate distribution of financial resources and addressing stigma are all priorities that will contribute to significantly improving mental healthcare in Bangladesh.

The current state of mental healthcare in Bangladesh: part 1 - an updated country profile.

Mental health is a significant factor for a sound and productive life; nevertheless, mental disorders do not often receive adequate research attention and are not addressed as a serious public health issue in countries such as Bangladesh. Part 1 of this two-part profile describes the current situation of mental health in Bangladesh in its wider sociocultural context, outlining existing policies and highlighting mental illness as a neglected healthcare problem in the country using a narrative synthesis method. The prevalence of mental disorders is very high and augmented in nature among different population groups in Bangladesh. A lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, inadequately stewarded mental health policies and stigma contribute to making current mental healthcare significantly inadequate in Bangladesh. The country has few community care facilities for psychiatric patients. Furthermore, the current mental health expenditure by the Bangladeshi government is only 0.44% of the total health budget. Less than 0.11% of the population has access to free essential psychotropic medications.

A Clinicl Case Report on Black Dog (Depression)

Aim: - The intent of this case report is to define the top practice for a person detected with depressive disorder who has been denoted to a public mental health facility for treatment. To identify the black dog symptoms early to provide treatment and prevent potential complication.
 Presentation of case: A 45-year-old male patient got admitted in psychiatric ward AVBR Hospital Sawangi Meghe Wardha, Maharashtra, with the complaints of insomnia, low mood, social withdrawal, irritable, lack of interaction, lack of interest, sadness, hopelessness, helplessness, decrease appetite and suicide ideation such as hanging. patient was apparently asymptomatic 10 month ago when his younger brother passes away and his started show above clinical features of depression. patient received antidepressant drug citalopram, Imipramine and two-time Somatic therapy (Electroconvulsive Therapy). symptoms were minimized.
 Result: The patient was received psychopharmacological treatment antidepressant drug sertraline, citalopram, fluvoxamine along with somatic therapy (ECT) two times and psychosocial therapy, coping strategies, family therapy, yoga, recreation, meditation and symptoms was minimized.
 Discussion: Millions of people worldwide suffer from depression. it is most common disorder in outpatient clinic. which can result impairment and disability of individual ability to cope up with daily life.
 Conclusion: A positive outcome gets by the patient not only with the help of therapeutic management but also the family coping and support even. later on, due to proper psychopharmacological treatment, patient shown positive feedback and slowly all the aims are achieved which were planned in period. Finally, the patient got discharged from the hospital and now he is continuing his on follow up.

The Peculiar Institution and the Making of Modern Psychiatry, 1840–1880 by Wendy Gonaver

Reviewed by: The Peculiar Institution and the Making of Modern Psychiatry, 1840–1880 by Wendy Gonaver Dea H. Boster (bio) The Peculiar Institution and the Making of Modern Psychiatry, 1840–1880. By Wendy Gonaver. (Chapel Hill: University of North Carolina Press, 2019. Pp. 268. Cloth, $90.00; paper, $32.95.) Founded in Williamsburg in 1773 and renamed in 1841, the Eastern Lunatic Asylum of Virginia was the first public mental health facility in America. Physician John M. Galt II, who served as its superintendent from 1841 until his death by laudanum overdose in 1862, had a unique, albeit racialized vision for the institution and the populations it would serve. The asylum was progressive in the United States for its utilization of environmental-moral therapy, nonrestraint, and outpatient treatment strategies, all of which were novel approaches to psychiatric intervention in the early nineteenth century. Galt also courted controversy for his admission of black patients (both free and enslaved) and use of enslaved staff and caregivers, making it the only institution in the United States “to openly contend with the contradiction of deploying nonviolent curative means within a context of systemic social violence” (6). In that respect, the phrase “the peculiar institution” in the book’s title has a double meaning, referring both to slavery and to the asylum itself. Delving deeply into the asylum’s archive (housed until recently in a hospital storage closet), the author traces the complex genealogy of this fascinating institution through physician notes, patient records, family and staff correspondence, and a variety of other primary documents to identify how it changed from a racially integrated site of treatment for the mentally ill to a segregated institution for the “defective” within a forty-year period. The monograph is organized around different themes: psychiatry and treatment regimes in the context of racism and slavery, the roles and strategic negotiations of enslaved attendants and patients, the slippery relationships between madness and religious enthusiasm, issues of gender and the psychological trauma of domestic violence, and the impact of [End Page 261] the Civil War and Reconstruction on the asylum (as well as broader ideas about mental illness and eugenic defectiveness). Each chapter is rich with poignant details that illuminate the complexities of this institution and the humanity of those who lived with it, breathing life (and agency) into individuals whose stories would otherwise remain unknown. When Galt assumed his role as superintendent at the institution, many of his policies were on the fringe of medical practice and seemed discordant with his personal views on slavery and racial difference. As a result of Galt’s untimely death and Union occupation of the region during the Civil War, the asylum became increasingly obsolete and disorganized. During Reconstruction, the Central Lunatic Asylum was established as a separate institution for African American patients and featured more punitive incarceration (including restraint and eugenic sterilization) for those increasingly seen as “permanently defective” (196). In many ways, Gonaver’s riveting and thorough analysis of the Eastern Lunatic Asylum defies easy explanation. Although the book’s subject matter is limited to one institution and a discrete time period, the author makes a strong case for situating that place and time at a number of crucial intersections in American medicine, society, and culture. On the surface, the book reinforces historical links between ideas about race and disability, particularly mental illness, which is an increasingly prevalent perspective in recent scholarship. However, Gonaver’s analysis simultaneously combats prevalent biases in Western medical history more broadly, most notably the focus on European and northern American (also white) institutions and physicians in declension narratives of asylum medicine. The author also demonstrates how nineteenth-century constructions of insanity were linked with a staggering variety of other factors, including slavery as both a social category and a labor system; gender, race, and social class in the American South; religiosity and antislavery activism during the Second Great Awakening; sexuality and propriety in the Victorian era; medical eclecticism and professional identities; the social and political upheaval of the Civil War; and Reconstruction policies and the rise of Jim Crow in the late nineteenth century. Yet, at the same time, the book never loses its close connection to the...

Practice analysis for nursing tutors

The aim of the nurse tutor programme is to support the induction and training of newly recruited professionals, a real challenge for public mental health facilities. Such a facility in Ville-Évrardis experimenting with an innovative training course for nurse tutors. A practice analysis group is organised as part of advanced practice. This approach enables tutors to reinforce their position andtheir practice. It also helps to identify ways in which the institute can improve support of this function.

Psychoanalytic Approaches to Psychotic Disorders in a Public Mental Health System

The Centre for Psychoanalysis of the Mental Health Association in the 13th district of Paris is part of a community psychiatric public facility. It specializes in non‐neurotic pathologies. The Centre offers several forms of psychoanalytic therapy for more than 200 patients, suffering from psychoses or severe borderline personality disorders. This double particularity of the Centre (public mental health facility and type of patients) has led it to develop distinct treatment techniques (for example, psychodrama) and to give special attention to the conditions of countertransference, as the demand for therapy is a challenge for both psychoanalysts and the psychiatric team who care for patients and refer them to the Centre. Over four decades, the analysts of the Centre have elaborated certain theoretical concepts (transference investment, thirdness and the ‘third person’, processual interpretation, ‘presence’ of the analyst, erotomaniac position …) that take into account the necessity of adapting the psychoanalytic approach to working with these categories of patients.

Systematic evaluation of the QualityRights programme in public mental health facilities in Gujarat, India.

Recognising the significant extent of poor-quality care and human rights issues in mental health, the World Health Organization launched the QualityRights initiative in 2013 as a practical tool for implementing human rights standards including the United Nations Convention on Rights of Persons with Disabilities (CRPD) at the ground level. To describe the first large-scale implementation and evaluation of QualityRights as a scalable human rights-based approach in public mental health services in Gujarat, India. This is a pragmatic trial involving implementation of QualityRights at six public mental health services chosen by the Government of Gujarat. For comparison, we identified three other public mental health services in Gujarat that did not receive the QualityRights intervention. Over a 12-month period, the quality of services provided by those services receiving the QualityRights intervention improved significantly. Staff in these services showed substantially improved attitudes towards service users (effect sizes 0.50-0.17), and service users reported feeling significantly more empowered (effect size 0.07) and satisfied with the services offered (effect size 0.09). Caregivers at the intervention services also reported a moderately reduced burden of care (effect size 0.15). To date, some countries are hesitant to reforming mental health services in line with the CRPD, which is partially attributable to a lack of knowledge and understanding about how this can be achieved. This evaluation shows that QualityRights can be effectively implemented even in resource-constrained settings and has a significant impact on the quality of mental health services.

Newly qualified nurses' perceptions of working at mental health facilities: A qualitative study.

WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Newly qualified nurses often feel overwhelmed by the challenges of the work environment and struggle to transition into healthcare work environments. Nurses require opportunities during the transition period to develop both competence and confidence in their ability to practise independently. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Newly qualified mental health nurses experience fear during their adaptation period, especially when they perceive mental healthcare users as dangerous and the working environment as risky, with little concern for their safety. Nurses new to the mental health environment learn from accepting responsibility, taking on challenges and making adjustments, in order to develop confidence as mental healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing management should ensure a safe and supportive mental healthcare environment. The potential for and consequences of negative stereotyping of patients among mental health nurses should be acknowledged and addressed as it may hinder the smooth adaptation of newly qualified nurses. Although stressful experiences can help mental health nurses to develop confidence and skills to manage future demanding situations, newly qualified nurses need to be given appropriate support and debriefing to ensure challenging situations do not "go the wrong way" and decrease confidence levels. Abstract Introduction Much has been written about the experiences of newly qualified nurses in their first year of employment, yet not much has been heard from the perspectives of newly qualified nurses working in mental health facilities. Aim To explore and describe the adaptation process of newly qualified nurses working in public mental health facilities in South Africa. Method Following a qualitative descriptive design, 11 newly qualified nurses in their first 6-18months of employment were purposively selected from three public mental health facilities in South Africa. Data collected through unstructured individual interviews were thematically analysed. Results Four themes emerged from the analysis: fear related to the mental healthcare environment; self-doubt upon meeting the expectations of the inter-professional team; ways to adjust to the challenges; and confidence as mental healthcare professionals. Discussion During the adaptation process newly qualified nurses working in mental health facilities need support to overcome their initial fears and develop self-confidence in both managerial and therapeutic realms. Implications for practice Management of mental healthcare facilities needs to be cognisant of the importance of creating a supportive and safe environment that discourages negative stereotyping of patients and fosters newly qualified nurses' adaptation.

175 Years of Caring: A Celebration

Back to table of contents Previous article Next article From The PresidentFull Access175 Years of Caring: A CelebrationAltha StewartM.D.Altha StewartSearch for more papers by this authorM.D.Published Online:28 Dec 2018https://doi.org/10.1176/appi.pn.2019.1a23In 1844, 13 superintendents of our young country’s institutions for people with mental illness came together for the purpose of improving the lives of the individuals under their care. The founders of what they named the Association of Medical Superintendents of American Institutions for the Insane were proponents of moral treatment—the idea that society should provide psychosocial care in a humane environment. One of the founders, Dr. Thomas Kirkbride, devised an architectural plan used in the building of many asylums for decades to come that featured natural light and abundant fresh air surrounded by spacious landscapes.One hundred and seventy-five years later, the American Psychiatric Association—the flower of that first meeting in 1844—is marking a milestone in its remarkable history. A high point of the year will be a gala at San Francisco City Hall during APA’s 2019 Annual Meeting.The celebration in San Francisco means a lot to me—and not just because it marks the culmination of my presidential year.Remembering our roots is dear to me because I trained in Philadelphia and spent a career doing the kind of work in public mental health systems originally envisioned by the founders of what became APA. Today, there is a renewed emphasis on the social determinants of health—which I have tried to underscore during my presidency—and an understanding that real recovery depends on understanding the social context in which a person lives. I like to think that Thomas Kirkbride would smile on this development. But owning our history also means owning the fact that sometimes we have fallen short of our ideals. “Not everything that is faced can be changed,” James Baldwin famously wrote. “But nothing can be changed that is not faced.” We need to face the fact that racism mars our country’s history from its colonial beginnings and even the history of our profession. One of APA’s founders, Dr. Francis Stribling, insisted there be a Committee on Asylums for Colored Persons, assuring the segregation of treatment by race. In addition, there is no publicly available evidence that in the 1950s APA supported overturning school segregation in the case Brown v. Board of Education. In response to a request by a prominent African-American member, Dr. Charles Prudhomme, to file an amicus brief in the case, he was told to “withdraw from involvement in the case and remain aloof from such a political issue.” Dr. Prudhomme went on to become APA vice president in the 1970s. In May 1969, a group of black psychiatrists led by Dr. Chester Pierce came to a meeting of the APA Board of Trustees demanding that APA acknowledge racism as a mental health problem and work to desegregate all public and private mental health facilities in the United States. Understanding and facing our past can help us shape the future. We have an exciting opportunity to learn more about our history at the Annual Meeting in San Francisco, where APA and the APA Foundation will be sponsoring a special historical scientific program track. The track will include sessions on the history of psychiatry divided into four separate eras. Here are the four historical eras and their faculty chairs: The advent of organized medicine in caring for people with mental illness (colonial times-1844): John Oldham, M.D.The dawn of the modern era: reforms in care and treatment (1844-1944): Jeffrey Geller, M.D., M.P.H.Advancing diagnosis, treatment, and education (1944-present): Carolyn Robinowitz, M.D.Shaping the future of psychiatry: breakthroughs in research and delivery of clinical care (looking ahead): Josh Gordon, M.D., director of the National Institute of Mental Health.Additionally, the history track will include a session on the history of global psychiatry chaired by Dr. Tsuyoshi Akiyama and sessions on the history of psychiatry as related to our minority and underrepresented groups. Those groups are American Indian, Alaska Native, and Native Hawaiian psychiatrists; Asian American psychiatrists; black psychiatrists; Hispanic psychiatrists; IMG psychiatrists; LGBTQ psychiatrists; and women psychiatrists. Look for detailed information in upcoming issues of Psychiatric News.Finally, I would like to suggest that all of us have a stake in the history of our profession and can participate in its preservation. Last year, APA and the APA Foundation opened the Melvin Sabshin, M.D., Library and Archives at APA’s new headquarters in Washington, D.C. I invite you to search your personal archives for historical documents, books, and artifacts that might be worthy of preservation. Information about the library’s acquisition policy can be obtained by emailing [email protected] You can also help support the library through its Adopt-a-Book program.The history of our profession belongs to all of us. I look forward to celebrating it with you! ■ ISSUES NewArchived

Rates of treated mental disorders in migrants using data from the Parisian sectorized psychiatric hospitals.

Background Increased incidence and prevalence of severe mental disorders (especially psychosis) are reported among migrants in Europe (Jongsma et al., 2017). However, there is evidence that pathways to care and service use are not similar between these groups (Bhui et al., 2003). Paris has about 2 million inhabitants including 20% of migrants. A previous study showed increased admissions for first episode of psychosis among migrants in one district (Tortelli et al., 2014); there is need to extend data regarding the use of all kinds of mental health care facilities. We aimed to estimate the proportion and socio-economic characteristics of migrants treated for mental disorders in mental health facilities in comparison to natives. Methods We calculated day-point estimations of treated population rates in natives and migrants using the number of patients seen on January 31, 2017 in the public psychiatric facilities and Paris population data. We compared socio-economic situations, diagnosis and rates of compulsory admission, using odds-ratios (OR). Results A total of 4,005 patients were included in the study. The treated population rates were 2.15/1 000 inh. among natives and 2.4./1 000 among migrants (p Conclusion We found increased rates of treated mental disorders among migrants than natives, suggesting higher rates of mental disorders compared to the general population. We observed, to some extent, a fair access to public mental health facilities, despite differences in pathways to care and use of specialist services.

Implementation of the Safewards model in public mental health facilities: A qualitative evaluation of staff perceptions

BackgroundThe Safewards model is gaining increasing acceptance in the mental health field in Australia and overseas. One of the most important goals of inpatient psychiatric services is to provide a safe and therapeutic environment for both patients and staff. However, this goal can be difficult to achieve if staff-patient interaction is not conducive to preventing violence and aggression. ObjectiveThe purpose of this study was to explore nursing staff perceptions of the factors impacting on their capacity to establish Safewards in acute adult inpatient wards. DesignThis study was guided by a phenomenological approach to develop a rich understanding of staff perceptions using semi-structured interviews. Setting and sampleThe setting was three acute mental health wards attached to general hospitals; one in a large provincial hospital and two in metropolitan hospitals in south-east Queensland. Interview participants were a purposive sample of fifteen registered nurses across each of the three wards. MethodSemi-structured interviews were conducted at 12 months post-implementation of Safewards. The study was underpinned by Michie’s integrative framework of behaviour change that helped identify target areas in order to enhance successful implementation of this model. ResultsContent analysis of interview transcripts highlighted a range of factors including failure to address the difficulties encountered by some staff in engaging with Safewards interventions, lack of support from management, poor use of nurse educator time, the ‘language’ of Safewards, high acuity on the study wards, and staff and patient turnover. ConclusionThis study highlights some difficulties with implementing Safewards and maintaining fidelity of the Safewards interventions in busy acute inpatient wards. Although these findings are from a qualitative study consisting of only 15 staff, our results indicate that efforts to implement Safewards need to address challenges faced by staff in engaging with the interventions, ensure buy-in from management, ensure adequate training and support during implementation and review training materials to ensure they fit with the local (i.e. Australian) context. Safewards provides an opportunity for a change in attitudes and development of a more therapeutic ward environment.

The “constant tug-of-war” in mental health care in Greece

PurposeThe purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process.Design/methodology/approachIn all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data.FindingsThe results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations.Research limitations/implicationsThe study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives.Practical implicationsThe study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail.Social implicationsThe results associate severe austerity with major changes in family and community life.Originality/valueThe paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.

Crisis Intervention Team Training and the Protection Motivation Theory

The problem addressed in this phenomenological study was the lack of documentation that supported the lived experiences of crisis intervention team (CIT)-trained police officers related to their field encounters with persons with mental illnesses. The purpose of the study was to explore the lived experiences of officers among CIT-trained police officers to address the problem. The protection motivation theory was aligned closest with the teachings of CIT training as described by the study participants’ lived experiences. Participants provided the study’s collected data, which was composed of completed questionnaires and transcribed interviews. The empirical theoretical framework method of analysis used was a combination of inductive coding and theme analysis that established the results of this study. Key findings of the study identified a significant amount of frustration expressed in the lived experiences of the CIT-trained police officers. Frustration was experienced by officers who applied the protection motivation theory to ensure the well-being of persons experiencing a mental crisis. There was considerable pushback from the public mental health facilities, which added to the frustration experienced by CIT-trained police officers who attempted to navigate treatment with the limited resources available to help persons in mental crisis. The positive social change produced from this study included recommendations to police leadership and mental health advocates to encourage certain CIT-training-related practices that directly impact CIT field encounters with persons in mental crises. Specialized training may promote improved departmental outcomes such as sustainability of gains for those in crises and enable police officer accountability and reliability.

A review of ECG and QT interval measurement use in a public psychiatric inpatient setting.

There is an increased rate of sudden cardiac death (SCD) in mental health patients. Some antipsychotic medications are known to prolong the QT interval, thus increasing a patient's risk of SCD via the arrhythmia, torsades de pointes (TdP). Our aim was to evaluate assessment for QT prolongation within a public inpatient mental health facility by auditing electrocardiograph (ECG) use. We reviewed records of all mental health inpatient admissions to a public emergency mental health inpatient unit between 1 January 2016 and 11 February 2016. ECG availability was noted and QT interval was manually measured and assessed for risk of TdP using the QT nomogram when present. Demographic information and medication use was collected. Of 263 mental health inpatient admissions, 50 (19%) presentations had an ECG. A total of four (8%) had a prolonged QT interval. Of the 50 patients with an ECG, 12 (24%) were taking medication known to prolong the QT interval. There was very limited risk assessment for QT prolongation in a public hospital psychiatric inpatient unit, with less than 20% of patients having an ECG performed. Our study supports an association between QT-prolonging drugs and a clinically significant prolonged QT interval; however, a larger study with routine ECG screening is required.

Synthetic cannabinoid use in an acute psychiatric inpatient unit.

In the present study, we explored the prevalence of new psychoactive substance use by people admitted into an Australian acute public mental health facility specializing in comorbid mental health and substance use. These substances have since been banned from retail outlets, but the pattern of uptake and reasons people use them is informative in terms of motivations and the management of substance use more generally. A cross-sectional study to explore the use of synthetic cannabis by people admitted to an acute adult mental health unit was undertaken. Associations with diagnostic, service use, and demographic profiles were explored. Fifty-six percent of people reported having used at least one type of new psychoactive substance, including 53.5% who reported using synthetic cannabis alone, and 18.8% who reported using both synthetic cannabis and other new psychoactive substances. Synthetic cannabis use was not associated with any demographic or diagnostic groups. Legality and availability (43% combined) were common reasons for use, along with the feeling of intoxication (20%). The high prevalence of new psychoactive substance use adds weight to the recommendation that clinicians should routinely screen for substances from the time of admission. Accurate information about these substances is required in order to provide accurate guidance and appropriate interventions to people in their care.

Mental Health and the Health System in Bangladesh: Situation Analysis of a Neglected Domain

Mental Health constitutes a major public health challenge undermining the social and economic development throughout much of the developing world. It is estimated that mental disorders account for 13% of the global burden of disease (WHO 2008). However, in most developing countries mental health remains utterly neglected by the health system. In Bangladesh, for example, a meager 0.5% of the total health budget is allocated to mental health. On the other hand, as more than 65% of the total expenditure on health is out-of-pocket expenses, mental illness takes a heavy toll on the poor and the disadvantaged Based on a review of secondary data, the paper assesses the current situation of mental health in Bangladesh. The paper suggests that mental health care system in Bangladesh faces multifaceted challenges such as lack of public mental health facilities, scarcity of skilled workforce, inadequate financial resource allocation and social stigma. Bangladesh still does not have a comprehensive mental health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall mental health care. Such strong leadership could bring about meaningful and effective health sector reform, which will work more efficiently for the betterment of the health and social and emotional wellbeing of the people of Bangladesh, and would be built upon the values of equity and accountability.