1
|
Abi Zeid Daou M, Halbreich U, Geller J. Impact of global and national crises on people with severe mental illness. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2020.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYAs experts in disaster mental health push to reframe disaster response as a preventive medicine rather than its actual state of acute management, various factors should be considered. Although a whole population may be victim to the effects of disasters, particularly vulnerable are those with severe mental illness. Therefore, efforts geared to bolster trauma response should centre on these individuals, starting at a community level and reaching organisational and governmental endeavours and funding.
Collapse
|
2
|
Wong AH, Roppolo LP, Chang BP, Yonkers KA, Wilson MP, Powsner S, Rozel JS. Management of Agitation During the COVID-19 Pandemic. West J Emerg Med 2020; 21:795-800. [PMID: 32726244 PMCID: PMC7390577 DOI: 10.5811/westjem.2020.5.47789] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/02/2020] [Accepted: 05/10/2020] [Indexed: 01/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus SARS-CoV-2 has radically altered delivery of care in emergency settings. Unprecedented hardship due to ongoing fears of exposure and threats to personal safety, along with societal measures enacted to curb disease transmission, have had broad psychosocial impact on patients and healthcare workers alike. These changes can significantly affect diagnosing and managing behavioral emergencies such as agitation in the emergency department. On behalf of the American Association for Emergency Psychiatry, we highlight unique considerations for patients with severe behavioral symptoms and staff members managing symptoms of agitation during COVID-19. Early detection and treatment of agitation, precautions to minimize staff hazards, coordination with security personnel and psychiatric services, and avoidance of coercive strategies that cause respiratory depression will help mitigate heightened risks to safety caused by this outbreak.
Collapse
Affiliation(s)
- Ambrose H. Wong
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Lynn P. Roppolo
- University of Texas Southwestern, Department of Emergency Medicine, Dallas, Texas
| | - Bernard P. Chang
- Columbia University, Irving Medical Center, Department of Emergency Medicine, New York, New York
| | - Kimberly A. Yonkers
- Yale School of Medicine, Department of Psychiatry, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, Connecticut
| | - Michael P. Wilson
- University of Arkansas for Medical Sciences, Department of Emergency Medicine, Department of Psychiatry, Little Rock, Arkansas
| | - Seth Powsner
- Yale School of Medicine, Department of Psychiatry, Department of Emergency Medicine New Haven, Connecticut
| | - John S. Rozel
- University of Pittsburgh School of Law and School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania
| |
Collapse
|
3
|
Psychiatric hospitalization rates in Italy before and during COVID-19: did they change? An analysis of register data. Ir J Psychol Med 2020; 37:283-290. [PMID: 32368994 PMCID: PMC7264453 DOI: 10.1017/ipm.2020.29] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES. To assess admission rates to seven General Hospital Psychiatric Wards (GHPWs) located in the Lombardy Region in the 40 days after the start of Coronavirus disease 2019 (COVID-19) epidemic, compared to similar periods of 2020 and 2019. METHODS. Anonymized data from the regional psychiatric care register have been obtained and analyzed. The seven GHPWs care for approximately 1.4 million inhabitants and have a total of 119 beds. RESULTS. In the 40-day period (February 21-March 31, 2020) after the start of the COVID-19 epidemic in Italy, compared to a similar 40-day period prior to February 21, and compared to two 40-day periods of 2019, there has been a marked reduction in psychiatric admission rates. The reduction was explained by voluntary admissions, while there was not a noticeable reduction for involuntary admissions. The reduction was visible for all diagnostic groups, except for a group of 'Other' diagnoses, which includes anxiety disorders, neurocognitive disorders, etc. CONCLUSIONS. Large-scale pandemics can modify voluntary admission rates to psychiatric facilities in the early phases following pandemic onset. We suggest that the reduction in admission rates may be due to fear of hospitals, seen as possible sites of contagion, as well as to a change in thresholds of behavioral problems acting as a trigger for admission requests from family relatives or referrals from treating clinicians. It is unclear from the study whether the reduction in admissions was contributed to most by the current pandemic or the lockdown imposed due to the pandemic.
Collapse
|
4
|
Allen J, Brown LM, Alpass FM, Stephens CV. Longitudinal health and disaster impact in older New Zealand adults in the 2010-2011 Canterbury earthquake series. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:701-718. [PMID: 29989482 DOI: 10.1080/01634372.2018.1494073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50-83), who lived in the Canterbury region of New Zealand during the 2010-2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre-post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative-positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.
Collapse
Affiliation(s)
- Joanne Allen
- a School of Psychology , Massey University , Palmerston North , New Zealand
| | - Lisa M Brown
- b Trauma Program , Palo Alto University , Palo Alto , California , USA
| | - Fiona M Alpass
- a School of Psychology , Massey University , Palmerston North , New Zealand
| | | |
Collapse
|
5
|
Sakuma A, Ueda I, Rengi S, Shingai T, Matsuoka H, Matsumoto K. Increase in the number of admissions to psychiatric hospitals immediately after the Great East Japan Earthquake. Asia Pac Psychiatry 2018; 10:e12307. [PMID: 29285896 PMCID: PMC6175335 DOI: 10.1111/appy.12307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/17/2017] [Accepted: 12/04/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Major natural disasters have a significant impact on the mental health of survivors in affected communities. Although it has been speculated that the number of survivors requiring admission to psychiatric hospital increases immediately after a major disaster, few studies have examined the issue. METHODS On March 11, 2011, the Great East Japan Earthquake and subsequent tsunami devastated the relatively isolated city of Kesennuma. We therefore compared the weekly number of patients admitted to 2 psychiatric hospitals in Kesennuma in the 4 weeks immediately after the earthquake with those in the 4 weeks immediately preceding the earthquake. We also made comparisons between this 8-week period and the corresponding 8-week periods in 2009, 2010, and 2012. RESULTS The number of patients admitted to the 2 psychiatric hospitals increased in 4 weeks after the disaster in 2011, with a weekly median (range) of 13 (9-16), compared with 6 (5-9) in the preceding 4 weeks in 2011. The corresponding figures were 5.5 (2-10) in 2009, 6.5 (5-9) in 2010, and 4 (3-7) in 2012 (P = .01, H = 13.05). By diagnostic category, admissions for schizophrenia spectrum disorder and neurotic stress-related disorder increased significantly following the disaster. DISCUSSION Demands for inpatient psychiatric treatment increased immediately after the Great East Japan Earthquake. Government officials and mental health professionals must strengthen support for survivors with mental illness, especially those with schizophrenia spectrum disorder. This should include support for mental health authorities and medical staff in the affected community.
Collapse
Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Miyagi Disaster Mental Health Care Center, Kesennuma, Japan
| | - Ikki Ueda
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Miyagi Disaster Mental Health Care Center, Kesennuma, Japan
| | - Shigehito Rengi
- Department of Psychiatry, Mitsumine Hospital, Kesennuma, Japan
| | - Toshiyasu Shingai
- Department of Psychiatry, Hikarigaoka-Hoyouen Hospital, Kesennuma, Japan
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
6
|
Beaglehole B, Frampton CM, Boden JM, Mulder RT, Bell CJ. An evaluation of Health of the Nation Outcome Scales data to inform psychiatric morbidity following the Canterbury earthquakes. Aust N Z J Psychiatry 2017. [PMID: 28639479 DOI: 10.1177/0004867417714879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. METHOD Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. RESULTS Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. CONCLUSION The Canterbury earthquakes were followed by an increase in Health of the Nation Outcome Scales scores for attendees of local mental health services compared to other large district health boards. This suggests that patients presented with greater degrees of psychiatric distress, social disruption, behavioural change and impairment as a result of the earthquakes.
Collapse
Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Caroline J Bell
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| |
Collapse
|
7
|
Beaglehole B, Bell C, Frampton C, Moor S. The impact of the Canterbury earthquakes on successful school leaving for adolescents. Aust N Z J Public Health 2016; 41:70-73. [PMID: 27960250 DOI: 10.1111/1753-6405.12625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/01/2016] [Accepted: 09/01/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine the impact of the Canterbury earthquakes on the important adolescent transition period of school leaving. METHOD Local and national data on school leaving age, attainment of National Certificate of Educational Achievement (NCEA) standards, and school rolls (total registered students for schools) were examined to clarify long-term trends and delineate these from any impacts of the Canterbury earthquakes. Results: Despite concerns about negative impacts, there was no evidence for increased school disengagement or poorer academic performance by students as a consequence of the earthquakes. CONCLUSION Although there may have been negative effects for a minority, the possibility of post-disaster growth and resilience being the norm for the majority meant that negative effects on school leaving were not observed following the earthquakes. A range of post-disaster responses may have mitigated adverse effects on the adolescent population. Implications for Public Health: Overall long-term negative effects are unlikely for the affected adolescent population. The results also indicate that similar populations exposed to disasters in other settings are likely to do well in the presence of a comprehensive post-disaster response.
Collapse
Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago, New Zealand
| | | | - Stephanie Moor
- Department of Psychological Medicine, University of Otago, New Zealand
| |
Collapse
|
8
|
Hogg D, Kingham S, Wilson TM, Ardagh M. The effects of spatially varying earthquake impacts on mood and anxiety symptom treatments among long-term Christchurch residents following the 2010/11 Canterbury earthquakes, New Zealand. Health Place 2016; 41:78-88. [PMID: 27583524 DOI: 10.1016/j.healthplace.2016.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 01/24/2023]
Abstract
This study investigates the effects of disruptions to different community environments, community resilience and cumulated felt earthquake intensities on yearly mood and anxiety symptom treatments from the New Zealand Ministry of Health's administrative databases between September 2009 and August 2012. The sample includes 172,284 long-term residents from different Christchurch communities. Living in a better physical environment was associated with lower mood and anxiety treatment rates after the beginning of the Canterbury earthquake sequence whereas an inverse effect could be found for social community environment and community resilience. These results may be confounded by pre-existing patterns, as well as intensified treatment-seeking behaviour and intervention programmes in severely affected areas. Nevertheless, the findings indicate that adverse mental health outcomes can be found in communities with worse physical but stronger social environments or community resilience post-disaster. Also, they do not necessarily follow felt intensities since cumulative earthquake intensity did not show a significant effect.
Collapse
Affiliation(s)
- Daniel Hogg
- GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Cooperative Research Centre for Spatial Information (CRCSI), Carlton, Victoria 3053, Australia.
| | - Simon Kingham
- GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Cooperative Research Centre for Spatial Information (CRCSI), Carlton, Victoria 3053, Australia.
| | - Thomas M Wilson
- Department of Geological Sciences, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; The Natural Hazards Research Platform (NHRP), New Zealand.
| | - Michael Ardagh
- University of Otago, PO Box 4345, Christchurch, New Zealand; Canterbury District Health Board (CDHB), New Zealand.
| |
Collapse
|
9
|
Beaglehole B, Bell C, Frampton C, Hamilton G, McKean A. The impact of the Canterbury earthquakes on prescribing for mental health. Aust N Z J Psychiatry 2015; 49:742-50. [PMID: 26041790 DOI: 10.1177/0004867415589794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the impact of the Canterbury earthquakes on the mental health of the local population by examining prescribing patterns of psychotropic medication. METHOD Dispensing data from community pharmacies for antidepressants, antipsychotics, anxiolytics and sedatives/hypnotics are routinely recorded in a national database. The close relationship between prescribing and dispensing provides the opportunity to assess prescribing trends for Canterbury compared to national data and therefore examines the longitudinal impact of the earthquakes on prescribing patterns. RESULTS Short-term increases in the use of anxiolytics and sedatives/hypnotics were observed after the most devastating February 2011 earthquake, but this effect was not sustained. There were no observable effects of the earthquakes on antidepressant or antipsychotic dispensing. CONCLUSION Short-term increases in dispensing were only observed for the classes of anxiolytics and sedatives/hypnotics. No sustained changes in dispensing occurred. These findings suggest that long-term detrimental effects on the mental health of the Canterbury population were either not present or have not resulted in increased prescribing of psychotropic medication.
Collapse
Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Christopher Frampton
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Greg Hamilton
- Canterbury District Health Board, Christchurch, New Zealand
| | - Andrew McKean
- Canterbury District Health Board, Christchurch, New Zealand
| |
Collapse
|
10
|
McFarlane AC, Van Hoof M. The counterintuitive effect of a disaster: the need for a long-term perspective. Aust N Z J Psychiatry 2015; 49:313-4. [PMID: 25802180 DOI: 10.1177/0004867415576393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Miranda Van Hoof
- Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, Australia
| |
Collapse
|