scholarly journals Smokefree mental health inpatient settings – a matter of debate?

2019 ◽  
Vol 65 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Elena Ratschen
Keyword(s):  
Mental Health ◽  
Policy Implementation ◽  
Mental Health Treatment ◽  
Evidence Based ◽  
Smoking Abstinence ◽  
Inpatient Stay ◽  
National Guidance ◽  
Smokefree Policy ◽  
Mental Health Settings ◽  
Inpatient Settings

Abstract. Background: The prevalence of tobacco smoking among people with severe mental illness (SMI) substantially exceeds smoking rates in the general population and has been identified as the largest contributor to health inequalities in this group. Historically deeply embedded in the culture of mental health treatment environments, smoking until very recently was the norm in inpatient settings and still prevails in many settings internationally. In England however, mental health Trusts are currently implementing recent national guidance, according to which mental health settings will become entirely smokefree, with no exemptions, providing comprehensive evidence-based support to patients for smoking cessation and smoking abstinence during the inpatient stay. Aim: The aim of this article is to summarise the rationale for and the debate surrounding smokefree mental health inpatient settings, and to review and discuss the evidence on challenges, opportunities and impact of smokefree policy implementation in these settings, with a focus on the English debate and experience to date.

Response

2013 ◽  
pp. 277-278
Author(s):  
Belinda McIntosh ◽  
Michael T. Compton
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Supported Employment ◽  
Psychotic Disorders ◽  
Evidence Based ◽  
Psychosocial Treatments ◽  
Assessment And Treatment ◽  
Mental Health Settings ◽  
Community Mental Health Settings ◽  
Abuse Treatment

Dr. Bellack’s commentary highlights a number of important points in the assessment and treatment of patients with schizophrenia and related psychotic disorders. He emphasizes that, although many patients with schizophrenia receive pharmacotherapeutic and psychosocial treatments in keeping with the spirit of the recommendations, often the treatments being applied are not evidence-based. Dr. Bellack stresses that there are a number of manualized psychosocial treatments to guide clinicians wishing to provide evidence-based supported employment, social skills training, and substance abuse treatment. He also aptly cites that the bulk of mental health treatment for patients with schizophrenia occurs in community mental health settings that lack the resources to adequately provide these treatments....

Abstract 16363: An 18-month Smoking Cessation Intervention Incorporating Pharmacotherapy and Behavioral Counseling Improves Tobacco Abstinence Rates in Adult Smokers With Serious Mental Illness (smi) in Community Mental Health Settings: Results of a Randomized Clinical Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gail Daumit ◽  
A. Eden Evins ◽  
Corinne Cather ◽  
Arlene Dalcin ◽  
Faith Dickerson ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Smoking Cessation ◽  
Weight Gain ◽  
Evidence Based ◽  
Smoking Abstinence ◽  
Behavioral Counseling ◽  
Mental Health Settings ◽  
Readiness To Quit ◽  
Community Mental Health Settings

Introduction: Tobacco smoking is the largest contributor to markedly elevated CVD and preventable death in persons with SMI. Trials of combined pharmacologic and behavioral treatments improve abstinence rates, but have targeted those ready to quit right away, and evidence-based treatments are rarely used in the community. Weight gain often accompanies abstinence. Our objective was to determine the effectiveness of an 18m smoking cessation pharmacotherapy and behavioral counseling intervention incorporating weight management and physical activity in persons with SMI. Hypothesis: The active intervention is more effective than control in achieving biochemically validated, 7-day point prevalence smoking abstinence at 18m. Methods: We conducted an RCT in 4 community mental health settings in 192 smokers with SMI, stratified by readiness to quit within 30d or in 1 to 6m. The active intervention group was offered 18m of 1 st -line cessation pharmacotherapy, smoking cessation and weight management counseling tailored to readiness to quit, and support for physical activity. Controls received a quit line referral. Results: Mean(SD) age was 49.6(11.7); cigarettes/day 12.1(9.5); BMI 32.0(7.6) kg/m 2 ; 49% were male, 48% African-American, 62% willing to quit in 30d, 95% completed 18m follow-up. At 18m, 27.8% of active group and 6.3% of controls achieved 7d smoking abstinence (p<0.0001); adjusted odds ratio 6.0 (95% CI: 2.3 –15.6; p=0.0002). There was no significant modification of intervention effect on abstinence by readiness to quit. Mean difference in weight change over 18m between active and control was not significant (3.5 lbs, 95% CI: -3.3 –10.3; p=0.32). Conclusions: Offering 18m of evidence-based cessation treatment in the community substantially increased smoking abstinence without significant weight gain in SMI. Implementing best practice guidelines to treat all smokers regardless of readiness to quit should improve CVD health in this high-risk population.

What is the impact of staff wearing uniforms in psychiatric inpatient settings?

2021 ◽  
Author(s):  
Sophie Collingwood ◽  
Laura McKenzie-Smith
Keyword(s):  
Mental Health ◽  
Thematic Analysis ◽  
Negative Impact ◽  
Psychiatric Inpatient ◽  
Ideal Self ◽  
Search Terms ◽  
Mental Health Settings ◽  
Inpatient Settings ◽  
The Impact

Background: Uniform has traditionally been worn in psychiatric inpatient and other mental health settings, but there has been a move to non-uniform in recent years. Some services have made the change back to uniform, raising questionsabout the potential impact on patients and staff.Aim: To review the impact of uniform within a psychiatric inpatient or mental health setting.Method: Databases were searched for articles exploring the impact of uniform use using specified search terms. Articles were assessed for suitability with inclusion and exclusion criteria, critically appraised, then analysed for themes using thematic analysis.Results: 17 papers were included in the review. Thematic analysis identified five main themes and 29 subthemes. Main themes were Attitudes and interactions, A freer environment, Are you both nurses?, The ‘ideal self’ and There are more important things. A critical appraisal of the articles suggested issues with validityand reliability, which are discussed.Discussion: Studies identified that wearing non-uniform facilitated positive changes in both patients and staff. This raises the potential negative impact of uniform on both patients and staff, and the role of power imbalance in these settings is discussed. Further themes around identification of staff out of uniform were considered.Implications for practice: The use of uniform in mental health and psychiatric inpatient settings should be considered carefully, due to the potential negative impact, whilst also recognising the importance of staff identification and supporting professional identity.

Utilization of evidence-based treatment models at community-based mental health settings for young children exposed to violence

2020 ◽  
Vol 116 ◽  
pp. 105233
Author(s):  
Tamaki H. Urban ◽  
Thuy Trang T. Nguyen ◽  
Alexandra E. Morford ◽  
Tawny Spinelli ◽  
Zoran Martinovich ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Children ◽  
Evidence Based ◽  
Community Based ◽  
Evidence Based Treatment ◽  
Treatment Models ◽  
Mental Health Settings ◽  
Children Exposed To Violence

The compatibility of clinical child mental health treatment and evidence-based treatment protocols.

2020 ◽  
Vol 17 (1) ◽  
pp. 25-32
Author(s):  
Stephen P. H. Whiteside ◽  
Jarrod M. Leffler ◽  
Melissa K. Hord ◽  
Leslie A. Sim ◽  
Michele M. Schmidt ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Child Mental Health ◽  
Evidence Based ◽  
Health Treatment ◽  
Treatment Protocols ◽  
Evidence Based Treatment

Prisoners and mental health

2018 ◽  
pp. 217-224
Author(s):  
Kenneth L. Appelbaum
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Health And Safety ◽  
Public Mental Health ◽  
Mass Incarceration ◽  
Crime Rates ◽  
Evidence Based ◽  
Beneficial Effects ◽  
Alternatives To Incarceration ◽  
Reducing Recidivism

This chapter examines how incarceration affects public mental health and safety. It describes the benefits of mental health treatment during and after incarceration for individual patients and for society. It also reviews how the conditions of confinement can make inmates either better or worse, including the detrimental effects that harsh prison environments can have on future criminal behaviour. The chapter examines the history and misconceptions about rehabilitative programmes and the effectiveness of evidence-based interventions in reducing recidivism. It describes how mass incarceration has had great fiscal and social costs but few beneficial effects on crime rates. Finally, it reviews the advantages of alternatives to incarceration for individual offenders, family members, and the broader community.

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