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Mental Disorders and Treatment

ISSN: 2471-271X

Open Access

Current Issue

Volume 6, Issue 3 (2020)

    Short Communication Pages: 1 - 2

    Euro Mental Health 2017- Exposure to Suicide at Work: How to Manage Incidents and Support Staff and Consumers- Cheryl Staal-Enhance Supervision and Training

    Cheryl Staal

    During the past two decades there has been a strong focus on suicide prevention, intervention and bereavement research. In Australia alone, over ten million dollars has been provided annually for suicide bereavement services. The impact of being exposed to suicide at work can be just as traumatizing as direct bereavement and have broad reaching, and sometimes lifelong implications. However, this issue and group have not been acknowledged, and there is a dearth of dedicated research or funded support. Suicide is commonly perceived as three slightly different concepts. Most common is a person taking their own life, whereas assisted suicide is when the person intentionally kills themselves with the assistance of another person who provides the knowledge or means to do so. Followed by euthanasia which in Australia is perceived as the deliberate, intentional act of one person to end the life of another person in order to relieve that persons suffering . According to Australia Bureau of Statistics there was an average daily rate of 8 suicide deaths during 2015 and 2016.

    Though the Australian StandBy support after suicide service is not targeted to staff exposed to suicide at work, its client support data validates this bread of exposure in the most common relationship of clients to the deceased being 23% partners, parents or other relatives, 13% worked with the deceased and 4% service providers. Furthermore, it is commonly presumed police or ambulance officers are first to arrive at the scene of a suicide. However, this is often not so. According to StandBy support after suicide data 27% of its clients in 2016, who were not emergency service staff had discovered the deceased

    As all senses are extremely heightened at the time of crisis, if the staff member experiences post-traumatic stress disorder a reoccurrence of those senses such as seeing blood or smelling the deceased’s cologne could trigger future reactions. Depending on the closeness of their relationship with the deceased this could also be associated with sudden temporary upsurges of grief – STUGS which exposed staff report are just as overwhelming as during the initial phase of grief

    Furthermore, the exposed staff member may have been a close friend of the deceased, and be the critical incident coordinator or investigator. In this instance they not only experience the trauma of finding their deceased colleague, but also having to maintain their professionalism until the incident has been dealt with. By postponing their grief and obtaining support, it could exacerbate issues for them. Interestingly Pitman, Osborn and Rantell’s  research found people directly bereaved by suicide are 80% more likely to drop out of work or education. One ponders what the dropout rate and ongoing implications are for those not only bereaved, but also directly exposed to suicide in other manners? When back at work the majority of those exposed also report they experiencing presenteeism. That is physically being there, but finding their mind wanders thinking about the deceased person or the scene they encountered. A poignant example is after the suicide of a fellow police officer, officers of various ranks commented “you’re expected to get on with things, even if we had been their best mate since the academy, 20 years ago, so we turned up for shift as usual but found it hard to keep our minds on the job

    Managing this type of critical incident in a workplace entails a myriad of aspects coupled with immediate, short and long term actions which are beyond the scope of this paper. However the author can provide further information and professional development on this topic. 4 suicide are resilient after a period of adjustment and may even experience post-traumatic growth

    Conclusion So from the above discussion it is evident that staff can be exposed to suicide at any work place. And there are some similarities between exposure related trauma and that of other precipitating traumatic events. Additionally the impact of exposure can be just as significant as bereavement depending on the type of exposure, the strength of the collegial relationship with the deceased and potential difficulty adjusting to the trauma or loss. With the breadth of exposure spanning various staff, across a team, a whole organization and its stakeholder. Further, there are also professional, organizational and environmental specific issues that should be considered. And the level of trauma experienced can be exacerbated through various interrelated issues such as not being death competent, role requirements when already traumatized, or a workplace culture resistant to help seeking. Therefore there is a significant need to acknowledge and research the impact of exposure to suicide at work.

    Note: This work is partly presented at 3rd International Conference on Mental Health and Human Resilience on June 21-23, 2017 held in London, UK

    Short Communication Pages: 1 - 3

    Euro Mental Health 2017- Patient-doctor concordance of perceived mental health service needs in Chinese hospitalized patients: a cross-sectional study- Zihan Liu, Mental Health Center of West China Hospital

    Zihan Liu

    The prevalence of emotional disorders is high among people who seek help from general medical services. In most international studies, the prevalence of depression and anxiety ranges from 3.6% to 13.1%. Co-morbid emotional problems such as depression and anxiety are associated with a decreased quality of life, impaired self-management behaviors, and a diminished perception of disease control in medical patients.

    Unfortunately, most of the patients with emotional problems are not properly treated. For example, an investigation of the Epidemiology of Mental Disorders (ESEMeD) of 21,400 adults from six European countries indicated that the lifetime prevalence of major depression was 13.4%, but only 4.6% of the depressive patients accepted antidepressants treatment.

    Moreover, we believe that a high concordance in the assessment of psychological needs rated by patients and medical staff is another important precondition for an adequate treatment of patients with depression or anxiety. However, it has been shown that doctor and patient attitudes relating to mental health services are not always consistent (19,20). Richards et al. reported that 37% and 12% of patients with psoriasis were identified as probable clinical cases for anxiety disorder and depression respectively. Dermatologists identified only 39% of the patients with significant psychological difficulties during the consultation. The level of concordance between patients’ ratings and dermatologists’ ratings regarding the presence of anxiety or depression was low (kappa values of 0.24 and 0.26 respectively)

    Methods

    Research design and sampling

    This cross-sectional survey was approved by the Ethics Committee of West China Hospital of Sichuan University and was conducted from October to November, 2013. Participants in this study were inpatients recruited from 10 voluntary departments (Oncology, Internal Cardiology, Respiratory Medicine, Rehabilitation, Geriatrics and Gerontology, General Practice, Pain Management, Rheumatology, Hepatic Surgery, and Thyroid and Breast Surgery) of West China Hospital, a major tertiary general hospital in Chengdu, China. All hospitalized patients of the listed departments were selected as potential participants

    Instruments and measures

    • Demographic questionnaire
    • Patient Health Questionnaire-9 (PHQ-9)
    • Generalized Anxiety Disorder 7-item scale (GAD-7)
    • Investigation of patients’ mental health service needs
    • Doctors’ evaluation of patients’ mental health service needs
    • Interviewing and data collection
    • Ethical
    • Data analysis

    Results

    Participants

    From the 1,662 hospitalized patients which could be approached at the 10 departments that day, 151 patients were excluded based on the exclusion criteria. Among the included 1,511 hospitalized patients, 149 patients refused to participate in the study with “lack of time” and “not interested” as the most common reasons; 89 participants were excluded because their doctors did not respond. The overall response rate was 84.25% and the final sample consisted of 1,273 participants. The sociodemographic characteristics of the study group. The mean (SD) age was 53.1±16.3 years; 58.37% of the sample were men (n=743).

    Discussion

    The ability to recognize emotional problems is believed to be one of the most important influencing factors for the proper treatment of patients with depression or anxiety. Unfortunately, patients’ and doctors’ ability to recognize distress is poor.

    In this study, only 59.56% of patients with significant depression or anxiety indicated their need for psychological help. The result was similar to the results of a study from Seekles [2012] who found that just over half of patients had needs for mental health services (55.3%) (15). Prins et al. conducted a systematic review including 71 studies and found that only 49% to 84% of the patients with depression or anxiety perceived the need for treatment 

    Discussion of the patients’ emotional problems requires time, good communication skills and sufficient knowledge about emotional problems in patients. Most of the doctors did not have the skills or expertise to deal with these problems.

     

    Moreover, medical staff may refer patients for psychiatric evaluation only when the problems become acute. McDonald et al. reported that when patients had obvious symptoms, such as crying and a depressed mood, the detection of psychological needs by staff was higher.

    The concordance between doctors’ and patients’ perception of psychological needs was low (kappa =0.055). The concordance between patients and doctors on perceived needs for psychological services has not been broadly studied before. Therefore, it is difficult to compare our results with previous research. Richards conducted a study on patients with psoriasis and found that the level of concordance between patients’ and dermatologists’ rating for the presence of anxiety or depression was also low (kappa values of 0.24 and 0.26).

    Logistic regression was used to find potential influencing factors of the concordance rate. However, only the wards in which the patients were treated at the time of the investigation could be identified as a reason for the discordance and this result might be not persuasive because of the low ratio (6.21%) of surgical patients. In the next study, the ward of the patient should be reasonably included and the number of surgical patients might be increased.

    Conclusion

    In this paper, we explored the concordance between Chinese patients’ perception of their own mental needs and the corresponding evaluation by doctors in charge of these inpatients. This concordance is believed to be an important factor to guarantee timely and adequate treatment. However, the concordance in this study was very low (kappa =0.055), even in patients with depression and anxiety, which is a severe problem on inpatients’ mental health. Therefore, in the future, we hope to shed some light on this topic by studying potential effective strategies to prompt this process, such as the raising of doctors’ awareness, the use of screening-instruments, and the training of health professionals.

     

    Note: This work is partly presented at 3rd International Conference on Mental Health and Human Resilience on June 21-23, 2017 held in London, UK

     

    Volume 6, Issue 4 (2020)

      Short Communication Pages: 1 - 2

      Mental Health 2017- The Influence of Music with Children at Risk in a Hospital Context: Music Therapy Program at the Hospital La Paz from Madrid (Spain)- MarÝa Jes˙s del Olmo- Autonoma University

      Mar├şa Jes├║s Del Olmo Barros and Lorenzo Alicia

      Aim: the rate of postural puncture headache (PDPH) was associated after caesarean section with spinal anaesthesia consuming the 25 gauge spinal hand with the 27 gauge.

      Methods: present study is a randomized scientific trial and 220 full term women arrived for caesarean section. We entered full term women casually for spinal anesthesia with the 25 gauge (group A) and 27 gauge (group B) Quincke spinal needles. In 3 postoperative days, we prepared and compared Participants in 2 groups for the rate and severity of PDPH. PDPH was defined occipital or frontal headache that made hard the position on session or vertical.

      Results: Data of 220 patients were analyzed. The rate of PDPH was significantly higher in women in group A compared to group B at first (P=0.015), second (P=0.037) and third (P=0.005) follow up days. The severity of the PDPH was not significantly different between 2 groups in three follow up days. The rate of achievement in spinal anesthesia success was not significantly different between 2 groups.

      Conclusion: The consequences of present study recommended that the size of spinal needle can effect on the rate of PDPH after caesarean subdivision.

      Introduction

      Since May 2002, a Music Therapy Programme has been going on at the Children’s Hospital La Paz in Madrid. The idea of counting music therapy in hospitals is nothing new. There are different programmes of music therapy in hospitals in numerous European countries such as Germany, UK, Denmark, France, etc., as well as in the United States, maintained by university degree programmes where specific training in music therapy is provided. In Spain there has been a fast growth in this area helped by a number of training programmes in Music Therapy, like the Master in Advanced Music Therapy offered at Autonoma University in Madrid, as well as those offered by other colleges and universities catering to professionals in the fields of health, music, psychology, and education, among others. The welcome of this Music Therapy Programme by the hospital community at the Children’s Hospital La Paz has been strange from the very first day. The host of the music therapy program at Children’s hospital was fantastic from day one. The healing use of music as an influence on the physical, psychological and/or expressive states of patients before, during or after medical treatment, as well as the non-verbal nature of music makes it a worldwide means of communication.

      Description of the Intervention in Pediatrics

      In music therapy sessions patients are by the medical and nursing team of each unit complicated. A registration form is presented to the staff with questions about the desirable objectives of music therapy. The medical and nursing specialists point out what those goals should be. For example: Relaxation; Activation; Distraction to a cure; Mitigation of pain; Material about the patient’s emotional state, etc. Next the musical decisions about how to intervene with the various instruments and voice are taken: rhythm; accent, tonality, harmony, etc., and how to involve the patient with the music. Annually, the Music Therapy Programme taking place at La Paz Hospital in Madrid indulgences a total of 970 pediatric patients among the morning and the afternoon shifts, with 6 music therapists who are volunteers from the Music Therapy and Health Foundation

      Description of the Intervention in Adults: Unit of Pain and Palliative Care MT has been applied in the hospital setting with adults and more specifically in the “Units of pain” for several decades. Many composition therapists from various countries have already reported interesting results that provision the practice of this discipline in the clinic setting and patients with this profile. Alonso-Cardaño et al., related to decreased pain, Brown, in terms of increased communication, Nakayama et al.,  in terms of stress reduction Lorenzo cited in Mercadall et al. about the standing of emotional appearance.

      The main objectives in this area are

       • Create a well-being environment

      • Encourage connection with oneself and the family

      • Provide emotional expression

      • Make contact with your emotions and learn to express them

      • Facilitate the process of taking responsibility in the healing process

      • Develop acceptance, flexibility, creativity and sense of humor

      • Increase your self-esteem

      Conclusion

      The Music Therapy and Health Foundation is helping this Music Therapy Plan to consolidate itself day by day in the hospital, providing the Music Therapy experts who carry out both the direct care and the devoted research. Chief among the overall aims of the Foundation are: to grow direct care in Music Therapy in the health, schooling and social fields, as well as to promote research in these fields, both nationwide and internationally. It is indisputable that having foundations and companies that support Music Therapy sequencers in both direct care and research is key to the development of this profession, shown to be essential in a hospital context where not only physical but also emotional and psychological needs are met. It has been influentially proven that they will have a straight repercussion in the well-being of the patient both inside and outside the hospital.

      Music potential is immense and we all respond to it, beyond the music and sounds of our philosophy. So it is our main tool of treatment. The Music Therapy and Health Foundation offers music therapy professionals to contribution those people who need to “retune” some aspect of their lives. Music Therapy is a “sound process” which can help us attach with our emotions, give us relaxation, increase our attention and sense of wellbeing, improve creativity, develop motor and cognitive skills, build self-confidence, raise the vital tone, among its many useful contributions. If direct attention in Music Therapy in the health, education and social fields, as well as endorsing research in these fields, both nationally and globally, is our utmost motivation to continue every day taking music therapy anywhere is desirable.

      Note: This work is partly presented at 3rd International Conference on Mental Health and Human Resilience on June 21-23, 2017 held in London, UK

      Short Communication Pages: 1 - 2

      Euro Mental Health 2017- Men???s recovery from schizophrenia in northern Nigeria- Bello Utoblo- Leeds Beckett University

      Bello Utoblo

      Schizophreniais a chronic and severe mental health difficulty that affects over twenty-one million people worldwide. In Nigeria, it is predictable that there are more men than women existing  with  schizophrenia. Though,  there  havebeen  studies  on  men  and  healthin Nigeria,  these have focusedon  sexual health  or  strength. In contrast, men’s involvement of schizophrenia, and the role of gender in manipulating their beliefs about retrieval has not been voyaged.

      The aim of thisqualitative study was to explore the factors influencing men’s recovery from schizophrenia in northern Nigeria.

      Thirty male outpatients aged between 18 and 65 and ten mental health practitioners (psychiatrists and nurses) were purposively sampled and recruited finished Nigerian psychiatric hospital outpatient clinics.  Data were collected using separate interviews, and analysed through Braun and Clarke’s (2006) analytical framework. Results: The findings recommend that participants identified three themes on recovery from mental illness: western medicine, traditional medicine, and family support. Whilst, western medication aided relief of symptoms related with schizophrenia, costs and side effects of these medications hindered their utilisation. The participants’ also highlight the significance of religion to recovery, premised on the confidence that God is a naturopath, therefore the data suggests that many endowed the agency of their recovery to God. Alongside these, the role of family support was vital in easing participants’ links to healthcare. Cross cutting these themes is the notion of gender flexibility. Traditional masculinity expectations of being the head of the household involves  stressful  challenges  that  can  increase  the  threat  of  emerging  schizophrenia. In contrast, the presence   of   gender   elasticity   within   household   members,   where   their contributions changed over time, were seen as manipulating the men’s ability to become involved in  salvage.  In particular, providing for the family wants becomes a shared accountability, where the departure from traditional gender imposes fewer family adversities, thus aiding the men’s willingness to seek help, which rolls over to their retrieval.

      1 Introduction

       In provide  the justification for  conducting  this  study. I begin by providing a meaning of schizophrenia and some data about its occurrence. In furthering discussion about the nature of schizophrenia, I highlight the impact of mental health problems on the individual and  the  burden  of  care  among  families  of service users’ with mental  health  difficult. I then introduce the current research gaps in relation to the people who use facilities ‘perceptions and experiences of schizophrenia and the role of gender inside this. In the last part of this chapter, the organisation and structure of the thesis is drew.

      Background to this qualitative study

      The  Diagnostic  and  Statistical  Manual  of  Mental  Disorders-DSM  5(American  Psychiatric Association,   2013)   and   the International   Classification   of   Illnesses (World   Health Organisation,  2010),the main controllers used  by  health  professionals to  aid diagnosis of schizophrenia,  highlight  schizophrenias  a  severe  mental health  problem, considered by symptoms and changes in the behaviour of the discrete. In one study of 1,080 patients,Baueret al. (2011)suggests that people with schizophrenia can presentation symptoms such as hearing or seeing things that are not there (hallucinations) or have false beliefs (delusions) that are external of  reality  and not  experienced  by  others. Morrison (2014) also linked wandering or roaming the streets and sleeplessness with onset of the disorder.

      It is perhaps understandable to focus on the men’s perceptions and experiences of schizophrenia and role of gender within this. Besides,  some  studies  in Africa, such as those carried out by Jewkes and Morrell(2010)and Odimegwu andOkemgbo (2008) have optional that traditional notions of masculinity, has an influence on sexual health risks such as vulnerability to obtaining HIV/AIDS and health programs have been intended to address issues beneficial to these men and their associates. In contrast, there is a notable lack of

      6research on understanding of the role of gender and its impact on service users’ insights and involvements of schizophrenia

      Aim of the research the aim of this qualitative study was to explore the factors that influence men’s recovery after schizophrenia in northern Nigeria.

      Research questions

      The two research questions in this study are:

      (1)What are perceptions and experiences of developing schizophrenia in Nigeria? 

      (2)What factors influence recovery from schizophrenia in Nigeria? Objectives of the research

      The specific objectives of this study are:

      (1)To explore the perceptions and experiences about the causes of schizophrenia.

      (2)To examine the meanings of recovery.

      (3)To understand influences on men’s recovery.

      Structure of the thesis

      In the body of this thesis, I explore involvements of developing schizophrenia and the factors that influence patients’ recovery from the condition in northern Nigeria.  The overall structure of the thesis including the introductory chapter takes the form of nine chapters. In chapter two, a literature review on conceptual issues of genders presented. The first part presents discussions on the meanings of  gender.  The  second  part  of  this  episode  focuses  on concepts  of  masculine  expectations,  which  highlights how gender  is  practised  in  the  family including marriage  and effort.  The third part, discusses men’s changing identity in modern Africa.  This  includes a discussion  on  post-colonialism  in  Nigeria, and  the belongings  of  the changing economic  condition and  introduction  of  gender  polices. In the  last  section of  this chapter, the literature and related discussion focuses on the influence of gender on men’s health. Chapter three presents a literature review and conceptual discussion relating to schizophrenia and its retrieval. The first part presents approaches that have been employed in the diagnosis of  schizophrenia and the load  associated  with  onset  of  the  disorder. 

      Conclusion: The influence of gender flexibility established in this study has implications for understanding the origins of schizophrenia and its repossession. This includes the need for gender educational awareness programmes for the  men  and  those  involved  in their  care.  Future study is needed to explore in more factor how the conceptualisation of gender influences on men’s mental health within the Nigerian and broader African context.

      Note: This work is partly presented at 3rd International Conference on Mental Health and Human Resilience  on June 21-23, 2017 held in London, UK

       

      Short Communication Pages: 1 - 2

      Euro Mental Health 2017- Improving Outcomes for Criminal Offenders with Serious Mental Illness- Lorena Fulton- Ohio University Zanesville

      Lorena Fulton

      This qualitative study used an action research design and an appreciative inquiry methodology. The key purpose of this study was to innovate collaborative processes between the Mental Health Court and mental health service providers as they work together to design new strategies to reduce recidivism among adult offenders with serious mental illness. This study followed a pragmatic approach that allowed for evolving assumptions about the causes that influence the outcomes. The stakeholders in this study were legal professionals and mental health service providers. Individual interviews, focus groups, and a survey were used to explore effective ways to help offenders with serious mental illness to coexist successfully in the community and avoid further incarceration. The outcome of this research was an improvement in collaboration between stakeholders to ensure successful transition from jail to the community, for offenders with serious mental illness. This collaboration removed barriers to avoiding recidivism and re-incarceration among adults with serious mental illness and improved policy and procedure followed by the mental health service providers and court professionals.

      1. Introduction

      The purpose of this appreciative inquiry project was to innovate collaborative processes between the Mental Health Court (MHC) and mental health service providers, particularly as they work together to design new strategies to reduce recidivism among adult offenders with serious mental illness. The study objective was to reduce recidivism among criminal offenders with serious mental illness. The study included legal professionals and mental health service providers. A survey, individual interviews, and focus groups were used to explore effective ways to help offenders with serious mental illness to coexist successfully in the community and avoid further incarceration. This study was prompted by observations from a community prisoner review team that found people with serious mental illness often struggle more than their counterparts to overcome legal involvement and chronic incarceration. The results from this study will be useful to improve outcomes for offenders with serious mental illness.

      3. Methodology

      The purpose of this study was to reduce recidivism through improving outpatient mental health service delivery for criminal offenders with serious mental illness. The courts also have a responsibility to advocate for this vulnerable population. This appreciative inquiry led to better collaboration between the legal system and the mental health service system. Participating stakeholders included attorneys, city police supervisors, and mental health service providers. The desired outcome of this research was to increase engagement in outpatient services so that defendants will spend more time in the community and less time incarcerated.

       

      The data collection and analysis process was designed to analyze information in the interest of creating a strategy for positive change with respect to improving collaboration between the legal and mental health service systems on behalf of offenders with serious mental illness

      Instruments

      A Likert-scaled survey titled “What are mental health service providers’ perceptions of how the county Mental Health Court can increase engagement in outpatient services so that defendants will spend more time in the community and less time incarcerated” was developed (Appendix A). According to Stringer and Dwyer [18], interviews and focus groups are effective tools, as they were primary entry points into an action research process, and because they help to support the research group’s focus on inclusion and problem solving strategies by those most affected by an issue.

      Results and Discussion

      The key purpose of this study was to reduce recidivism through a process of collaboration between the MHC and mental health service providers as they work together to design new strategies to reduce recidivism among adult offenders with serious mental illness. This study followed a pragmatic approach that allowed for evolving assumptions about the causes that influence the outcomes. Through brainstorming and sharing “big ideas,” this study applies AI to help facilitate improved processes that will help offenders with serious mental illness to avoid frequent incarceration. Legal professionals, mental health service providers, and professionals from the Adult Probation department were utilized as stakeholders. Individual interviews, focus groups, and a survey in an AI were utilized to explore effective ways to help offenders with serious mental illness to coexist successfully in the community and avoid further incarceration

      Summary of the Results

      Through the use of the survey, focus was improved for the individual interviews and focus group meetings. The survey helped to define perceptions about strengths and limitations associated with collaboration between the mental health service delivery and the legal system (Appendix A). The individual interviews helped to develop three broad themes around recidivism and the mental health system, and the focus groups helped move the analysis through an action research approach to action planning. There was general agreement in previous research [3,4,6] that offenders with serious mental illness find it more difficult to navigate the criminal justice system and that coordination between the outpatient mental health services and the judicial systems help to reduce recidivism rates among this population

      Conclusions

      The intent of the study was to increase collaboration between the two systems so that expectations placed on the defendant are consistent between the judicial and mental health treatment plans. The study validated the assumption that collaboration between the systems results in a united approach to reducing community crime and improving the quality of life for offenders with serious mental illness. Results of this project include action steps for this community to increase knowledge of other system goals, roles, and responsibilities and to combine individual case and system-to-system collaboration in the interest of duplicable and sustainable collaboration that improves outcomes for individuals and communities.

      Note: This work is partly presented at 3rd International Conference on Mental Health and Human Resilience on June 21-23, 2017 held in London, UK

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