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Preventing sexual contact between professionals and patients in forensic environments
- Author:
- PETER-THOMAS Brian
- Journal article citation:
- Journal of Forensic Psychiatry, 11(1), April 2000, pp.135-150.
- Publisher:
- Routledge
This articles considers the issue of sexual contact between staff and patients in psychiatry and, especially, forensic environments. The effect of these relationships is substantial on both the individual patient and the organization. Characteristics of patients and staff who become involved in this type of activity are discussed and the particular features of forensic environments are raised in relation to understanding the violation of intimate boundaries.
Psychiatric morbidity and health service use among attendees at a winter shelter
- Author:
- HAYWARD Marianne
- Journal article citation:
- Psychiatric Bulletin, 31(9), September 2007, pp.326-329.
- Publisher:
- Royal College of Psychiatrists
Homelessness is associated with raised psychiatric morbidity. Case records for 597 consecutive attendees at a winter shelter medical service were retrospectively reviewed to assess routine recording of psychiatric morbidity and to examine associations between current psychiatric symptoms and health service use. Previous psychiatric morbidity was recorded in 36.0% of attendees, including 20.4% with comorbid substance misuse. Current psychiatric morbidity was recorded in 31.3% of attendees, and was associated with reduced total medication prescription, increased referral to other services and increased re-presentation to the shelter medical service. Psychiatric morbidity was frequently recorded in this population. Current psychiatric symptoms were associated with increased health service use. Improved training of shelter staff should be instituted to increase engagement with mainstream mental health services.
Assertive outreach teams in London: staff experiences and perceptions: Pan-London Assertive Outreach Study, Part 2
- Authors:
- BILLINGS Joanne, et al
- Journal article citation:
- British Journal of Psychiatry, 183(8), August 2003, pp.139-147.
- Publisher:
- Cambridge University Press
The job satisfaction, burn-out and work experiences of assertive outreach team staff are likely to be important to the model's sustainability. The aim is to describe self-reported views and work experiences of staff in London's 24 assertive outreach teams and to compare these with staff in community mental health teams (CMHTs) and between different types of assertive outreach team. Confidential staff questionnaires in London's assertive outreach teams (n=187, response rate=89%) and nine randomly selected CMHTs (n=114, response rate=75%). Staff in assertive outreach teams and CMHTs were moderately satisfied with their jobs, with similar sources of satisfaction and stress. Mean scores were low or average for all sub-scales of the Maslach Burnout Inventory for the assertive outreach team and the CMHT staff, with some differences suggesting less burn-out in the assertive outreach teams. Nine of the 24 assertive outreach teams had team means in the high range for emotional exhaustion and there were significant differences between types of assertive outreach team in some components of burn-out and satisfaction. These findings are encouraging, but repeated investigation is needed when assertive outreach teams have been established for longer.
Psychological and emotional problems in staff following assaults by patients
- Authors:
- WILDGOOSE Joanna, BRISCOE Martin, LLOYD Kieth
- Journal article citation:
- Psychiatric Bulletin, 27(8), August 2003, pp.295-297.
- Publisher:
- Royal College of Psychiatrists
The aim of this research determine psychological morbidity among staff following actual or threatened violence from patients on acute psychiatric wards. A retrospective survey of all 156 clinical staff on Exeter’s acute psychiatric wards was conducted by means of an anonymous questionnaire using standardised measures. The response rate was 81%, and 72% of respondents had experienced one or more distressing incidents of actual or threatened violence within the previous year. The 12-item General Health Questionnaire and Impact of Events Scale scores were significantly higher in those who reported exposure to ‘frequent’ violent incidents Some National Health Service staff may be harmed psychologically when they are at work. This consequently may have implications for patient care, employer liability and recruitment.
Clinical supervisors' countertransference reactions toward older clients: addressing the unconscious guide
- Authors:
- ALTSCHULER Joanne, KATZ Anne D.
- Journal article citation:
- Journal of Gerontological Social Work, 39(4), 2002, pp.75-87.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article describes a method that has been effective in helping supervisors identify countertransference reactions in themselves. It offers clinical supervisors a way to identify their own countertransference when supervising students, interns and professional staff who are working with older adults. This technique can be utilized in a variety of work settings such as hospitals, long-term care settings, mental health clinics, multi-purpose centers for older adults and private practice. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
From the asylum to the community: A longitudinal study of staff involved in the transition from Tone Vale Hospital to community-based services
- Authors:
- CARPENTER John, et al
- Journal article citation:
- Journal of Mental Health, 9(2), April 2000, pp.211-230.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Reports on a longitudinal study of the effects on staff of the transition from a Victorian asylum to dispersed community-based services is reported. The majority of staff supported the policy of community care in general and following the closure, two-thirds thought it better for staff, although only half considered it was better for people with mental health problems. Throughout the transition, relatively low levels of stress were reported and job satisfaction was high. Role clarity and low role conflict were predictors of low stress and job satisfaction. Job satisfaction was also predicted by supportive management and job responsibilities. The study demonstrates that major changes in working environments and in job responsibilities can be accomplished without undue stress and uncertainty and also that the job satisfaction of mental health staff can be maintained.
Developing a systematic method analysing serious incidents in mental health
- Authors:
- VINCENT Charles, STANHOPE Nicola, TAYLOR-ADAMS Sally
- Journal article citation:
- Journal of Mental Health, 9(1), February 2000, pp.89-103.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Formal, quasi-legal, inquiries into homicides, suicides and serious incidents, even when sensitively and carefully conducted, may be experienced as persecuting to staff, excessively blame-oriented and damaging to an already weakened service. This article describes a structured and systematic method of investigating adverse incidents on an acute psychiatric ward which draws attention to the wider organisational context as well as to the actions or omissions of individuals. An analysis of a serious incident, albeit one from which no permanent harm resulted is also presented. Detailed analysis provides information both about specific management problems and more general unsafe features of an organisation, such as deficiencies in training or supervision, and problems in written or verbal communication, both between staff and between staff and patients.
Finding and keeping: review of recruitment and retention in the mental health workforce
- Author:
- SAINSBURY CENTRE FOR MENTAL HEALTH
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 2000
- Pagination:
- 136p.,bibliog.
- Place of publication:
- London
This report aims to describe and analyse difficulties in recruiting and retaining mental health staff and to identify practicable and sustainable ways of addressing these difficulties. It presents conclusions from a review carried out by staff from the Sainsbury Centre for Mental Health and external consultants, and involved desk-based research and literature reviews on topics such as stocks and flows in the mental health workforce, problems with recruitment and retention, and possible solutions; advice from expert consultants; and fieldwork using focus group discussions with professional staff and managers. Staff groups covered are: psychiatrists, mental health nurses, social workers, clinical psychologists and occupational therapists.
The response of nursing staff to psychiatric inpatient misdemeanour
- Author:
- CRICHTON John
- Journal article citation:
- Journal of Forensic Psychiatry, 8(1), May 1997, pp.36-61.
- Publisher:
- Routledge
Rule-breaking by psychiatric inpatients is introduced as a common problem, but, surprisingly, how staff respond to such behaviour has attracted little specific literature. It is a subject that raises complex and difficult questions of ethics, law and clinical practice. A sample of psychiatric nursing staff, from low-, medium- and maximum-security settings, took part in a decision-making exercise, designed to examine attitudes towards, and concepts of, patients' rule-breaking. A theoretical model is proposed, in which the response to patient misdemeanour involves three in inseparable components: containment of the unsafe; treatment of the underlying pathology; and moral censure. It is concluded that clinical policies and guidelines must recognise the influence of moral judgements, through education, staff support, supervision and mechanisms of appeal.