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GLOBAL MENTAL HEALTH ASSESSMENT TOOL

Background There is growing global interest into the attitudes and clinical management of persons who deliberately self-harm. People who self-harm experience many problems and typically have many needs related to management of their psychological well being. A positive attitude among general hospital staff should prevail with people who self-harm.Aims The principal purpose was to determine qualified and student staff staff attitudes towards patients that self-harmed from a professional and cultural perspective, which might influence patient treatment following hospital admission. The focus concentrated upon staff knowledge, attitudes and beliefs regrading self-harm. Methods A validated questionnaire was carried out. This paper reports on interdisciplinary staff from two large general hospitals in Mysore, Southern India (n=773) .Results Findings suggest that within a general hospital setting there is wide variation in staff attitudes and knowledge levels related to self-harm. Whilst there is attitudinal evidence for staff attitudes, this study investigates inter professional differences in an attempt to progress treatment approaches to a vulnerable societal group. Conclusion The results allow a series of recommendations for educational and skills initiatives before progressing to patient assessment and treatment projects and opens potential for cross cultural comparison studies. In addition interventions must focus on current resources and contexts to move the evidence base and approaches to patient care forward.

Purpose Limited availability of specialist services places a considerable burden on caregivers of Persons with Dementia (PwD) in Low- and Middle-Income Countries (LMICs). There are limited qualitative data on coercive behavior towards PwD in an LMIC setting. Aim The aim of this study was to find relevant themes of the lived experience of relatives as caregivers for PwD in view of their use of coercive measures in community setting in South India. Method Primary caregivers (n = 13) of PwDs from the Mysore study of Natal effects on Ageing and Health (MYNAH) in South India were interviewed to explore the nature and impact of coercion towards community dwelling older adults with dementia. The narrative data were coded using an Interpretative Phenomenological Analysis (IPA) approach for thematic analysis and theory formation. Results Caregivers reported feeling physical and emotional burn-out, a lack of respite care, an absence of shared caregiving arrangements, limited knowledge of dementia, and a complete lack of community support services. They reported restrictions on their lives through not being able take employment, a poor social life, reduced income and job opportunities, and restricted movement that impacted on their physical and emotional well-being. Inappropriate use of sedatives, seclusion and environmental restraint, and restricted dietary intake, access to finances and participation in social events, was commonly reported methods of coercion used by caregivers towards PwD. Reasons given by caregivers for employing these coercive measures included safeguarding of the PwD and for the management of behavioral problems and physical health. Conclusion There is an urgent need for training health and social care professionals to better understand the use of coercive measures and their impact on persons with dementia in India. It is feasible to conduct qualitative research using IPA in South India.

Background There is growing global interest into the attitudes and clinical management of persons who have attempted suicide. Aims The principal purpose was to determine senior nursing staff attitudes towards patients who had attempted suicide from a professional and cultural perspective, which might influence care following hospital admission. The focus concerned nursing staff interactions at a psychological level that compete with physical tasks on general hospital wards. Methods A qualitative methodology was employed with audio-taped interviews utilising four level data coding. This paper reports on a group of 15 nursing staff from a large general hospital in Mysore, Southern India .Results Findings suggested that patient care and treatment is directly influenced by the nurse’s religious beliefs within a general hospital setting with physical duties prioritised over psychological support, which was underdeveloped throughout the participant group. Conclusion The results allow a series of recommendations for educational and skills initiatives before progressing to patient assessment and treatment projects and cross cultural comparison studies. In addition interventions must focus on current resources and context to move the evidence base suicide prevention forward.

Steve Jones and colleagues provide an insight into attempted suicide following clinical practice visits and research in Southern India and draw comparisons with the UK situation.

peer-reviewed, Background: People with an intellectual disability are a vulnerable group during COVID-19 due to multi-morbidity, frailty, underlying conditions/health problems, social circumstances and limitations in understanding. This places them at greater risk of more severe outcomes from COVID-19. Objective: To chart the evidence of the effects of the COVID-19 pandemic on people with intellectual disability and their carers reported in the research. Methods: A scoping review method was used to review literature published across eight databases in 2020 and included manual searches of reference lists of included articles. Results: Sixteen studies were selected for inclusion. The findings highlight that professionals, people with intellectual disability and their carers were keen to comply with pandemic related public health guidance. However, implementing infection prevention and control measures in certain contexts for people with intellectual disability was challenging. Thereby a rights-based, person-centred approach to care is essential and professionals need to extend their understanding and practice of collaborative working to include people with intellectual disability and their family/carers. The findings highlight that compliance with public health guidance and infection control measures can be difficult for people with intellectual disability to implement. Conclusions: There is limited good quality robust research on COVID-19 and people with intellectual disability and/or their carers experiences.