Mental Health Rehabilitation Research Articles

Increasing participation in the 2019 UK general election amongst patients on a high intensity rehabilitation ward

AimsTo increase participation in the 2019 UK general election amongst inpatients on a high intensity rehabilitation ward, by supporting patients to both register to vote (RTV) and vote.BackgroundIn 2000, the franchise was extended to those under section 2 or 3 as well as informal inpatients. Unfortunately, voting rates remain low: studies of the 2010 general election show voting rates amongst psychiatric inpatients to be 14%, compared to 65% for the general population. Engaging patients in the democratic process is not only just, it has been shown to be an effective avenue for rehabilitation through increasing social capital. The 2019 UK general election represents a singular opportunity for biopsychosocial rehabilitation.MethodIn the three weeks up until 26/11/19 – the deadline to RTV – visual displays and verbal information were used to notify patients of: The electionTheir eligibilityThe need to RTV before casting a ballotThe registration deadlineVoting methods (in person, by post, by proxy)We gathered patients’ intention to RTV and offered impartial, personalised support to register online or by paper, and to apply for a postal or proxy ballot if wished. Patients with no fixed abode were supported to use the ward as their declared place of residence.ResultOf the 17 patients on the ward there were:Four informal patients11 patients under section 3One patient each under a section 37 and a section 37/41, both ineligible to voteOf the 15 eligible patients, one (6.7%) had already registered, six patients (40%) wanted to register and eight (53.3%) stated they did not want to register. Those wanting to register were supported according to individual patient preference. Of the registered seven, five (33.3%) reported voting, one (6.7%) reported not having voted and one (6.7%) declined to say. Two (13.3%) voted in person and five (33.3%) voted by postal ballot.ConclusionOur intervention corresponded with an increase in number of patients registering – from one patient (6.7%) to seven (46.7%), with 5-6 (33.3-40%) casting their ballot. While the causal relationship should not be overstated, the uptake of assistance supports the intervention's efficacy.Good rehabilitation increases a person's social capital, empowering them to actively participate in societal life. Registering to vote is a tacit assertion of this principle. Our study shows that brief interventions that are easily incorporated into everyday care are a simple, effective and ultimately necessary tool in holistic mental health rehabilitation.

Remote mental health rehabilitation: Social Health Educators between experience and innovation

Following the Covid-19 pandemic, in our country strict containment measures have been put in place to safeguard, first and foremost, vulnerable swathes of the population, including people affected by psychiatric disorders. Nevertheless, a large part of Mental Health Centers activities, territorial rehabilitation, counselling sessions, aid and psychoeducational activities, social skills training, workshops, as well as family support, monitoring and network activities with rehabilitation centers workers and users have been rearranged in another modality, namely the socalled “remote modality”. Despite the undisputed and essential value of human contact and face-to- face relationships, the work reported here shows the importance, for Mental Health Services, of employing communicative modalities, like the current alternative virtual ones which, after the initial difficulties were overcome, have been appreciated, further implemented and widely used by now because of their efficacy, so much so that it is thought that they could eventually be combined with traditional modalities.

Remote mental health rehabilitation: Social Health Educators between experience and innovation

Following the Covid-19 pandemic, in our country strict containment measures have been put in place to safeguard, first and foremost, vulnerable swathes of the population, including people affected by psychiatric disorders. Nevertheless, a large part of Mental Health Centers activities, territorial rehabilitation, counselling sessions, aid and psychoeducational activities, social skills training, workshops, as well as family support, monitoring and network activities with rehabilitation centers workers and users have been rearranged in another modality, namely the so-called “remote modality”. Despite the undisputed and essential value of human contact and face-to-face relationships, the work reported here shows the importance, for Mental Health Services, of employing communicative modalities, like the current alternative virtual ones which, after the initial difficulties were overcome, have been appreciated, further implemented and widely used by now because of their efficacy, so much so that it is thought that they could eventually be combined with traditional modalities.

On Trial for Being Victims of Trauma: Sexual Abuse of Migrants in ICE Custody

On Trial for Being Victims of Trauma: Sexual Abuse of Migrants in ICE Custody

Faktor yang Memengaruhi Kualitas Hidup Pasien Paska Bedah Pintas Arteri Koroner

Coronary Artery Bypass Grafting (CABG) is aimed to improve the quality of life among post-CABG patients, there exist a large number of patients having a low level of quality of life. The study aimed to analyze factors that influenced the quality of life among post-CABG patients. The descriptive study was conducted using cross-sectional analysis with a consecutive sampling of 80 post CABG patients in Hasan Sadikin Hospital from 20 May-30 June 2019. Data were analyzed using multivariate linear regression. The independent variables in this study included age, gender, education level, pain, mental health, social support, spiritual well-being, and cardiac rehabilitation. The data were collected using three questionnaires which included Short-Form 36 (SF-36) to measure patient-reported pain, mental health, and the quality of life; Multidimensional Scale of Perceived Social Support (MSPSS) to provide information about the role of social support; and Spirituality Index of Well Being (SIWB) designed to measure the spiritual well-being of the patients. The results showed four factors had significantly influenced the quality of life among patients after CABG. The factors included age (p-value<0,001; r=0,521), pain level (p-value<0,001; r=0,666), mental health (p-value<0,001; r=0,426), and social support (p-value<0,001; r=0,345). Pain factor had the most significant effect on the patients (r=0,497). Pain could cause a stress response that influenced the recovery stage which eventually impacted the quality of life. This study implies that the management of post-CABG patients could be performed by applying pain and stress management in discharge planning.

Are in-patient mental health rehabilitation units the most appropriate pathway for patients detained on section 47/49 of the Mental Health Act in England?

Prisoners that require secondary mental health care and treatment either remain within the Criminal Justice system or may be transferred into a hospital environment, via the Mental Health Act (MHA). Remaining in prison is usually inappropriate, with prisoners unable to access the same level of care afforded to those transferred to hospital. However, hospital services are expensive and highly variable in their provision of care and include ill-defined Rehabilitation Units.

A Follow-Up Investigation of Mental Health Among Discharged COVID-19 Patients in Wuhan, China.

Objective: To understand the mental health status and its risk factors among discharged COVID-19 patients during the first month of centralized quarantine and the subsequent home isolation.Methods: The scales of the Insomnia Severity Index (ISI), General Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ-9) were used to measure the symptoms of insomnia, anxiety, and depression in 782 COVID-19 patients during the first month of centralized quarantine (March 16 to 26, 2020) and then during home isolation (April 3 to 10, 2020).Results: During the centralized quarantine, the prevalence rates of insomnia, anxiety, and depressive symptoms were 44.37, 31.59, and 27.62%, respectively, and those during the home isolation decreased significantly at 27.11, 17.26, and 16.11%, respectively. In both waves, women showed a higher prevalence of symptoms of poor mental health compared to men, and middle-aged (40–59 years old) and elderly (≥60 years old) showed a higher risk of symptoms of poor mental health compared to the younger. In addition, the severity of COVID-19 revealed no significant relationship to symptoms of poor mental health, whereas, the interaction analysis revealed that those with other underlying diseases showed more symptoms of poor mental health during the centralized quarantine and a greater decrease during the follow-up home isolation.Conclusion: The discharged COVID-19 patients suffered from mental health problems such as, insomnia, depression, and anxiety, and this was especially so for women, the middle-aged and elderly, and those with underlying diseases, but along with the rehabilitation and the environmental change from centralized quarantine to home isolation, all the mental symptoms were significantly alleviated. Based on a follow-up investigation, the current results provide critical evidence for mental health and early rehabilitation upon the discharged COVID-19 patients.

Horticultural rehabilitation programme: Effects on schizophrenia

IntroductionHorticultural therapy is a professional practice that is increasingly used in a lot of mental health rehabilitation programs. This therapy was introduced in the Comunitary Rehabilitation Service of INAD, considering its beneficial results in patients with severe mental disorder in combination with the usual rehabilitation program.ObjectivesWe would like to study the benefits of this therapy compared to the usual in our patients.MethodsThis is an explanatory study for the purpose of establishing the association between the application of a Therapeutic Horticulture Program and the Clinical Symptomatology of Schizophrenia. A research with an experimental design Pre and Post-Test was carried out, by applying a Horticulture Program and evaluating with PANSS after 6 months its effects on the Clinical Symptomatology. The participants of the experimental group were selectively chosen. The only selection criteria were to attend the orchard at least once a week and be diagnosed with a schizophrenic disorder. The control group was chosen according to the number of members that made up the other group, with the criterion that they did not perform any outdoor activities and also had a diagnosis of schizophrenia.ResultsThe comparison of the Pre and Post-Test measures in the case of the experimental group reports the presence of statistically significant differences in the scale of positive symptomatology composite scale and general scale.ConclusionsThis psychopathological improvement of those participants open a door to possible applications of this therapy as a psychosocial treatment.

Interactional use of compliments in mental health rehabilitation

Complimenting is a valuable skill in mental health care. Today, several clinical models view positive reinforcement as beneficial for the client's process of change; however, they ignore the ambiguous nature of complimenting in social interaction. Drawing on a data set of 29 video-recorded mental health rehabilitation group meetings, and using conversation analysis as the method, we qualitatively analyzed the range of purposes served by positive assessments doing complimenting. Our results showed that compliments were used for 1) encouraging members to participate in the community, 2) increasing the pressure on members to respond, 3) closing down topics that were not relevant for discussion at that moment, and 4) generating exclusion and preparing a member for a negative decision. Our findings demonstrate that not all compliments serve straightforwardly positive interactional goals, as they are used for advancing mental-health professionals' own agendas. Moreover, due to the positive nature of the compliments per se, it is difficult for compliment recipients to resist the functions that compliments are designed to serve. The study contributes to a more nuanced understanding of what might constitute genuinely positive reinforcement in the continually changing context of moment-by-moment social interaction.

Mental Health and Community-Based Rehabilitation: A Qualitative Description of the Experiences and Perspectives of Service Users and Carers in Bangladesh.

Since 2016, Promotion of Human Rights of Persons with Disabilities in Bangladesh (PHRPB) has been working to include people with psychosocial disabilities in their community-based inclusive development work, and to increase access to formal mental health care. Field visits were carried out to PHRPBD catchment areas in Dhaka and Chittagong for a case study on the integration of mental health into community-based rehabilitation (CBR). This paper synthesizes the results of twenty-five semi-structured interviews carried out as part of the case study. Participants included people with psychosocial disabilities, intellectual disabilities, epilepsy or other cognitive impairments and their carers as needed. Interviews were audio-recorded, transcribed and translated from Bangla to English, then hand-coded for content analysis. Results were organized into five overarching categories: (1) explanatory models, (2) help-seeking behaviors, (3) impact of services, (4) challenges and barriers to improving mental health, (5) recommendations of users and carers. Respondents either had no explanation for why service users had become unwell or attributed it to physically and/or emotionally traumatic events or supernatural causes. Before attending PHRPBD's mental health services, most had visited formal or informal health care providers, often with disappointing results. Despite positive feedback on PHRPBD's services, participants identified ongoing challenges. Stigma, discrimination and human rights abuses persist and are compounded by issues of gender inequality. Participants also identified barriers and made recommendations specific to the program itself, mainly regarding accessibility (e.g., cost, distance, frequency). This study adds to the limited body of qualitative research on mental health in Bangladesh, reinforcing previous findings on explanatory models and health-seeking behaviors while providing new insights into the impact of a CBR program in this context. Feedback of service users and carers suggests that CBR may indeed be a useful approach to increase access to services in Bangladesh for people with psychosocial or intellectual disabilities, epilepsy or other cognitive impairments. However, this program is not without its limitations, some of which are the product of broader issues within the mental health system and others of the social and cultural context. More research is needed to formally evaluate this and other CBR programs in the Global South.

The meaning of work for people with severe mental illness: a systematic review

PurposeMental illness is associated with high unemployment rates, limited working opportunities, work-related discrimination, stigma and prejudices. For people with severe mental illness, the work reality is even more burdensome. This paper aims to explore in-depth and presents research results in the past decade on the meaning of work for people with severe mental illness.Design/methodology/approachThe authors conducted a systematic literature search in Medline, Science Direct, PsycINFO databases between 2000 and 2019. The review concluded in 13 studies.FindingsThis research showed actual results regarding the meaning of work for individuals with severe mental illness from a medical, social, psychological and financial perspective. Work is of great importance for people with severe mental illness, influencing their lives on many levels.Practical implicationsThe present research results can contribute to the information and further awareness of experts in mental health and vocational rehabilitation services. This review lightens the meaning of work and challenges the state's priorities in creating active and not marginalised citizens.Originality/valueThis review is original and adds to the existing knowledge that employment may benefit people with severe mental illness, especially the youngest adults, despite their labor market obstacles. It is for communities' benefit, employers, but mostly for people with severe mental illness themselves, to work.

Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers.

Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers.

Estratégias de enfrentamento para manutenção da saúde mental do trabalhador em tempos de Covid-19: Uma Revisão Integrativa

OBJETIVO: Apresentar evidências científicas de possíveis estratégias que podem ser empregadas em trabalhadores para minimização de sofrimento psíquico decorrente do contexto pandêmico. MÉTODO: Durante o mês de maio e junho de 2020 realizou-se uma revisão integrativa da literatura científica acerca da temática em questão, sendo utilizados os descritores indexados no DeCS: estratégias de enfrentamento; infecções por coronavírus; saúde mental e trabalhadores. Para realizar a pesquisa, os descritores foram combinados nas bases de dados Pepsic, Pubmed e Scielo. RESULTADOS: Foi possível identificar as seguintes estratégias de enfrentamento de caráter preventivo: medidas de identificação precoce dos sintomas mentais, medidas regulares de descanso e treinamento de pessoal. Assim como, foi possível evidenciar medidas de promoção em saúde mental aos trabalhadores, tais como: utilização de primeiros socorros psicológicos; participação de grupos terapêuticos; gerenciamento de crises. E, na área da reabilitação em saúde mental: utilização de técnicas de meditação e mindfulness, tanto para serem executadas por profissionais de saúde, no âmbito organizacional, quanto por ações governamentais. CONCLUSÃO: Considera-se que a informação de técnicas e práticas psicológicas voltadas a saúde psíquica do trabalhador possa contribuir na identificação e controle dos riscos psicossociais e colaborar para o desenvolvimento no campo da Saúde Pública em relação aos processos de saúde-doença dos trabalhadores, em especial, dos agravos a saúde mental derivados da pandemia.

Implementing an Action Over Inertia Group Program in Community Residential Rehabilitation Services: Group Participant and Facilitator Perspectives.

Introduction: A time-use focused intervention, Action Over Inertia (AOI) designed to address restricted activity patterns and support recovery, was adapted for use in Australian community residential mental health services.Method: Qualitative case study research explored the use of AOI groups across three Community Care Units from the perspectives of group participants with enduring mental illness and group facilitators. Fifteen interviews were conducted: five group participants were interviewed twice 4 weeks apart, and five group facilitators on completion of the group intervention. Interview data were analyzed thematically using constant comparative methods.Findings: Two overarching themes, “Making Change” and “Facilitating Change” were identified. Efforts to make change in their lives were supported by participants recognising the value of personally meaningful activities for well-being and of activity experiences that fostered hope and recovery, whereas a sense of “stuckness,” time for activities and life events could disrupt “getting me going.” For the facilitators, facilitating change involved recognizing inertia as a challenge; getting people going; and looking at how AOI intervention works to impact inertia.Conclusion: AOI in a group format supports participants to identify barriers to more active living; to appreciate how time-use and well-being interrelate; and to reframe and take steps to overcome inertia. Further research should evaluate AOI groups as a means of providing individualized support for activity re-engagement as part of recovery oriented mental health rehabilitation.

Consumer experiences of community-based residential mental health rehabilitation for severe and persistent mental illness: A pragmatic grounded theory analysis.

Semi-structured interviews were used to explore the consumer experience of community-based residential mental health rehabilitation support at Community Care Units in Australia. These clinical services provide recovery-oriented residential rehabilitation to people affected by severe and persistent mental illness. Typically, nurses occupy the majority of staff roles. However, two of the three sites in the study were trialling a novel integrated staffing model where the majority of staff were people with a lived experience of mental illness employed as peer support workers (PSWs). The interviews explored consumers' experiences of care 12-18months after admission. Fifteen interviews were completed with an independent interviewer. Most participants were diagnosed with schizophrenia or a related psychotic disorder. The analysis followed a pragmatic approach to grounded theory. Consumers viewed the CCU favourably, emphasizing the value of the relationships formed with staff and co-residents. No major differences in consumers' experience under the traditional versus integrated staffing models were identified; however, those from the integrated staffing model sites valued the contributions of the peer support workers. The understanding of the consumer experience emerging through this study aligned with their expectations of the service at the time of commencement.

1043 Standardized patient-care protocol for drug-use associated illness in pregnancy and postpartum decreases inpatient adverse events

Due to an increase in drug-use associated hospital admissions and adverse events (AE) among those patients, their visitors and staff, our institution offers a Drug-Use Associated Illness Protocol (DUAIP). DUAIP limits visitation and off-floor privileges, is driven by patient choice, with goal of integration into addiction facility after discharge. We hypothesized that pregnant/postpartum women admitted for drug-use related illness selecting DUAIP would have fewer AE, with secondary aims to assess utilization of psychiatric care/addiction treatment. A retrospective chart review was completed identifying women admitted for drug-use associated illness in pregnancy or postpartum between January 2017 and August 2020. Women were identified by ICD 10 codes, included for ongoing illicit drug-use, and excluded for delivery admission, prescribed opiates, or THC use only. Basic demographic data, frequency of AE, and disposition were reviewed (individually and as composite outcome) and compared by use of DUAIP. Data were analyzed using Chi-square and student T test where appropriate. 1088 patient encounters were identified: 108 meeting inclusion criteria, 24 DUAIP and 83 controls. Comparison of demographic data revealed similar populations between the 2 groups; majority Caucasian, had Medicaid, and positive Hepatitis C status. AEs, disposition, and outcomes are presented in the Table. Use of DUAIP was associated with higher rates of leaving against medical advice (p=0.003), but longer overall length of stay. Significantly fewer composite AEs were identified in the DUAIP compared to non-protocol (p=0.0007). Higher uptake of psychiatric and drug rehabilitation services were seen in the DUAIP group but did not reach statistical significance. DUAIP use was associated with higher rates of leaving AMA, but fewer composite AEs with a trend in greater utilization of mental health and long-term rehabilitation care. Further studies are planned to assess implications of DUAIP use and clinical practices that increase entry into drug rehabilitation programs.

State behavioral health agency website references to evidence-based program registers

PurposeEvidence-based program registers (EBPRs) are important tools for facilitating the use of evidence-based practices or programs (EBPs) by state statutory agencies responsible for behavioral healthcare, broadly defined as substance misuse, mental health, HIV/AIDS prevention, child welfare, and offender rehabilitation. There are currently no data on the purposes for which such state agencies reference EBPRs on their official websites. MethodA webscraping method was used to identify and classify relevant “hits”, defined as a state behavioral health webpage with single or multiple references to a study EBPR. A total of 778 hits (unique combinations of webpage and register) were coded. Up to three codes were applied to each hit for the “reasons for the EBPR reference” (EBPR use) dimension, one code was applied to each hit for the “purpose of the EBPR reference” and “intended audience of the webpage containing the hit” dimensions, and up to two codes were applied to each hit for the "funding mentions” dimension. ResultsThree EBPRs out of 28 accounted for 73.6% of the hits. The most frequent reason for referencing EBPRs were as a resource for selecting EBPs or validating existing programs and practices. The references tended to appear in reports from the state, in training materials, or guidelines. The references tended to address broad groups of behavioral healthcare professionals. EBPRs were frequently referenced in the context of federal block grants or other federal funding. ConclusionsIncreasing state agencies’ awareness and use of the entire range of existing EBPRs may improve implementation of EBPs nationally.

Kokon: Rehabilitation for Young People in Rohrbach-Berg, Austria

kokon Rohrbach-Berg ist das erste österreichische Rehabilitationszentrum, das ausschließlich für Kinder- und Jugendliche von 0–18 Jahren neu errichtet wurde. Im kokon Rohrbach-Berg stehen den Rehabilitanden insgesamt 77 Betten zur Verfügung. Dazu kommen 67 Betten für Begleitpersonen. Das Rehabilitationsangebot umfasst die Indikationsbereiche Mobilisierung, Rehabilitation bei kardiologischen und pulmologischen Erkrankungen sowie die Mental-health-Rehabilitation. Im Mittelpunkt stehen immer die chronisch erkrankten Kinder und Jugendlichen in einer ganzheitlichen Sichtweise. Das Rehabilitationsprogramm ist komplett auf die Bedürfnisse der Kinder und Jugendlichen ausgerichtet. Die interdisziplinären Teams erstellen individuelle Therapiepläne, helfen mit kindgerechten Angeboten mehr Selbstständigkeit zu erreichen und die Teilhabe am täglichen Leben zu verbessern.

Toxic Nightlife Relationships, Substance Abuse, and Mental Health: Is There a Link? A Qualitative Case Study of Two Patients.

Introduction and Aims: This article explores the role of toxic close relationships in night life on substance use disorders and mental health conditions. We also contrast the quality and effects of social relationships when doing drugs with those produced by a mental health program that fosters quality relationships between patients.Design and Methods: This qualitative case study was carried out at a mental health day care center of a hospital in Malaga (Spain). The cases of two patients with severe mental disorders and a history of drug addiction were analyzed. Data were collected through in-depth interviews with every patient, semi-structured interviews about each patient with the psychologist of the medical team of the program, and medical documentation. The analysis involved a combination of inductive and deductive approaches.Results: The analysis of the data revealed, on the one hand, the influence of toxic relationships in nightlife, including violent sporadic sexual relationships, in the initiation and persistence of substance use that took part of the mental health disorder in these patients. On the other hand, the findings show that these participants' current involvement in a mental health program, which fosters quality relationships between patients, has brought emotional benefits to both of them.Discussion and Conclusion: This paper points out the relevance of considering quality of social relationships when examining substance use disorders and related mental health problems. Additionally, the findings indicate the importance of fostering quality peer relationships in mental health rehabilitation programs addressed to patients with histories of drug addiction to improve treatment outcome.

Alleviate the Symptoms of Depression among Clients in Mental Health Rehabilitation Clinic at Royal Medical Services

The present study aimed to find out the effectiveness of Solution-Focused Therapy (SFT) in reducing the symptoms of depression in a sample of clients in the mental health rehabilitation clinic at Royal Medical Services. The sample consisted of (8) women, ages range was between 22-50 years. The sample of the study was determined by the application of the Beck Depression Scale and Standardized to the Jordanian Environment and approved by the Royal Medical Services as a diagnostic tool for women diagnosed with depression disorder and those who reviewed the psychiatric clinic. A single group pre-post test design was used in the study to examine the outcome of solution-focused therapy SFT in regards to reducing symptoms of depression. The Wilcoxon signed-rank test was used to analyze the data. The pre-treatment Beck Depression Scale scores were compared with post-treatment scores to evaluate the outcome of SFT. Results indicate significant differences in the Beck Depression Scale scores at pre- to post-treatment (T = 3; Wilcoxon T= 0.12, p = 0.05). This implies that the SFT was successful in reducing the symptoms of depression in the participants’ group.