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Olagunju AT, Wu A, Boudreau J, Nagari S, Bradford JM, Chaimowitz GA. Detection of contraband drugs in forensic-correctional mental health services using TeknoScan-a gas chromatography tool. Forensic Sci Int 2024; 357:111992. [PMID: 38518570 DOI: 10.1016/j.forsciint.2024.111992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
Substance misuse is a major problem among individuals involved in forensic-correctional mental health services. Urine drug screening detects substance use and deters the entry of contraband into forensic-correctional units, albeit with limitations. For example, a point-of-care urine sample may not be possible and patients can alter or substitute samples to avoid detection, highlighting the role of ancillary tools to detect contraband substances. This study describes the pattern and types of substances detected from environmental samples using a gas chromatographic analyzer (TeknoScan TSI3000) in forensic-correctional populations to model the benefits of similar tools in similar settings. Samples collected over 18 months (January 2020 to June 2021) by trained staff members using the machine were reviewed. During this period, 217 environmental samples were recorded, and 66 (30%) samples were positive for contraband substances, including tetrahydrocannabinol (25%), methamphetamines (19%), and cocaine (16%). Other substances detected include methylene-dioxymethamphetamine, heroin, morphine, lysergic acid diethylamide, tramadol, and methyl-benzoate. Fewer positive samples were detected, especially during the time corresponding with the COVID-19 restriction on the forensic units. TeknoScan was beneficial as an ancillary tool to detect and deter contraband substances. It also provided evidence for risk management. Adequate training is needed for the successful implementation of the tool.
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Affiliation(s)
- Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada; Discipline of Psychiatry, University of Adelaide, Adelaide, SA 5005, Australia.
| | - Aaron Wu
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada; Department of Psychiatry, University of Ottawa, 75 Laurier Ave. E, Ottawa, ON K1N 6N5, Canada
| | - Jay Boudreau
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada
| | - Satyadev Nagari
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada
| | - John Mw Bradford
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada; Department of Psychiatry, University of Ottawa, 75 Laurier Ave. E, Ottawa, ON K1N 6N5, Canada
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada; Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L9C 0E3, Canada
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Searby A, James R, Snipe J, Maude P. Locked external doors on inpatient mental health units: A scoping review. Int J Ment Health Nurs 2023; 32:1544-1560. [PMID: 37409776 DOI: 10.1111/inm.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
The principles of least restrictive care and recovery-focused practice are promoted as contemporary practice in the care of individuals with mental ill health, underpinning legislation concerning mental health and illness in many jurisdictions worldwide. Inpatient mental health units with locked doors are incompatible with this style of care and throwback to a time where care for mental illness was primarily custodial. The aim of this scoping review is to determine whether evidence exists for locking mental health unit doors, whether this practice is compatible with recovery-focused care and to determine whether door locking has changed since a review conducted by Van Der Merwe et al. (Journal of Psychiatric and Mental Health Nursing, 16, 2009, 293) found that door locking was not the preferred practice in the management of acute mental health units. We used Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8, 2005, 19) framework for scoping reviews, with our initial search locating 1377 studies, with screening narrowing final papers for inclusion to 20. Methodologies for papers included 12 using quantitative methodology, 5 qualitative and 3 that used mixed methods designs. Poor evidence was found for door locking to mitigate risks such as absconding, aggression or illicit substance importation. Furthermore, locked doors had a detrimental impact on the therapeutic relationship, nurse job satisfaction and intention to leave the profession. This scoping review indicates that research is urgently needed to address a mental healthcare culture where door locking is an entrenched practice. Studies of alternative approaches to risk management are required to ensure inpatient mental health units are truly least-restrictive, therapeutic environments.
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Affiliation(s)
- Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Russell James
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jim Snipe
- Five Arcs Consultancy, Melbourne, Victoria, Australia
| | - Phil Maude
- La Trobe Rural Health School, Violet Vines Marshman Centre for Rural Health Research, Latrobe University, Melbourne, Victoria, Australia
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Hove E, Hazelton MJ, Santangelo P, Wilson RL. Integrated nursing care for people with combined mental health and substance use disorders. Int J Ment Health Nurs 2023; 32:378-401. [PMID: 36408951 DOI: 10.1111/inm.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/22/2022]
Abstract
Many health problems arise from mental, neurological, and substance use disorders. These disorders are highly prevalent and complex and contribute to poor health outcomes, premature mortality, security risk, social isolation, and global and national economic loss. Mental health and substance use disorders are among Australia's top four causes of disease burden. Our objective was to investigate and synthesize contemporary literature regarding factors that influence nurses' delivery of integrated care to people with combined mental health and substance use disorders within mental health services. We systematically searched five electronic databases with a limit on publications from 2009 to 2021. The search yielded 26 articles. Following thematic analysis, three themes were identified: individual nursing characteristics, nursing education, and professional development characteristics, and organizational factors. This study reveals that there is a fundamental absence of adequate integrative models of care within mental health services to enable the optimal nursing care of people with combined mental health and substance use disorders. Future research is needed to determine nurses' perceptions and factors influencing their role as participants in integrative care. The results could strengthen nurses' contributions in developing/adopting integrative models of care and contribute to clinical, educational, and organizational development.
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Affiliation(s)
- Elizabeth Hove
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Newcastle Callaghan, University Drive, Australia
| | - Michael J Hazelton
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
| | - Peter Santangelo
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Newcastle Callaghan, University Drive, Australia
| | - Rhonda L Wilson
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Newcastle Callaghan, University Drive, Australia.,Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia.,School of Nursing, Massey University, Auckland, New Zealand
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