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Goodarzi S, Teymouri Athar MM, Beiky M, Fathi H, Nakhaee Z, Omran SP, Shafiee A. Effect of physical activity for reducing anxiety symptoms in older adults: a meta-analysis of randomized controlled trials. BMC Sports Sci Med Rehabil 2024; 16:153. [PMID: 39014515 PMCID: PMC11251295 DOI: 10.1186/s13102-024-00947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Anxiety symptoms in older adults can significantly impact their well-being. Physical activity is increasingly recognized as a potential intervention to alleviate anxiety in this population. We conducted a systematic review and meta-analysis to explore the impact of physical activity on anxiety symptoms in geriatric individuals. METHODS A systematic search was conducted in MEDLINE (via PubMed), Scopus, and Embase databases until November 29, 2023. Two independent reviewers screened articles based on predefined inclusion criteria. RESULTS Eleven randomized controlled trials were included. These trials, involving 770 geriatric participants, demonstrated a significant overall effect of physical activity on reducing anxiety symptoms (SMD =-0.60, 95% CI: -0.88 to -0.32). Subgroup analysis based on type of intervention and duration of follow-up was performed. The results showed all types of exercises reduced anxiety symptoms compared to the control group. Furthermore, those studies with shorter follow-up (less than 10 weeks) did not show a statistically significant reduction in anxiety symptoms. Moderate heterogeneity was observed (I2 = 67%). Sensitivity analyses confirmed the robustness of the overall effect size. Funnel plot inspection and Egger's test (p = 0.36) suggested no signs of publication bias or small study effects. CONCLUSION This meta-analysis provides strong evidence that physical activity significantly reduces anxiety symptoms in older adults. The study highlights the differential effects of cardio and strength exercises and underscores the high quality of evidence supporting the anxiolytic benefits of physical activity in geriatric populations.
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Affiliation(s)
- Saba Goodarzi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | | | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | - Hanieh Fathi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | - Zahra Nakhaee
- School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran.
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran.
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Kershaw S, Sunderland M, Grager A, Birrell L, Deen H, Newton NC, Stapinski LA, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Perceived barriers to help-seeking for people who use crystal methamphetamine: Perspectives of people with lived experience, family members and health workers. Drug Alcohol Rev 2024. [PMID: 38965840 DOI: 10.1111/dar.13897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 05/16/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Barriers to help-seeking for illicit drug use cross psychosocial (e.g., knowledge of where to seek help, attitudinal beliefs like being afraid of what people will think) and structural (e.g., service availability) domains. Along with people who use illicit drugs, it is important to consider the perspectives of other key groups who are often involved in the help-seeking and recovery process. This study aimed to examine the perceived barriers to help-seeking for people who use crystal methamphetamine ('ice') among key groups (people who use crystal methamphetamine, families and friends, health workers) as well as the general community. METHODS A cross-sectional online survey open to all Australian residents (aged ≥18 years) was conducted November 2018-March 2019. Four key groups of interest were recruited to examine and compare perceived barriers to help-seeking for crystal methamphetamine use. RESULTS Participants (n = 2108) included: people who use/have used crystal methamphetamine (n = 564, 39%), health workers (n = 288, 26.8%), affected family/friends (n = 434, 13.7%) and general community (n = 822, 20.6%). People who used crystal methamphetamine demonstrated increased odds of reporting attitudinal (OR 1.35; 1.02-1.80) or structural (OR 1.89; 1.09-3.27) barriers, or a previous negative help-seeking experience (OR 2.27; 1.41-3.66) compared to knowledge barriers. Health workers demonstrated decreased odds of reporting attitudinal compared to knowledge barriers (OR 0.69; 0.50-0.95). DISCUSSION AND CONCLUSIONS Perceived barriers to seeking help for crystal methamphetamine use differed among key groups involved in treatment and recovery. Acknowledging and addressing the mismatches between key groups, through targeted interventions may better support people to seek help for crystal methamphetamine use.
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Affiliation(s)
- Steph Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Anna Grager
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Hannah Deen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | | | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Teles ALS, Baldaçara L, da Silva AG, Leite VDS, Benito ALP, Ribeiro FV. Interfaces between oncology and psychiatry. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S129. [PMID: 38865548 PMCID: PMC11164258 DOI: 10.1590/1806-9282.2024s129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 10/26/2023] [Indexed: 06/14/2024]
Affiliation(s)
| | - Leonardo Baldaçara
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
| | - Antônio Geraldo da Silva
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
- Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil
| | - Verônica da Silveira Leite
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
| | - Ana Lucia Paya Benito
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
- Brazilian Society of Psycho-oncology – São Paulo (SP), Brazil
| | - Flávio Veloso Ribeiro
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
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Chukwuma OV, Ezeani EI, Fatoye EO, Benjamin J, Okobi OE, Nwume CG, Egberuare EN. A Systematic Review of the Effect of Stigmatization on Psychiatric Illness Outcomes. Cureus 2024; 16:e62642. [PMID: 39036187 PMCID: PMC11258934 DOI: 10.7759/cureus.62642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 07/23/2024] Open
Abstract
A significant proportion of individuals with psychiatric disorders face dual challenges such as managing the symptoms and disabilities of their conditions and enduring stigma arising from misconceptions about mental illness. This stigma denies them quality-of-life opportunities, such as access to satisfactory healthcare services, better employment, safer housing, and social affiliations. This systematic review aims to evaluate the effect of stigmatization on psychiatric illness outcomes, particularly its influence on treatment adherence, treatment-seeking behavior, and care outcomes. We conducted a systematic review of 39 studies published between 2010 and 2024, focusing on the effects of stigmatization on psychiatric illness outcomes. The review utilized robust methodology following Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies from 2010 to 2024 obtained from databases such as PubMed, Embase, Google Scholar, Web of Science, and SCOPUS. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies, with most studies rated as moderate to high quality. The findings indicate that stigma in psychiatric illness is closely associated with several factors, including illness duration (mean effect size = 0.42, p < 0.05), frequency of clinic visits (mean reduction = 2.3 visits/year), and diagnosis of psychotic disorders (OR = 1.78, 95% CI: 1.20-2.65). Stigma manifests through misinformation, prejudice, and discrimination, leading to significant barriers to accessing and adhering to psychiatric treatment, thereby worsening health outcomes. It leads to delays in accessing healthcare, poor adherence to medication and follow-up, and negative psychiatric health outcomes, including disempowerment, reduced self-efficacy, increased psychiatric symptoms, and decreased quality of life. Also, stigma extends to caregivers and healthcare professionals, complicating care delivery. This review highlights the need for effective interventions and strategies to address stigma, emphasizing the importance of educational interventions to mitigate the adverse effects of public stigma. Understanding the multifaceted nature of stigma is crucial for developing targeted approaches to improve psychiatric care outcomes and ensure better mental health services for individuals with mental illnesses.
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Affiliation(s)
| | - Esther I Ezeani
- Family Medicine, Indiana Regional Medical Center (IRMC), Indiana, USA
- Primary Care, Lifebridge Health, Baltimore, USA
| | | | - Janet Benjamin
- Internal Medicine, Ross University School of Medicine, Miramar, USA
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Chuka G Nwume
- Family Medicine, University of Port Harcourt, Port Harcourt, NGA
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Okabe S, Ito S, Goto A, Konno N. Comparative study of eating behavior between patients with mental illness and healthy controls using the Japanese version of the Dutch Eating Behavior Questionnaire. Asia Pac J Clin Nutr 2024; 33:228-236. [PMID: 38794982 PMCID: PMC11170011 DOI: 10.6133/apjcn.202406_33(2).0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 03/07/2024] [Accepted: 01/18/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND AND OBJECTIVES To examine the reliability and validity of the Japanese version of the Dutch Eating Behavior Questionnaire (DEBQ-J) for patients with mental illness, and to determine the characteristics of eating behavior among these patients when compared with healthy controls. METHODS AND STUDY DESIGN In May 2018, 120 outpatients with mental illness and 132 healthy controls were surveyed. First, exploratory factor analysis was conducted on the DEBQ-J statement responses for both patients and healthy controls. Next, reliability coefficients were calculated for the eating behavior scale scores (emotional, restrained, and external eating) extracted from the factor analysis. The association between BMI and eating behavior was examined using Student's t-test and Pearson's correlation coefficient. RESULTS The DEBQ-J had a similar factor structure to that of the original DEBQ for healthy controls, with a cumulative contribution of 52.4% for the three factors, and alpha coefficients ranging from 0.87 to 0.91. For patients, factor analysis showed that four statements classified as emotional eating items in the original DEBQ were recategorized as external eating items, and the percentage of patients with obesity (BMI≥25) was 57.5%, compared with only 25.4% among the healthy controls. The patients with obesity tended to score higher on the external eating scale than did those with BMI<25. CONCLUSIONS Patients tended to blur the distinction between emotional feelings of mental irritability or anxiety and feelings in response to external stimuli. Monitoring of the DEBQ-J external eating score and appropriate intervention among patients living with mental illness may help to prevent obesity.
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Affiliation(s)
| | - Shinya Ito
- Koriyama Women's University, Fukushima, Japan
| | - Aya Goto
- Center for Integrated Sciences and Humanities, Fukushima Medical University, Fukushima, Japan
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
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Billian J, Imfeld L, Roth CB, Moeller J, Lang UE, Huber CG. Treatment-seeking threshold and accessibility of psychiatric outpatient services in Switzerland: the relationship with stigma and self-esteem. Front Psychiatry 2024; 15:1377971. [PMID: 38680786 PMCID: PMC11045997 DOI: 10.3389/fpsyt.2024.1377971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/19/2024] [Indexed: 05/01/2024] Open
Abstract
Perceived stigmatization and low self-esteem are linked to poorer mental health outcomes, but their impact on treatment-seeking thresholds and the importance of outpatient service location remain unclear. The study included 525 outpatients of the University Psychiatric Clinic (UPK) Basel, Switzerland, of whom 346 were treated at inner city services and 179 at services located on the main site of the UPK at the outer city limits. Perceived discrimination and devaluation (PDD), self-esteem (SE), treatment-seeking threshold (TST), and accessibility were measured via a self-reported questionnaire. The PDD consisted of 12 items evaluating beliefs about the level of stigma towards individuals with mental illness in the general population on a 5-point Likert scale. SE, TST and accessibility were assessed through single-item 7-point Likert scales. PDD and SE were positively correlated (p < 0.001), suggesting that lower perceived stigma was linked to higher self-esteem, and were not associated with TST. The relationship between PDD and SE remained consistent after controlling for age, gender, and nationality. Age was negatively correlated with TST (p = 0.022), while gender did not significantly influence any of the variables. There was little variation regarding PDD, with emergencies at the site of the psychiatric clinic and substance use disorder (SUD) patients reporting higher levels of stigmatization. Emergency patients and those with SUD and personality disorder reported the lowest SE ratings. TST showed a broad range and was highest for emergency services and transcultural psychiatry patients. Differences in accessibility were mainly linked to the location, with outpatient service users in the inner city reporting better accessibility (p < 0.001) and higher SE (p = 0.009). In comparison to patients using services with planned contacts only, patients in emergency settings differed by higher TST (p = 0.018) and better ratings of accessibility (p = 0.004). In conclusion, there was a relevant amount of stigmatization, impaired self-esteem, and, for some outpatient services, high thresholds to seek treatment. Future research should explore other factors influencing TST. The findings highlight the need to address stigmatization and accessibility when planning mental health services.
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Affiliation(s)
- Janina Billian
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Lukas Imfeld
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Institute for Evaluation Research, Universitäre Psychiatrische Kliniken (UPK) Basel, University of Basel, Basel, Switzerland
| | - Carl B. Roth
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Julian Moeller
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Christian G. Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
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Shirvaniyan F, Eissazade N, Shariat SV, Khademoreza N, Daneshvar M, Shalbafan M. Attitude toward patients with mental disorders: what is going on amongst Iranian pharmacies? BMC Psychol 2024; 12:126. [PMID: 38448985 PMCID: PMC10916046 DOI: 10.1186/s40359-024-01604-0] [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: 09/14/2023] [Accepted: 02/18/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION As the incidence of mental disorders continues to rise, and pharmacy staff can significantly affect the willingness of patients with mental disorders to seek help; we aimed to evaluate the stigmatizing attitude of the pharmacy staff toward these patients in Iran. METHODS We conducted this cross-sectional study between April 2020 and December 2021 in Tehran, Iran, and included pharmacists, pharmacy technicians and pharmacy students, with the experience of working in a pharmacy for at least three months. The social distance scale (SDS) and dangerousness scale (DS) were used to measure the stigmatizing attitude of the participants. Higher scores indicated more stigmatizing attitudes. RESULTS We included a total of 186 participants with a mean age of 32.97 ± 9.41 years, of which 101 (54.3%) were male, and 75 (40.3%) were pharmacists, 101 (54.3%) were pharmacy technicians, and 8 (4.3%) were pharmacy students. The mean SDS score was 14.2 ± 4.13, and the mean DS score was 33.85 ± 8.92. The greatest tendency for social distance was reported for a patient with a mental disorder, 'being the caretaker of their children for an hour or two' and 'marrying their children.' The most perceived dangerousness was reported for a patient with a mental disorder 'owning a gun.' Positive personal history of psychopharmacological treatment was statistically correlated with lower DS (P = 0.001) and SDS (P = 0.007) scores. Positive family history of psychiatric inpatient admission was significantly correlated with higher DS (P = 0.05) and SDS (P = 0.03) scores. Higher rates of 'received psychiatric prescriptions per month' was associated with lower DS scores (P = 0.04). CONCLUSION Our participants did not have an overall positive attitude toward patients with mental disorders. Although, compared to previous studies, they held a more positive attitude. Positive personal history of psychopharmacological treatment predicted a more positive attitude and positive family history of psychiatric inpatient admission predicted a more negative attitude.
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Affiliation(s)
- Fatemeh Shirvaniyan
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Negin Eissazade
- Brain and Cognition Clinic, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Seved Vahid Shariat
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Noushin Khademoreza
- Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Daneshvar
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Brain and Cognition Clinic, Institute for Cognitive Sciences Studies, Tehran, Iran.
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Rudberg I, Olsson A, Thunborg C, Salzmann-Erikson M. Interprofessional communication in a psychiatric outpatient unit - an ethnographic study. BMC Nurs 2023; 22:286. [PMID: 37626326 PMCID: PMC10463438 DOI: 10.1186/s12912-023-01446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit. METHOD During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection. RESULTS We found that a workplace's history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit's code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks. CONCLUSION Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.
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Affiliation(s)
- Ingela Rudberg
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden.
| | - Annakarin Olsson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
| | - Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Welfare, Mälardalen University, Västerås, Sweden
| | - Martin Salzmann-Erikson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
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Goodwin J, Cummins J, O'Malley M. "I thought it would just be, like, older men in white coats": A qualitative exploration of first encounters with mental health services. Int J Ment Health Nurs 2023. [PMID: 37114682 DOI: 10.1111/inm.13157] [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] [Received: 01/23/2023] [Revised: 03/28/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Individuals whose mental health is becoming a concern may not receive the care they require. Although efforts have been made to reduce barriers to accessing services, including stigma reduction campaigns and healthcare practitioner training, there remains a lack of understanding of individual perspectives regarding help-seeking behaviour. The aim of this study was to explore people's first experiences accessing mental health services. A qualitative descriptive approach was adopted. Interviews were conducted with eight service users. Data were analysed using reflexive thematic analysis. The COREQ checklist guided this study (Tong et al., 2007, International Journal for Quality in Health Care, 19, 349). Three themes were identified: learning to navigate an unfamiliar system, making sense of mental health services, and promoting a positive image for those in need of care. Uncertainty about mental health services and stigmatizing images could be mitigated by developing positive media-based interventions. Systemic barriers need to be addressed and services need to be better resourced to ensure the benefits of early intervention are available to those experiencing mental health challenges. To encourage people to access services earlier, services need to be promoted in a positive way.
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Affiliation(s)
- John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Cummins
- Student Health and Wellbeing, University College Cork, Cork, Ireland
| | - Maria O'Malley
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Manesh AE, Dalvandi A, Zoladl M. The experience of stigma in family caregivers of people with schizophrenia spectrum disorders: A meta-synthesis study. Heliyon 2023; 9:e14333. [PMID: 36938397 PMCID: PMC10015248 DOI: 10.1016/j.heliyon.2023.e14333] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023] Open
Abstract
Introduction Schizophrenia is a chronic disabling and the most stigmatizing mental disorder worldwide. The stigma experienced by family caregivers impacts their lives in different ways. This study reports the results of qualitative synthesis to understand the perceptions and experiences of stigma in families of people with schizophrenia spectrum disorders across various socio-cultural contexts. Methods An initial comprehensive search was performed in databases like Web of Science, PsycINFO, CINAHL, Scopus, and Ovid-based MEDLINE. By searching, 3560 studies were found, of which 16 articles were included in the present study. A meta-synthesis was done according to the meta-ethnographic approach. Result Three themes were generated: perpetuated stigma by general misunderstandings about schizophrenia, mental health inequality contributes to structural stigma, and long-term family caregiving stigmas, attitudes, and coping strategies. These themes indicated the essential experiences of stigma in families of people with schizophrenia, which appeared due to unknown and socio-cultural misconceptions of schizophrenia that led to emotional challenges for family caregivers. Conclusion This study addresses stigma-related issues, and coping strategies used almost exclusively by family caregivers. Health policymakers and healthcare professionals working in mental health institutions should consider this data. Substantial steps must be taken to combat stigma, with education initiatives topping the list.
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Affiliation(s)
- Azadeh Eghbal Manesh
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Asghar Dalvandi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran
- Corresponding author.
| | - Mohammad Zoladl
- Associate Professor of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
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Baldaçara L. Editorial: Current challenges and evidence-based medicine in psychiatric emergencies. Front Psychiatry 2023; 14:1145280. [PMID: 36937733 PMCID: PMC10014996 DOI: 10.3389/fpsyt.2023.1145280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/07/2023] [Indexed: 03/05/2023] Open
Affiliation(s)
- Leonardo Baldaçara
- Medicine, Federal University of Tocantins, Palmas, Tocantins, Brazil
- Board of Directors, Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil
- *Correspondence: Leonardo Baldaçara
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Majhi G, Vasava TF. Buffering effects of social security benefits for persons with psychiatric disability on caregivers' burden and quality of life. J Family Med Prim Care 2022; 11:6420-6426. [PMID: 36618253 PMCID: PMC9810858 DOI: 10.4103/jfmpc.jfmpc_494_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Out-of-pocket mental health care expenditure has a catastrophic impact on the families living with severe mental illness, with high levels of burden and poor quality of life. Aim The present study aims to understand the buffering effects of social security benefits for persons with psychiatric disability on caregivers' burden and quality of life. Methodology Two groups of caregivers of people with severe mental illnesses, those receiving disability benefits (n = 100) for the past 6 months and those who were not receiving any benefits (n = 72), were recruited from the out-patient follow-up services. Both the groups were assessed with the Burden Assessment Scale (BAS) and the World Health Organization Quality of Life (WHO QoL-Bref). Result Those who were receiving the disability-related social benefits had reported better quality of life only in psychological and social domains. The maximum value of Pearson's correlation coefficient was observed between physical and psychological domains (r = 0.12; not significant), and the values did not change even after controlling for the social security status. Discussion The current study did not find full support for buffering effects of social security benefits on caregivers' quality of life. Thus, there is a need for a comprehensive plan for social security benefits, especially for persons with psychiatric disability, as caregivers are already experiencing high levels of financial stress.
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Affiliation(s)
- Gobinda Majhi
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India,Address for correspondence: Dr. Gobinda Majhi, Department of Psychiatric Social Work, NIMHANS, Bengaluru – 560 029, Karnataka, India. E-mail:
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Mengual-Pujante M, Morán-Sánchez I, Luna-Ruiz Cabello A, Pérez-Cárceles MD. Attitudes of the police towards individuals with a known psychiatric diagnosis. BMC Psychiatry 2022; 22:614. [PMID: 36123659 PMCID: PMC9484251 DOI: 10.1186/s12888-022-04234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Police officers are increasingly required to respond to incidents involving psychiatric patients. However, few studies have assessed whether the attitude of police officers depends on prior knowledge of their specific psychiatric diagnosis. Our aim was to analyze the effects of psychiatric diagnosis on the behavior of police officers. METHODS We utilized the Attribution Questionnaire adapted to the police context to examine the attitudes of 927 officers of the Spanish National Police Force towards persons diagnosed with either schizophrenia or depressive disorder playing the role of somebody in need of assistance, a victim of a crime, a witness, or a suspect in a criminal case. Different socio-demographic variables were also collected. RESULTS Compared to attitudes to individuals with a known psychiatric diagnosis, police officers expressed increased willingness to help psychiatric patients and increased sympathy and attributing to them less responsibility for their actions. They also showed increased feelings of avoidance, reported a greater perception of danger and a greater need for isolation and involuntary treatment. This was especially so in the case of schizophrenia. Stigmatizing attitudes were less apparent when the person was a woman, a veteran officer, or someone with a history of work experience. CONCLUSIONS Police officers may hold certain stigmatizing attitudes towards persons with mental illness, particularly schizophrenia, that require special attention, as they may negatively affect police action. We found several factors associated with the persistence of these stigmatizing attitudes among police officers that may guide us when implementing training programs for promoting attitude change, especially at the beginning of an officer's professional career.
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Affiliation(s)
- M. Mengual-Pujante
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - I. Morán-Sánchez
- Cartagena Mental Health Centre, Real St 8, E-30201, Cartagena, Murcia, Spain ,grid.411967.c0000 0001 2288 3068Department of Forensic Psychiatry, Law Faculty, Catholic University of Murcia, Murcia, Spain
| | - A. Luna-Ruiz Cabello
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - M. D. Pérez-Cárceles
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
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Fasanella NA, Custódio CG, do Cabo JS, Andrade GS, de Almeida FA, Pavan MV. Use of prescribed psychotropic drugs among medical students and associated factors: a cross-sectional study. SAO PAULO MED J 2022; 140:697-704. [PMID: 35976367 PMCID: PMC9514864 DOI: 10.1590/1516-3180.2021.0566.r2.05012022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The worldwide prevalences of anxiety and depressive disorders are 3.6% and 4.4%, respectively. Among medical students, many studies have indicated that the prevalences of these mental disorders vary between 19.7% and 47.1%, but there is a lack of information on psychotropic drug usage in this group of students. OBJECTIVE To evaluate the prevalence of psychotropic drug use, adherence to therapy and main clinical and diagnostic indications relating to psychotropic drug use among medical students. DESIGN AND SETTING Cross-sectional study at a Brazilian private university in the city of Sorocaba, state of São Paulo. METHODS Observational analytical cross-sectional study, conducted during the second semester of 2019, through a semi-structured online questionnaire, answered by first to sixth-year medical students. RESULTS Among the 263 participants (41.7% of the 630 enrolled students), the current prevalence of psychotropic drug usage was 30.4%. This prevalence increased over the course and 90.7% of the drugs were prescribed at regular medical consultations (85.5% by psychiatrists). The main indications for psychotropic drug usage were anxiety (30.0%), depression (22.8%), insomnia (7.2%), panic (5.3%) and attention deficit hyperactivity disorder (3.8%). Women were more likely to present diagnoses of depression and panic. Most of the participants used antidepressants and had good adherence to medications. Adequate sleep and regular physical activity were identified as protective factors against mental disorders. CONCLUSION The prevalence of mental disorders among medical students is high, which justifies the use of psychotropic drugs. This study provides valuable information and recommendations for institutional educational actions to improve students' mental health.
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Affiliation(s)
- Nicoli Abrão Fasanella
- MD. Professor, Department of Public Health, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Clarissa Garcia Custódio
- Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Júlia Santos do Cabo
- Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | | | - Fernando Antônio de Almeida
- MD, PhD. Full Professor, Department of Clinics, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Maria Valéria Pavan
- MD, MSc, PhD. Professor, Department of Public Health, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
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Fernandes JB, Família C, Castro C, Simões A. Stigma towards People with Mental Illness among Portuguese Nursing Students. J Pers Med 2022; 12:jpm12030326. [PMID: 35330326 PMCID: PMC8955632 DOI: 10.3390/jpm12030326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/17/2022] [Indexed: 12/31/2022] Open
Abstract
Stigma is a substantial obstacle when caring for people with mental illness. Nursing students’ negative attitudes towards people with mental illness may impact the quality of care delivered and consequentially patient outcomes. In this study, we assessed the stigmatising attitudes and beliefs of nursing students towards people with mental illness and examined its relationship with several psycho-socio-demographic variables. This was a quantitative, cross-sectional descriptive correlational study, which was developed with a non-probabilistic convenience sample of 110 nursing students. Stigmatising attitudes and beliefs were assessed using the Portuguese version of the Attribution Questionnaire AQ-27. Results show that the dimensions of stigma with higher scores were help, pity, coercion and avoidance. However, significant differences were only observed depending on the year of study (fourth-year students, who already had clinical placements in this area, are less likely to show stigma), the relationship (family is less prone to show coercion), the history of mental health treatment (students with a history of mental health treatment have more tendency to help) and whether they considered working in the mental health field (students who have considered working in this field are less prone to show anger, avoidance and think of patients as dangerous). Therefore, we conclude that education in a classroom setting alone is not enough to reduce stigma in nursing students, clinical placement in the area is required to achieve such results. It is thus essential to improve nursing curricula worldwide so that students are exposed to both psychiatric nursing theory and clinical practice in the first years of the nursing degree.
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Affiliation(s)
- Júlio Belo Fernandes
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Correspondence:
| | - Carlos Família
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
- Molecular Pathology and Forensic Biochemistry Laboratory (MPFBL), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, 2829-511 Caparica, Portugal
| | - Cidália Castro
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
| | - Aida Simões
- Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal; (C.F.); (C.C.); (A.S.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
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Duarte D, El-Hagrassy MM, Couto T, Gurgel W, Frey BN, Kapczinski F, Corrêa H. Physician suicide demographics and the COVID-19 pandemic. BRAZILIAN JOURNAL OF PSYCHIATRY 2022; 44:124-135. [PMID: 35081210 PMCID: PMC9041957 DOI: 10.1590/1516-4446-2021-1865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023]
Abstract
Objective: Methods: Results: Conclusions:
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Affiliation(s)
| | | | | | | | - Benicio N. Frey
- McMaster University, Canada; St. Joseph’s Healthcare Hamilton, Canada
| | - Flavio Kapczinski
- McMaster University, Canada; Universidade Federal do Rio Grande do Sul, Brazil
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Kargin M, Aydin A. The experiences of Turkish psychiatric nurses with psychiatric emergencies in the clinics of Turkey's mental health and diseases hospital: A descriptive qualitative study. Perspect Psychiatr Care 2022; 58:39-46. [PMID: 34260750 DOI: 10.1111/ppc.12914] [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] [Received: 03/23/2021] [Revised: 06/08/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to describe the experiences of Turkish nurses in the psychiatry clinics of Turkey's Mental Health and Diseases Hospital DESIGN AND METHODS: This descriptive qualitative study was conducted on 20 psychiatric nurses working at a psychiatric hospital. A semi-structured in-person interview technique was used for data collection. RESULTS Six themes were defined in this study. The majority of psychiatric nurses stated that they usually faced suicidal and aggressive cases and that they used security measures, restraint and isolation, medical treatment, and emergency codes as basic interventions. PRACTICE IMPLICATIONS Psychiatry is a field of clinical practice requiring case management skills to deal with various psychiatric presentations.
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Affiliation(s)
- Maral Kargin
- Nursing Department, Faculty of Health Sciences, Cyprus Science University, Kyrenia, Cyprus
| | - Adeviye Aydin
- Nursing Department, Faculty of Health Sciences, Sinop University, Sinop, Turkey
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Ciobanu AM, Catrinescu LM, Ivașcu DM, Niculae CP, Szalontay AS. Stigma and quality of life among people diagnosed with mental disorders: a Narrative Review. CONSORTIUM PSYCHIATRICUM 2021; 2:23-29. [PMID: 39045895 PMCID: PMC11262073 DOI: 10.17816/cp83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION The anti-psychiatric movements that emerged in the early 1960s led to the appearance of stigma in psychiatry. The misunderstanding of the concept of mental disorder, the negative way in which associated hospitalization was perceived, the inclination to treat patients through psychological therapies, and the criticism of pharmacological treatment led to the discrediting of psychiatry. AIM The current paper aims to review the available literature regarding the impact of stigma on the quality of life of people diagnosed with mental disorders. MATERIAL AND METHODS A narrative review of relevant literature published between 1999 and 2021 was conducted. The authors analysed studies found on PubMed and the Web of Science electronic databases. The search terms combined two overlapping areas with keywords such as "stigma" and "mental disorders". A descriptive analysis was employed to synthesize the obtained data. RESULTS Stigma continues to be an important challenge to the management of health conditions in people with mental disorders. A lack of comprehension may give the impression that all psychiatric patients are aggressive and are unable to function adequately. Such stigmatizing beliefs and habits have proven to be very difficult to change. CONCLUSIONS Due to the stigmatization and repulsive attitudes in society, patients are reluctant to be linked to any form of mental disorder or to be seen as having any contact with mental health professionals. This undermines the beneficial effects of treatment, resulting in a poor quality of life and diminished socio-occupational functioning.
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Najarian D, Sanga P, Wang S, Lim P, Singh A, Robertson MJ, Cohen K, Schotte A, Milz R, Venkatasubramanian R, T’Jollyn H, Walling DP, Galderisi S, Gopal S. A Randomized, Double-Blind, Multicenter, Noninferiority Study Comparing Paliperidone Palmitate 6-Month Versus the 3-Month Long-Acting Injectable in Patients With Schizophrenia. Int J Neuropsychopharmacol 2021; 25:238-251. [PMID: 34791283 PMCID: PMC8929757 DOI: 10.1093/ijnp/pyab071] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/18/2021] [Accepted: 11/10/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This double-blind (DB), randomized, parallel-group study was designed to evaluate efficacy and safety of paliperidone palmitate 6-month (PP6M) formulation relative to paliperidone palmitate 3-month (PP3M) formulation in patients with schizophrenia. METHODS Following screening, patients entered an open-label (OL) maintenance phase and received 1 injection cycle of paliperidone palmitate 1-month (PP1M; 100 or 150 mg eq.) or PP3M (350 or 525 mg eq.). Clinically stable patients were randomized (2:1) to receive PP6M (700 or 1000 mg eq., gluteal injections) or PP3M (350 or 525 mg eq.) in a 12-month DB phase; 2 doses of PP6M (corresponding to doses of PP1M and PP3M) were chosen. RESULTS Overall, 1036 patients were screened, 838 entered the OL phase, and 702 (mean age: 40.8 years) were randomized (PP6M: 478; PP3M: 224); 618 (88.0%) patients completed the DB phase (PP6M: 416 [87.0%]; PP3M: 202 [90.2%]). Relapse rates were PP6M, 7.5% (n = 36) and PP3M, 4.9% (n = 11). The Kaplan-Meier estimate of the difference (95% CI) between treatment groups (PP6M - PP3M) in the percentages of patients who remained relapse free was -2.9% (-6.8%, 1.1%), thus meeting noninferiority criteria (95% CI lower bound is larger than the pre-specified noninferiority margin of -10%). Secondary efficacy endpoints corroborated the primary analysis. Incidences of treatment-emergent adverse events were similar between PP6M (62.1%) and PP3M (58.5%). No new safety concerns emerged. CONCLUSIONS The efficacy of a twice-yearly dosing regimen of PP6M was noninferior to that of PP3M in preventing relapse in patients with schizophrenia adequately treated with PP1M or PP3M. TRIAL REGISTRATION Clinical Trials.gov identifier: NCT03345342.
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Affiliation(s)
- Dean Najarian
- Janssen Scientific Affairs, LLC, New Jersey, USA,Correspondence: Dean Najarian, PharmD, BCPP, Janssen Scientific Affairs, LLC, NJ, USA, 1125 Trenton Harbourton Rd, Titusville, NJ 08560 ()
| | - Panna Sanga
- Janssen Research and Development LLC, New Jersey, USA
| | - Steven Wang
- Janssen Research and Development LLC, New Jersey, USA
| | - Pilar Lim
- Janssen Research and Development LLC, New Jersey, USA
| | - Arun Singh
- Janssen Research and Development LLC, New Jersey, USA
| | | | - Kristin Cohen
- Janssen Research and Development LLC, New Jersey, USA
| | | | | | | | | | | | | | - Srihari Gopal
- Janssen Research and Development LLC, New Jersey, USA
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Baldaçara L, da Silva AG, Pereira LA, Malloy-Diniz L, Tung TC. The Management of Psychiatric Emergencies in Situations of Public Calamity. Front Psychiatry 2021; 12:556792. [PMID: 33643085 PMCID: PMC7905390 DOI: 10.3389/fpsyt.2021.556792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022] Open
Abstract
The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.
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Affiliation(s)
- Leonardo Baldaçara
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Medicine, Universidade Federal do Tocantins, Palmas, Brazil
| | - Antônio Geraldo da Silva
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Lucas Alves Pereira
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Departamento de Psiquiatria, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Leandro Malloy-Diniz
- Mental Health Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Psychology Department, Universidade FUMEC, Belo Horizonte, Brazil
| | - Teng Chei Tung
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Universidade de São Paulo, São Paulo, Brazil
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Roe J, Brown S, Yeo C, Rennick-Egglestone S, Repper J, Ng F, Llewelyn-Beardsley J, Hui A, Cuijpers P, Thornicroft G, Manley D, Pollock K, Slade M. Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings. Front Psychiatry 2020; 11:589731. [PMID: 33192738 PMCID: PMC7661955 DOI: 10.3389/fpsyt.2020.589731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education. Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education. Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted. Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements). Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress. Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.
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Affiliation(s)
- James Roe
- National Institute for Health Research, Applied Research Collaboration (ARC) East Midlands, University of Nottingham, Nottingham, United Kingdom
| | - Susan Brown
- Mindtech MedTech Cooperative, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Julie Repper
- Implementing Recovery Through Organisational Change (ImROC), Nottingham, United Kingdom
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewelyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Ada Hui
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - David Manley
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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