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Udo T, Roberts PC, Dyett J, Mullin S, Cummings D, Morano C. Opportunities and Challenges to Build Behavioral Health Crisis Capacity in Rural America. Psychiatr Serv 2024:appips20230111. [PMID: 38650491 DOI: 10.1176/appi.ps.20230111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
This column shares lessons learned from a 1-year pilot implementation of a crisis response program deploying crisis professionals to rural parts of Albany County, New York. The data (325 crisis interventions for 191 unique individuals, 57% of cases resolved on the scene) suggest that the program helps fill the crisis services gap in these communities. Police were present on 80% of cases. Educating police to build confidence in the program and providing clearer guidelines on the triage process for dispatchers may be important strategies to continue shifting crisis response duties from traditional first responders to crisis professionals.
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Affiliation(s)
- Tomoko Udo
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
| | - Preston Cody Roberts
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
| | - Jordan Dyett
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
| | - Shannon Mullin
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
| | - Denard Cummings
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
| | - Carmen Morano
- Department of Health Policy, Management and Behavior (Udo, Mullin, Cummings) and Department of Epidemiology and Biostatistics (Udo), School of Public Health, University at Albany, Rensselaer, New York; School of Criminal Justice (Roberts) and School of Social Welfare (Dyett, Morano), University at Albany, Albany, New York
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Eapen V, Gerstl B, Ahinkorah BO, John JR, Hawker P, Nguyen TP, Brice F, Winata T, Bowden M. Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review. BJPsych Open 2024; 10:e78. [PMID: 38602192 PMCID: PMC11060074 DOI: 10.1192/bjo.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. AIMS To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0-17 years) presenting with an acute mental health condition. METHOD A systematic literature search was conducted, and the studies' methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. RESULTS We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent-child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. CONCLUSIONS This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and School of Public Health, University of Technology Sydney, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Mental Health Team, School of Medicine, Western Sydney University, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Australia
| | - Michael Bowden
- Child and Youth Mental Health, New South Wales Ministry of Health, Australia; Sydney Medical School, University of Sydney, Australia; and Department of Psychological Medicine, Sydney Children's Hospitals Network, Australia
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Kazemi A, Boyd M, Choi F, Tai AMY, Tsang VW, To T, Kim J, Jang K, Shams F, Schreiter S, Cabanis M, Krausz RM. Architecture and Development Framework for a Web-Based Risk Assessment and Management Platform Developed on WordPress to Address Opioid Overdose. JMIR Form Res 2024; 8:e49759. [PMID: 38466977 DOI: 10.2196/49759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 03/13/2024] Open
Abstract
The number of overdose-related fatalities continues to reach historic levels across Canada, despite ongoing efforts by authorities. To reduce mortality, a clinical trajectory ranging from preventative measures to crisis intervention, skill training to treatment, and risk assessment to risk management needs to be supported. The web-based Risk Assessment and Management Platform (RAMP) was developed to realize this concept and to empower people who use drugs through an integrated tool that allows them to better understand and manage their risk of overdose. This paper outlines the architecture and development of RAMP, which is built on the WordPress platform. WordPress components are mapped onto a 3-tier architecture that consists of presentation, application, and database layers. The architecture facilitates the development of a modular software that includes several features that are independent in functionality but interact with each other in an integrated platform. The relatively low coupling and high coherence of the features may reduce the cost of maintenance and increase flexibility of future developments. RAMP's architecture comprises a user interface, conceptual framework, and backend layers. The RAMP front end effectively uses some of the WordPress' features such as HTML5, CSS, and JavaScript to create a mobile, friendly, and scalable user interface. The RAMP backend uses several standard and custom WordPress plug-ins to support risk assessment and monitoring, with the goal of mitigating the impacts and eliminating risks together. A rule-based decision support system has been hard-coded to suggest relevant modules and goals to complement each user's lifestyle and goals based on their risk assessment. Finally, the backend uses the MySQL database management system and communicates with the RAMP framework layer via the data access layer to facilitate a timely and secure handling of information. Overall, RAMP is a modular system developed to identify and manage the risk of opioid overdose in the population of people who use drugs. Its modular design uses the WordPress architecture to efficiently communicate between layers and provide a base for external plug-ins. There is potential for the current system to adopt and address other related fields such as suicide, anxiety, and trauma. Broader implementation will support this concept and lead to the next level of functionality.
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Affiliation(s)
- Alireza Kazemi
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Marisha Boyd
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Fiona Choi
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Andy Man Yeung Tai
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Vivian Wl Tsang
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Tam To
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jane Kim
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Kerry Jang
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Farhud Shams
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Stefanie Schreiter
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Institution: Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maurice Cabanis
- Hospital for Addiction and Addictive Behavior, Center of Mental Health, Klinikum Stuttgart, Esttutgarth, Germany
| | - Reinhard Michael Krausz
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Huber JP, Milton A, Brewer MC, Norrie LM, Hartog SM, Glozier N. The effectiveness of brief non-pharmacological interventions in emergency departments and psychiatric inpatient units for people in crisis: A systematic review and narrative synthesis. Aust N Z J Psychiatry 2024; 58:207-226. [PMID: 38140961 DOI: 10.1177/00048674231216348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Heterogeneous brief non-pharmacological interventions and guidelines exist to treat the burgeoning presentations to both emergency department and inpatient settings, for those in a crisis of mental ill-health. We systematically reviewed the literature to create a taxonomy of these brief non-pharmacological interventions, and review their evaluation methods and effectiveness. METHOD We conducted a systematic review across Cochrane, CINAHL, DARE, Embase, MEDLINE, PsycINFO databases. Studies meeting quality criteria, using Joanna Briggs Institute tools, were eligible. Interventions were categorised, and outcomes synthesised. RESULTS Thirty-nine studies were included: 8 randomised controlled trials, 17 quasi-experimental, 11 qualitative studies, and 3 file audits. Taxonomy produced six coherent intervention types: Skills-focussed, Environment-focussed, Special Observation, Psychoeducation, Multicomponent Group and Multicomponent Individual. Despite this, a broad and inconsistent range of outcome measures reflected different outcome priorities and prevented systematic comparison of different types of intervention or meta-analysis. Few brief non-pharmacological interventions had consistent evidential support: sensory modulation rooms consistently improved distress in inpatient settings. Short admissions may reduce suicide attempts and readmission, if accompanied by psychotherapy. Suicide-specific interventions in emergency departments may improve depressive symptoms, but not suicide attempt rates. There was evidence that brief non-pharmacological interventions did not reduce incidence of self-harm on inpatient wards. We found no evidence for frequently used interventions such as no-suicide contracting, special observation or inpatient self-harm interventions. CONCLUSION Categorising brief non-pharmacological interventions is feasible, but an evidence base for many is severely limited if not missing. Even when there is evidence, the inconsistency in outcomes often precludes clinicians from making inferences, although some interventions show promise.
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Affiliation(s)
- Jacqueline P Huber
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- Centre of Excellence for Children and Families over the Life Course, Australian Research Council, Canberra, ACT, Australia
- Mental Health, St Vincent's Hospital Sydney, Sydney, NSW, Australia
| | - Alyssa Milton
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- Centre of Excellence for Children and Families over the Life Course, Australian Research Council, Canberra, ACT, Australia
| | - Matthew C Brewer
- Mental Health, St Vincent's Hospital Sydney, Sydney, NSW, Australia
| | - Louisa M Norrie
- Mental Health, St Vincent's Hospital Sydney, Sydney, NSW, Australia
| | - Saskia M Hartog
- Centre of Excellence for Children and Families over the Life Course, Australian Research Council, Canberra, ACT, Australia
| | - Nick Glozier
- Centre of Excellence for Children and Families over the Life Course, Australian Research Council, Canberra, ACT, Australia
- Mental Health, St Vincent's Hospital Sydney, Sydney, NSW, Australia
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Edwards D, Carrier J, Csontos J, Evans N, Elliott M, Gillen E, Hannigan B, Lane R, Williams L. Review: Crisis responses for children and young people - a systematic review of effectiveness, experiences and service organisation (CAMH-Crisis). Child Adolesc Ment Health 2024; 29:70-83. [PMID: 36785997 DOI: 10.1111/camh.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND In England, one in six children aged 5-19 has a probable diagnosable mental health disorder. This is a major public health problem, with multiple agencies adopting varying approaches to care delivery for children and young people (CYP) in crisis. OBJECTIVES To examine the organisation of crisis services across education, health, social care and voluntary sectors; the experiences and perceptions of CYP, families and staff; the effectiveness of current approaches to care and the goals of crisis intervention. METHODS A systematic review of all relevant English language evidence regarding the provision and receipt of crisis support for CYP aged 5-25 (PROSPERO-CRD42019160134). Seventeen databases were searched from 1995 to 2021 and relevant UK-only grey literature was identified. Critical appraisal was conducted using appropriate design specific appraisal tools. A narrative approach to synthesis was conducted. RESULTS In total, 138 reports (48 reports covering 42 primary research studies; 36 reports covering 39 descriptive accounts of the organisation services and 54 UK-only grey literature reports) were included. The evidence suggests that crisis services were organised as follows: triage/assessment-only, digitally mediated support approaches, and intervention approaches and models. When looking at experiences of crisis care, four themes were identified: (a) barriers and facilitators to seeking and accessing appropriate support; (b) what children and young people want from crisis services; (c) children's, young people's and families' experiences of crisis services; and (d) service provision. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies. The goals of crisis services were identified. DISCUSSION Despite a lack of high-quality international studies, findings suggest that support prior to reaching crisis point is important. From this work, various aspects of crisis care have been identified that can be incorporated into existing services across education, health, social care and the voluntary sector.
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Affiliation(s)
- Deborah Edwards
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Judith Carrier
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Judit Csontos
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Nicola Evans
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Mair Elliott
- Independent Service User Researcher, Cardiff, UK
| | - Elizabeth Gillen
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Ben Hannigan
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Rhiannon Lane
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Liz Williams
- Independent Service User Researcher, Cardiff, UK
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Park S, Ko Y. Development and Validation of the Bystander Engagement Scale for Witnessed Intimate Partner Violence: A South Korean Version. J Interpers Violence 2024:8862605231222902. [PMID: 38243761 DOI: 10.1177/08862605231222902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Bystanders play a crucial role in assisting and rescuing victims of intimate partner violence (IPV) or sexual assault, thereby preventing further harm. Consequently, an increasing amount of research has focused on improving bystander interventions in such situations. While many existing scales that measure bystanders' willingness to intervene and their behaviors are likely tailored to Western settings and primarily focused on preventing sexual assaults, pursuing diversity to make these scales applicable to a variety of contexts is necessary. This study aimed to develop and validate a scale from South Korean samples that measure the likely level of bystander engagement in witnessed IPV situations, named the Bystander Engagement Scale for Witnessed Intimate Partner Violence (BESW-IPV). Preliminary items, developed to describe various IPV situations that a bystander might witness, underwent content validity testing through expert review and cognitive focus group interviews. Afterward, the scale was administered to 311 participants from the target population in South Korea. The scale's factor structure was assessed through exploratory factor analysis (EFA) and confirmed through confirmatory factor analysis (CFA). The reliability and validity were rigorously assessed. The final version of the BESW-IPV comprised 28 items. Through EFA, "direct IPV indicators" and "indirect IPV indicators" were identified. Together, these factors accounted for 76.10% of the total variance. CFA affirmed that the final model offers an acceptable fit. The scale's convergent and discriminant validities were also well established. The Cronbach's alpha and the McDonald's omega values were 0.98 and 0.99, respectively. In contrast to many existing tools that measure bystander intervention predominantly within the confines of Western educational settings, we believe that the BESW-IPV can be applied in broader contexts, especially in patriarchal environments. Further research is required to translate and validate this tool in different cultural contexts.
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Affiliation(s)
- Sihyun Park
- Department of Nursing, Chung-Ang University, Seoul, South Korea
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, South Korea
| | - Yejung Ko
- College of Nursing and Health, Kongju National University, Gongju, South Korea
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Mickelson JM, Cox DW, Young RA, Kealy D. A Distress-Processing Model for Clients in Suicidal Crisis. Crisis 2024; 45:18-25. [PMID: 37278001 DOI: 10.1027/0227-5910/a000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background: While crisis intervention frameworks have indicated the importance of clients in suicidal crisis better understanding their distress to decrease suicidality, it is unclear how clients in suicidal crisis process their distress. Aims: To develop (Study 1) and validate (Study 2) a sequential distress-processing model for clients in suicidal crisis. Methods: Applying task analysis, Study 1 consisted of three phases, which resulted in a theoretically and empirically informed model. In Study 2, we examined the distress-processing model's validity using a longitudinal design. In both studies, data were online crisis chats with adults in suicidal crisis. Results: In Study 1, we developed a sequential five-stage distress-processing model: (Stage 1) unengaged with distress, (Stage 2) distress awareness, (Stage 3) distress clarity, (Stage 4) distress insight, and (Stage 5) applying distress insight. In Study 2, the model's validity was supported via evidence that (H1) progression through the processing stages was sequential and (H2) clients with good outcomes had greater progression in their processing than clients with poor outcomes. Limitation: Clients who were suicidal but did not disclose their suicidality were not included. Conclusion: Our findings provide a framework for conceptualizing and operationalizing how clients move through suicidal crises, which can facilitate intervention and research developments.
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Affiliation(s)
- Johanna M Mickelson
- Counselling Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Daniel W Cox
- Counselling Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Richard A Young
- Counselling Psychology, University of British Columbia, Vancouver, BC, Canada
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Foster MJ, Blamires J, Neill S, Coyne I, Kristjánsdóttir G, Feeg VD, Paraszczuk AM, Al-Motlaq M. The long-term impact of COVID-19 on nursing: An e-panel discussion from the International Network for Child and Family Centred Care. J Clin Nurs 2024; 33:404-415. [PMID: 36922725 DOI: 10.1111/jocn.16683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/20/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
AIM To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce. BACKGROUND On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread. DESIGN Discursive paper. METHODS A web-based survey was e-mailed to 63 INCFCC members from 28 March to 30 April 2022, as an invitation to share their experience concerning the long-term impact of COVID-19 on their role as a nurse educator, clinician or researcher. RESULTS Sixteen members responded, and the responses were grouped under the themes stress and anxiety, safe staffing and pay, doing things differently, impact on research, impact on teaching and learning, impact on clinical practice, nursing made visible and lessons for the future. CONCLUSION The INCFCC members provided their views and highlighted the impact on their role in nursing education, administration, research and/or practice. This discussion of international perspectives on the similarities and differences imposed by COVID-19 found that the impact was wide-ranging and prolonged. The overarching theme revealed the resilience of the participating members in the face of COVID-19. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of all areas of nursing, be it in academia or in clinical practice, to work together to learn from the present and to plan for the future. Future work should focus on supporting organizational and personal resiliency and effective interventions to support the nursing workforce both during a disaster and in the recovery phase. Nursing workforce resilience in the face of COVID-19.
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Affiliation(s)
- Mandie Jane Foster
- School of Clinical Sciences, Nursing, Auckland University of Technology, Auckland, New Zealand
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, Western Australia, Australia
| | - Julie Blamires
- School of Clinical Sciences, Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Sarah Neill
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Imelda Coyne
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Guðrún Kristjánsdóttir
- Faculty of Nursing and Midwifery, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Ann Marie Paraszczuk
- Barbara H. Hagan School of Nursing and Health Sciences, Molloy University, Rockville Centre, New York, USA
| | - Mohammad Al-Motlaq
- Department of Maternal Child and Family Health, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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O’Neill JC, O’Callaghan ET, Sullivan S, Winsberg M. Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program. Healthcare (Basel) 2023; 11:3158. [PMID: 38132048 PMCID: PMC10743225 DOI: 10.3390/healthcare11243158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Background: Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Methods: Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients (n = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Results: Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Conclusions: Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.
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Affiliation(s)
- J. Conor O’Neill
- Brightside Health, 2471a Peralta Street, Oakland, CA 94607, USA (M.W.)
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Banjo J, Madson K, Hromis S. Effective management of patients with borderline personality disorder in a busy acute inpatient ward using dialectical behaviour therapy principles. Australas Psychiatry 2023; 31:771-775. [PMID: 37965756 DOI: 10.1177/10398562231209822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVE The study aimed to highlight principles of Dialectical Behaviour Therapy (DBT) that can provide a framework in the management of patients with borderline personality disorder (BPD) and outline some guiding principles in the effective management of these patients on a busy acute inpatient ward. CONCLUSIONS The inpatient environment is often a place where invalidating experiences can occur. These include feeling ignored, misunderstood and where private experiences are trivialised or denied. Patients with BPD are extremely sensitive to these experiences and are likely to decompensate if strategies are not in place to facilitate a more validating experience during admission. The proposed guidelines are feasible to implement and support a cohesive treatment team and collaborative patient-centred care which is likely to improve patient outcomes.
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Affiliation(s)
- Jumi Banjo
- Metro South Addiction and Mental Health Services, Metro South Hospital and Health Service, Brisbane, QLD, Australia
| | - Kathy Madson
- Metro South Addiction and Mental Health Services, Metro South Hospital and Health Service, Brisbane, QLD, Australia
| | - Sanya Hromis
- Metro South Addiction and Mental Health Services, Metro South Hospital and Health Service, Brisbane, QLD, Australia
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Clibbens N, Booth A, Sharda L, Baker J, Thompson J, Ashman M, Berzins K, Weich S, Kendal S. Explaining context, mechanism and outcome in adult community mental health crisis care: A realist evidence synthesis. Int J Ment Health Nurs 2023; 32:1636-1653. [PMID: 37574714 DOI: 10.1111/inm.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, for whom and in what circumstances community mental health crisis services for adults work to resolve crises and is reported according to RAMESES guidelines. Using realist methodology, initial programme theories were identified and then tested through iterative evidence searching across 10 electronic databases, four expert stakeholder consultations and n = 20 individual interviews. 45 relevant records informed the three initial programme theories, and 77 documents, were included in programme theory testing. 39 context, mechanism, outcome configurations were meta-synthesized into three themes: (1) The gateway to urgent support; (2) Values based crisis interventions and (3) Leadership and organizational values. Fragmented cross-agency responses exacerbated staff stress and created barriers to access. Services should focus on evaluating interagency working to improve staff role clarity and ensure boundaries between services are planned for. Organizations experienced as compassionate contributed positively to perceived accessibility but relied on compassionate leadership. Attending to the support needs of staff and the proximity of leaders to the front line of crisis care are key. Designing interventions that are easy to navigate, prioritize shared decision-making and reduce the risk of re-traumatizing people is a priority.
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Affiliation(s)
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Leila Sharda
- School of Healthcare, University of Leeds, Leeds, UK
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | | | | | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
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12
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Hu CS, Zhang H, Short LA, Liu M, Huang C, Liang Z, Yang Y, Huang M, Xie D. Learning of a Classmate's Suicide Ideation Affects Emotions When Advising the Classmate and the Helpfulness of the Advice Provided. Arch Suicide Res 2023:1-14. [PMID: 37970867 DOI: 10.1080/13811118.2023.2280227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Suicide ideation (SI) is prevalent among college students, and suicide disclosure (SD) is critical for crisis intervention. However, students with SI may worry about stigmatizing responses to their disclosure. To better understand the mechanism of stigmatizing responses to SD, we investigated the effects of a hypothetical classmate's SD on college students' emotions and reasoning when providing advice to a distressed classmate. METHOD In a randomized controlled experiment, students wrote advice to a hypothetical classmate who recently failed in his pursuit of a romantic relationship with a peer. The experimental/control group also learned he wanted to either commit suicide/quit school. When typing the advice, participants' facial expressions were recorded and analyzed by Facereader7.1. After advising, participants reported their sadness, joy, fear, anger, surprise, and disgust when advising. Finally, trained coders coded the common themes of their advice and rated the wise reasoning involved. Additionally, two experts in suicide prevention rated the helpfulness of their advice for the classmate. RESULTS The experimental group showed significantly fewer facial expressions of happiness, reported higher sadness and fear, provided less helpful advice, and mentioned "confronting reality" less during advising. The difference in disgust and wise reasoning was nonsignificant. CONCLUSION Learning of a classmate's SI may increase fear and sadness among recipients and reduce the helpfulness of their advice. Increased psychoeducation for students that focuses on improving emotional regulation (especially facial expressions) during SI may reduce the stigma surrounding SI and prevent perceived burdensomeness among individuals with SI after SD.
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13
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Robles R, Infante S, Feria M, Arango I, Tirado E, Rodríguez-Delgado A, Miranda E, Fresán A, Becerra C, Escamilla R, Madrigal de León EA. Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers. Front Psychol 2023; 14:1253179. [PMID: 38022932 PMCID: PMC10645097 DOI: 10.3389/fpsyg.2023.1253179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Despite the propagation of virtual mental health services for vulnerable groups during COVID-19 pandemic, the implementation and evaluation of remote evidence-based practices (EBP) to manage them in low- and middle-income countries remains scarce. In the current study, we describe and evaluate the implementation process and clinical impact of brief, remote, manualized EBP for crisis intervention and suicide risk management among healthcare workers attending patients with COVID-19 (COVID-19-HCWs) in Mexico. Methods The implementation process comprised community engagement of volunteer mental health specialists, creation of new clinical teams with different disciplines and skills, intervention systematization through manuals and education through 4-h remote training as main strategies. Mexican COVID-19-HCWs who had used a free 24-h helpline rated their pre- and post-intervention emotional distress. Therapists recorded patients' pre-intervention diagnosis, severity, and suicide risk, the techniques used in each case, and their post-treatment perception of COVID-19-HCWs' improvement at the end of the intervention. Results All techniques included in the intervention manual were employed at least in one case (n = 51). At the beginning of the intervention, 65.9% of the COVID-19-HCWs were considered moderately ill or worse according to Clinical Global Impression-Severity (CGI-S) scores, whereas at the end, 79.4% of them were perceived as much or very much improved according to CGI-Improvement scores (CGI-I), and their emotional distress had been significantly reduced (p < 0.001). Discussion This prospective study provides evidence that implementation of remote EBP is feasible and useful to reduce emotional distress and suicide risk among COVID-19-HCWs from a middle-income country. However, this study was limited by lack of a control group, improvement ratings provided by therapists and non-anonymous satisfaction ratings.
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Affiliation(s)
- Rebeca Robles
- Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Sara Infante
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Miriam Feria
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Iván Arango
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Elsa Tirado
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Andrés Rodríguez-Delgado
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Edgar Miranda
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Ana Fresán
- Laboratory of Clinical Epidemiology, Subdirectorate of Clinical Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Claudia Becerra
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Raul Escamilla
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
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14
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Laporte N, Hechtman L, Rousseau C, Greenfield B. Striking a balance: triage and crisis intervention models within the pediatric emergency room. Front Psychiatry 2023; 14:1277095. [PMID: 37920538 PMCID: PMC10618677 DOI: 10.3389/fpsyt.2023.1277095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Nicolas Laporte
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Montreal Children's Hospital, Montreal, QC, Canada
| | - Cécile Rousseau
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Montreal Children's Hospital, Montreal, QC, Canada
| | - Brian Greenfield
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Montreal Children's Hospital, Montreal, QC, Canada
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15
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Eapen V, Gerstl B, Winata T, Jairam R, Barton G, Bowden M. A Study Protocol for Safeguards Child and Adolescent Mental Health Rapid Response Teams ('Safeguards Teams') Service. Int J Integr Care 2023; 23:4. [PMID: 37577140 PMCID: PMC10417910 DOI: 10.5334/ijic.7004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction As the number of children and young people (CYP) presenting to Emergency Departments (ED) with acute mental health (MH) presentations has been steadily increasing over the years and further accelerated by the pandemic, there is an urgent need to develop and evaluate innovative solutions to respond to this growing challenge. Description The evaluation of the Safeguards Teams Program (STP) aims to ascertain the impact, implementation and economic analysis of this acute rapid response recovery-focused, trauma-informed assessment and brief intervention for CYP (aged 0-17 years) presenting in acute MH crisis and their families/caregivers.The STP will support consumers (patients) and their families/caregivers to navigate the complex and often fragmented child and adolescent MH services (CAMHS) landscape, thereby avoiding unnecessary ED presentations or hospitalisations, and facilitating comprehensive assessment and appropriate care pathways for those who present in crisis. Discussion The STP is expected to provide CYP in MH crisis and their support networks with early access to evidence-based specialist care at the right place and time. Conclusion Implementation of the STP will assist with identifying and addressing gaps in acute care for CYP and provide the necessary evidence for service redesign in collaboration with consumers, service providers and other stakeholders.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Rajeev Jairam
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Giles Barton
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Michael Bowden
- Mental Health Branch, NSW Ministry of Health, Sydney, Australia
- Sydney Children’s Hospitals Network, Sydney, Australia
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
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16
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Perkins E, Blair EW, Allen DE, Teal LA, Marcus PE, Fordmeir JL. Updates to American Psychiatric Nurses Association: Seclusion and Restraint Position Statement and Standards of Practice. J Am Psychiatr Nurses Assoc 2023:10783903231184200. [PMID: 37382297 DOI: 10.1177/10783903231184200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVE The purpose of this discussion paper is to summarize the 2022 updates to the American Psychiatric Nurses Association's (APNA) Seclusion and Restraint Position Statement and Seclusion and Restraint Standards of Practice. METHOD Both documents were the work of the APNA 2022 Seclusion and Restraint Task Force that consisted of APNA nurses with expertise in the use of Seclusion and Restraint, who practice across a wide range of clinical settings. RESULTS The 2022 Updates to the APNA Position Statement and Standards were guided by evidence-based information found in the review of seclusion and restraint literature and clinical expertise from the 2022 Seclusion and Restraint Task Force. CONCLUSIONS Updates were evidence-based and in line with APNA's core values and initiatives in diversity, equity, and inclusion.
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Affiliation(s)
- Evelyn Perkins
- Evelyn Perkins, MS, RN, PMH-BC, NE-BC, American Psychiatric Nurses Association, Falls Church, VA, USA
- Evelyn Perkins, MS, RN, PMH-BC, NE-BC, Northwestern Memorial Hospital, Olympia Fields, IL, USA
| | - Ellen W Blair
- Ellen W. Blair, DNP, APRN, PMHCNS-BC, NEA-BC, CPHQ, FAAN, Hartford HealthCare, Hartford, CT, USA
| | - Diane E Allen
- Diane E. Allen, DNP, PMHRN-BC, FACHE(R), Private Practice, Manchester NH USA
| | - Lincoln Akre Teal
- Lincoln Akre Teal, RN, MSN, PMH-BC, Boston Children's Hospital, Boston, MA, USA
- Lincoln Akre Teal, Salem State University, Salem, MA, USA
| | - Pamela E Marcus
- Pamela E. Marcus, RN APRN/PMH-BC, Prince George's Community College, Largo, MD, USA
| | - Jennifer L Fordmeir
- Jennifer L. Fordmeir, MSN, ARNP, PMHNP-BC, ARNP, Mindful Psychiatry, Kennewick, WA USA
- Jennifer L. Fordmeir, MSN, ARNP, PMHNP-BC, ARNP, Awareness Consulting & Training, Kennewick, WA, USA
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17
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Pierini MM, Boska GDA, Claro HG, Luz PDO, de Oliveira MAF. The ability of Psychosocial Care Centers specialized in Alcohol and Drugs to handle crises. Rev Lat Am Enfermagem 2023; 31:e3848. [PMID: 37283417 PMCID: PMC10243431 DOI: 10.1590/1518-8345.6167.3848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/26/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE (1) To our knowledge, this is the first study to evaluate CAPS AD's ability to handle crises. (2) The ability to handle crises of the CAPS AD from downtown São Paulo was 86.6%. (3) Of the nine users referred to other services, only one evolved to hospitalization. to assess the ability of 24-hour Psychosocial Care Centers specialized in Alcohol and Other Drugs to handle the users' crises in comprehensive care. METHOD a quantitative, evaluative, and longitudinal study was conducted from February to November 2019. The initial sample consisted of 121 users, who were part of the comprehensibly care in crises by two 24-hour Psychosocial Care Centers specialized in Alcohol and other Drugs in downtown São Paulo. These users were re-evaluated 14 days after admission. The ability to handle the crisis was assessed using a validated indicator. The data were analyzed using descriptive statistics and regression of mixed-effects models. RESULTS 67 users (54.9%) finished the follow-up period. During crises, nine users (13.4%; p=0.470) were referred to other services from the health network: seven due to clinical complications, one due to a suicide attempt, and another for psychiatric hospitalization. The ability to handle the crisis in the services was 86.6%, which was evaluated as positive. CONCLUSION both of the services analyzed were able to handle crises in their territory, avoiding hospitalizations and enjoying network support when necessary, thus achieving the de-institutionalization objectives.
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Affiliation(s)
- Marianna Martins Pierini
- Universidade Federal de São Paulo, Comissão de Residência Multiprofissional/COREMU, São Paulo, SP, Brasil
| | | | - Heloísa Garcia Claro
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brasil
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18
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Robins JE, Morley KI, Hayes RD, Pritchard M, Kornblum D, Kalk NJ. Outcomes following suicidal crisis among hazardous and harmful alcohol users in the Crisis Resolution Team. Int J Ment Health Nurs 2023; 32:590-602. [PMID: 36594457 DOI: 10.1111/inm.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 01/04/2023]
Abstract
Despite associations between alcohol use and suicidal acts, little research measures prognoses of alcohol-using patients treated by Crisis Resolution Teams (CRTs), an intensive community-based intervention. We estimated the association of alcohol use amongst patients accepted following suicidal acts or ideation in four London-based Crisis Resolution Teams, with death-by-any-cause or recontact with crisis care. We analysed the electronic health records of 1615 CRT patients accepted following suicidal acts or ideation over 38 months, following STROBE guidelines. Using logistic regression we estimated the association of alcohol use (indicated by risk-assessment, AUDIT, or ICD-10 diagnosis) with death-or-recontact at (i) 30-days and (ii) 1-year after treatment start, adjusted for age, sex, ethnicity, psychiatric diagnosis, and severity of need. Hazardous, harmful, or dependent drinking was identified in 270 cases at baseline (16.7%); 73 (4.5%) were alcohol dependent. By 1-year, 622 patients (38.5%) had recontacted crisis care or died. After adjustment, alcohol use at a hazardous, harmful, or dependent level was not associated with increased odds of death-or-recontact at 30-days (AOR 1.17, 95%CI 0.73, 1.88) or 1-year (AOR 1.17, 95%CI 0.85, 1.60). Patients with hazardous, harmful, and dependent alcohol use are a small proportion of CRT patients, despite being more commonly encountered in emergency settings from which patients may be referred to CRTs, indicating a potential gap in provision. Those who are included in CRTs are not at increased risk of death-or-recontact within 1 year of treatment, suggesting that their inclusion can work, at least in a sample with predominantly hazardous or harmful alcohol use.
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Affiliation(s)
- John E Robins
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IOPPN) King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Katherine I Morley
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IOPPN) King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK.,Innovation, Health, and Science, RAND Europe, Cambridge, UK.,Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard D Hayes
- South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine and NIHR Maudsley Biomedical Research Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Megan Pritchard
- South London and Maudsley NHS Foundation Trust, London, UK.,NIHR Maudsley Biomedical Research Centre (BRC), King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Daisy Kornblum
- South London and Maudsley NHS Foundation Trust, London, UK.,NIHR Maudsley Biomedical Research Centre (BRC), King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nicola J Kalk
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IOPPN) King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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19
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Baldaçara L, Weber CAT, Gorender M, Grudtner RR, Peu S, Teles ALS, Passos IC, Quevedo J, da Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 3. Suicide prevention hotlines. Braz J Psychiatry 2023; 45:54-61. [PMID: 35809251 PMCID: PMC9976911 DOI: 10.47626/1516-4446-2022-2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/10/2022] [Indexed: 11/20/2022]
Abstract
Crisis hotlines are direct communication systems, usually telephone-based, set up to prevent suicide. However, few studies have evaluated their effectiveness. The present study aims to perform a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, of the effectiveness of interventions through direct communication systems to reduce the number of suicides or suicide attempts. We searched the MEDLINE, Cochrane, SciELO, and ClinicaTrials.gov databases, and used the 2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence classification. The literature search yielded 267 studies, of which 35 fulfilled the selection criteria. Although significant heterogeneity was found among studies, there is evidence that direct telephone interventions are effective when included in broader preventive protocols and provided by trained staff. Despite the limitations, which included heterogeneity of samples, designs, and outcome measures, we were able to design a protocol for the use of remote services to prevent suicide and suicide attempts. A hotline or similar system could be an effective intervention for broader suicide prevention programs. However, further research is necessary to specify which protocol components are key to enhance effectiveness.
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Affiliation(s)
- Leonardo Baldaçara
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Universidade Federal do Tocantins, Palmas, TO, Brazil
| | - César Augusto Trinta Weber
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Centro de Estudos José de Barros Falcão, Porto Alegre, RS, Brazil
| | - Miriam Gorender
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Roberta R. Grudtner
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Hospital Psiquiátrico São Pedro, Secretaria Estadual da Saúde do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra Peu
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Centro Universitário de Brasília, Brasília, DF, Brazil
| | | | - Ives Cavalcante Passos
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - João Quevedo
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas, Houston, TX, USA
| | - Antônio Geraldo da Silva
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
- Asociación Psiquiátrica de América Latina (APAL)
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Programa de Pós-Graduação em Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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20
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Santos-Burgoa C, Garcia-Meza A, Talayero MJ, Kuenster N, Goldman Hawes AS, Andrade E. Total Excess Mortality Surveillance for Real-Time Decision-Making in Disasters and Crises. Disaster Med Public Health Prep 2023; 17:e350. [PMID: 36912748 DOI: 10.1017/dmp.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Crises such as Hurricane Maria and the coronavirus disease 2019 (COVID-19) pandemic have revealed that untimely reporting of the death toll results in inadequate interventions, impacts communication, and fuels distrust on response agencies. Delays in establishing mortality are due to the contested definition of deaths attributable to a disaster and lack of rapid collection of vital statistics data from inadequate health system infrastructure. Readily available death counts, combined with geographic, demographic, and socioeconomic data, can serve as a baseline to build a continuous mortality surveillance system. In an emergency setting, real-time Total, All-cause, Excess Mortality (TEM) can be a critical tool, granting authorities timely information ensuring a targeted response and reduce disaster impact. TEM measurement can identify spikes in mortality, including geographic disparities and disproportionate deaths in vulnerable populations. This study recommends that measuring total, all-cause, excess mortality as a first line of response should become the global standard for measuring disaster impact.
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21
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Wang Y. Innovative technology-enhanced social work service during COVID-19: How 'Garden on the Balcony' promoted resilience, community bonds and a green lifestyle. Qual Soc Work 2023; 22:321-339. [PMID: 38603103 PMCID: PMC8819563 DOI: 10.1177/14733250211059431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The ongoing COVID-19 pandemic has motivated social workers to reckon with and transform traditions in service delivery. The development, application, and evaluation of technology-enhanced practices have become more vital than ever. Garden on the Balcony (GOB) was an innovative internet-based social work service designed to respond rapidly to the COVID-19 outbreak in Beijing. This paper introduces the underlying perspectives and design of GOB and reports participants' reflections on the program to understand its mechanisms and implications. Interview data from GOB participants were collected 4 months after the program ended. Thematic analysis generated three major themes, suggesting that GOB had (a) promoted individual resilience and family cohesion; (b) built online and offline community bonds; and (c) cultivated a green lifestyle and spiritual reflection on life. This study demonstrates a practical example of the effective use of technology-enhanced practice.
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Affiliation(s)
- Yixuan Wang
- Department of Social Work, China Youth University of Political
Studies, Beijing, China
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22
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Huber J, Ryan CJ, Gupta R, Rosen A, Tietze T, Drew K, Ahmed T, Skopek M. The NSW Emergency Psychiatry Network. Aust N Z J Psychiatry 2023; 57:312-314. [PMID: 36440616 DOI: 10.1177/00048674221137820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Emergency Psychiatry is evolving. In an environment that lacks a clear evidence base, and where a constellation of factors is driving up Emergency Department presentation rates and lengths of stay, several stakeholders are working towards and clamouring for change. With the goal of collaborating with such parties, we believe Emergency Psychiatrists should position themselves to establish and advocate for best-practice change in culture, research, clinical care and training, and funding in the provision of mental health crisis care. To this end, we have formed the NSW Emergency Psychiatry Network, a group of Emergency Psychiatrists with a broad experience in a range of settings, from tertiary metropolitan emergency facilities with access to subspecialty psychiatric services, to rural and remote emergency settings with sporadic in-reach from local mental health services and telehealth. We unanimously recognise the need to upskill both Emergency Department and Mental Health clinicians in crisis care, and the need for committed, evidence-based Mental Health resourcing within Emergency Departments.
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Affiliation(s)
- Jacqueline Huber
- Psychiatry, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.,Psychiatry, School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia
| | - Christopher James Ryan
- Psychiatry, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.,Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Rahul Gupta
- NMHEC-RAP Telepsychiatry Service, Hunter New England Mental Health, Newcastle, NSW, Australia.,Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Alan Rosen
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Tad Tietze
- Mental Health Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Kathryn Drew
- Tweed Byron Mental Health Service, Northern NSW Local Health District, Tweed Heads, NSW, Australia
| | - Tanya Ahmed
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Wesley Mission Hospital, Ashfield, NSW, Australia
| | - Michaela Skopek
- Emergency Department Mental Health Team, Central Coast Local Health District, Gosford, NSW, Australia.,Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW
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Zhang L, Li L, Zheng W, Zhang Y, Gao X, Tan L, Wang X, Chen Q, Xu J, Tang J, Luo X, Chen X, Zhang X, He L, Liu J, Cheng P, Xu L, Tian Y, Wen C, Li W. Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:92-105. [PMID: 36935182 PMCID: PMC10930552 DOI: 10.11817/j.issn.1672-7347.2023.210803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Indexed: 03/21/2023]
Abstract
OBJECTIVES Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model. METHODS The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention. RESULTS The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful. CONCLUSIONS Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.
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Affiliation(s)
- Li Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China.
| | - Lingjiang Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown 26505, WV, United States
| | - Yan Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xueping Gao
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Liwen Tan
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xiaoping Wang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Qiongni Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Junmei Xu
- Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Juanjuan Tang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xingwei Luo
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xudong Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xiaocui Zhang
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Li He
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Jin Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Peng Cheng
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Lizhi Xu
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Yi Tian
- Department of Infection, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Chuan Wen
- Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Weihui Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China.
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24
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Zhou S, Yu W, Tang X, Li X. Government crisis communication innovation and its psychological intervention coupling: Based on an analysis of China's provincial COVID-19 outbreak updates. Front Psychol 2023; 13:1008948. [PMID: 36778169 PMCID: PMC9909028 DOI: 10.3389/fpsyg.2022.1008948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/30/2022] [Indexed: 01/27/2023] Open
Abstract
Outbreak updates are an integral part of crisis communication during epidemics. Regarding the COVID-19 crisis communication, localities in China present different strategies for managing outbreak updates, which largely determine the effect of crisis communication and the evolution of social psychology. Depending on the analysis of the update texts from 31 provincial (autonomous regions and municipalities directly under the central government) health committees in China, the study found the differences among the provincial outbreak updates and summarizes 12 innovative crisis communication ways. A coupling analysis was applied using the equilibrium-cognitive-psychosocial transition model to further expound on the psychological connotation and intervention potential of the crisis communication innovations. Coupling crisis communication with interventions has a positive effect on designing crisis communication strategies by taking into account psychological factors. It can help construct and optimize the public crisis communication systems and emphasize "care" in modernizing the emergency management capacity.
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Affiliation(s)
- Shen Zhou
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, China,*Correspondence: Shen Zhou,
| | - Wensheng Yu
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, China
| | - Xinwen Tang
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, China
| | - Xiaoqian Li
- College of Public Administration, Huazhong University of Science and Technology, Wuhan, China
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25
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Rival G, Chalbet S, Dupont C, Brun P, Letranchant L, Reynaud C, Dureault A, Saison J, Jeannot M, Barbour S, Bacconnier M, Paulus V, Champagne H, Buiret G. Post-traumatic stress among COVID-19 survivors: A descriptive study of hospitalized first-wave survivors. Can J Respir Ther 2023; 59:20-25. [PMID: 36741307 PMCID: PMC9854389 DOI: 10.29390/cjrt-2022-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction The coronavirus Severe Acute Respiratory Syndrome Coronavirus Type 1 induces a severe respiratory disease, coronavirus disease 2019 (COVID-19). After Severe Acute Respiratory Syndrome Coronavirus Type 1 and Middle East Respiratory Syndrome infection, increased post-traumatic stress disorder (PTSD) rates were described. Methods This single-centred, prospective study aimed to evaluate the rates of PTSD in patients who were hospitalized for COVID-19. Inclusion criteria were COVID-19 patients hospitalized in the intensive care unit (ICU) or in a standard unit with at least 2 L/min oxygen. Six months post-hospitalization, subjects were assessed for PTSD using a validated screening tool, the Post-Traumatic Stress Checklist-5 (PCL-5). Results A total of 40 patients were included. No demographic differences between the ICU and non-ICU groups were found. The mean PCL-5 score for the population was 8.85±10. The mean PCL-5 score was 6.7±8 in the ICU group and 10.5±11 in the non-ICU group (P=0.27). We screened one patient with a positive PCL-5 score and one with a possible PCL-5 cluster score. Nine patients had a PCL-5 score of up to 15. Seven patients reported no symptoms. Seven patients accepted a psychological follow-up: one for PTSD, three for possible PTSD and three for other psychological problems. Discussion The PCL-5 tool can be used by lung physicians during consultations to identify patients for whom follow-up mental health assessment and treatment for PTSD are warranted. Conclusion Lung physicians should be aware of the risk of PTSD in patients hospitalized for COVID-19 and ensure appropriate screening and follow-up care.
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Affiliation(s)
- Gilles Rival
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Sophie Chalbet
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Clarisse Dupont
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Philippe Brun
- Pneumology Department, Valence Hospital Center, Valence, France
| | | | - Claire Reynaud
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Aurélie Dureault
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Julien Saison
- Infectious Diseases Department, Valence Hospital Center, Valence, France,Clinical Research Unit, Valence Hospital Center, Valence, France
| | - Mathieu Jeannot
- Intensive Care Department, Valence Hospital Center, Valence, France
| | - Sophie Barbour
- Pneumology Department, Valence Hospital Center, Valence, France
| | | | - Valérie Paulus
- Pneumology Department, Valence Hospital Center, Valence, France,Clinical Research Unit, Valence Hospital Center, Valence, France
| | - Hélène Champagne
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Guillaume Buiret
- Clinical Research Unit, Valence Hospital Center, Valence, France,Correspondence: Guillaume Buiret, Unité de Recherche Clinique, Valence Hospital Center, 179 Boulevard Maréchal Juin, 26 953 Valence Cedex 9, France. Tel: +33475757528. Fax: +33475757110, E-mail:
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26
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Ganesan S, Balasubramanian B, Krishnamurthy P, Govindan R, Mani N. Effects of Tele-Counseling on Reducing Anxiety Levels of COVID-19 Patients in Isolation Wards: An Observational Study. Indian J Psychol Med 2023; 45:43-46. [PMID: 36778622 PMCID: PMC9896101 DOI: 10.1177/02537176221139598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND COVID-19 causes psychological distress and anxiety due to fear of infection and the possibility of worsening symptoms leading to mortality. Public health measures like contact tracing and lockdowns further increase the panic among infected patients and the public. We intended to assess the effect of telecounseling in reducing anxiety in patients admitted to isolation wards. METHODS In this multi-center observational study, we administered a Generalized Anxiety Disorder-7 (GAD-7) scale before and after telecounseling. The study group consisted of participants who gave consent for telecounseling, and those who did not give consent constituted the control group. The telecounseling was based on the Psychological First Aid model, due to its simplicity. RESULTS There was a statistically significant decrease in anxiety after telecounseling in the study group (P value ≤ 0.001, effect size = 0.484). There was a statistically significant decrease in anxiety in the study group compared to the control group (P value ≤ 0.001). CONCLUSION Telecounseling contributed to the reduction in anxiety in COVID-19 patients in isolation wards. Several other factors like severity of the infection, comorbid medical illness, pre-existing mental health issues, individual's level of coping with stress, and duration and place of admission may have affected the anxiety levels in the patients.
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Affiliation(s)
- Sivaraman Ganesan
- Villupuram Medical College and Hospital, Mundiyampakkam, Tamil Nadu, India
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27
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Hawgood J, Spafford SG, Evans A, Webster A, Koo YW. Suicide risk assessment fears, attitudes and behaviours of lifeline crisis supporters. Health Soc Care Community 2022; 30:e5083-e5094. [PMID: 35915919 PMCID: PMC10087418 DOI: 10.1111/hsc.13923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/11/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Lifeline Australia operates crisis support services through Lifeline Crisis Supporters. An integral part of their role is to conduct online suicide risk assessments with help-seekers. However, there is limited literature regarding suicide risk assessment practices for this population. This study aimed to examine how suicide prevention training, vicarious trauma and fears impacted suicide risk assessment behaviours of Lifeline Crisis Supporters. A cross-sectional survey design was used to recruit a volunteer convenience sample of 125 Lifeline Australia Crisis Supporters (75.2% females; Mage = 54.9) in 2018 to participate in an online survey. Findings revealed that those with more suicide-specific training had less risk assessment-related fears, and that fears were not related to attitudes towards suicide prevention. There was no significant relationship between vicarious trauma and amount of training or years of experience in the role. Further, participants with higher levels of vicarious trauma demonstrated significantly more negative attitudes towards suicide prevention. Overall, training appears to be a significant factor in suicide risk assessment practice behaviours of Lifeline Crisis Supporters, highlighting a need for ongoing training and support for them. This research also suggests that whilst fears exist, they do not significantly impair Lifeline Crisis Supporters' ability to undertake suicide risk assessment.
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Affiliation(s)
- Jacinta Hawgood
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention; School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
| | - Sarah G. Spafford
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention; School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
- Department of Counseling Psychology and Human ServicesUniversity of OregonEugeneOregonUSA
| | - Ann Evans
- Lifeline AustraliaSydneyNew South WalesAustralia
| | - Amy Webster
- Lifeline AustraliaSydneyNew South WalesAustralia
| | - Yu Wen Koo
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention; School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
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28
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Magill R, Jenkin G, Collings S. 'Really there because they care': The importance of service users' interpretations of staff motivations at a crisis intervention service in New Zealand. Health Soc Care Community 2022; 30:e1756-e1764. [PMID: 34633720 DOI: 10.1111/hsc.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/11/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
Crisis intervention services for people experiencing psychological distress and suicidal ideation are frequently described by the people accessing them as failing to meet their needs. This paper reports a prominent finding from a realist evaluation of Taranaki Retreat-a charitable, non-clinical organisation in New Zealand, which offers free respite for people experiencing acute distress. Using qualitative methods, the study aimed to move beyond vague notions regarding the helpfulness of respite, to a deeper understanding of the contextual factors and mechanisms which generate outcomes for such an intervention. Participant observation, focus groups with staff, semi-structured interviews with service users, and analysis of service users' case notes were conducted over a six-month period in 2018. The most prominent finding from the study related to 'genuine care'-care which is interpreted by the recipient as being motivated by a genuine desire to help. We present this finding as to the central mechanism in a wider programme theory developed through the realist evaluation study. We also present five key features of the care participants were offered at Taranaki Retreat which contributed to their common interpretation regarding the motivations behind this care. Upon considering the centrality of this mechanism we conclude that, in designing crisis interventions, greater consideration should be given to how the intervention can demonstrate genuine care. Having highlighted the ways in which the structure of charitable organisations appears conducive for interpretations of genuine care, we further conclude that the provision of comprehensive crisis intervention by charitable organisations should be further explored and supported.
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Affiliation(s)
- Rowan Magill
- Suicide and Mental Health Research Group, University of Otago (Wellington), Wellington, New Zealand
| | - Gabrielle Jenkin
- Suicide and Mental Health Research Group, University of Otago (Wellington), Wellington, New Zealand
| | - Sunny Collings
- School of Health, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
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29
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Marcus N, Stergiopoulos V. Re-examining mental health crisis intervention: A rapid review comparing outcomes across police, co-responder and non-police models. Health Soc Care Community 2022; 30:1665-1679. [PMID: 35103364 DOI: 10.1111/hsc.13731] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/29/2021] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
Police are the default first responders in most mental health crisis intervention models worldwide, resulting in a heavy burden on police, perceived criminalization of individuals with complex mental health needs, and escalation of aggression that resort to violence. Models, such as crisis intervention teams (CIT), and co-response programmes aim to improve service user experiences and outcomes by providing mental health training to police, or pairing law enforcement officers with mental health clinicians, respectively. Despite these efforts, mental health-related calls continue to result in negative outcomes, and activists and policymakers are advocating for non-police models of crisis intervention. Evidence-based practice in mental health crisis intervention is urgently needed. The present review's main objective was to examine, synthesise and compare outcomes across police, co-responder and non-police models of mental health crisis intervention internationally using a rapid review framework. A systematic search of four electronic databases of studies published between 2010-2020 and a grey literature search was conducted, yielding (n = 1008) articles. A total of 62 articles were included in the present review. Studies were largely observational, lacking control groups and were of low-moderate quality with a high potential for bias. Overall, there is little evidence to suggest that the CIT model impacts crisis outcomes. Co-responder models evidenced improved outcomes compared to police only models, however, evidence was often mixed. Non-police models varied significantly, and studies tended to be too low quality to make comparisons or draw conclusions, however, research on youth models and crisis resolution home treatment suggested positive outcomes. Findings highlight the need for high-quality studies and policies to facilitate the implementation and evaluation of novel approaches not involving police. Cross-sectorial collaboration and service user input are urgently needed to inform, develop, test and disseminate effective models of crisis intervention acceptable to service users.
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Affiliation(s)
- Natania Marcus
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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30
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Trail K, Wilson MJ, Rice SM, Hunt T, Pirkis J, Seidler ZE. "I Called When I Was at My Lowest": Australian Men's Experiences of Crisis Helplines. Int J Environ Res Public Health 2022; 19:ijerph19159143. [PMID: 35897513 PMCID: PMC9332851 DOI: 10.3390/ijerph19159143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/09/2023]
Abstract
Background: Helplines are an accessible form of support for people struggling with difficulties in their lives and are key services in suicide prevention and intervention. Men’s experiences of telephone helplines are not well understood, despite high male suicide rates. Methods: We conducted an online cross-sectional survey with N = 684 Australian men (aged 17–83 years, M = 50.13) using open- and closed-ended questions about their experiences of helplines during the COVID-19 pandemic. Descriptive statistics were analysed to investigate differences between men using and not using helplines. Qualitative responses were analysed using thematic analysis. Results: Within the sample, 100 men (14.6%) had used a helpline service. Men using helplines were more likely to be unemployed and in younger age brackets than those not using helplines. They were also more likely to report experiencing stressors related to COVID-19, including financial stress and job loss, perceived impact on mental health and relationship breakdown. Qualitative analysis indicated varied experiences of helplines, with men shedding light on how their interaction with a counsellor, the structure of services and their expectations of the service impacted their experience. Conclusions: Further in-depth qualitative enquiry in this space is required, with the objective of understanding how helpline services may seek to better engage with male callers.
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Affiliation(s)
- Katherine Trail
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
- Correspondence:
| | - Michael J. Wilson
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Simon M. Rice
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Tara Hunt
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW 2000, Australia;
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Zac E. Seidler
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
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31
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Lake AM, Niederkrotenthaler T, Aspden R, Kleinman M, Hoyte‐Badu AM, Galfalvy H, Gould MS. Lifeline Crisis Chat: Coding form development and findings on chatters' risk status and counselor behaviors. Suicide Life Threat Behav 2022; 52:452-466. [PMID: 35112387 PMCID: PMC9304218 DOI: 10.1111/sltb.12835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to develop a reliable tool for the abstraction of data from crisis chat transcripts; to describe chatters' suicide risk status and selected counselor behaviors; and to examine the relationship of chatters' self-reported pre-chat suicidal thoughts to counselor behaviors and to chatters' disclosures of suicide risk during the chat conversation. METHODS Coders used an instrument developed for this study to abstract data from 1034 crisis chats handled by the National Suicide Prevention Lifeline Crisis Chat network in 2015. The relationship of transcript coding data to data from an automated pre-chat survey (PCS) was examined. RESULTS Lifeline Crisis Chat serves a young (median age = 21), high-risk population: 84.0% of chats (869/1034) came from chatters endorsing current or recent suicidal thoughts on the PCS. Counselors engaged in rapport-building on 93.3%, problem-solving on 70.1%, and suicide risk assessment on 67.7% of these 869 chats. Counselor risk assessment behavior, and the availability of information on suicide risk in the chat transcript, varied significantly by the chatter's PCS response. CONCLUSION Crisis counselors are able to implement keystones of Lifeline's crisis intervention model over the medium of online chat. Additional efforts are needed to ensure that suicide risk is assessed on every chat.
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Affiliation(s)
- Alison M. Lake
- Division of Child and Adolescent PsychiatryNew York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive MedicineCenter for Public HealthMedical University of ViennaWienAustria
| | - Rebecca Aspden
- Department of Child and Adolescent Psychiatry and Behavioral SciencesChildren’s Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Marjorie Kleinman
- Division of Child and Adolescent PsychiatryNew York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Amanda M. Hoyte‐Badu
- Division of Child and Adolescent PsychiatryNew York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Hanga Galfalvy
- Department of PsychiatryColumbia University College of Physicians & SurgeonsNew YorkNew YorkUSA,Department of BiostatisticsColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Madelyn S. Gould
- Division of Child and Adolescent PsychiatryNew York State Psychiatric InstituteNew YorkNew YorkUSA,Division of Child and Adolescent PsychiatryColumbia University College of Physicians & SurgeonsNew YorkNew YorkUSA,Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
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32
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Xie M, Wodzinski M, Gajaria A, Battaglia M, Rotem A. Review: Impact of urgent youth outpatient mental health care on patient and health system outcomes - a scoping review. Child Adolesc Ment Health 2022; 28:287-298. [PMID: 35509220 DOI: 10.1111/camh.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Young people often face barriers to psychiatric care and are increasingly seeking crisis services for mental health issues through the emergency department (ED). Urgent psychiatric care models provide youth in crisis with rapid access to time-limited mental health care on an outpatient basis. This scoping review aims to evaluate the impact of such urgent psychiatric services for youth aged 13-25 on patient and health system outcomes. METHODS We conducted a literature search on PubMed, EMBASE, MEDLINE, PsycINFO, and the Cochrane Database of Systematic Reviews for studies published from inception to November 20, 2020. We included studies that described outpatient psychiatric services designed for youth aged 13 to 25, took place in a clinical setting, and offered any combination of assessment, treatment, and referral. We excluded studies describing suicide intervention programmes. RESULTS Our search yielded six studies, four of which were descriptive studies and two of which were randomized controlled trials. Most studies found that access to urgent psychiatric care for youth was associated with reduced ED volumes, fewer health system costs, and fewer hospitalizations. None of the studies presented evidence that urgent psychiatric services are associated with improved patient symptomatology or functioning. CONCLUSIONS The results of this scoping review highlight the scarcity of robust evidence evaluating the effectiveness of urgent care for youth mental health. Further experimental studies and a set of standardized quality measures for evaluating these services are needed to bridge this critical gap in mental health care for youth in crisis.
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Affiliation(s)
- Mary Xie
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael Wodzinski
- Residency Training Program, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amy Gajaria
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Marco Battaglia
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Amit Rotem
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
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Prieto N, Vignaud P, Darbon R, Cheucle E, Philippe JM. An appropriate and reactive response to the repeated waves of the COVID-19 pandemic by the national medico-psychological network (CUMP) in France. Int J Soc Psychiatry 2022; 68:477-480. [PMID: 33663267 DOI: 10.1177/0020764021997492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION France has been impacted by the COVID-19 pandemic. Anxiety, depression, burn out and the high proportion of post-traumatic stress disorder proved to be the most expected troubles caused by this pandemic and the confinement. Medico-psychological emergency units (CUMP) have been solicited at the very early stage of the pandemic because CUMP units are very well known by the French government and systematically associated to emergency plans. METHODS In this article we describe the process which has been developed to cope with the psychological needs in the general population. At a first level, platforms of volunteers specialised into listening were available. Then those platforms could directly mobilise the CUMP in case of psychiatric disorders. It ran over the whole first wave and it has been reactivated because of the second confinement in France. RESULTS During the first wave, approximately 1% of all the calls made on the national Covid number required to be redirected to the listening platforms. Of this group, 4% were related to reactive pathology or a psychiatric decompensating that required adapted and specialised care. CONCLUSION The high rates of psychological distress detected in the general population in recent scientific literature seem discrepant with our findings of relatively low reorientation towards the CUMP. Nevertheless, our study highlights that the response of the CUMP network in France during the first wave was supportive. The second wave displays its adaptability to the public health policies.
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Affiliation(s)
- Nathalie Prieto
- Emergency Medical Service, Cellule D'urgences Medico-Psychologiques, Hôpital Edouard Herriot, Lyon, France.,Regional Centre for Psychotraumatic Disorders, Hôpital Edouard Herriot, Lyon, France
| | - Philippe Vignaud
- Emergency Medical Service, Cellule D'urgences Medico-Psychologiques, Hôpital Edouard Herriot, Lyon, France.,Regional Centre for Psychotraumatic Disorders, Hôpital Edouard Herriot, Lyon, France
| | - Remy Darbon
- Emergency Medical Service, Cellule D'urgences Medico-Psychologiques, Hôpital Edouard Herriot, Lyon, France.,Regional Centre for Psychotraumatic Disorders, Hôpital Edouard Herriot, Lyon, France
| | - Eric Cheucle
- Emergency Medical Service, Cellule D'urgences Medico-Psychologiques, Hôpital Edouard Herriot, Lyon, France.,Regional Centre for Psychotraumatic Disorders, Hôpital Edouard Herriot, Lyon, France
| | - Jean-Marc Philippe
- Direction Générale de la Santé, Ministère de la Santé et des Solidarités, République Française, Paris, France
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Abstract
SUMMARY COVID-19 is shaping all aspects of life throughout the world. The unexpected number of people who have been infected with and died from coronavirus disease (COVID-19) is evidence that the pandemic has affected families and societies. The strong shock wave that has resulted in the international response has focused more on medical rather than psychosocial interventions. Little has been written or studied about the impact of COVID-19 on families. This article explores the impact of the COVID-19 quarantine on the mental health of families. We conducted 20 in-depth interviews with Jordanian families through snowball sampling. FINDINGS The results show that 20 interviewees described varied and new experiences. Many of the families we interviewed displayed symptoms of mental health problems, including disrupted sleep patterns, changes in eating habits, excessive digital media use, anxiety, depression, excessive smoking, stomach aches, bedwetting among children, and persistent headaches. The study also demonstrated the psychological stress partners felt during the lockdown due to their worries about job security. They also communicated their hope that renewed family commitments might bring more stability to their relationships. During the lockdown, family members spent more time together, and it became harder to conceal any issues from each other. APPLICATIONS The findings of this research demonstrate a critical need for social workers, and it is hoped that future legislation will include a role for social workers in various fields of crisis. Moreover, social workers should encourage families to ask for intervention to overcome the long-term effects that may result from COVID-19.
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Affiliation(s)
- Fakir Al Gharaibeh
- Fakir Al Gharaibeh, College of Arts, Humanities and Social Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
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DeLeo K, Maconick L, McCabe R, Broeckelmann E, Sheridan Rains L, Rowe S, Johnson S. Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature. BJPsych Open 2022; 8:e53. [PMID: 35197131 PMCID: PMC8935933 DOI: 10.1192/bjo.2022.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services. AIMS We aimed to synthesise the relevant qualitative literature. METHOD Five databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis. RESULTS Eleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support. CONCLUSIONS Our findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed.
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Affiliation(s)
| | - Lucy Maconick
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | - Rose McCabe
- School of Health Sciences, City University of London, UK
| | - Eva Broeckelmann
- Health Service and Population Research Department, NIHR Mental Health Policy Research Unit Complex Emotional Needs Lived Experience Working Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Sarah Rowe
- Division of Psychiatry, University College London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
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Beniwal RP, Shrivastava MK, Gupta V, Sharma V, Sharma S, Kumari S, Bhatia T, Deshpande SN. Why Do People Live or Die? A Retrospective Study from a Crisis Intervention Clinic in North India. Indian J Psychol Med 2022; 44:17-21. [PMID: 35509647 PMCID: PMC9022914 DOI: 10.1177/02537176211022508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Suicide results from complex interactions of various risk factors-reasons for dying (RFD)-and protective factors-reasons for living (RFL). Suicide is not necessarily a wish to die but may be an appeal for help. We analyzed RFD and RFL in persons who had attempted suicide, through their clinical records at a Crisis Intervention Clinic (CIC). METHODS We retrospectively analyzed demographic and clinical data, and classified RFD and RFL, among patients with either ideas or attempt of suicide registered at our CIC (N = 83). Using two open-ended questions from the clinical history data, we derived their RFD or RFL; (n = 53) completed these questions regarding RFD-RFL. RESULTS In the total sample, males and females were equally represented and educated, but males were significantly older. Most common diagnosis was nonpsychotic mood disorder. Commonest mode of suicide attempt was hanging. Family conflict vs. family responsibility, hope vs. hopelessness, stressful life events, and negative cognitions about the self and the world were important RFD. RFL included feeling responsible, love for family and for self, hope, career success, and religious beliefs. CONCLUSION RFD and RFL could both be grouped in similar categories related to family, career, hope, etc.
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Affiliation(s)
- Ram Pratap Beniwal
- Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Manohar Kant Shrivastava
- Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Varsha Gupta
- Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Vikas Sharma
- Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Satyam Sharma
- Dept. of Psychology, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Sunita Kumari
- Dept. of Psychiatric Social Work, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Triptish Bhatia
- Dept. of Psychology, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
| | - Smita N Deshpande
- Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS-Dr RML Hospital, New Delhi, India
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Huynh VS, Giang TV, Do TT, Bui HQ, Nguyen TT, Nguyen VK. The PSYCARE model: Its efficacy in mental health care during the fourth outbreak of COVID-19 in Vietnam. Int J Health Sci (Qassim) 2022; 16:11-19. [PMID: 35599939 PMCID: PMC9092536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Ho Chi Minh City (Vietnam) was seriously affected by the 4th COVID-19 outbreak. This study aimed to provide mental health care services for people through a psychological intervention model, called "PSYCARE." The model included five MHC services: active and passive education, propagation, 24-h hotline consultation, online interventions/counseling, and crisis intervention. Methods The entire workflow was implemented in the three steps under the leadership of the Ho Chi Minh City government: (1) Preparation and mobilization, (2) Multidisciplinary team establishment, and (3) Feedback mechanism, and project completion. By statistical method on service usage data of people during the outbreak, we evaluated the results as well as discussed the model's effectiveness. Results In 42 days of implementation, there were a total of 149 posts, 1660 shares in social networks with more than 4,000 interactions per week. A MHC handbook was published. Ten episodes of MHC radio and ten live TV programs were broadcast with more than 10,000 listening times. We successfully propagated 35 topics at 4 COVID-19 hospitals and 34 quarantine areas. A total of 2,069 hotline consultations were done. 1,382 cases were counseled online, and 145 one-on-one crisis interventions were done to three groups: COVID-19 infected/affected children and adults, vulnerable people, frontline medical, and military staff. Conclusion The PSYCARE model has been proven to positively affect the general population's mental health during the COVID-19 outbreak. Our framework and model could be used as an expert reference guide in providing effective psychological intervention in the COVID-19 pandemic.
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Affiliation(s)
- Van-Son Huynh
- Department of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Thien-Vu Giang
- Department of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam,Address for correspondence: Thien-Vu Giang, No. 280 An Duong Vuong St., Ward 4, District 5, Ho Chi Minh City, 700000, Vietnam. E-mail:
| | - Tat-Thien Do
- Department of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Hong-Quan Bui
- Ho Chi Minh City Cadre Academy, Ho Chi Minh City, Vietnam
| | - Thi-Tu Nguyen
- Department of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Vinh-Khuong Nguyen
- Department of Science and Technology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
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Figueroa RA, Cortés PF, Marín H, Vergés A, Gillibrand R, Repetto P. The ABCDE psychological first aid intervention decreases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial. Eur J Psychotraumatol 2022; 13:2031829. [PMID: 35251529 PMCID: PMC8890535 DOI: 10.1080/20008198.2022.2031829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early Psychological First Aid (PFA) has been widely recommended for preventing posttraumatic stress disorder (PTSD). However, its lack of empirical evidence of safety and effectiveness has been criticized. OBJECTIVES To assess the effectiveness of PFA-ABCDE, an original PFA protocol, for preventing PTSD one month after the intervention and decreasing PTSD symptoms at one and six months of follow up. METHODS We assessed the eligibility of 1,140 adult survivors of recent trauma (≤ 72 hours) consulting five emergency departments in Chile. Two hundred twenty-one were randomized to receive either PFA-ABCDE (active listening, breathing retraining, categorization of needs, referral to ancillary services, and psychoeducation) or only psychoeducation. We used the Composite International Diagnostic Interview (CIDI) to assess PTSD diagnosis. The Posttraumatic Checklist (PCL), the Beck Depression Inventory-II (BDI-II), and a 0-10 points analogue visual scale were used to assess PTSD symptoms, depressive symptoms, and immediate distress relief after the intervention. RESULTS We found no difference between the experimental and control groups in the frequency of PTSD one month after the intervention (PFA-ABCDE = 23/76 [30.3%], psychoeducation = 18/75 [24.0%], adjusted odds ratio = 1.39, 95% confidence interval = 0.63-3.07, p = .408). Immediately after the intervention, participants who received PFA-ABCDE reported greater distress relief (PFA-ABCDE mean = 9.06, psychoeducation mean = 8.55, Cohen's d = 0.30, p = .038). Fewer PTSD symptoms were reported by those who received PFA-ABCDE one month after the intervention (PFA-ABCDE mean = 36.26, psychoeducation mean = 43.62, Cohen's d = 0.42, p = .033). We found no difference in depressive symptoms at one-month follow up (p = .713) nor in PTSD symptoms six months after the intervention (p = .986). CONCLUSIONS PFA-ABCDE does not prevent PTSD diagnosis, but it provides immediate distress relief and decreases PTSD symptoms in the short term.
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Affiliation(s)
- Rodrigo Andrés Figueroa
- Trauma & Dissociation Unit, Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Paula Francisca Cortés
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Humberto Marín
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Alvaro Vergés
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007.,Escuela de Psicología, Pontificia Universidad Católica de Chile, Macul, Chile
| | - Rodrigo Gillibrand
- Hospital Del Trabajador, Asociación Chilena de Seguridad, Providencia, Chile
| | - Paula Repetto
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007.,Escuela de Psicología, Pontificia Universidad Católica de Chile, Macul, Chile
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He C, Chang S, Lu Y, Zhang H, Zhou H, Guo Y, Gao BL. Effects of Online Psychological Crisis Intervention for Frontline Nurses in COVID-19 Pandemic. Front Psychiatry 2022; 13:937573. [PMID: 35903639 PMCID: PMC9316614 DOI: 10.3389/fpsyt.2022.937573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The psychological problems of frontline nurses in COVID-19 prevention and control are very prominent, and targeted intervention is needed to alleviate them. This study was to assess the impact of online intervention programs on psychological crisis of anxiety, depression levels and physical symptoms among frontline nurses fighting the COVID-19 pandemic. METHODS A three-stage online psychological crisis intervention program was established. The General Anxiety 7 (GAD-7) assessment, Patient Health Questionnaire-9 (PHQ-9), and the Self-rating Somatic Symptom Scale (SSS) were used to evaluate the effect of intervention on the day before entering isolation wards (Time 1), the first day after leaving the isolation ward (Time 2), and at the end of the intervention (Time 3). RESULTS Sixty-two nurses completed the study, including 59 female (95.2%) and three male nurses (4.8%) with an age range of 23-49 (mean 33.37 ± 6.01). A significant (P < 0.01) difference existed in the scores of GAD-7, PHQ-9, and SSS at different intervention periods. The GAD-7 score was significantly (P < 0.001) lower at the end of quarantine period (time 3) than that before entering the isolation wards (time 1) or after leaving the isolation wards (time 2), the PHQ-9 score was significantly (P = 0.016) lower at the end of quarantine period (time 3) than that after leaving the isolation wards (time 2), and the SSS score was significantly (P < 0.001) lower at the end of quarantine period (time 3) than that before entering the isolation wards (time 1) or after leaving the isolation wards (time 2). CONCLUSION The three-stage online intervention program based on the psychological crisis can be effective in reducing negative emotions and somatic symptoms and improving the mental health of frontline nurses in prevention and control of the COVID-19 epidemic. It may provide an empirical basis for psychological crisis intervention of frontline medical staff when facing public health emergencies.
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Affiliation(s)
- Chunyan He
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Shuying Chang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Ying Lu
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Hongmei Zhang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Haining Zhou
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Yunfei Guo
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Bu-Lang Gao
- Henan Provincial People's Hospital, Zhengzhou, China
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40
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Yip PSF, Chan WL, Chan CS, He L, Xu Y, Chan E, Chau YC, Cheng Q, Cheng SH, Cheung F, Chow J, Chow S, Fung J, Hsu SM, Law YW, Lo B, Miu SM, Ng WM, Ngai K, Tsang C, Xiong C, Xu Z. The Opportunities and Challenges of the First Three Years of Open Up, an Online Text-Based Counselling Service for Youth and Young Adults. Int J Environ Res Public Health 2021; 18:13194. [PMID: 34948802 PMCID: PMC8701729 DOI: 10.3390/ijerph182413194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 11/22/2022]
Abstract
We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe.
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Affiliation(s)
- Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Wai-Leung Chan
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China;
| | - Lihong He
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yucan Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Evangeline Chan
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yui Chi Chau
- Head Office, Hong Kong Children and Youth Services, Hong Kong, China;
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China;
| | | | - Florence Cheung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - James Chow
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Shirley Chow
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Jerry Fung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Siu-Man Hsu
- Headquarter, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Billie Lo
- IT Unit, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Sze-Man Miu
- Jockey Club Online Youth Emotional Support, The Boys’ and Girls’ Clubs Association of Hong Kong, Hong Kong, China;
| | - Wai Man Ng
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Ken Ngai
- Independent Researcher, Hong Kong, China;
| | - Christy Tsang
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Cynthia Xiong
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Zhongzhi Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
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Abstract
A disaster is commonly thought of as an occurrence that results in property damage and physical injuries that exceed the response capabilities of local resources. History teaches that disasters also result in a surge in demand for psychological support amongst survivors and disaster responders. This surge quickly exceeds local response capacities and has the potential to exceed even the mental health resources that may be imported from neighbouring jurisdictions and disaster relief agencies. Efficient and effective acute mental health intervention is, therefore, needed. However, the effectiveness of traditional multi-session counselling during and shortly after disasters has been questioned. Instead, the utilization of efficient and effective crisis-focussed psychological interventions has been suggested as acute phase alternatives. This paper asserts psychological first aid (PFA) may be considered a specific crisis-focussed disaster mental health intervention for use during and after disasters. PFA is designed for use in assessing and mitigating acute distress, while serving as a platform for psychological triage complementing more traditional psychological and psychiatric interventions. PFA may be employed by mental health clinicians as well as 'peer responders'.
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Affiliation(s)
- George S Everly
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Mitchell JT. Continuum of care for disasters and catastrophes. Int Rev Psychiatry 2021; 33:728-739. [PMID: 35412427 DOI: 10.1080/09540261.2022.2030678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disasters and their more extensive and more serious variant, catastrophes, are different than most human experiences. They are inherently quite complex. Extensive and diverse resources are required to assist disaster survivors as well as disaster response personnel, and hospital medical staffs. Except for warfare, there are few other human predicaments that require such a massive and highly coordinated response. Traditional psycho-therapeutic interventions have little chance of being helpful in the acute stages of a disaster. Research demonstrates that selected crisis intervention processes provided by crisis-trained psychological support personnel have been quite successful in assisting both the survivors and responders in coping with disasters and catastrophes. Assistance to military personnel, emergency operations personnel, and survivors must be carefully crafted to assure that the right type of help is provided at the right time by the most appropriate, well-trained, and experienced personnel. This paper employed a scoping review methodology synthesizing the lessons gleaned from wars and past disasters beginning in the late 1800's up to the present. It sets a course for the appropriate management of the psychological impacts of future disasters and catastrophes. Evidence suggests effective psychiatric and psychological services provided during and in the aftermath of a disaster must be simple, brief, immediate, practical, and innovative. Most importantly, disaster mental health support services must consist of an integrated and comprehensive continuum of mental health services spanning all levels of intensity of support and care.
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Affiliation(s)
- Jeffrey T Mitchell
- Emergency Health Services, University of Maryland, Baltimore County, Baltimore, MD, USA
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Yang BX, Xia L, Liu L, Nie W, Liu Q, Li XY, Ao MQ, Wang XQ, Xie YD, Liu Z, Huang YJ, Huang Z, Gong X, Luo D. A Suicide Monitoring and Crisis Intervention Strategy Based on Knowledge Graph Technology for "Tree Hole" Microblog Users in China. Front Psychol 2021; 12:674481. [PMID: 34759854 PMCID: PMC8573267 DOI: 10.3389/fpsyg.2021.674481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
“Zou Fan” is currently the largest “tree hole” on Weibo, where people having suicidal ideation often express their thoughts and use this channel to seek support. Therefore, early suicide monitoring and timely crisis intervention based on artificial intelligence technology are needed for this social media user group. This research was based on the knowledge graph technology, whereby “Tree Hole Intelligent Agent” (i.e., Artificial Intelligence Program) was used to identify “Zou Fan Tree Hole” users at high risk for suicide, and then, the “Tree Hole Action” carried out proactive suicide crisis intervention with them. The “Tree Hole Action” has temporarily prevented 3,629 potential suicides. The “Tree Hole Action” plays a significant role in suicide risk monitoring and crisis intervention for social media users and has been seen to have an important social impact.
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Affiliation(s)
- Bing Xiang Yang
- School of Health Sciences, Wuhan University, Wuhan, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.,Population and Health Research Center, Wuhan University, Wuhan, China
| | - Lin Xia
- School of Health Sciences, Wuhan University, Wuhan, China
| | | | - Wentao Nie
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Qian Liu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xin Yi Li
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Meng Qin Ao
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Ya Dian Xie
- School of Health Sciences, Wuhan University, Wuhan, China.,Teaching Office, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yi Jia Huang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhisheng Huang
- Division of Mathematics and Computer Science, Faculty of Sciences, Vrije University Amsterdam, Amsterdam, Netherlands
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Luo
- School of Health Sciences, Wuhan University, Wuhan, China
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Uhrecký B, Gurňáková J, Marcinechová D. 'We Ought to Be Professionals': Strategies of Intrapersonal and Interpersonal Emotion Regulation of Emergency Medical Services Professionals in Confrontation With the Death of a Newborn in Simulated Task. Qual Health Res 2021; 31:2364-2377. [PMID: 34617836 DOI: 10.1177/10497323211037644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Managing one's own and others' emotions is a necessary part of emergency medical services (EMS) professionals' work. For that reason, we explored their emotion regulation strategies in a simulated task which focused these skills. Short semistructured interviews were conducted with 48 EMS professionals immediately after completing the task. They described their experience during this task as distressing on a manageable level. Emergent emotion regulation strategies are largely in line with established theoretical frameworks, but their specification is unique and offers new insights. Focusing on the task along with emotional distancing is a crucial combination employed by many EMS professionals. Pre-existing cognitive frames also help with processing of emotional stimuli. Among interpersonal strategies, allowing the relatives of a deceased child to cope with their grief was the most typical reaction. However, attempts to distract them or positively reframe their situation were also present, along with few other strategies.
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Affiliation(s)
- Branislav Uhrecký
- Institute of Experimental Psychology, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Jitka Gurňáková
- Institute of Experimental Psychology, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Denisa Marcinechová
- Institute of Experimental Psychology, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Bratislava, Slovak Republic
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Sosa Lovera A, Ureña AJ, Arias J, Araujo Rodríguez A, Canario Guzmán JA. Psychological helpline in response to the COVID-19 pandemic in the Dominican Republic. Couns Psychother Res 2021; 22:534-541. [PMID: 34899067 PMCID: PMC8653092 DOI: 10.1002/capr.12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022]
Abstract
The global health emergency due to COVID‐19 is a disruptive event that has had various effects on mental health. Given this emergency, the Dominican Republic intervened to mitigate the negative impact of the pandemic, considering the physical isolation decreed in the country. In this context, the Autonomous University of Santo Domingo and the School of Psychology designed the UASD COVID‐19 Psychological Helpline. The objective of this article is to describe the development, implementation and evaluation of a programme of psychological first aid. The programme aimed to attenuate the impact of morbidity and mortality due to mental health issues associated with the COVID‐19 pandemic through mobile technology. There were 62 psychologists involved and trained to provide care, and a protocol was developed, implemented, monitored and evaluated. Over the course of four months, the programme assisted 497 people. The average age of the participants was 32 years, and 73% were women. The reasons for contacting the helpline included anxiety, stress, depression, domestic violence, suicidal behaviours and other behavioural problems. Following the intervention, most users reported feeling satisfied and having improved emotions. The first psychological aid in the country developed through telephone and chat messaging was an optimal resource since face‐to‐face interaction was not possible. It also reached more people and reduced the attention gap.
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Affiliation(s)
- Angelina Sosa Lovera
- School of Psychology Faculty of Humanities Autonomous University of Santo Domingo (UASD) Santo Domingo Dominican Republic
| | - Ana Jacqueline Ureña
- School of Psychology Faculty of Humanities Autonomous University of Santo Domingo (UASD) Santo Domingo Dominican Republic
| | - Josefina Arias
- School of Psychology Faculty of Humanities Autonomous University of Santo Domingo (UASD) Santo Domingo Dominican Republic
| | - Amarilis Araujo Rodríguez
- School of Psychology Faculty of Humanities Autonomous University of Santo Domingo (UASD) Santo Domingo Dominican Republic
| | - Julio Arturo Canario Guzmán
- School of Psychology Faculty of Humanities Autonomous University of Santo Domingo (UASD) Santo Domingo Dominican Republic.,National Center for Research in Maternal and Child Health Dr. Hugo Mendoza (CENISMI) Santo Domingo Dominican Republic
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Chopra J, Hanlon CA, Boland J, Harrison R, Timpson H, Saini P. A case series study of an innovative community-based brief psychological model for men in suicidal crisis. J Ment Health 2021; 31:392-401. [PMID: 34643159 DOI: 10.1080/09638237.2021.1979489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To conduct a 1-year evaluation of James' Place, a suicidal crisis centre delivering a clinical intervention in a community setting. DESIGN A case series study, following men entering the service during the first year of operation. PARTICIPANTS Men experiencing a suicidal crisis referred to the service (N = 265), with N = 176 going on to engage in therapy. INTERVENTION The James' Place Model is a therapeutic intervention offered to men who are in a suicidal crisis. Trained therapists provide a range of therapeutic approaches and interventions, focusing on decreasing suicidal distress and supporting men to develop resilience and coping strategies. MAIN OUTCOME MEASURES CORE-34 Clinical Outcome Measure (CORE-OM). RESULTS For all subscales of the CORE-OM there was a significant reduction in mean scores between assessment and discharge (p < 0.001), with all outcomes demonstrating a large effect size. All reductions illustrated a clinically significant change or a reliable change. CONCLUSIONS Our results support the use of the James' Place Model for men in suicidal distress to aid in potentially preventing suicides in this high-risk group of the population.HighlightsEvaluates a brief psychological clinical intervention delivered in the community.Model effectively reduces suicide risk and findings can inform future services.Accessed men receiving an innovative intervention at the time of suicidal crisis.
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Affiliation(s)
- J Chopra
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - C A Hanlon
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - R Harrison
- Public Health Institute, Exchange Station, Liverpool John Moores University, Liverpool, UK
| | - H Timpson
- Public Health Institute, Exchange Station, Liverpool John Moores University, Liverpool, UK
| | - P Saini
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
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Romeu-Labayen M, Tort-Nasarre G, Alvarez B, Subias-Miquel M, Vázquez-Segura E, Marre D, Galbany-Estragués P. Spanish nurses' experiences with personal protective equipment and perceptions of risk of contagion from COVID-19: A qualitative rapid appraisal. J Clin Nurs 2021; 31:2154-2166. [PMID: 34528310 PMCID: PMC8662180 DOI: 10.1111/jocn.16031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/19/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJETIVES Explore nurses' experiences and perception of risk regarding the use of personal protective equipment during the first wave of the pandemic in Spain. BACKGROUND The contribution of our study is to use qualitative methods to understand nurses' experiences and perceptions of the risk of the contagion linked to the shortage of PPE during the first wave of the pandemic, whose explosive start strained health systems around the globe. DESIGN Qualitative descriptive design according to the Rapid Research Evaluation and Appraisal model. METHODS Semi-structured videoconference interviews were conducted to explore the experiences of 29 nurses including staff nurses, nursing supervisors and nursing directors from hospital and community services of the Spanish health system. Interviews lasted 30-45 min and were conducted in May 2020. We carried out a thematic analysis using Dedoose. The COREQ checklist was used to report findings. RESULTS We identified the following themes and subthemes: 1. Experiences with personal protective equipment: scarcity, inequality, reutilization, self-protection, delegation of responsibility, and gap between protocols and reality; 2. Perception of the risk of contagion: lack of credibility, lack of trust, lack of support, and meeting subjective needs. CONCLUSIONS The scarcity of personal protective equipment and inequality in its distribution led nurses to take initiatives to feel more protected. Mid-ranking supervisors were caught between the responsibility of monitoring and rationing personal protective equipment and providing the necessary protection to nurses. The disjuncture between protocols and the available supply of personal protective equipment caused confusion. Lack of credibility, lack of trust and lack of support from management influenced participants' perception of the risk of contagion. Mid-ranking supervisors were often responsible for trying to alleviate fear among nursing staff. RELEVANCE TO CLINICAL PRACTICE Understanding the factors involved in risk perception can be helpful to decision-makers who help protect nurses in clinical practice. These results can help administrators and policymakers because they point to the need for nurses to feel that their departments and centers look after their safety at work. Transparent communication and emotional support may contribute to their well-being in the face of risk.
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Affiliation(s)
- Maria Romeu-Labayen
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain
| | - Glòria Tort-Nasarre
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.,Department of Nursing, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Education Research Group (GREpS), Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Anoia Primary Care Service, Gerència Territorial Catalunya Central, Institut Català de la Salut (ICS), St. Fruitós del Bages, Spain
| | - Bruna Alvarez
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Martí Subias-Miquel
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Vázquez-Segura
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Manso's Sexual and Reproductive Healthcare Center, Gerència Territorial Barcelona, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Diana Marre
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Paola Galbany-Estragués
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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Kuppusamy C, Shanmugam B, Ezhumalai S. Psychiatric Social Work Services In Neurology Emergency Care Setting. Natl J Prof Soc Work 2021; 22:160-167. [PMID: 35309501 PMCID: PMC8932406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychiatric social workers are important multi-disciplinary team members, and they assess patients and their families social, emotional, environmental, financial, and support needs in emergency settings. They support patients and their families through difficult times and improve patient lives. AIM To study the profile of patients availed psychiatric social work services in neurology casualty and emergency settings. MATERIALS & METHODS The study was retrospective in nature. The ex-post facto research design was used in the study. Data were obtained from a casualty & emergency psychiatric social work referral registry maintained by the psychiatric social work team at the Neurology emergency setting at NIMHANS, Bangalore. Patients referred for psychiatric social work interventions from April 2020 to March 2021 were considered for the study purpose. Frequency and percentages were used to describe the data. RESULTS Psychiatric social work services at the neurology emergency setting were started in July 2018. Social workers get referrals from triage (four hours to 24 hours), followed by priority ward (72 hours to two weeks), observation ward (72 hours days - two weeks) and emergency ICU. There are 100 beds available for neuro-emergency settings. Of ≈15,939 patients who availed the neurology emergency services, 159 patients were referred for psychiatric social work services. A majority (61.6%) received neuro-education about their illness; awareness about their illness were given to patients and their family members. More than half of them were given guidance for availing treatment welfare benefits under below poverty line and Ayushman Bharath Scheme (54%), 43.3% received supportive psychotherapy, 35.2% pre-discharge counselling, one-third received crisis intervention,12.6% family interventions, 10.7% were facilitated for hospital charges waiver off, few unknown patients management and tracing their family members. Most patients were diagnosed with a stroke, GBS, neuro-infections, and seizure disorder patients who sought psychiatric social work services in emergency and casualty settings. Assessment of their functionality revealed that most were partially independent and dependent. Social workers work from 9 am to 9 pm in the neuro-emergency setting. Immediate social work referrals were made for unknown patients, tracing the caregivers who left the emergency ward without permission, which required financial assistance and communicating poor prognosis (breaking the bad news). CONCLUSION The most common psychiatric social work intervention provided in the neurology emergency care setting were education about the illness, facilitating poor patients to avail social welfare benefits, supportive psychotherapy and crisis intervention.
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Affiliation(s)
- Chithiraivalli Kuppusamy
- Department of Psychiatric Social Work, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Backiyaraj Shanmugam
- Department of Psychiatric Social Work, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Sinu Ezhumalai
- Department of Psychiatric Social Work, National Institute of Mental Health And Neurosciences, Bangalore, India
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Park S, Kim SH. A mixed-method pilot study to test a program for friend-supporters of victims of dating violence. J Community Psychol 2021; 49:1153-1168. [PMID: 33778972 DOI: 10.1002/jcop.22568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/02/2021] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to evaluate the acceptability and impact of a bystander program (With You Education) in South Korea, designed to enhance the competencies of friend-supporters to help victims of dating violence (DV). To assess the potential impact of the program, the participants (n = 46) were asked to complete pre-, post-, and 1-year follow-up surveys and take part in a focused group interview after the training. Participants exhibited significant changes from pretest to posttest evaluation in terms of their competencies as a supporter. Most improvements were sustained over time. Four qualitative themes revealed the multilayered outcomes of this program: increased readiness to help, awareness of DV, beginning to understand the victims, and awareness of DV as a public health problem. With You Education was seen to be an acceptable program for young adults, which can be potentially utilized as a formal violence-related education.
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Affiliation(s)
- Sihyun Park
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Sin-Hyang Kim
- Department of Nursing, Shinsung University, Dangjin-Si, South Korea
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Abstract
Crisis intervention psychotherapy (CIP) is an underutilized form of therapy that can be offered as a treatment during psychiatric disasters and emergencies, and it may be especially useful during the age of Coronavirus Disease 2019 (COVID-19). CIP is a problem-solving, solution-focused, trauma-informed treatment, utilizing an individual or systemic/family-centered approach. CIP is a brief form of psychotherapy delivered as a companion or follow-up to psychological first aid. Crisis psychotherapy is designed to resolve a crisis and restore daily functioning. CIP can be adapted as a single session for a COVID-19 mental health emergency or for a hotline or as 2 to 20 sessions of treatment with COVID-19 patients and families offered virtually on a psychiatric inpatient unit, through a consultation-liaison service, or in outpatient settings. This article reviews the history of critical incident stress management and the use of its replacement, psychological first aid. The history and core principles of crisis psychotherapy and 8 core elements of treatment are described. The use of digital and virtual technology has enabled the delivery of crisis psychotherapy during the COVID-19 pandemic. A case study of a family impacted by COVID-19 is reported as an illustration. The use of a 6-week timeline, an ecological map, and a problem-solving wheel-and-spoke treatment plan are demonstrated.
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Affiliation(s)
- Robert E Feinstein
- FEINSTEIN: Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX
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