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Thériault, François L., William Gardner, Franco Momoli, Bryan G. Garber, Mila Kingsbury, Zahra Clayborne, Daniel Y. Cousineau-Short, Hugues Sampasa-Kanyinga, Hannah Landry, and Ian Colman. "Mental Health Service Use in Depressed Military Personnel: A Systematic Review." Military Medicine 185, no. 7-8 (February 17, 2020): e1255-e1262. http://dx.doi.org/10.1093/milmed/usaa015.
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Abstract Introduction Major depression is a leading cause of morbidity in military personnel and an important impediment to operational readiness in military organizations. Although treatment options are available, a large proportion of individuals with depression do not access mental health services. Quantifying and closing this treatment gap is a public health priority. However, the scientific literature on the major depression treatment gap in military organizations has never been systematically reviewed. Methods We systematically searched the EMBASE, MEDLINE, and PsychINFO databases for studies measuring recent mental health service use in personnel serving in the armed forces of a Five-Eye country (Australia, Canada, New Zealand, the United Kingdom, or the United States). We excluded studies conducted with retired veterans. Because of the substantial heterogeneity in included studies, we did not pool their results. Instead, we computed median period prevalence of mental health service use. Results Twenty-eight studies were included in the systematic review; 12 had estimated mental health service use in personnel with depression, and another 16 had estimated mental health service use in personnel with depression or another mental health disorder. The period prevalence of mental health service use in depressed military personnel ranged from 20 to 75% in 12 included studies, with a median of 48%, over 2–12 months. The other 16 studies yielded similar conclusions; they reported period prevalence of mental health service use in personnel with any mental health disorder ranging from 14 to 75%, with a median of 36%, over 1–12 months. The median was higher in studies relying on diagnostic interviews to identify depressed personnel, compared to studies relying on screening tools (60% vs. 44%). Conclusions There is a large treatment gap for major depression in particular, and for mental health disorders in general, among military personnel. However, our results highlight the association between the use of measurement tools and treatment gaps: estimated treatment gaps were larger when depressed patients were identified by screening tools instead of diagnostic interviews. Researchers should be wary of overestimating the mental health treatment gap when using screening tools in future studies.
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Kolves, Kairi, Urska Arnautovska, Angelo De Gioannis, and Diego De Leo. "Community care of individuals at risk of suicide: the Life Promotion Clinic model." Mental Illness 5, no. 2 (September 1, 2013): 41–45. http://dx.doi.org/10.1108/mi.2013.e12.
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Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC), Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide) are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.
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Kolves, Kairi, Urska Arnautovska, Angelo De Gioannis, and Diego De Leo. "Community care of individuals at risk of suicide: the Life Promotion Clinic model." Mental Illness 5, no. 2 (October 18, 2013): 12. http://dx.doi.org/10.4081/mi.2013.e12.
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Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC), Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide) are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.
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McCarthy, Stuart. "Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force." Journal of Parasitology Research 2015 (2015): 1–23. http://dx.doi.org/10.1155/2015/287651.
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The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug’s use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.
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Micheal, G. L., N. T. Fear, and J. Hacker Hughes. "Mental Health Referrals to the Falkland Islands British Military Mental Health Team, 1986-96." Journal of The Royal Naval Medical Service 93, no. 1 (March 2007): 12–16. http://dx.doi.org/10.1136/jrnms-93-12.
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AbstractObjectivesTo examine the pattern of out-patient mental health care referrals for military personnel deployed to the Falklands Islands, 1986-96.MethodsData from referral books of British Military Community Mental Health Nurses based in the Falkland Islands were abstracted, entered into an electronic database and analysed.ResultsOver the period 1986-96, 538 Service personnel were referred to the mental health out-patient facility on the Falkland Islands. The majority were male (96%) and junior ranks (81%). Approximately a third of patients were referred for reasons relating to alcohol (31%) and for over two-thirds of patients no follow-up was required (68%). Differences were observed by Service with the Army having more referrals due to alcohol than the other two Services, whilst the Navy had more deliberate self-harm referrals and the RAF more referrals for anxiety.ConclusionsThe lack of information on the total population deployed to the Falkland Islands over this period limit the interpretation of the results.
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Granek, Leeat, Ora Nakash, Samuel Ariad, Shahar Shapira, and Merav Ben-David. "Cancer Patients' Mental Health Distress and Suicidality." Crisis 40, no. 6 (November 2019): 429–36. http://dx.doi.org/10.1027/0227-5910/a000591.
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Abstract. Background: A substantial number of people with cancer endorse suicidality when compared with the general population. Thus, oncology healthcare workers may experience the death of a patient to suicide over their careers. Aims: To explore the impact of patients' mental health distress and suicidality on oncology personnel with a secondary aim of exploring how personnel cope with these types of events. Method: We interviewed 61 healthcare professionals (HCPs) at two cancer centers. The grounded theory method (GT) was used. Results: The impact of patients' mental health distress and suicidal ideation on oncology HCPs included sadness, depression, worry and concern, and feeling emotionally overwhelmed. The impact of patient suicide on HCPs included trauma, guilt, and surprise. Oncology personnel reported a change in practice, including communication style, being attuned to patient cues, and changing the physical environment. Coping strategies included colleague support, seeking professional help, and setting boundaries between their work and home life. Limitations: It is likely that HCPs who participated in the study represent those who are more willing to discuss issues related to suicide. Thus, the impact of patient suicide on healthcare providers may be even more pronounced among the general oncology HCP community. Conclusion: Given the higher risk of suicide among cancer patients, it is necessary to increase awareness about the impact these events may have on HCPs. Professional guidelines can highlight the need for a balance between ensuring the availability of informal support and more formal methods of help.
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Forbes, David, and Olivia Metcalf. "Veteran and military mental health: the Australian experience." International Psychiatry 11, no. 4 (November 2014): 83–85. http://dx.doi.org/10.1192/s1749367600004641.
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Australia has deployed over 25 000 personnel to recent conflicts in the Middle East and has been involved in peacekeeping missions. Australian veterans report elevated rates of mental health problems such as post-traumatic stress disorder, anxiety disorders, affective disorders and substance use disorders. Veteran healthcare is delivered through publicly funded services, as well as through private services, at primary, secondary and tertiary levels. Some of the challenges involve coordination of services for veterans transitioning from Defence to Veterans' Affairs, service delivery across a large continent and stigma inhibiting service-seeking. Initiatives have been introduced in screening and delivery of evidence-based treatments. While challenges remain, Australia has come a long way towards an integrated and comprehensive approach to veteran mental healthcare.
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Creammer, Mark, and Bruce Singh. "An Integrated Approach to Veteran and Military Mental Health: An Overview of the Australian Centre for Posttraumatic Mental Health." Australasian Psychiatry 11, no. 2 (June 2003): 225–27. http://dx.doi.org/10.1046/j.1039-8562.2003.00514.x.
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Objective: To provide an overview of the development of mental health services for veterans and currently serving military personnel in Australia, with reference to the role of the Australian Centre for Posttraumatic Mental Health (ACPMH). Conclusions: Recent years have seen significant changes in attitudes to the mental health sequelae of military service. The ACPMH, working in collaboration with the Department of Veterans’ Affairs (DVA) and the Australian Defence Force (ADF), as well as with clinicians, researchers, and consumers around Australia, acts as a focus for an integrated approach to veteran and military mental health. The active involvement of both the ADF and DVA in the challenge of mental health provides new opportunities to address psychiatric morbidity at every stage, from recruitment, through deployments and discharge, to veteran status. The ACPMH is in a unique position to facilitate an integrated approach to prevention, intervention, policy development, training, research, and evaluation in order to ensure that Australia remains at the forefront of world's best practice in veteran and military psychiatry. The Centre is also uniquely placed to offer those same services in the field of traumatic stress to the broader community.
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Vasiliadis, Helen-Maria, and Anne Dezetter. "Les programmes de prise en charge financière des psychothérapies en Australie et en Angleterre." Santé mentale au Québec 40, no. 4 (April 5, 2016): 101–18. http://dx.doi.org/10.7202/1036096ar.
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L’article décrit les programmes de prise en charge financière des psychothérapies en Australie et en Angleterre. Au début des années 2000, le gouvernement australien a implanté une réforme de santé publique visant à permettre un meilleur accès, gratuit ou peu coûteux, aux psychothérapies brèves, en soin primaire, pour les personnes souffrant de troubles mentaux courants. Cette réforme reconnaît l’importance du rôle du médecin généraliste dans la prise en charge des troubles, et la collaboration avec les professionnels de santé mentale. Deux programmes ont été mis en oeuvre : Access to Allied Psychological Services en 2003 et Better Access en 2006. En 2009, deux millions d’Australiens ont reçu onze millions de séances de psychothérapies. Les études ont montré des résultats positifs sur l’amélioration de l’accès aux soins de santé mentale primaires et sur la santé des patients. L’Angleterre a mis en place le programme Improving Access to psychological Therapies en 2007 en offrant un service de psychothérapies brèves pour les personnes souffrant de troubles mentaux courants. Le modèle de soin en étape suit les guides cliniques du National Institute for Health and Clinical Excellence, le type de professionnel (counselor ou psychothérapeute formés), le nombre de séances (4 à 13) et la méthode thérapeutique varient selon la sévérité du trouble. Un million de patients ont été traités depuis le début du programme. Les études ont aussi montré des résultats de santé positifs pour les patients du programme. En conclusion les programmes de prise en charge des psychothérapies s’avèrent coûts-efficaces.
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Khoo, Joanna, Helen Hasan, and Kathy Eagar. "Utilisation patterns of privately funded mental health services in Australia." Journal of Health Organization and Management 33, no. 1 (March 18, 2019): 5–17. http://dx.doi.org/10.1108/jhom-02-2018-0062.
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Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.
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Monk, Lee-Ann. "Exploiting patient labour at Kew Cottages, Australia, 1887-1950." British Journal of Learning Disabilities 38, no. 2 (June 2010): 86–94. http://dx.doi.org/10.1111/j.1468-3156.2010.00634.x.
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Lawn, Sharon, Elaine Waddell, Taryn Cowain, Carol Turnbull, and Janne McMahon. "Implementing national mental health carer partnership standards in South Australia." Australian Health Review 44, no. 6 (2020): 880. http://dx.doi.org/10.1071/ah19156.
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ObjectiveThe aim of this study was to describe the current state of carer engagement and partnership in two mental health (MH) services in South Australia and the implementation of the six partnership standards in A Practical Guide to Working with Carers of People with a Mental Illness. MethodsAnonymous surveys of carer experiences and clinician self-ratings of their own practice against the six partnership standards were completed by 94 staff and 58 carers within public and private MH in-patient units before and after exposure of clinicians to education about the partnership standards. Descriptive statistical analysis was performed and, where applicable, a comparative analysis used the two-sample Z-test of proportions. Qualitative data was analysed thematically. ResultsConsiderable gaps were evident between carer experiences and clinician self-ratings of their own practice. Overall, the surveys point to the lack of a consistent approach by both public and private services, and suggest potential barriers to fostering carer participation and engagement. Confidentiality was a particularly noted barrier to partnership with carers. ConclusionSignificant improvement is needed to meet the partnership standards. Brief exposure to the Guide is not, in itself, sufficient to effect change in the overall attitudes, skills and knowledge of clinical staff about engaging carers. Significantly more focus on staff education, clinical discussions and supervision is needed to meet the MH carer partnership standards. What is known about the topic?Partnership with MH consumers and carers is an established key principle within national MH policies and accreditation standards. Family carers play an important role in supporting consumers’ recovery, yet many carers continue to report being excluded, particularly by in-patient clinical staff. What does this paper add?This is the first study to investigate the partnership standards in practice by comparing the perspectives of carers and in-patient MH clinical staff. What are the implications for practitioners?Improving partnership with carers of people with mental illness will require significant MH service leadership support shifts in current practice and culture. In addition, a more nuanced understanding of confidentiality is required to overcome the barriers to involving family carers more meaningfully in care.
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Dedman, Paul. "Community Treatment Orders in Victoria, Australia." Psychiatric Bulletin 14, no. 8 (August 1990): 462–64. http://dx.doi.org/10.1192/pb.14.8.462.
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It is one of the failures of contemporary psychiatry that many patients who respond well to neuroleptic medication given to them when they are in-patients relapse after discharge due to not taking any further medication. Those working closely with the acute psychiatric patient in the community are often forced to stand by powerlessly as a patient deteriorates, causing damage to himself and his social milieu until such a point is reached when he is again ill enough to warrant compulsory admission and treatment. This process is, of course, devastating for a patient's family and also disheartening for professionals involved, and is perhaps partly responsible for the high turnover of staff involved in front line services. Even if assertive outreach methods are employed such as those involved in a number of comprehensive community-based programmes (Stein & Test, 1980; Borland et al, 1989) so that contact with the patient is not lost, it is not possible without the necessary legislation to enforce treatment in the community.
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Grigg, Margaret, Helen Herrman, Carol Harvey, and Ruth Endacott. "Factors influencing triage decisions in mental health services." Australian Health Review 31, no. 2 (2007): 239. http://dx.doi.org/10.1071/ah070239.
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The aim of the study was to identify the factors influencing the timing of an assessment after contact with a triage program in a communitybased area mental health service in Australia. Triage decisions apparently were influenced by several groups of factors: patient characteristics; the source and mode of the contact with triage; and to a large extent by mental health service factors including the training, supervision and support of triage workers and the perceived availability of an assessment. While demand factors such as patient characteristics influenced the triage decision, supply factors also played an important role.
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Swain, Sarada Prasanna, Manoj Kumar Dash, Jigyansha Ipsita Pattnaik, and Neelamadhab Rath. "An analysis of occupation related mental health referrals of paramillitary forces to a tertiary care hospital." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 1131. http://dx.doi.org/10.18203/2394-6040.ijcmph20171337.
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Background: The security personnel of our country including Army Personnel, C.I.S.F., Police and other security personnel bear a large amount of physical and psychological stress to maintain law and order situations at different corners of the country at different situations. To assess the Psychiatric Morbidity in C.I.S.F., the course of referrals of Para-military persons to a tertiary care hospital and to evaluate the Mental Health burden in the Para-military set up by virtue of their occupation. Methods: The study sample included all the consecutive patients referred by CISF Headquarters Hospital to the Mental Health Institute (MHI), S.C.B. Medical College, Cuttack, Odisha, from April 2015 to March 2016. The clinical information is collected from the patient and accompanying personnel from CISF or family members who accompanied the patient. The diagnosis is based on ICD-10 and the final opinion is given by the consultants of Psychiatry after final evaluation of all the reports. Results: Psychiatric assessment for job fitness (48%) was the dominant cause for referral of PMF staff to MHI. Substance abuse (alcohol) related disorders were the next common cause of referral (20%).Conclusions: Mental health burden in Para-military bases are substantial which should be taken care of in urgency basis. There is urgent need of posting of Psychiatrists with Clinical Psychologists and Psychiatric Social Worker or a team of the Mental Health Professionals should visit the paramilitary set ups regularly to look into improper diagnosis and review cases.
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Goldsmith, Jill, and Sharon Kurpius. "Older Adults and Integrated Health Settings: Opportunities and Challenges for Mental Health Counselors." Journal of Mental Health Counseling 37, no. 2 (March 31, 2015): 124–37. http://dx.doi.org/10.17744/mehc.37.2.q57403638j4671n0.
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The growing number of older adults and the increasing recognition and growth of integrated health teams are creating expanded career opportunities for mental health counselors (MHCs). Collaborative integrated teams, staffed with medical personnel and MHCs, can provide comprehensive patient-centered care that addresses client issues from a biopsychosocial perspective. However, working with older adults on an integrated health team or in an interdisciplinary setting presents unique challenges and raises ethical issues. The evolving opportunities and strategies to address accompanying challenges are highlighted so that MHCs can be prepared to work effectively with older adults in interdisciplinary settings and on integrated health care teams.
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Monaghan, Timothy, Jo-Anne Manski-Nankervis, and Rachel Canaway. "Big data or big risk: general practitioner, practice nurse and practice manager attitudes to providing de-identified patient health data from electronic medical records to researchers." Australian Journal of Primary Health 26, no. 6 (2020): 466. http://dx.doi.org/10.1071/py20153.
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Research utilising de-identified patient health information extracted from electronic medical records (EMRs) from general practices has steadily grown in recent years in response to calls to increase use of health data for research and other secondary purposes in Australia. Little is known about the views of key primary care personnel on this issue, which are important, as they may influence whether practices agree to provide EMR data for research. This exploratory qualitative study investigated the attitudes and beliefs of general practitioners (GPs), practice managers (PMs) and practice nurses (PNs) around sharing de-identified EMR patient health information with researchers. Semi-structured interviews were conducted with 11 participants (6 GPs, 3 PMs and 2 PNs) recruited via purposive sampling from general practices in Victoria, Australia. Transcripts were coded and thematically analysed. Participants were generally enthusiastic about research utilising de-identified health information extracted from EMRs for altruistic reasons, including: positive effects on primary care research, clinical practice and population health outcomes. Concerns raised included patient privacy and data breaches, third-party use of extracted data and patient consent. These findings can provide guidance to researchers and policymakers in designing and implementing projects involving de-identified health information extracted from EMRs.
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Langlen Devi, Thangjam, and Arunjyoti Baruah. "Practice of Standard Safety Measures among Nursing Personnel at Tertiary Mental Health Institute, North-East, India." International Journal of Research and Review 8, no. 6 (June 29, 2021): 324–31. http://dx.doi.org/10.52403/ijrr.20210641.
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Background: Health care-associated infection (HAI) is a serious problem that deeply impacts patient safety and is a major cause of patient morbidity and mortality. Adherence to standard safety measures while performing procedures and related infection control measures is a part of nurses responsibility as it protects patients and health care workers from transmission of health-care associated infections. Assessing practice of standard safety measures while performing nursing procedures is immensely important so that necessary changes can be brought to enhanced quality nursing care. Methodology: The study adopted an observational descriptive research design. The setting of the study was the Tertiary Mental Health Institute, North-East, India. The sample of the study consisted of the thirty eight (38) nursing personnel who performed the total 150 procedures i.e. 30 times of each five domains (waste disposal, intramuscular injection, intravenous injection, hand-washing, aseptic wound dressing). Convenience sampling technique was used. Result: Finding showed that all the nursing personnel followed proper waste disposal practice but partially adhere to standard safety measures while administering intramuscular and intravenous injections. Whereas practice on standard safety measures while performing hand washing and aseptic wound dressing were less than average. Conclusion: The present study highlights the importance of in-service education on standard safety measures by incorporating new guidelines of nursing procedures based on evidence based practices. In-service education brought changes in the performance level as it is showed that the nursing personnel who had earlier received in-service education on Bio-medical waste management from the institute followed satisfactory waste disposal practice. Keywords: Standard safety measures, nursing personnel.
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Guo, Dan, Yi Guo, and YanJi Xing. "Data on the Impact of Epidemic on Nursing Staff’s Mental Health in the Context of Wireless Network." Journal of Healthcare Engineering 2022 (April 7, 2022): 1–11. http://dx.doi.org/10.1155/2022/3413815.
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The research was aimed to analyze the impact of epidemic pneumonia on nursing personnel’s mental health under wireless network background and to improve the selection of random forest classification (RFC) algorithm parameters by the whale optimization algorithm (WOA). Besides, a total of 148 in-service nursing personnel were selected as the research objects, and 148 questionnaires were recycled effectively. The collected data were analyzed by the improved RFC algorithm. In addition, the research investigated the impacts of demographic factors on nursing personnel’s mental health by the one-way variance method. The results demonstrated that the accuracy of the improved algorithm in training samples and test samples reached 83.3% and 81.6%, respectively, both of which were obviously higher than those of support vector machine (SVM) (80.1% and 79.3%, respectively) and back-propagation neural network (BPNN) (78.23% and 77.9%, respectively), and the differences showed statistical meanings P < 0.05 . The Patient Health Questionnaire-9 (PHQ-9) showed that the depression levels of 9.46% of the included personnel were above moderate. The Generalized Anxiety Disorder (GAD-7) demonstrated that the anxiety levels of 3.38% of the included personnel were above moderate. The insomnia severity index (ISI) indicated that the insomnia levels of 3.38% of the included personnel were above moderate. The average score of male personnel (3.65) was obviously lower than that of female personnel (3.71). Besides, the average scale score of married personnel (3.78) was significantly higher than that of unmarried personnel (3.65). The average scale scores of personnel with bachelor’s (3.66) and master’s degrees (3.62) were obviously lower than those of personnel with junior college (3.77) and technical secondary school (3.75) diplomas. The average scale score of personnel with over 5-year work experience (3.68) was significantly lower than that of personnel working for less than five years (3.72). The average scale score of personnel with experience in responding to public emergencies (3.65) was obviously lower than that of personnel without related experience (3.74). The differences all showed statistical meaning P < 0.05 . The results of this research revealed that the accuracy of the improved RFC algorithm was remarkably higher than that of the SVM and BPNN algorithms. Furthermore, many nursing personnel suffered from mental diseases at different levels with the impact of the epidemic. Gender, marital status, education level, and experience in responding to public emergencies were the main factors affecting nursing personnel’s mental health.
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Giorgi, S., T. Oniani, G. Nino, K. Giorgi, and L. Estate. "Prevalence Study of Mental Disorders in Georgian Military Personnel Participating in Peace-keeping Missions." European Psychiatry 41, S1 (April 2017): S723—S724. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1312.
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IntroductionDue to the professional activities acute stress disorder and PTSD are most diffuse disorders among military servants. Number of studies revealed relationships between post-traumatic stress and depression, anxiety or somatic complaints.ObjectiveThough Georgian military personnel actively take part in the international peacekeeping missions since 2004 and no research was conducted to investigate the prevalence of abovementioned disorders.AimsThus, this study aims to investigate the prevalence of PTSD, depression, anxiety and somatic complaints in the cohort of Georgian military servants.MethodThe research participants were 2799 military servicemen who had been deployed on the 6 month long period to the peace-keeping missions and were screened for psychological problems after deployment. All of them were Caucasian males, with average age of 29.3 years. All participants were asked to complete a PTSD Checklist for DSM-5 (PCL-5), as well as a 15-item somatic subscale of the Patient History Questionnaire (PHQ-15), a 9-item depression subscale of the Patient History Questionnaire (PHQ-9), a 7-item anxiety subscale of the Patient History Questionnaire (GAD-7).ResultsPrevalence rate of probable PTSD screened by the PCL-5 was 2.7%. Further investigation showed that depressive, anxiety and somatic symptoms among them was 21.6%, 8.7% and 21.7% respectively.ConclusionAppreciable positive relationship was found (r = 0.65–0.70; P < 0.001) between these variables in the deployed military servants. Therefore, it is recommended that military servants should be screened on all above mentioned conditions along with PTSD, in order to see full picture of co-morbid problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Scott, Russ, and Duangta Graipaspong. "Repatriation of a Patient Under a Forensic Order from Australia to Thailand." Australasian Psychiatry 19, no. 4 (August 2011): 335–38. http://dx.doi.org/10.3109/10398562.2011.579615.
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Kerr, Katelyn, Madeline Romaniuk, Sarah McLeay, Andrew Khoo, Michael T. Dent, and Mark Boshen. "Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity." Australian & New Zealand Journal of Psychiatry 52, no. 6 (July 14, 2017): 552–60. http://dx.doi.org/10.1177/0004867417718945.
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Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.
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Boothby, Neil, Maggie Veatch, and Matina Pentes. "Evaluating treatment of Axis I mental health disorders in Aceh, Indonesia." Psychiatrist 35, no. 7 (July 2011): 248–55. http://dx.doi.org/10.1192/pb.bp.110.030205.
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Aims and methodTo share evaluation findings of a new decentralised mental healthcare system addressing Axis I disorders, developed in four subdistricts of Aceh Besar in Indonesia following the 2004 Asian tsunami. Two complementary methodologies were employed: an adequacy survey that assessed whether agreed programme implementation tasks were completed, and an outcome study that utilised patient, caregiver and staff assessment of the programme to determine what changes, if any, resulted from participation in the programme.ResultsThe system is functional in 3 of 4 subdistricts, and 47 of 53 subdistrict clinics (puskesmas) have trained mental healthcare nurses. Both patients and caregivers reported statistically significant differences when ranking patient wellbeing and were able to qualitatively describe specific changes in patient symptomatology and social functioning.Clinical implicationsResults indicate that (a) the creation of a decentralised system with outreach at multiple levels, (b) emphasis on staff capacity building within a wider household-to-hospital continuum of care, and (c) incorporation of community volunteers working with trained medical personnel led to effective treatment options for people with Axis I disorders in a resource-poor setting.
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Gibbs, Chris, Barbara Murphy, Kate Hoppe, Patricia Clarke, Deepika Ratnaike, and Harry Lovelock. "Enhancing the Capacity of the Australian Health Care Workforce to Support Veterans’ Mental Health: A Collaborative Interdisciplinary Approach." Military Medicine 185, no. 3-4 (October 30, 2019): 499–505. http://dx.doi.org/10.1093/milmed/usz188.
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Abstract Introduction Military personnel and veterans can have higher rates of mental health problems than the general population, but are no more likely to receive appropriate mental health care. A lack of experience among Australia’s mental health workforce in treating veteran-specific issues has been identified, pointing to a need for strategies to strengthen the workforce capacity. To this end, the Department of Veteran’s Affairs joined with the Mental Health Professionals Network (MHPN) to produce and deliver a series of veteran-specific webinars for health professionals working with military personnel, veterans and their families. Materials and Method Five webinars were produced and delivered between August 2016 and July 2017. Each involved a panel of health professionals with content expertise and was facilitated by a nationally recognized expert in veteran mental health. Each webinar was evaluated using an online survey to address whether learning needs were achieved, likely improvements to work practice, and improvements in knowledge of and confidence in treating veteran mental health issues. Results Of the 5,127 attendees across the five webinars, registration data was collected for 4,809 (94%) and post-webinar data for 3,334 (70%) of registrants. Of these, over 90% indicated that their learning objectives were achieved, that the content was relevant to their practice, and that their work practices would be improved as a result of their participation. Further, almost three quarters reported increased knowledge and skills, and two-thirds increased confidence in treating veterans’ mental health needs. Conclusions The Veterans’ webinar series was effective in engaging a large number and a wide range of professionals working in mental health care in Australia, underscoring the strength of MHPN’s initiatives in terms of scale and reach. With its emphasis on interdisciplinary practice and collaborative care, MHPN is well-placed to continue to support Australia’s mental health workforce.
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Arbon, Paul, Franklin H. G. Bridgewater, and Colleen Smith. "Mass Gathering Medicine: A Predictive Model for Patient Presentation and Transport Rates." Prehospital and Disaster Medicine 16, no. 3 (September 2001): 150–58. http://dx.doi.org/10.1017/s1049023x00025905.
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AbstractIntroduction:This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to firstaid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings.Objective:To develop a data set and predictive model that can be applied across venues and types of mass gathering events that is not venue or event specific. Data collected will allow informed event planning for future mass gatherings for which health care services are required.Methods:Mass gatherings were defined as public events attended by in excess of 25,000 people. Over a period of 12 months, 201 mass gatherings attended by a combined audience in excess of 12 million people were surveyed through-out Australia. The survey was undertaken by St. John Ambulance Australia personnel. The researchers collected data on the incidence and type of patients presenting for treatment and on the environmental factors that may influence these presentations. A standard reporting format and definition of event geography was employed to overcome the event-specific nature of many previous surveys.Results:There are 11,956 patients in the sample. The patient presentation rate across all event types was 0.992/1,000 attendees, and the transportation-to-hospital rate was 0.027/1,000 persons in attendance. The rates of patient presentations declined slightly as crowd sizes increased. The weather (particularly the relative humidity) was related positively to an increase in the rates of presentations. Other factors that influenced the number and type of patients presenting were the mobility of the crowd, the availability of alcohol, the event being enclosed by a boundary, and the number of patient-care personnel on duty.Three regression models were developed to predict presentation rates at future events.Conclusions:Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.
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Meadley, Liz, Jane Conway, and Margaret McMillan. "Education and training needs of nurses in general practice." Australian Journal of Primary Health 10, no. 1 (2004): 21. http://dx.doi.org/10.1071/py04004.
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Practice nurses have been identified as key personnel in management of patients either in the prevention of hospitalisation or follow-up post-discharge from acute settings. There is an increase in numbers of practice nurses (PNs) in Australia, but the role of nurses who work in general practice is poorly understood. There is considerable variation in the activities of PNs, which can include functions as diverse as receptionist duties, performing a range of clinical skills at the direction of the medical practitioner, and conducting independent patient assessment and education. This paper reports on an investigation of PNs? perceptions of their ongoing professional development needs, and identifies issues in providing education and training to nurses who work with general practitioners (GPs).
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Turner, Mark A., Mathew D. Kiernan, Andrew G. McKechanie, Peter J. C. Finch, Frank B. McManus, and Leigh A. Neal. "Acute military psychiatric casualties from the war in Iraq." British Journal of Psychiatry 186, no. 6 (June 2005): 476–79. http://dx.doi.org/10.1192/bjp.186.6.476.
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BackgroundThe view that most military personnel evacuated from war zones are suffering from combat stress reactions, or are otherwise traumatised by the horrors of war, has an impact on all aspects of military psychiatry.AimsTo delineate the reasons for psychiatric aeromedical evacuation from Iraq from the start of build-up of UK forces in January 2003 until the end of October that year, 6 months after the end of formal hostilities.MethodA retrospective study was conducted of field and in-patient psychiatric assessments of 116 military personnel evacuated to the UK military psychiatric in-patient facility in Catterick Garrison.ResultsEvacuees were mainly non-combatants (69%). A significant proportion were in reserve service (21%) and had a history of contact with mental health services (37%). Only 3% had a combat stress reaction. In over 85% of cases evacuation was for low mood attributed to separation from friends or family, or difficulties adjusting to the environment.ConclusionsThese findings have implications especially for screening for suitability for deployment, and for understanding any longer-term mental health problems arising in veterans from Iraq.
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Caplehorn, John R. M., and Robert G. Batey. "Methadone Maintenance in Australia." Journal of Drug Issues 22, no. 3 (July 1992): 661–78. http://dx.doi.org/10.1177/002204269202200314.
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The history of methadone treatment in Australia has been and continues to be marked by conflict between two competing aims: harm minimisation and abstinence. The two approaches tend to be associated with high dose-long term and low dose-short term treatment, respectively. Most programmes fail to provide adequate ancillary services, often to the detriment of patient outcome. Despite chronic under-funding, a relative lack of staff training and, in some states, the absence of a system of clinical accountability, Australian methadone services have grown significantly in the last decade. Factors influencing the growth of programmes have been described using the New South Wales programme as the example as it represents the largest and most complex programme in the country. Current problems and the impact of the Human Immunodeficiency Virus on policy development are highlighted.
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Shields, Robyn E., Stephanie Korol, R. Nicholas Carleton, Megan McElheran, Andrea M. Stelnicki, Dianne Groll, and Gregory S. Anderson. "Brief Mental Health Disorder Screening Questionnaires and Use with Public Safety Personnel: A Review." International Journal of Environmental Research and Public Health 18, no. 7 (April 3, 2021): 3743. http://dx.doi.org/10.3390/ijerph18073743.
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Brief mental health disorder screening questionnaires (SQs) are used by psychiatrists, physicians, researchers, psychologists, and other mental health professionals and may provide an efficient method to guide clinicians to query symptom areas requiring further assessment. For example, annual screening has been used to help identify military personnel who may need help. Nearly half (44.5%) of Canadian public safety personnel (PSP) screen positive for one or more mental health disorder(s); as such, regular mental health screenings for PSP may be a valuable way to support mental health. The following review was conducted to (1) identify existing brief mental health disorder SQs; (2) review empirical evidence of the validity of identified SQs; (3) identify SQs validated within PSP populations; and (4) recommend appropriately validated brief screening questionnaires for five common mental health disorders (i.e., generalized anxiety disorder (GAD), major depressive depression (MDD), panic disorder, posttraumatic stress disorder, alcohol use disorder). After reviewing the psychometric properties of the identified brief screening questionnaires, we recommend the following four brief screening tools for use with PSP: the Patient Health Questionnaire-4 (screening for MDD and GAD), the Brief Panic Disorder Symptom Screen—Self-Report, the Short-Form Posttraumatic Checklist-5, and the Alcohol Use Disorders Identification Test-Consumption.
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Wieczorek, Aleksandra, Agnieszka Fusińska-Korpik, and Łukasz Cichocki. "Educational program “Communication in the Treatment Process” – description, goals, and theoretical background." Psychiatria i Psychologia Kliniczna 21, no. 2 (July 30, 2021): 134–40. http://dx.doi.org/10.15557/pipk.2021.0015.
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Effective medical communication is an extremely important aspect of patient-centered medicine. It allows for achieving better treatment outcomes and is of key importance in the case of patients experiencing mental problems. Research clearly indicates that the quality of communication is a fundamental element of medical services, which not only affects patient satisfaction, but can also reduce the risk of burnout among staff who have contact with patients. A sense of mutual understanding translates into trust and contributes to more conscientious adherence to medical recommendations. Considering the cooperation of all medical and non-medical personnel, high-quality communication reduces the risk of tensions and conflicts, as well as the number of complaints reported by patients. Both research findings and our own experience show that individuals with mental disorders often feel misunderstood, stigmatised, or ignored by healthcare personnel. Based on the above assumptions, the experts from Józef Babiński Specialist Hospital in Kraków developed their own program entitled “Communication in the Treatment Process.” It was implemented in 2018 by the Ministry of Health among over 2,500 professionals in the Małopolskie and Podkarpackie provinces. The aim of the project was to improve the communication skills of medical and non-medical personnel in the context of communication with patients with mental disorders. The paper describes in detail the theoretical background, the goals, and the course of the program.
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Iversen, Amy C., Lauren van Staden, Jamie Hacker Hughes, Tess Browne, Neil Greenberg, Matthew Hotopf, Roberto J. Rona, Simon Wessely, Graham Thornicroft, and Nicola T. Fear. "Help-seeking and receipt of treatment among UK service personnel." British Journal of Psychiatry 197, no. 2 (August 2010): 149–55. http://dx.doi.org/10.1192/bjp.bp.109.075762.
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BackgroundFor armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy.AimsTo examine mental healthcare service use and receipt of treatment in a sample of the UK military.MethodParticipants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt.ResultsOnly 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive–behavioural therapy (CBT). These findings are comparable with those reported for the general population.ConclusionsIn the UK armed forces, the majority of those with mental disorders are not currently seeking medical help for their symptoms. Further work to understand barriers to care is important and timely given that this is a group at risk of occupational psychiatric injury.
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Carey, Timothy A., Sara J. Tai, and William B. Stiles. "Effective and efficient: Using patient-led appointment scheduling in routine mental health practice in remote Australia." Professional Psychology: Research and Practice 44, no. 6 (December 2013): 405–14. http://dx.doi.org/10.1037/a0035038.
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Alanazy, Ahmed, John Fraser, and Stuart Wark. "Provision of Emergency Medical Services in Rural and Urban Saudi Arabia: An overview of personnel experiences." Asia Pacific Journal of Health Management 16, no. 2 (June 27, 2021): 148–57. http://dx.doi.org/10.24083/apjhm.v16i2.559.
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Objective: Pre-hospital emergency medical services (EMS) are a vital component of health management, however there are disparities in the provision of EMS between rural and urban locations. While rural people experience lower levels of pre-hospital care, there has been little examination of the reasons underpinning these differences through discussion with the providers of EMS, and particularly in countries other than the USA, UK and Australia. The purpose of this paper is to provide an overview of the lived experience of EMS personnel in Saudi Arabia regarding the key issues they face in their work practice. Design: This research focussed on frontline workers and middle-level station managers within the Saudi Arabian EMS system and adopted a hermeneutic phenomenology design to better understand the factors contributing to observed disparities between rural and urban areas in Riyadh region in Saudi Arabia. A semi-structured interview approach was used to collect data reflecting realistic experiences of EMS personnel in both urban and rural locations. Results: 20 interviews (10 each with rural and urban personnel) were done. Data analyses identified three primary thematic categories impacting EMS delivery: EMS Personnel Factors; Patient Factors; and, Organisational Factors. Underpinning each category were sub-themes, including Working Conditions, Stress, Education and training, and Resources, amongst others. Conclusions: The quality and efficiency of EMS services, in both rural and urban areas, was affected by a number of over-arching organizational factors. Implementing major policy shifts, such as recruitment of female EMS professionals, will be critical in addressing these challenges, but is acknowledged that this will take time. Quicker changes, such as improving the advanced training options for rural EMS staff, may help to remediate some of the issues. Public awareness campaigns may also be effective in addressing the identified misconceptions about the role of EMS in Saudi Arabia.
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O'Brien, Anthony P., Julie M. Boddy, and Derrylea J. Hardy. "Culturally Specific Process Measures to Improve Mental Health Clinical Practice: Indigenous Focus." Australian & New Zealand Journal of Psychiatry 41, no. 8 (August 2007): 667–74. http://dx.doi.org/10.1080/00048670701449211.
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Objective: In New Zealand and Australia, a renewed emphasis on equity and efficiency in the provision of mental health care has seen outcomes-focused, culturally appropriate clinical practice become essential within mental health services. Ascertaining the degree to which quality improvement and monitoring systems are enhancing professional practice and patient outcomes, however, is hindered by the difficulty of measuring the process of quality care delivery. Method: This paper argues that it is the process of care delivery (i.e. what clinicians do to, and for, patients) that is critical to the effectiveness of treatment and the degree to which treatment either inhibits or promotes an improvement in mental health recovery. Identification of the underlying causes of poor achievement of process factors is likely to positively impact on things such as readmission rates, shared care initiatives, and ultimately patient recovery. Such attention could be the difference between low-quality service provision and a high-quality service provision with positive recovery outcomes for patients. Results: Ascertaining the degree to which quality improvement and monitoring systems are enhancing professional practice and patient outcomes for indigenous people, however, is hindered by the difficulty of measuring such concepts. Australia has indeed embraced ‘culturally appropriate’ practice in recent years, but this appears to be piecemeal when compared with New Zealand. Certainly, there are inconsistent and variable approaches to cultural practices with indigenous people when comparing the two countries. Conclusions: Using evidence from a bicultural mental health nursing study that developed and validated generic and Mâori-specific (indigenous) clinical indicators for mental health nursing standards of practice in New Zealand, it is argued that the process of care delivery is equally as important as outcome measures when ascertaining the effectiveness of nursing care. Second, this paper contends that accurate process measures must be culturally responsive to indigenous and other ethnic groups.
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KISELY, STEPHEN, MARK SMITH, NEIL J. PRESTON, and JIANGUO XIAO. "A comparison of health service use in two jurisdictions with and without compulsory community treatment." Psychological Medicine 35, no. 9 (September 2005): 1357–67. http://dx.doi.org/10.1017/s0033291705004824.
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Background. This study examines whether community treatment orders (CTOs) reduce psychiatric admission rates or bed-days for patients from Western Australia compared to control patients from a jurisdiction without this legislation (Nova Scotia).Method. A population-based record linkage analysis of an inception cohort using a two-stage design of matching and multivariate analyses to control for sociodemographics, clinical features and psychiatric history. All discharges from in-patient psychiatric services in Western Australia and Nova Scotia were included covering a population of 2·6 million people. Patients on CTOs in the first year of implementation in Western Australia were compared with controls from Nova Scotia matched on date of discharge from in-patient care, demographics, diagnosis and past in-patient psychiatric history. We analysed time to admission using Cox regression analyses and number of bed-days using logistic regression.Results. We matched 196 CTO cases with an equal number of controls. On survival analyses, CTO cases had a significantly greater readmission rate. Co-morbid personality disorder and previous psychiatric history were also associated with readmission. However, on logistic regression, patients on CTOs spent less time in hospital in the following year, with reduced in-patient stays of over 100 days.Conclusions. Although compulsory community treatment does not reduce hospital admission rates, increased surveillance of patients on CTOs may lead to earlier intervention such as admission, so reducing length of hospital stay. However, we do not know if it is the intensity of treatment, or its compulsory nature, that effects outcome.
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Beecham, Jennifer, Daniel Chisholm, Anne O'Herlihy, and Jack Astin. "Variations in the costs of child and adolescent psychiatric in-patient units." British Journal of Psychiatry 183, no. 3 (September 2003): 220–25. http://dx.doi.org/10.1192/bjp.183.3.220.
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BackgroundChild and adolescent inpatient care is a highly specialised service, ideally requiring planning at a national level, but there are no routine data collections specifically for these services.AimsTo estimate unit costs for child and adolescent psychiatric in-patient units and to analyse the variations in costs between units.MethodData collection alongside a national survey with cost estimations guided by principles drawn from economic theory. Bivariate and multivariate analyses are employed to identify cost influences.ResultsFifty-eight units could provide sufficient data to allow calculation of the cost per in-patient day; mean=$197 (s.d.=71.6; 1999–2000 prices). The management sector, type of provision, number of rooms, capacity and location explained nearly half of the cost variation.ConclusionsChild and adolescent psychiatric in-patient units are an expensive resource, with personnel absorbing two-thirds of the total costs. Costs per in-patient day vary fourfold and the exploration of cost variations can inform commissioning strategies.
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Goldney, Robert D., Kirsten I. Dunn, Eleonora Dal Grande, Shona Crabb, and Anne Taylor. "Tracking Depression-Related Mental Health Literacy Across South Australia: A Decade of Change." Australian & New Zealand Journal of Psychiatry 43, no. 5 (January 1, 2009): 476–83. http://dx.doi.org/10.1080/00048670902817729.
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Objective: The aim of the present study was to measure and compare levels of depression-related mental health literacy in South Australia across three points in time: 1998, 2004, and 2008. Method: Participants were those recruited for the 1998, 2004, and 2008 South Australian Health Omnibus Surveys. Comparisons were made across overall levels of depression-related mental health literacy as well as between responses to independent questionnaire items. Results: A significant improvement was found in the overall measure of depression-related mental health literacy between 1998 and 2004 and this was consolidated in 2008. Some discrete changes in literacy were found between 2004 and 2008, with improvements recorded across some demographic groups and in participants’ ability to accurately classify symptoms. Participants in 2008, however, were significantly less likely to endorse providers or treatments as ‘helpful’ than in 2004. Conclusions: Although knowledge and understanding of depression have improved significantly and stabilized since 1998, patient confidence in both mental health therapists and treatment options fell between 2004 and 2008, although it is still greater than in 1998.
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Restuputri, Dian Palupi, Anindia Karunia Pangesti, and Annisa Kesy Garside. "The measurement of Physical Workload and Mental Workload Level of Medical Personnel." Jurnal Teknik Industri 20, no. 1 (February 26, 2019): 34. http://dx.doi.org/10.22219/jtiumm.vol20.no1.34-44.
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As the primary health reference center, a hospital is required to provide excellent quality services to each patient. The impact of the extreme physical and mental workload cause negligence in activities. It affects the quality of services provided by medical personnel. This study investigated the level of mental workload and physical workload in medical staff in a hospital. This study was conducted at 15 units in the hospital. The mental workload was assessed using the NASA-TLX Questionnaire. The physical workload analysis was carried out with the Heart Rate reserve percentage of medical personnel. The results of this study show that the mental workload on nurses in the ICU is higher than the other units. Whereas the calculation of physical load using% HR reserve turns out the head of the nurse in-unit class 1 has the highest value compared to the others unit. The statistical analysis showed there was a difference in the general practitioner workload toward the Head of the NursingAs the primary health reference center, a hospital is required to provide excellent quality services to each patient. The impact of the extreme physical and mental workload cause negligence in activities. It affects the quality of services provided by medical personnel. This study investigated the level of mental workload and physical workload in medical staff in a hospital. This study was conducted at 15 units in the hospital. The mental workload was assessed using the NASA-TLX Questionnaire. The physical workload analysis was carried out with the Heart Rate reserve percentage of medical personnel. The results of this study show that the mental workload on nurses in the ICU is higher than the other units. Whereas the calculation of physical load using% HR reserve turns out the head of the nurse in-unit class 1 has the highest value compared to the others unit. The statistical analysis showed there was a difference in the general practitioner workload toward the Head of the Nursing.
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Botega, Neury José, Diogo Gomes Reginato, Sidney Volk da Silva, Carlos Filinto da Silva Cais, Claudemir Benedito Rapeli, Marisa Lúcia Fabrício Mauro, Janaína Phillipe Cecconi, and Sabrina Stefanello. "Nursing personnel attitudes towards suicide: the development of a measure scale." Revista Brasileira de Psiquiatria 27, no. 4 (December 2005): 315–18. http://dx.doi.org/10.1590/s1516-44462005000400011.
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OBJECTIVE: To describe the construction of the Suicide Behavior Attitude Questionnaire (SBAQ) which measures attitudes of nursing personnel towards suicide, and verify attitude differences among these professionals. METHODS: The Suicide Behavior Attitude Questionnaire comprises 21 visual analogue scale items (beliefs, feelings and reactions on suicidal patients) selected from a pool of attitude statements generated by focal groups and experts' judgement. The questionnaire was completed by 317 nursing professionals who worked in a teaching hospital. Factor analysis and internal consistency were calculated. RESULTS: Three interpretable factors were extracted, accounting jointly for 40% of the total variance: Feelings when caring for the patient, Professional Capacity and Right to Suicide, comprising 7, 4 and 5 items, respectively. The Cronbach's alpha coefficients were 0.7, 0.6 and 0.5, respectively. Greater Professional Capacity was reported by nursing assistants and those who had already took care of suicidal patients. The belief that a person does not have the right to commit suicide was stronger among older professionals, those who had never taken care of suicidal patients, those who had a family history of suicide, those who were Protestants and that used to go more frequently to church services. CONCLUSIONS: The Suicide Behavior Attitude Questionnaire proved to be user-friendly and quite a simple instrument to assess attitude towards suicide among nursing personnel.
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Rossi, Alberto, Vera Morgan, Francesco Amaddeo, Marco Sandri, Michele Tansella, and Assen Jablensky. "Psychiatric Out-Patients Seen Once Only in South Verona and Western Australia: A Comparative Case-Register Study." Australian & New Zealand Journal of Psychiatry 39, no. 5 (May 2005): 414–22. http://dx.doi.org/10.1080/j.1440-1614.2005.01590.x.
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Objective: This study examined variables associated with having a once-only contact with the out-patient department of two community mental health services in Italy and Australia. Method: Two 8-year cohorts of patients, who had a new episode of care with out-patient psychiatric departments in South Verona and in Western Australia, were followed-up for 3 months after the first contact, to identify those patients who had no further contact with services. Potential determinants of once-only contact were analysed. Results: Thirty percent of new episodes of care for persons who met the inclusion criteria of the study were once-only contacts with the service in South Verona. In Western Australia, the figure was 24%. Moreover, the proportion of once-only contact patients has increased over time in South Verona whereas, in Western Australia, it has remained stable. In Western Australia, once-only contact patients were younger whereas in South Verona they tended to be older. At both research sites, patients who had a once-only contact were more likely to be male and to have a less severe mental illness. Conclusions: The results of this study suggest that only clinical characteristics were significant determinants of this pattern of contact with services consistently at both sites: the less severe the patient's diagnosis, the more likely the patient is to have a once-only contact. This may well indicate good screening at the initial point of contact by both sets of mental health service providers. Prospective studies are necessary to clarify the problem of ‘onceonly contact’ and to organize a proper psychiatric care.
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DiBenigno, Julia, and Michaela Kerrissey. "Structuring mental health support for frontline caregivers during COVID-19: lessons from organisational scholarship on unit-aligned support." BMJ Leader 4, no. 3 (June 2, 2020): 124–27. http://dx.doi.org/10.1136/leader-2020-000279.
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BackgroundAlthough the COVID-19 pandemic exposes frontline caregivers to severe prolonged stresses and trauma, there has been little clarity on how healthcare organisations can structure support to address these mental health needs. This article translates organisational scholarship on professionals working in organisations to elucidate why traditional approaches to supporting employee mental health, which often ask employees to seek assistance from centralised resources that separate mental health personnel from frontline units, may be insufficient under crisis conditions. We identify a critical but often overlooked aspect of employee mental health support: how frontline professionals respond to mental health services. In high-risk, high-pressure fields, frontline professionals may perceive mental health support as coming at the expense of urgent frontline work goals (ie, patient care) and as clashing with their central professional identities (ie, as expert, self-reliant ironmen/women).FindingsTo address these pervasive goal and identity conflicts in professional organisations, we translate the results of a multiyear research study examining the US Army’s efforts to transform its mental health support during the wars in Iraq and Afghanistan. We highlight parallels between providing support to frontline military units and frontline healthcare units during COVID-19 and surface implications for structuring mental health supports during a crisis. We describe how an intentional organisational design used by the US Army that assigned specific mental health personnel to frontline units helped to mitigate professional goal and identity conflicts by creating personalised relationships and contextualising mental health offerings.ConclusionAddressing frontline caregivers’ mental health needs is a vital part of health delivery organisations’ response to COVID-19, but without thoughtful organisational design, well-intentioned efforts may fall short. An approach that assigns individual mental health personnel to support specific frontline units may be particularly promising.
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Boast, Neil. "Forensic psychiatry – a tale of two systems." Psychiatric Bulletin 14, no. 12 (December 1990): 722–24. http://dx.doi.org/10.1192/pb.14.12.722.
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During registrar training I had the privilege of working in the interim secure unit at Friern Hospital in London. To gain further experience in the field of forensic psychiatry, I secured (if that is an appropriate term), a post as trainee psychiatrist at James Nash House, centre for forensic psychiatry, Adelaide, South Australia. This article compares the legal and health care frameworks in England and South Australia relevant to mentally abnormal offenders. The two units are described and differences in facilities, patient populations and working practices are discussed.
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LaMonica, Haley M., Tracey A. Davenport, Jane Burns, Shane Cross, Stephanie Hodson, Jennifer Veitch, and Ian B. Hickie. "Technology-Enabled Mental Health Service Reform for Open Arms – Veterans and Families Counselling: Participatory Design Study." JMIR Formative Research 3, no. 3 (September 19, 2019): e13662. http://dx.doi.org/10.2196/13662.
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Background The impact of mental ill-health on every aspect of the lives of a large number of Australian Defence Force (ADF) personnel, their partners, and their families is widely recognized. Recent Senate inquiries have highlighted gaps in service delivery as well as the need for service reform to ensure appropriate care options for individuals who are currently engaged with mental health and support services as well as for those who, for a variety of reasons, have not sought help. To that end, successive Australian governments generally and the Department of Veterans’ Affairs specifically have prioritized veteran-centric reform. Open Arms is an Australia-wide service that provides counseling and support to current and former ADF personnel, and their family members, for mental health conditions. Objective The aim of this study was to develop and configure a prototypic Web-based platform for Open Arms – Veterans & Families Counselling (formerly Veterans and Veterans Families Counselling Service) with the Open Arms community to enhance the quality of mental health services provided by Open Arms. Methods The study aimed to recruit up to 100 people from the Open Arms community (current and former ADF personnel and their families, health professionals, service managers, and administrators) in regions of New South Wales, including Sydney, Canberra, Maitland, Singleton, and Port Stephens. Participants were invited to participate in 4-hour participatory design workshops. A variety of methods were used within the workshops, including prompted discussion, review of working prototypes, creation of descriptive artifacts, and group-based development of user journeys. Results Seven participatory design workshops were held, including a total of 49 participants. Participants highlighted that the prototype has the potential to (1) provide the opportunity for greater and better-informed personal choice in relation to options for care based on the level of need and personal preferences; (2) ensure transparency in care by providing the individual with access to all of their personal health information; and (3) improve collaborative care and care continuity by allowing information to be shared securely with current and future providers. Conclusions Our findings highlight the value of actively engaging stakeholders in participatory design processes for the development and configuration of new technologies.
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Kim, Sunah, Wongyeong Lee, and Chaehyeon Kang. "A Survey on the Perception of Psychiatric Hospital Nurses on Patient Safety." Journal of Korean Academy of psychiatric and Mental Health Nursing 31, no. 4 (December 31, 2022): 448–57. http://dx.doi.org/10.12934/jkpmhn.2022.31.4.448.
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Purpose: The purpose of this study is to investigate the patient safety status and patient safety education contents and methods perceived by nurses working in psychiatric hospitals.Methods: Data were collected using a semi-structured questionnaire for psychiatric hospital nurses who had worked for more than one year. A total of 157 questionnaires were filled and were used for analysis using descriptive statistics. Open-ended questions about the contents and methods of patient safety education were classified by each researcher and a reclassification was conducted by consensus through discussions.Results: Overall, 142 nurses (90.4%) experienced patient safety accident during the previous 1 month. Among those who experienced a patient safety accident, profanity, violence, and aggression-related accident counted for the highest percentage (82.8%). The demand for education on workplace stress management and education on psychiatric medication were the highest. Required education methods included case-by-case education on patient safety accidents, regular and continuous education, and small-scale face-to-face education.Conclusion: In the future, it is necessary to actively utilize the results of this study as basic data for in-depth research on the causes of patient safety accidents, accident prevention, and the workload of nursing personnel.
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Looi, Jeffrey CL, Tarun Bastiampillai, William Pring, Stephen R. Kisely, and Stephen Allison. "Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes." Australasian Psychiatry 30, no. 2 (November 27, 2021): 174–78. http://dx.doi.org/10.1177/10398562211051252.
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Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals. Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015–2016 to 2019–2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network. Results: In 2019–2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019–2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years. Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care.
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Wood, Debra A., Debra A. Wood, and Philip M. Burgess. "Epidemiological Analysis of Electroconvulsive Therapy in Victoria, Australia." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 307–11. http://dx.doi.org/10.1046/j.1440-1614.2003.01182.x.
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Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998–1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age–sex specific utilization rates were calculated using this statutory data for the 1998–1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age–sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.
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Cronin, T., P. Gouda, C. McDonald, and B. Hallahan. "A comparison of mental health legislation in five developed countries: a narrative review." Irish Journal of Psychological Medicine 34, no. 4 (November 23, 2017): 261–69. http://dx.doi.org/10.1017/ipm.2017.48.
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ObjectivesTo describe similarities and differences in mental health legislation between five jurisdictions: the Republic of Ireland, England and Wales, Scotland, Ontario (Canada), and Victoria (Australia).MethodsAn in-depth examination was undertaken focussing on the process of involuntary admission, review of Admission Orders and the legal processes in relation to treatment in the absence of patient consent in each of the five jurisdictions of interest.ResultsAll jurisdictions permit the detention of a patient if they have a mental disorder although the definition of mental disorder varies between jurisdictions. Several additional differences exist between the five jurisdictions, including the duration of admission prior to independent review of involuntary detention and the role of supported decision making.ConclusionsAcross the five jurisdictions examined, largely similar procedures for admission, detention and treatment of involuntary patients are employed, reflecting adherence with international standards and incorporation of human rights-based principles. Differences exist in relation to the criteria to define mental disorder, the occurrence of automatic review hearings in a timely fashion after a patient is involuntarily admitted and the role for supported decision making under mental health legislation.
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Hazell, Philip, Titia Sprague, and Joanne Sharpe. "Psychiatric hospital treatment of children and adolescents in New South Wales, Australia: 12-year trends." BJPsych Open 2, no. 1 (January 2016): 1–5. http://dx.doi.org/10.1192/bjpo.bp.115.000794.
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BackgroundIt is preferable that children and adolescents requiring in-patient care for mental health problems are managed in age-appropriate facilities. To achieve this, nine specialist Child and Adolescent Mental Health Services (CAMHS) in-patient units have been commissioned in New South Wales (NSW) since 2002.AimsTo examine trends in child and adolescent in-patient admissions since the opening of these CAMHS units.MethodAnalysis of separation data for under 18-year-olds to CAMHS, adult mental health and paediatric units for the period 2002 to 2013 in NSW, comparing districts with and without specialist CAMHS units.ResultsSeparations from CAMHS, adult and paediatric units rose with time, but there was no interaction between time and health district type (with/without CAMHS unit). Five of eight health districts experienced increased separations of under 18-year-olds from adult units in the year of opening a CAMHS unit. Separations from related paediatric units increased in three of seven health districts.ConclusionsOpening CAMHS units may be followed by a temporary increase in separations of young people from adult units, but it does not influence the flow of patients to non-CAMHS facilities in the longer term.
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Dewa, Lindsay H., Kevin Murray, Bethan Thibaut, Sonny Christian Ramtale, Sheila Adam, Ara Darzi, and Stephanie Archer. "Identifying research priorities for patient safety in mental health: an international expert Delphi study." BMJ Open 8, no. 3 (March 2018): e021361. http://dx.doi.org/10.1136/bmjopen-2017-021361.
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ObjectivePhysical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health.DesignSemistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements.Setting and participantsAcademic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included.Main outcome measuresAgreement in research priorities on a five-point scale.ResultsSeventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important.ConclusionsThis is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.
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Cooper, A. J., and J. D. Mendonca. "A Prospective Study of Patient Assaults on Nursing Staff in a Psychogeriatric Unit." Canadian Journal of Psychiatry 34, no. 5 (June 1989): 399–404. http://dx.doi.org/10.1177/070674378903400507.
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A 27 month prospective study concerned with aspects of patient-nurse assaults on the geriatric unit (three wards) of a Canadian provincial mental hospital was conducted. The findings were compared with those for the other wards. The incidence of assaults was approximately the same in both areas (0.24–0.25 assaults/occupied bed/year respectively). In the former, the commonest diagnoses associated with assaultiveness were dementia followed by schizophrenia and in the rest of the hospital, schizophrenia. However, when base rates of assaultiveness were calculated allowing for the disproportionate number of patients with these conditions, mental retardation, and dementia were approximately twice as likely to be related to assaultiveness as schizophrenia; regardless of where the patients were located. In the geriatric unit attacks were more likely when patients were being physically guided or led and during the administration of drugs; elsewhere whilst physical restraints were being applied. In both hospital areas a comparatively small number of patients accounted for a disproportionate number of assaults and a few nurses were attacked repeatedly. The majority of episodes were trivial but in isolated cases personnel were off work for several months. The discussion focuses on the possibility of generalizing results.