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Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Public safety personnel (PSP), including police officers, often work in high-stress environments that expose them to potentially psychologically traumatic events (PPTE). As a result, PSP are at a higher risk than most other occupational roles for the development of new or worsening mental health concerns, such as posttraumatic stress disorder (PTSD), major depressive disorder, general or social anxiety disorder, and substance use disorders (Carleton et al., Canadian Journal of Psychiatry 63(1):54–64, 2018; Haugen et al., Journal of Psychiatric Research 94:218–229, 2017; Velazquez and Hernandez, Policing: An International Journal 42(4):711–724, 2019). Given these higher rates, research examining how to support the mental health of individuals in these occupations and how to improve our understanding of mental health help-seeking beliefs is critical. Consequently, the overall objective of the current study was to examine predictors of help-seeking attitudes among a group of police officers, while accounting for the effects of gender, years of employment, type of training experience, and mental health status (i.e. presence of mental illness, perceived resilience) on mental health-related help-seeking behaviours. A total of 112 police officers in a mid-sized law enforcement organization in Ontario, Canada, completed an online survey as part of a larger study exploring their mental health. Results indicate that years of experience and mental health training may improve attitudes toward seeking help for mental health. Our discussion offers suggestions for law enforcement organizations to consider to encourage their members to seek help for mental health difficulties. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of mental disorders among Canadian police officers, treatment-seeking is lower than expected. Toward understanding how mental health services can be tailored for higher utilization by police, we aim to uncover factors that contribute to stigma and barriers to use, specifically within the context of group dynamics between officers. Nine semi-structured focus groups and one interview were conducted with civilian and non-civilian police service employees in Ontario, Canada. Data were coded to allow for themes to emerge from the transcripts. Participant voices (n =33) revealed the presence of three characteristics of Janis' groupthink: high group cohesion, conditions that create high stress and low self-esteem, and operating under directive leadership; each creating pressures that serve as barriers to treatment-seeking [Janis IL (1972) Victims of Groupthink: A Psychological Study of Foreign-Policy Decisions And Fiascoes. Boston: Houghton Mifflin]. Groupthink offers a potential explanation about why police, despite a high prevalence of mental disorders and access to mental health services, do not seek treatment as expected. Janis's theory of groupthink is supported by police officer dialogue in focus groups. Understanding police group interactions can better inform prevention and treatment programs, ultimately leading to better access and use of existing mental health services, a reduction in stigma associated with treatment-seeking, and a healthier police workforce. [ABSTRACT FROM AUTHOR]

Documenting patient care is an important part of mental health services. The documentation is expected to be accurate, relevant, and informative for all future readers as it provides details about patients and the care they are receiving. Language can produce positive or negative emotions in individuals, and these emotions can influence their thoughts and actions. Considering this, nursing documentation can impact the future care of patients. In this study, our aim was to analyse the language and words nurses use when documenting about their patients. Through a qualitative review of notes transcribed by mental health nurses in a forensic setting (n = 55), we explored the adjectives and verbs used across a subsection of their documentation over a three‐month period. More specifically, we identified the most common words used, looked for patterns in use, and examined the emotional weight – or valence – of word choice. Examination of valence scores of the adjectives and verbs in the notes indicates that while nurses describe their patients in a rather neutral manner overall, some words and phrases are ambiguous and/or repetitive, and have the potential to negatively influence the perceptions of the reader regarding the patient. Clinical implications of patient care are discussed in the context of bias management. Nurses need to consider how word choice is linked to negative prosody and the need to provide additional information to avoid ambiguity. Without such care, notes can be subject to misinterpretation by readers leading to undue labels, stigma, and bias. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Our aim was to examine the notes produced by nurses, paying specific attention to the style in which these notes are written and observing whether there are concerns of distortions and biases. Background: Clinicians are responsible to document and record accurately. However, nurses' attitudes towards their patients can influence the quality of care they provide their patients and this inevitably impacts their perceptions and judgments, with implications to patients' care, treatment, and recovery. Negative attitudes or bias can cascade to other care providers and professionals. Design: This study used a retrospective chart review design and qualitative exploration of documentation using an emergent theme analysis. Methods: We examined the notes taken by 55 mental health nurses working with inpatients in the forensic services department at a psychiatric hospital. The study complies with the SRQR Checklist (Appendix S1) published in 2014. Results: The results highlight some evidence of nurses' empathic responses to patients, but suggest that most nurses have a style of writing that much of the time includes themes that are negative in nature to discount, pathologise, or paternalise their patients. Conclusions: When reviewing the documentation of nurses in this study, it is easy to see how they can influence and bias the perspective of other staff. Such bias cascade and bias snowball have been shown in many domains, and in the context of nursing it can bias the type of care provided, the assessments made and the decisions formed by other professionals. Relevance to Clinical Practice: Given the critical role documentation plays in healthcare, our results indicate that efforts to improve documentation made by mental health nurses are needed and specifically, attention needs to be given to the writing styles of the notation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the present study was to elucidate what non‐pharmacological interventions are applied by nursing staff prior to the administration of psychotropic pro re nata (PRN) medication. Best practices would instruct clinical staff to provide non‐pharmacological strategies, such as de‐escalation and skills coaching, as the first response to patient distress, anxiety, or agitation. Non‐pharmacological strategies might be safer for patients, promote more collaborative relationships, and facilitate greater skills development for managing symptoms. The literature has highlighted that poor documentation of pre‐PRN administration interventions has limited our understanding of this practice, but evidence suggests that when this information is available, non‐pharmaceutical approaches are not being attempted in the majority of cases. This is troubling given that, while clinically appropriate in some instances, PRN have been subject to criticism and lack critical evidence to support their use. The current study is a continuation of our previous work, which examined the reason, frequency, documentation, and outcome (e.g. effectiveness, side‐effects) of PRN medication use at our facility. A chart review was conducted to understand what happens prior to the administration of PRN medication at our facility across all inpatient units over the course of 3 months. Results support previous findings that non‐pharmacological interventions are poorly documented by front‐line staff and are seemingly used infrequently. The use of these interventions differs by patient presentation (e.g. agitation, insomnia), and most often include supportive measures. The findings suggest that both documentation and intervention practices of nursing staff require further investigation and adjustment to align with best practices. [ABSTRACT FROM AUTHOR]

Pro re nata ( PRN), a Latin phrase meaning 'as needed', is used to describe medications that might be used in specific situations, in addition to regularly-scheduled medications, such as when a patient is particularly anxious, experiencing insomnia, or suffering pain. While helpful in some circumstances, PRN are associated with an increased risk of morbidity, overuse, dependence, and polypharmacy. There is also a dearth of medical literature describing current practices and trends of PRN administration in mental health facilities, especially in Canada, and the literature that does exist is limited by poor documentation practices. Therefore, the primary objective of the current study was to understand the reason (purpose), frequency, use, documentation practices, and outcome (i.e. effectiveness, side-effects) of PRN medication use on inpatient units. Data were pulled to capture a snapshot of PRN administrations over a 3-month period, and included information related to the administration of the PRN medication, such as time of administration, type and dose of PRN medication, and prescribed indication, as well as patient-specific information. Results indicated that approximately 8200 psychotropic PRN medications were administered during the designated 3-month time period, and over 90% of patients received at least one PRN. Most of these were benzodiazepines, followed by antipsychotics. Further analyses were conducted to determine other characteristics of PRN use patterns and to provide a baseline of understanding that will inform future research to investigate the practice of PRN administration to psychiatric inpatients. [ABSTRACT FROM AUTHOR]

It is the responsibility of forensic psychiatric hospitals to detain and treat patients, gradually reintegrating them into society; decisions to release patients must balance risk to the public with maintaining the least restrictive environment for patients. Little is known about the factors considered when making such decisions and whether these factors have been empirically linked to future risk of violence. The current study explores the factors predictive of forensic treatment teams' recommendations for patients under the care of the Ontario Review Board (ORB). Factors differ depending on level of security; decisions on medium secure units were influenced by the presence of active symptoms and patients' overall violence risk level and decisions made on minimum secure units were influenced by the number of critical incidents that occurred within the recommendation year. Understanding the factors used to make recommendations to the ORB tribunal helps treatment teams to reflect on their own decision-making practices. Furthermore, the results serve to inform us about factors that influence length of stay for forensic psychiatric patients. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Low back and neck pain are common in the general population, but the prevalence among Canadian post-secondary students is not well known. We aimed to determine the one-week prevalence of neck pain (NP) and low back pain (LBP) among postsecondary students in Canada., Methods: We conducted a cross-sectional study of students enrolled in the Faculty of Health Sciences and Faculty of Education at Ontario Tech University, and the Canadian Memorial Chiropractic College (CMCC) in the Fall of 2017. Neck and low back pain intensity in the past week were measured with the 11-point numerical rating scale. We report the cumulative, gender- and institution-specific one-week prevalence (95% CI) of any pain (1-10/10) and moderate to severe pain (≥ 3/10)., Results: The one-week prevalence of any neck pain ranged from 45.4% (95% CI: 38.4, 52.4) in the Faculty of Education to 76.9% (95% CI: 72.9, 80.4) at CMCC. The one-week prevalence of neck pain ≥3/10 ranged from 44.4% (95% CI: 37.5, 51.4) in the Faculty of Education to 58.4% (95% CI: 54.0, 62.7) at CMCC. The one-week prevalence of any low back pain ranged from 60.9% (95% CI: 53.8, 67.5) in the Faculty of Education to 69.0% (95% CI: 64.8, 73.0) at CMCC, and the one-week prevalence of low back pain ≥ 3/10 ranged from 47.8% (95% CI: 43.4, 52.2) at CMCC to 55.1% (95% CI: 51.2, 58.9) in the Faculty of Health Sciences. The prevalence of any back or neck pain and pain ≥ 3/10 was consistently higher in females than males, with the largest difference seen for neck pain at CMCC., Conclusion: Most post-secondary students in our samples experienced LBP and NP in the past week. Overall, the one-week prevalence of NP and LBP was higher among chiropractic students and among females. This study should draw attention to school administrators about the burden of NP and LBP in post-secondary students., (© 2023. The Author(s).)

In contrast to growing regard for the psychological construct of hope in medical and psychological arenas, hope has not yet found a permanent place in the field of criminology. Traditionally, treatment programs and risk assessment tools have focused on the deficits that criminal offenders possess. However, the orientation of our approach to corrections has recently shifted to embrace more strengths-based, offender-focused programming designed to rehabilitate offenders. The assessment for risk for recidivism has been slower to make this transition and use research supporting the use of more dynamic risk factors for reducing reoffending. This study investigates the nature of hope in offenders in relation to their risk for future criminal behaviour. The results indicate that hope is indeed related to the risk for reoffending. The information obtained through this research will inform researchers and clinicians about the nature of hope in a correctional population and its relation with risk for future criminal behaviour.