Academic literature on the topic 'Psychiatric aides Training of Victoria'

Objective: The drug and alcohol related knowledge and attitudes of trainee psychiatrists were examined to obtain a baseline measure of these factors in order to determine whether current training is appropriate and adequate. Method: A questionnaire was distributed to trainees enrolled in the training program of the Royal Australian and New Zealand College of Psychiatrists in New South Wales, Victoria, Queensland and South Australia (N=425). Questions were asked relating to theoretical knowledge, diagnostic and problem solving skills for a number of drug groups; further questions concerned the respondents' attitudes and opinions on aspects of management. Results: Sixty per cent of recipients returned the questionnaire. Theoretical and applied knowledge levels were of an adequate standard overall, but highly variable. Notable areas of weakness included knowledge of opiates, barbiturates and stimulants. Trainees' views regarding treatment options were also variable. Alcoholics Anonymous was considered the best supported form of treatment from evidence from controlled trials. Low levels of self efficacy and little support were recognised for early intervention strategies. Conclusions: While positive views were generally expressed towards involvement with patients with alcohol and drug problems, specific strategies to enhance training and performance are needed. Findings are discussed in terms of continuing education. It is recommended that if sufficient training in this area is not provided then psychiatrists will have little confidence in appropriate therapeutic approaches in treating substance misusers.

Objective: In light of developments in training and service provision, the aim of the present study was to compare two state-wide surveys, undertaken in 1994 and in 2004, of psychiatrists about their perceptions of their training and psychiatric treatment of adults with intellectual disabilities who also have mental health needs. Methods: A 50-item self-administered questionnaire was developed for the 2004 survey, based on the 1994 study. This was sent to all 624 Fellows of the Royal Australian and New Zealand College of Psychiatry registered in Victoria at the time. A series of questions was asked based on workload, training, the role of psychiatry in intellectual disabilities, opinions on assessment and management, improving services, and the demographics of participant psychiatrists. Results of the 2004 survey are compared with the 1994 study. Results: There has been some change in psychiatrists’ opinions about acute admission wards, believing strongly that they do not meet the needs of the adults with severe intellectual disabilities, leaving them vulnerable to exploitation. There has been some improvement in their ability to adequately manage adults with intellectual disabilities who have mental health needs and/or problem behaviours. Conclusions: Mainstream mental health services fail to meet the needs of adults with intellectual disabilities. Improved specialist clinical services and more clinical training opportunities are required.

Background: The health care sector is one of the most rapidly growing industry sectors in the United States. This study examined differences in the rates and trends of violent occupational injuries among health care workers in the United States. Methods: This study used data about violent occupational injuries among health care workers in the United States collected by the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII). The BLS SOII collects data about injuries that result in at least one lost workday. Violent injuries are defined as intentional injury by another person. Data were obtained for years 2011 to 2017. We examined injury rates and trends according to industry and occupation, as well as age, sex, and race/ethnicity. Results: Intentional injuries increased among health care workers between 2011 and 2017. Rates, expressed as injuries per 10,000 workers, were particularly elevated in residential care facilities (44.07) and among health practitioner support technologists and technicians (22.54); nursing, psychiatric, and home health aides (28.13); and occupational therapy and physical therapist assistants and aides (39.72). Black health care support and practitioners workers had injury rates three times higher than White workers. Conclusions/Application to practice: Efforts should be made to address the increasing rates of intentional occupational injuries among health care workers. These efforts should focus on comprehensive programs enforcing policies for prevention and management (including reporting and training) and employee engagement in such efforts. High-rate industries and occupations should receive particular attention.

Objective: This study was undertaken to establish the perceptions of psychiatrists regarding the care of people with intellectual disabilities. Method: A 28-item self-administered questionnaire was developed, piloted and sent on two occasions to 467 psychiatrists who receive the newsletter of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists. The questionnaire incorporated a Likert scale to document the opinions of the respondents. Results: A response rate of 51.1 % was achieved. The respondents indicated that, in their opinion, people with intellectual disabilities receive a poor standard of care in the inpatient and community setting. To improve this situation, the following strategies were recommended: the development of improved liaison between services; improved training for all personnel who provide services to people with intellectual disabilities; the development of greater resources; and support for professionals working in the area. The study also indicates that there is a core group of very interested psychiatrists who are currently practising and that people with intellectual disabilities are accessing private psychiatric services. In addition, the results suggest that diagnostic overshadowing is not a major barrier to psychiatric assessment, and that disorders which were presumed to be commonly overlooked by doctors (such as depression) are in fact frequently being diagnosed. Conclusions: Despite some positive findings, the majority of psychiatrists who responded held major concerns about the situation of people with intellectual disabilities. To improve the care provided to these people, it is recommended that these concerns are addressed by the psychiatric profession and responsible government departments in conjunction with university departments of psychiatry.

Background and Objective: With an aging population, it has become increasingly important that nurses are equipped to provide appropriate psychogeriatric care. Patients with dementia are more likely of committing legal violations related to their behavioural and psychosocial symptoms. Thus, it is imperative that we explore how nursing staff can effectively manage psychogeriatric care in a forensic setting, in order to minimize stress and burnout of staff. Material and Methods: Three populations were explored with the context of dementia and the justice system: patients with dementia who enter the forensic system, aging inmates in corrections, and criminal offenders in long-term residential care. The literature suggests that there is a dilemma as to where this population is best managed as there are no appropriate designated psychiatric facilities for the elderly offenders. Four options for geriatric service enhancement will be explored: Provide Gentle Persuasive Approach (GPA) training to forensic staff; modification of existing policies and procedures to support appropriate geriatric care; implement the use of Psychiatric Care Aides in skill mix; and create a secure forensic unit for geriatric populations. Results: The recommendation for action is to implement education specific to psychogeriatric care, while also adjusting policies and procedures for a forensic centre to support therapeutic care. Conclusions: The author argues that further research is needed that will determine the design of a new Psychogeriatric Forensic Centre.

ABSTRACTObjective: to investigate the level of knowledge of nursing professionals on the psychiatric reform, related to its technical and scientific training and professional practice. Methods: exploratory and descriptive research with a qualitative approach, to be held in the Residential Therapeutic Service of the Municipal Health Secretariat of Caicó - RN. The study subjects will be the health professionals who are part of the nursing staff (6 aides and nursing technicians and 1 nurse), and the data will be obtained through a semistructured interview, split into three parts (characterization of the professional, professional training and interview guide). The interviews will be recorded in digital audio, respecting the ethical principles in research with humans, and later transcribed in full. The analysis will be mediated by Microsoft Excel Software (characterization and vocational training), and by the theoretical and methodological feature of the Theory of Social Representations, being created thematic categories. Expected results: it is attempted to provide tools for reflection and guidance of health professionals working in the Residential Therapeutic Service, facing the new redesign of business practices, after the Psychiatric Reform. It may also indicate ways to overcome and improve service to all municipal replacement network which provides mental health services. Descriptors: mental health services; nursing, team; psychiatric nursing; assisted living facilities. RESUMOObjetivo: investigar o nível de conhecimento dos profissionais de enfermagem sobre a reforma psiquiátrica, relacionado à sua formação técnico-científica e a sua prática profissional. Métodos: pesquisa de natureza exploratória e descritiva, com abordagem qualitativa, que será realizada no Serviço Residencial Terapêutico da Secretaria Municipal de Saúde de Caicó-RN. Os sujeitos de pesquisa serão os profissionais de saúde que integram a equipe de enfermagem (6 auxiliares/técnicos de enfermagem e 1 enfermeiro), e os dados obtidos através de uma entrevista semi-estruturada dividida em III partes (caracterização do profissional, formação do profissional e roteiro de entrevista). As entrevistas serão gravadas em áudio digital, respeitando-se os preceitos éticos na pesquisa com seres humanos, e posteriormente transcritas na íntegra. A análise será mediada pelo Software Microsoft Excel (caracterização e formação profissional), e pelo recurso Teórico-Metodológico da Teoria das Representações Sociais, sendo construídas categorias temáticas. Resultados esperados: intenta-se fornecer subsídios para a reflexão e orientação prática dos profissionais de saúde que atuam no Serviço Residencial Terapêutico, diante do novo redesenhar das práticas profissionais advindas da Reforma Psiquiátrica. Além disso, pode indicar caminhos de superação e melhoria no atendimento a toda rede substitutiva municipal que presta serviços de saúde mental. Descritores: serviços de saúde mental; equipe de enfermagem; enfermagem psiquiátrica; moradias assistidas. RESUMENObjetivo: investigar el nivel de conocimientos de los profesionales de enfermería sobre la Reforma Psiquiátrica, en relación con su formación técnica y científica y la práctica profesional. Método: estudio de investigación descriptiva, con enfoque cualitativo, que se realizará en el Servicio de Terapia Residencial de la Municipal de Salud en Caicó-RN. Los sujetos del estudio serán los profesionales de la salud que constituyen el equipo de enfermería (6 auxiliares/técnicos de enfermería y 1 enfermera), y los datos obtenidos a través de una entrevista semiestructurada dividida en 3 partes (caracterización del profesional, su graduación y la guía de entrevista). Las entrevistas serán grabadas en audio digital, respetando los principios éticos en la investigación con seres humanos, y posteriormente transcritas en su totalidad. El análisis será mediado por el Software Microsoft Excel (caracterización y graduación), y por el recurso teórico y metodológico de la Teoría de las Representaciones Sociales, siendo construidas categorías temáticas. Resultados esperados: se intenta proveer elementos para la reflexión y la orientación de los profesionales de salud que trabajan en el servicio de terapia residencial, frente al nuevo rediseño de las prácticas profesionales derivadas de la Reforma Psiquiátrica. Del mismo modo, eso puede indicar maneras para la superación y mejoramiento de la asistencia a toda la red municipal que presta servicios de salud mental. Descriptores: servicios de salud mental; grupo de enfermería; enfermería psiquiátrica; instituciones de vida asistida.

BackgroundA variety of peer worker roles are being introduced into the mental health workforce in England, in a range of organisational contexts and service delivery settings. The evidence base demonstrating the effectiveness of peer worker-based interventions is inconclusive and largely from outside England. An emerging qualitative literature points to a range of benefits, as well as challenges to introducing the peer worker role.AimsIn this study we aimed to test the international evidence base, and what is known generally about role adoption in public services, in a range of mental health services in England. We also aimed to develop organisational learning supporting the introduction of peer worker roles, identifying learning that was generic across mental health services and that which was specific to organisational contexts or service delivery settings.TeamThe research was undertaken by a team that comprised researchers from a range of academic and clinical disciplines, service user researchers, a peer worker, and managers and service providers in the NHS and voluntary sector. Service user researchers undertook the majority of the data collection and analysis. We adopted a coproduction approach to research, integrating the range of perspectives in the team to shape the research process and interpret our findings.Study designThe study employed a qualitative, comparative case study design. We developed a framework, based on existing evidence and the experiential insight of the team, which conceptualised the challenges and facilitators of introducing peer worker roles into mental health services. The framework was used to inform data collection and to enable comparisons between different organisational contexts, service delivery settings and the perspectives of different stakeholders.SettingsThe study took place in 10 contrasting cases comprising mental health NHS trusts, voluntary sector service providers and partnerships between the NHS and voluntary sector or social care providers. Peer workers were employed in a variety of roles, paid and unpaid, in psychiatric inpatient settings, community mental health services and black and minority ethnic (BME)-specific services.ParticipantsParticipants were 89 people involved in services employing peer workers, recruited purposively in approximately equal proportion from the following stakeholder groups: service users; peer workers; (non-peer) coworkers; line managers; strategic managers; and commissioners.Data collectionAll participants completed an interview that comprised structured and open-ended questions. Structured questions addressed a number of domains identified in the existing evidence as barriers to, or facilitators of, peer worker role adoption. Open-ended questions elicited detailed data about participants’ views and experiences of peer worker roles.Data analysisStructured data were analysed using basic statistics to explore patterns in implementation across cases. Detailed data were analysed using a framework approach to produce a set of analytical categories. Patterns emerging in the structured analysis informed an in-depth interrogation of the detailed data set, using NVivo 9 qualitative software (QSR International Pty Ltd, Victoria, Australia) to compare data between organisational contexts, service delivery settings and stakeholder groups. Preliminary findings were refined through discussion with a range of stakeholders at feedback workshops.FindingsMany of the facilitators of peer worker role adoption identified in the existing evidence base were also evident in mental health services in England, although there were issues around pay, leadership, shared understanding of the role, training and management where good practice was uneven. A number of examples of good practice were evident in the voluntary sector, where peer worker roles had been established for longer and organisations were more flexible. In the NHS there were a range of challenges around introducing peer worker roles into existing structures and cultures of practice. Peer workers were able to engage people with services by building relationships based on shared lived experience – the language they used was particularly important in BME-specific services – but barriers to engagement could be created where roles were overformalised.ConclusionsKey barriers to, and facilitators of, peer worker role adoption were identified, including valuing the differential knowledge and practice that peer workers brought to the role (especially around maintaining personally, rather than professionally defined boundaries); maintaining peer identity in a role of work; changing organisational structures to support peer workers to remain well in their work; and challenging organisational cultures to empower peer workers to use their lived experience. Recommendations for future research include developing a theoretical framework articulating the change mechanisms underpinning ‘what peer workers do’, piloting and formally evaluating the effectiveness and cost-effectiveness of peer worker interventions, and mixed-method research to better understand the impact of working as a peer worker.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Objectives: Virtual reality (VR) has emerged as a highly promising tool for assessing and treating a range of mental illnesses. However, little is known about the perspectives of key stakeholders in mental healthcare, whose support will be critical for its successful implementation into routine clinical practise. This study aimed to explore the perspectives of staff working in the private mental health sector around the use of therapeutic VR, including potential implementation barriers and facilitators.Methods: Semi-structured qualitative interviews were conducted with cross-disciplinary clinicians (n = 14) and service managers (n = 5), aged 28–70 years working in a major private mental health hospital in Victoria, Australia. Transcripts were analysed using general inductive coding to allow themes to naturally emerge.Results: Three major themes were identified: clinical factors (four subthemes), organisational factors (five subthemes), and professional factors (three subthemes). The themes encompassed enabling factors and potential barriers that need to be addressed for successful implementation of VR. Clinical factors highlighted the influence of knowledge or perceptions about appropriate clinical applications, therapeutic efficacy, safety and ethical concerns, and patient engagement. Organisational factors emphasised the importance of service contexts, including having a strong business case, stakeholder planning, recruitment of local opinion leaders to champion change, and an understanding of resourcing challenges. Professional factors highlighted the need for education and training for staff, and the influence of staff attitudes towards technology and perceived usability of VR.Conclusions: In addition to enabling factors, potential implementation barriers of therapeutic VR were identified, including resourcing constraints, safety and ethical concerns, negative staff attitudes towards technology and VR system limitations. Future dissemination should focus on addressing knowledge and skills gaps and attitudinal barriers through development of clinical guidelines, training programs, and implementation resources (e.g., adoption decision tools, consultation opportunities).