Search results for ‘Subject term:"mental health problems"’ Sort:
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Improving the management of patients with mental ill health in emergency care settings
- Author:
- NATIONAL HEALTH SERVICE
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2004
- Pagination:
- 37p.
- Place of publication:
- London
It is estimated that up to five per cent of those attending an emergency department have a primary diagnosis of mental ill health, of which substance misuse and deliberate self-harm (DSH) are the largest groups. A further 20-30 per cent of attendees have coexisting physical and psychological problems, with much of the latter remaining undetected. It is estimated that 35 per cent of emergency departments attendances are related to alcohol including violent assaults, road traffic accidents, mental health emergencies and deliberate self-harm.
Sexual and nonsexual offenders with intellectual and learning disabilities: a comparison of characteristics, referral patterns, and outcome
- Authors:
- LINDSAY William R., et al
- Journal article citation:
- Journal of Interpersonal Violence, 19(8), August 2004, pp.875-890.
- Publisher:
- Sage
This article reports an evaluation of a community intellectual disability offender service over the period from 1990 to 2001. Men who committed sex offenses or sexually abusive incidents (n = 106) and men who committed other types of offenses and serious incidents (n = 78) are compared on personal characteristics, referral sources, forensic details, and outcome up to 7 years after referral. The cohorts are older than one would expect from the criminology literature, and, at about 33%, the incidence of mental illness is consistent with some previous studies. A greater proportion of sex offenders had criminal justice involvement and a formal disposal from court. Fire raising was not overly represented as an offense. There was a higher rate of reoffending in the nonsexual cohort, which persisted up to 7 years. Investigating only reoffenders, there was a considerable amount of harm reduction recorded up to 7 years, statistically significant up to 5 years following initial referral.
Assaultive behaviour in state psychiatric hospitals: differences between forensic and nonforensic patients
- Authors:
- LINHORST Donald M., SCOTT Lisa Parker
- Journal article citation:
- Journal of Interpersonal Violence, 19(8), August 2004, pp.857-874.
- Publisher:
- Sage
Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two groups of forensic patients including 469 patients found not guilty by reason of insanity and 76 pretrial patients. Consistent with other studies, nonforensic patients had higher rates of assaults than either group of forensic patients. However, being a forensic patient did not affect the odds of assault when controlling for the effects of demographic and clinical variables in a multivariate logistic regression analysis. Factors associated with assaults in each of the three patient groups were identified using multivariate analyses. Implications are presented for treatment of assaultive behavior, mixing of forensic and nonforensic patients within state hospitals, forensic release policies, and future research.
The link between mental health problems and violence behaviour
- Author:
- GREGORY Nathan
- Journal article citation:
- Nursing Times, 6.4.04, 2004, pp.34-36.
- Publisher:
- Nursing Times
Reviews literature on mental illness and violence with the aim of clarifying whether there is a link between the two. Concludes that while higher rates of violence have been found among people with mental illness, most studies have flaws and their results should be viewed with caution. Calls for the development of preventative strategies by providing appropriate support for people with mental health problems.
Assessing psychiatric patients for violence
- Authors:
- ANDERSON Tanya R., et al
- Journal article citation:
- Community Mental Health Journal, 40(4), August 2004, pp.379-399.
- Publisher:
- Springer
Managing violent patients is a dilemma that every clinician faces. This article reviews the current literature and assesses the evidence on the management of violent patients in the clinical setting. Risk factors (dispositional, historical, contextual and clinical) and early warning signs of violence will be outlined. Understanding these issues will facilitate the short-term prediction and prevention of violence in clinical settings. Interventions have been categorized for use according to the urgency of the situation. This degree of urgency has been designated as either potential, imminent or emergent violence. Special considerations that may alter the management of violence will be delineated. Specifically, we will highlight issues related to gender, age and mental retardation. Aspects of professional training in regards to the management of the violent patient will be underscored as well. Finally, the review of the literature has led to a decision tree that can inform the reader in the evidence-based management of the violent patient. This decision tree is offered to the busy practitioner as a practical clinical tool for using evidence based practices in managing violent patients.
Beyond PTSD: mental health consequences of violence against women
- Author:
- MECHANIC Mindy B.
- Journal article citation:
- Journal of Interpersonal Violence, 19(11), 2004, pp.1283-1289.
- Publisher:
- Sage
This article proposes that we move beyond posttraumatic stress disorder (PTSD) in our conceptualization of traumatic stress responses of victimized women exposed to serial forms of unrelenting violence, such as intimate partner violence and stalking. It is argued that the traditional PTSD framework is ill fitting in the context of some forms of violence against women (VAW), and these limits have consequences for developing appropriate interventions for some victimized women. The article further suggests going beyond PTSD by developing a more nuanced understanding of the ways in which PTSD and other mental health symptoms contribute to the vast array of deleterious personal, societal, and economic costs of VAW.
Initial development of a measure of emotional dysregulation for individuals with Cluster B personality disorders
- Authors:
- NEWHILL Christina E., MULVEY Edward P., PILKONIS Paul A.
- Journal article citation:
- Research on Social Work Practice, 14(6), November 2004, pp.443-449.
- Publisher:
- Sage
Individuals with DSM-IV Cluster B personality disorders are at particular risk of violence toward self or others. Emotional dysregulation is likely to be a factor in such incidents and is a central issue addressed in therapies with personality-disordered individuals. This article reports findings from a study that developed an original 18-item measure of emotional dysregulation and administered the scale to 100 participants diagnosed with Cluster B personality disorders or traits. A 13-item scale (the General Emotional Dysregulation Measure or GEDM) reflecting general emotional arousal and dysregulation of negative affect was derived using principal components analysis. The GEDM demonstrates good reliability and validity and correlates significantly with other established measures of affect. This measure is seen as potentially useful in clinical social work practice and in future investigations of the relationships among emotional dysregulation, personality disorders, substance abuse, and violence.
Air travel by passengers with mental disorder
- Authors:
- GORDON Harvey, KINGHAM Mike, GOODWIN Tony
- Journal article citation:
- Psychiatric Bulletin, 28(8), August 2004, pp.295-297.
- Publisher:
- Royal College of Psychiatrists
Air travel is a rapid and efficient mode of travel nationally and internationally. People with a psychiatric disorder can usually travel safely, but may at times require an escort. People whose mental state or behaviour are disturbed are not fit to travel until stability has been achieved. Suicidal or homicidal behaviour by those so disposed are fortunately rare, but can be catastrophic in outcome. Careful assessment is necessary, and psychiatrists are advised to be more aware of the possibility of liaison with airport medical services when appropriate. Despite a recent reduction in the number of passengers on commercial aircraft following acts of terrorism, war in Iraq, communicable diseases such as severe acute respiratory syndrome (SARS) and a down-turn in the global economy, air transportation continues to convey millions of people each year across the world. Among this multitude of air passengers are an unknown number of people with mental disorder. Aspects of air travel relevant to psychiatric evaluation are reviewed here.
Unusually persistent complainants
- Authors:
- LESTER Grant, et al
- Journal article citation:
- British Journal of Psychiatry, 184(4), April 2004, pp.352-356.
- Publisher:
- Cambridge University Press
Querulous paranoia may have disappeared from the psychiatric literature, but is it flourishing in modern complaints organisations and the courts? The aim was to investigate the unusually persistent complainants who lay waste to their own lives and place inordinate demands and stress on complaints organisations. Complaints officers completed questionnaires on both unusually persistent complainants and matched controls. Persistent complainants (distinguished by their pursuit of vindication and retribution) consumed time and resources and resorted to both direct and veiled threats. Attempts to distinguish these people from a control group on the basis of the manner in which their claims were initially managed failed. Persistent complainants’ pursuit of vindication and retribution fits badly with complaints systems established to deliver reparation and compensation. These complainants damaged the financial and social fabric of their own lives and frightened those dealing with their claims. The study suggests methods of early detection and alternative management strategies.
Lone mothers' experience of physical and sexual violence: association with psychiatric disorders
- Author:
- BUTTERWORTH Peter
- Journal article citation:
- British Journal of Psychiatry, 184(1), January 2004, pp.21-27.
- Publisher:
- Cambridge University Press
Violence against women is increasingly recognised as an important issue in both research and social policy. The aim was to assess the lifetime experience of physical and sexual violence among lone and partnered mothers and the association with psychiatric disorders. Analysis of the Australian National Survey of Mental Health and Wellbeing. The representative sample included 2232 women with children who completed the Composite International Diagnostic Interview, a scale of psychological distress and sociodemographic measures. Lone mothers were morelikely to have psychiatric disorders (odds ratios between 2.4 and 3.4) and have experienced physical and sexual violence (odds ratios between 3.1 and 4.1) than partnered mothers. The measures of physical and sexual violence were better predictors of psychiatric disorders than either lone parent status or the sociodemographic measures. Experience of physical and sexual violence accounted for much of the greater prevalence of psychiatric disorders among lone compared with partnered mothers.