Clinical Social Work Journal, 49(3), 2021, pp.356-367.
Publisher:
Springer
Place of publication:
New York
The re-emergence of therapeutic uses for mind-altering, psychedelic drugs has brought the field of mental health to a new frontier in research, practice, and policymaking. In the past two decades dozens of clinical trials investigating therapeutic applications of psychedelics—including MDMA, psilocybin, and ketamine—have shown promising results in the treatment of trauma-related disorders, some forms of anxiety, and depression. These substances have also garnered preliminary support from the Food and Drug Administration, which has fast-tracked their development. As the field of psychedelic science continues to grow, a serious consideration of these novel treatments in the context of social work practice and values is imperative. This paper offers a brief overview of MDMA-, psilocybin-, and ketamine-assisted treatments, and presents an initial discussion of questions pertinent to social work practice raised by their use, including: safety, efficacy, theory of change, training needs, and social justice considerations.
The re-emergence of therapeutic uses for mind-altering, psychedelic drugs has brought the field of mental health to a new frontier in research, practice, and policymaking. In the past two decades dozens of clinical trials investigating therapeutic applications of psychedelics—including MDMA, psilocybin, and ketamine—have shown promising results in the treatment of trauma-related disorders, some forms of anxiety, and depression. These substances have also garnered preliminary support from the Food and Drug Administration, which has fast-tracked their development. As the field of psychedelic science continues to grow, a serious consideration of these novel treatments in the context of social work practice and values is imperative. This paper offers a brief overview of MDMA-, psilocybin-, and ketamine-assisted treatments, and presents an initial discussion of questions pertinent to social work practice raised by their use, including: safety, efficacy, theory of change, training needs, and social justice considerations.
Subject terms:
social work, medication, drug prescription, mental health care, mental health problems;
The use of psychotropic medications in children in the US has increased over the past 2 decades, and research has shown significantly greater usage among child welfare-involved children. In this article the authors explore factors that may contribute to this higher incidence of psychotropic medication usage and discuss unintended negative consequences for foster children and the public health system. The section on contributing factors covers biological vulnerability of foster children, psychosocial factors, fragmented assessment practices, the role of the foster parent, health insurance reimbursement, reactive rather than prevention-based practice, the role of pharmaceutical companies, and community mental health and child welfare. The discussion about consequences considers the health of the child, impact on mental health systems and professionals, and economics. The authors make proposals for addressing the issue of psychotropic medication use in foster children, including approaching it as a multisystem problem and instituting guidelines for a prevention-based biopsychosocial medical and mental health assessment of all children in the child welfare system.
The use of psychotropic medications in children in the US has increased over the past 2 decades, and research has shown significantly greater usage among child welfare-involved children. In this article the authors explore factors that may contribute to this higher incidence of psychotropic medication usage and discuss unintended negative consequences for foster children and the public health system. The section on contributing factors covers biological vulnerability of foster children, psychosocial factors, fragmented assessment practices, the role of the foster parent, health insurance reimbursement, reactive rather than prevention-based practice, the role of pharmaceutical companies, and community mental health and child welfare. The discussion about consequences considers the health of the child, impact on mental health systems and professionals, and economics. The authors make proposals for addressing the issue of psychotropic medication use in foster children, including approaching it as a multisystem problem and instituting guidelines for a prevention-based biopsychosocial medical and mental health assessment of all children in the child welfare system.
Subject terms:
medication, mental health care, mental health problems, public health, child protection, foster children;
This new handbook explains the science behind nutrition and its effects on mental health, in a clear, accessible way. It explores: the complex and dynamic relationship between mental health, diet and nutrition, and how mental health and mental illness related factors, dietary factors and other social, biological and environmental factors interact to affect mental well-being. Leading health practitioners have contributed their own valuable insights, experiences and nutritional strategies to create an informed, up-to-date and fully referenced resource. The Nutrition and Mental Health handbook offers all those working in the mental health sector advice and support on using nutritional approaches to improve the lives of people who are experiencing mental health problems. It is presented in a clear, understandable format, with a glossary and summary chapter, designed to be useful for those with little previous nutritional knowledge, as well as more experienced practitioners, carers and health care practitioners. Vital information for: carers, trainers, managers and professionals working within mental health both in social and health care fields within the public, private and voluntary sectors.
This new handbook explains the science behind nutrition and its effects on mental health, in a clear, accessible way. It explores: the complex and dynamic relationship between mental health, diet and nutrition, and how mental health and mental illness related factors, dietary factors and other social, biological and environmental factors interact to affect mental well-being. Leading health practitioners have contributed their own valuable insights, experiences and nutritional strategies to create an informed, up-to-date and fully referenced resource. The Nutrition and Mental Health handbook offers all those working in the mental health sector advice and support on using nutritional approaches to improve the lives of people who are experiencing mental health problems. It is presented in a clear, understandable format, with a glossary and summary chapter, designed to be useful for those with little previous nutritional knowledge, as well as more experienced practitioners, carers and health care practitioners. Vital information for: carers, trainers, managers and professionals working within mental health both in social and health care fields within the public, private and voluntary sectors.
Subject terms:
medication, mental health care, mental health problems, nutrition, self care, complementary therapies;
Children and Youth Services Review, 66, 2016, pp.9-17.
Publisher:
Elsevier
Background and objective: Children in the welfare system are prone to uncoordinated and unmonitored mental health care, including psychotropic medications. To address these issues, federal legislation mandated that state child welfare agencies improve the coordination and oversight of psychotropic medications. However, there is no clear guidance on how to improve these practices, particularly at the level of direct care. The authors aimed to identify specific areas for improvement through state-wide surveys of four groups.
Methods: The authors surveyed all known members of four groups working directly with children in foster care in one small northeastern state. Respondents included 209 foster and adoptive parents, 169 child welfare staff, 84 mental health therapists, and 33 clinical prescribers. Survey items addressed practices and perceptions related to sharing of information and cross-system communication and monitoring of medication effects and side effects.
Results: Nearly two in five foster and adoptive parents reported not regularly receiving information about the purpose or side effects of psychotropic medications, and they disagreed among themselves on who was primarily responsible for monitoring safety and effectiveness. One-third of child welfare staff and two-thirds of mental health therapists reported that information about psychotropic medications is not regularly shared with the child's provider team. Half of clinical prescribers reported not regularly communicating with child welfare staff.
Conclusions: The authors identified specific areas for improvement related to communication, sharing of information, monitoring, and role clarification. Strategies to improving these activities are key to ensuring the safe and effective use of psychotropic medications in this population.
(Edited publisher abstract)
Background and objective: Children in the welfare system are prone to uncoordinated and unmonitored mental health care, including psychotropic medications. To address these issues, federal legislation mandated that state child welfare agencies improve the coordination and oversight of psychotropic medications. However, there is no clear guidance on how to improve these practices, particularly at the level of direct care. The authors aimed to identify specific areas for improvement through state-wide surveys of four groups.
Methods: The authors surveyed all known members of four groups working directly with children in foster care in one small northeastern state. Respondents included 209 foster and adoptive parents, 169 child welfare staff, 84 mental health therapists, and 33 clinical prescribers. Survey items addressed practices and perceptions related to sharing of information and cross-system communication and monitoring of medication effects and side effects.
Results: Nearly two in five foster and adoptive parents reported not regularly receiving information about the purpose or side effects of psychotropic medications, and they disagreed among themselves on who was primarily responsible for monitoring safety and effectiveness. One-third of child welfare staff and two-thirds of mental health therapists reported that information about psychotropic medications is not regularly shared with the child's provider team. Half of clinical prescribers reported not regularly communicating with child welfare staff.
Conclusions: The authors identified specific areas for improvement related to communication, sharing of information, monitoring, and role clarification. Strategies to improving these activities are key to ensuring the safe and effective use of psychotropic medications in this population.
(Edited publisher abstract)
Subject terms:
medication, looked after children, mental health problems, monitoring, mental health care, foster children, information sharing, communication, childrens social care;
Journal of Mental Health, 19(5), October 2010, pp.470-474.
Publisher:
Taylor and Francis
Place of publication:
London
The proportion of referrals who self-reported sub-optimal adherence among 172 referrals to a crisis resolution home treatment (CHRT) service in the North East of England were examined. The study also investigated whether non-adherence was associated with greater likelihood of admission rather than community treatment. The Tablet Routines Questionnaire was used to quantify medication adherence patterns for the month prior to presentation to the CHRT service. Thirty percent of subjects reported suboptimal adherence to prescribed psychotropic medications (less than 70% adherence) in the month prior to the CHRT assessment. These individuals were significantly more likely to have a dual diagnosis and assessment was significantly more likely to be followed by admission. Non-adherence remained a significant predictor of admission when the odds were adjusted for confounders. The authors conclude that clinicians need to proactively identify and manage non-adherence as it is a potentially preventable trigger of relapse often present for months prior to the index crisis referral. Non-adherence is a meaningful target for improving clinical and cost-effectiveness of general adult mental health services.
The proportion of referrals who self-reported sub-optimal adherence among 172 referrals to a crisis resolution home treatment (CHRT) service in the North East of England were examined. The study also investigated whether non-adherence was associated with greater likelihood of admission rather than community treatment. The Tablet Routines Questionnaire was used to quantify medication adherence patterns for the month prior to presentation to the CHRT service. Thirty percent of subjects reported suboptimal adherence to prescribed psychotropic medications (less than 70% adherence) in the month prior to the CHRT assessment. These individuals were significantly more likely to have a dual diagnosis and assessment was significantly more likely to be followed by admission. Non-adherence remained a significant predictor of admission when the odds were adjusted for confounders. The authors conclude that clinicians need to proactively identify and manage non-adherence as it is a potentially preventable trigger of relapse often present for months prior to the index crisis referral. Non-adherence is a meaningful target for improving clinical and cost-effectiveness of general adult mental health services.
Subject terms:
medication, mental health care, mental health problems, hospital admission, risk, treatment compliance, crisis resolution, dual diagnosis;
This book examines the consequences of long-term psychiatric drug use from the perspectives of people who have taken them. It begins with an overview of the place of drug treatments in mental health services, introducing the drugs most commonly used in psychiatry and looking at current guidance, how current practice diverges from these guidelines, and criticisms of the guidelines. Drawing on surveys from the UK it looks at key issues from the perspective of people who have taken psychiatric drugs, including effects on people's lives, issues about psychiatric drugs for people in black and minority ethnic communities, and the stages of coming off or attempting to come off psychiatric drugs. It examines the Coping with Coming Off (CWCO) research project and its findings about people’s reasons for trying to come off drugs and their experience, including factors influencing success, what support people received, and tension between doctors and patients about whether they should stay on their medication. Finally, it draws conclusions and makes suggestions for improving practice.
This book examines the consequences of long-term psychiatric drug use from the perspectives of people who have taken them. It begins with an overview of the place of drug treatments in mental health services, introducing the drugs most commonly used in psychiatry and looking at current guidance, how current practice diverges from these guidelines, and criticisms of the guidelines. Drawing on surveys from the UK it looks at key issues from the perspective of people who have taken psychiatric drugs, including effects on people's lives, issues about psychiatric drugs for people in black and minority ethnic communities, and the stages of coming off or attempting to come off psychiatric drugs. It examines the Coping with Coming Off (CWCO) research project and its findings about people’s reasons for trying to come off drugs and their experience, including factors influencing success, what support people received, and tension between doctors and patients about whether they should stay on their medication. Finally, it draws conclusions and makes suggestions for improving practice.
Subject terms:
medication, mental health care, mental health problems, psychiatric care, service users, user views, black and minority ethnic people, drug prescription;
This book is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health. The booklet covers the following topics: mental health problems; commonly prescribed medication for mental health; mental health services - what do they do?; drug use and mental health - dual diagnosis; roles of the drug worker - responding to drugs and mental health issues; and summaries of mental health law, standards and guidance.
This book is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health. The booklet covers the following topics: mental health problems; commonly prescribed medication for mental health; mental health services - what do they do?; drug use and mental health - dual diagnosis; roles of the drug worker - responding to drugs and mental health issues; and summaries of mental health law, standards and guidance.
Extended abstract:
Author
VOSE Colin
Title
Mental health and drugs: a drug workers' guide to working with service users who have a mental illness
Publisher
HIT, 2005
Summary
This booklet is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health.
Context
There is increasing concern about the link between drug use and mental health problems. People with drug problems are more likely than the rest of the population to have mental health problems, and people with mental health problems are more likely to have drug problems. Mental health and drug services have gaps in service provision and knowledge with the result that many individuals with both problems find themselves being passed between services, each service claiming it is ill-equipped to respond to the combination of drug dependence and mental illness.
Contents
The booklet seeks to provide drug workers with a sufficient knowledge base about mental health problems to ensure they can recognise and assess mental health problems in the client group and liaise with and work alongside mental health services to deliver effective care. The introduction outlines the extent and nature of illicit drug use in the UK ; use by young people and the general population; effects, risks and harms; and the pattern of drug use. Section 1 explains mental health problems, with sections on neurosis, depression, anxiety states, insomnia, eating disorders, post-traumatic stress disorder, personality disorder, psychosis, organic psychosis, functional psychosis, hallucinations, delusions, schizophrenia, psychosis and mania, schizoid-affective disorder, bipolar disorders, suicide, diagnosing mental health problems, early diagnosis of psychosis, and the cost of mental illness. Section 2 describes commonly-prescribed medication for mental illness: anti-psychotics, anti-depressants, and minor tranquillisers and sleeping tablets, and interactions between prescribed and abused medication. It also states there is more to treating mental illness than medication, and discusses the drug worker's paradox: his or her aim is to reduce harmful drug use; the mental health worker's role is often to encourage them to take their prescribed drugs. Section 3 explains what mental health services do, outlining primary and secondary care, the community mental health team, assertive outreach, crisis resolution and the home treatment team, the early intervention team, the acute psychiatric hospital ward, the psychiatric intensive care unit, and the way in and out of mental health services. Section 4 discusses the dual diagnosis of drug use and mental health (co-morbidity), with sub-sections on the prevalence of substance misuse among those with severe and enduring mental health problems and of mental health problems among substance-misuse populations, and the relationship between drug misuse and mental health. It summarises the links between certain drugs and mental health problems, discussing cannabis, dopamine, other psychedelic drugs, stimulants, and alcohol. Section 5 is about the role of the drug worker in responding to drugs and mental health issues: assessment, treatment and care at three levels (screening and referral, drug use triage assessment, and comprehensive drug use assessment); key indicators of mental health and/or substance misuse problems; risk assessment; care planning and the care programme approach; and discharge planning. Section 6 summarises mental health law. Section 7 describes standards and guidance: the National Service Framework for Mental Health, the Department of Health Dual Diagnosis Good Practice Guide, the UK drugs strategy, and the National Treatment Agency and Models of Care. It ends with a “Must do!” list and three case studies, giving for each the required action and a summary. Sources of further information are listed.
13 references
Subject terms:
medication, mental health care, mental health law, mental health problems, mental health services, standards, drug misuse, dual diagnosis;
Practice guideline which covers preventing, assessing and managing mental health problems in children, young people and adults with learning disabilities. The guideline aims to improve assessment and support for mental health conditions, and help people with learning disabilities and their families and carers to be involved in their care. The recommendations include that: the person's communication needs and level of understanding should be considered throughout their assessment, treatment and care; that professionals with expertise in mental health problems in people with learning disabilities should coordinate mental health assessments; the impact of the social and physical environment on the mental health of people with learning disabilities should be considered when developing care plans; adults with learning disabilities should be supported to participate in paid or voluntary work. The recommendations also provide guidance on delivering psychological and pharmacological interventions. The guideline covers all settings, including health, social care, education, and forensic and criminal justice.
(Edited publisher abstract)
Practice guideline which covers preventing, assessing and managing mental health problems in children, young people and adults with learning disabilities. The guideline aims to improve assessment and support for mental health conditions, and help people with learning disabilities and their families and carers to be involved in their care. The recommendations include that: the person's communication needs and level of understanding should be considered throughout their assessment, treatment and care; that professionals with expertise in mental health problems in people with learning disabilities should coordinate mental health assessments; the impact of the social and physical environment on the mental health of people with learning disabilities should be considered when developing care plans; adults with learning disabilities should be supported to participate in paid or voluntary work. The recommendations also provide guidance on delivering psychological and pharmacological interventions. The guideline covers all settings, including health, social care, education, and forensic and criminal justice.
(Edited publisher abstract)
Subject terms:
mental health problems, learning disabilities, prevention, assessment, mental health care, intervention, user participation, psychotherapy, medication, employment, care planning;
This document provides the full national results tables from a 2010 survey of people who use community mental health services. The 2010 survey comprises a sample of service users aged 16 and over who had been in contact with NHS community mental health services in the period 1 July 2009 to 30 September 2009 and who were receiving specialist help for a mental health condition. The survey involved 66 NHS trusts in England. A total of 17,199 questionnaires were returned, a response rate of 32%. The survey aimed to find out about the experiences of people using mental health services in the community. These services provide care and treatment to people who have been referred to a psychiatric outpatient clinic, local community mental health team, or other community-based mental health services. The survey results are presented separately for those on Care Programme Approach (CPA) and those not on CPA. The survey questions relate to: health and social care workers; medications; talking therapies; care coordinators or lead professionals; care plans; care reviews; day to day living; and crisis care.
This document provides the full national results tables from a 2010 survey of people who use community mental health services. The 2010 survey comprises a sample of service users aged 16 and over who had been in contact with NHS community mental health services in the period 1 July 2009 to 30 September 2009 and who were receiving specialist help for a mental health condition. The survey involved 66 NHS trusts in England. A total of 17,199 questionnaires were returned, a response rate of 32%. The survey aimed to find out about the experiences of people using mental health services in the community. These services provide care and treatment to people who have been referred to a psychiatric outpatient clinic, local community mental health team, or other community-based mental health services. The survey results are presented separately for those on Care Programme Approach (CPA) and those not on CPA. The survey questions relate to: health and social care workers; medications; talking therapies; care coordinators or lead professionals; care plans; care reviews; day to day living; and crisis care.
Subject terms:
medication, mental health care, mental health problems, surveys, therapies, therapy and treatment, user views, care planning, care programme approach, community mental health services, health professionals;
This new edition has been revised to incorporate changes to the UK policy and legal framework and includes seven new chapters. The publication organised in six parts. Part 1, Foundations, deals with the historical origins and development of mental health nursing. Part 2, Contexts, considers the policy, legislative and ethical frameworks within nursing practice. Part 3, Interventions, covers the main therapeutic approaches, including: assessment, lifestyle interventions, psychosocial interventions, psychopharmacological and complementary therapies, and physical health care of people suffering from mental health problems. Part 4, Client groups, looks at the challenges facing those using mental health services. Part 5, Core procedures, covers the processes of nursing care and the skills nurses need to work with clients in different settings. Part 6, Future directions looks at developments for mental health nursing. Chapters are written in an accessible style and include on outline, bullet points to summarise the main points, questions for reflection and references for further reading. Case studies are also used to illustrate the practical application of the material. New chapters include The person with dementia; Strategies for living and lifestyle options; Self help and mental health; Future directions in mental health promotion and public mental health; Taking recovery into society. Primarily aimed at mental health nurses and nursing students, this text will also be useful to other health professionals, carers and people with mental health problems.
This new edition has been revised to incorporate changes to the UK policy and legal framework and includes seven new chapters. The publication organised in six parts. Part 1, Foundations, deals with the historical origins and development of mental health nursing. Part 2, Contexts, considers the policy, legislative and ethical frameworks within nursing practice. Part 3, Interventions, covers the main therapeutic approaches, including: assessment, lifestyle interventions, psychosocial interventions, psychopharmacological and complementary therapies, and physical health care of people suffering from mental health problems. Part 4, Client groups, looks at the challenges facing those using mental health services. Part 5, Core procedures, covers the processes of nursing care and the skills nurses need to work with clients in different settings. Part 6, Future directions looks at developments for mental health nursing. Chapters are written in an accessible style and include on outline, bullet points to summarise the main points, questions for reflection and references for further reading. Case studies are also used to illustrate the practical application of the material. New chapters include The person with dementia; Strategies for living and lifestyle options; Self help and mental health; Future directions in mental health promotion and public mental health; Taking recovery into society. Primarily aimed at mental health nurses and nursing students, this text will also be useful to other health professionals, carers and people with mental health problems.
Subject terms:
intervention, medication, mental health care, mental health problems, nursing, policy, service users, severe mental health problems, therapies, therapy and treatment, assessment, dementia, health care, health and social care law;