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Introduction: Quantification of the social climate of mental health care environments has received considerable attention. Investigations of the resulting measures indicate that social climate is associated with individual outcomes including patient satisfaction and staff burnout. Interest has grown in developing interventions to improve social climate in anticipation of subsequent related benefits. This study aimed to identify and critically review research about the effectiveness of interventions for improving social climate in inpatient adult acute mental health settings. Methods: Systematic review reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive terms were used to search multiple electronic databases from inception to July 2019. Information about intervention type(s), complexity was extracted and study quality was assessed. Results: Twenty-three papers met inclusion criteria of which 20 used a pretest–posttest study design and three employed randomized and/or controlled designs. Interventions were environmental/structural, operational/process-oriented and developmental/person-oriented in nature and they ranged in complexity. The Ward Atmosphere Scale was the most common outcome measure used. Following quality assessment, six studies were judged to be sufficiently robust in terms of quality, theory-base, user-inclusion, and outcomes evaluation to contribute credibly to the evidence base. Of these, four complex person- and process-oriented intervention studies and two less complex structural/environmental intervention studies resulted in positive outcomes. Conclusion: There is limited strong evidence that interventions positively influence measures of ward social climate in acute adult mental health settings. Such measures should not be the sole criterion of success when evaluating change. Decisions about implementing change to improve social climate should be informed by meaningful proxy measures including the views and preferences of service users and other stakeholders. Studies using stronger designs are required to establish the ability of interventions to improve social climate. [ABSTRACT FROM AUTHOR]

The treatment of the mentally ill people is a challenge across the world, and different professionals, such as doctors, social workers, psychologists, or nurses, take care of this group. Nonetheless, mental health is not a vocational sector preferred by students and professionals of many of these careers. Research has proposed that professional preference for a patient group would be positively influenced by intergroup contact (quantity and quality) and empathy (perspective‐taking), and negatively associated with intergroup anxiety and social distance. However, the evidence testing this proposal was partial and mainly referring to other patient groups such as minorities or immigrants. The major aim of this cross‐sectional study was to clarify two research questions referring to mentally ill persons: Do contact and empathy protect undergraduates from intergroup anxiety and social distance and promote professional preference? Do intergroup anxiety and social distance predict professional preference and mediate the influence of contact and empathy in professional preference? A convenience sample of 409 Social Work undergraduates (81% females) from three Spanish universities completed a questionnaire between February and June 2020. Concerning direct relationships, the structural equation model showed that the quantity of contact only predicted intergroup anxiety negatively; quality of contact and empathy negatively predicted intergroup anxiety and social distance; intergroup anxiety positively predicted social distance; intergroup anxiety and social distance negatively predicted professional preference. Concerning mediated relationships, the influence of quality of contact and empathy on social distance was mediated by intergroup anxiety; social distance mediated the relationship of intergroup anxiety with professional preference; both anxiety and distance mediated the influence of quality of contact and empathy in professional preference. These results encourage interventions aimed at enhancing professional preference for mental illness by improving contact, knowledge, and empathy and reducing stigma in students and workers from diverse mental health careers. [ABSTRACT FROM AUTHOR]

Tobacco use remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness.

This paper aims to help people understand better the lives of people who are mentally ill by describing the general concept of the Interpersonal Caring Theory (ICT) and deducing 10 key components of interpersonal caring. The literature review described the definition of interpersonal caring, and its assumptions and characteristics. Furthermore, the authors’ experience with patient care suggested the critical components of interpersonal caring, which is the compassion-based therapeutic actions/behaviors through the collaborative partnership developed between nurse and client. Essential characteristics of interpersonal caring include the following: person-to-person interaction between nurse and patient, genuine love and concern toward the person, conveying trust and hope, transcending space, time, and culture, holistic approach expressed through a comprehensive and dynamic mode of communication, helping the patient focus on their self-worth, and providing culturally relevant and sensitive nursing. Ten key components of interpersonal caring in ICT include noticing, participating, sharing, active listening, companioning, complimenting, comforting, hoping, forgiving, and accepting. Interpersonal caring results from the blended understanding of the empirical, aesthetic, ethical, and intuitive aspects of a given clinical situation, and a nexus of pre-conditions, content, feelings, and sense of self-worth/self-esteem.

Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index（BMI）and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3 ± 11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

Background: We aimed to find out the overall reported and intended behavior of the general population of India toward mentally ill persons. Materials and Methods: Participants were included in an online survey using a nonprobability snowball sampling technique. After taking informed consent, sociodemographic details were recorded, and the “Reported and Intended Behaviour Scale” was administered. Results: Out of 818 responses, 684 responses were eligible for study after exclusion. The mean age (standard deviation) of the study population was 31.01 (7.79) years. Maximum participants reported that they did not live (76.6%), did not work (75.7%), did not live nearby (66.4 %), or have not had a close friend (79.8%) with mental health problems. However, most individuals neither agreed nor disagreed to live (48.5%), work (38%), and live nearby (42.7%) a mentally ill person, but maximum individuals strongly agreed to continue a relationship with a friend having mental health problems (34.5%). There were 77.5% males and 32.2% healthcare workers. Regarding intended behavior, there was a significant difference between healthcare workers and persons other than these as well as between males and females. Participants who had previous interaction with the mentally ill person were more willing to interact with the same. Conclusion: Most people do not intend to have stigmatized behavior toward mentally ill persons. Healthcare workers and males have less negative social reactions toward mentally ill persons in different domains of life. However, there is still a need to intensify awareness about mental health.

BackgroundWe employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings.MethodsWe hypothesized “jobs to be done” in three broad stakeholder groups: “decision makers” (DM = state and community clinic administrators), “clinician consumers” (CC = case managers, peer supports, nurses, prescribers) and “service consumers” (SC = patients, peers and family members). Semistructured interviews (N = 29) were recorded and transcribed ver batim and coded based on pragmatic-variant grounded theory methods.ResultsFour themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on implementation ownership, intersecting with professional development, suggesting the importance of training and supervision in scalability. Sub-themes in resources and intertia differed between CC and SC groups, suggesting illness severity and access to healthy food as major barriers to engagement, whereas the SC group identified the need for enhanced emotional support, in addition to pragmatic skills like menu planning and cooking, to promote health behavior change. Although SMS was percieved as a viable education and support tool, CC and DM groups had limited familiarity with use in clinical care delivery.ConclusionsBased on customer discovery, the characteristics of a minimum viable iOTA for implementation, scalability and sustainability include population- and context-specific adaptations to treatment content, interventionist training and delivery mechanism. Successful implementation of an SMS-based intervention will likely require micro-adaptations to fit specific clinical settings.

This paper aims to help people understand better the lives of people who are mentally ill by describing the general concept of the Interpersonal Caring Theory (ICT) and deducing 10 key components of interpersonal caring. The literature review described the definition of interpersonal caring, and its assumptions and characteristics. Furthermore, the authors' experience with patient care suggested the critical components of interpersonal caring, which is the compassion-based therapeutic actions/behaviors through the collaborative partnership developed between nurse and client. Essential characteristics of interpersonal caring include the following: person-to-person interaction between nurse and patient, genuine love and concern toward the person, conveying trust and hope, transcending space, time, and culture, holistic approach expressed through a comprehensive and dynamic mode of communication, helping the patient focus on their self-worth, and providing culturally relevant and sensitive nursing. Ten key components of interpersonal caring in ICT include noticing, participating, sharing, active listening, companioning, complimenting, comforting, hoping, forgiving, and accepting. Interpersonal caring results from the blended understanding of the empirical, aesthetic, ethical, and intuitive aspects of a given clinical situation, and a nexus of pre-conditions, content, feelings, and sense of self-worth/self-esteem. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapeut is the property of Springer Nature 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.)

Objective: In Canada and elsewhere, making treatment decisions for a person with serious mental illness (SMI) who was found incapable for treatment decisions via a substitute decision maker (SDM) is the norm. This practice is often called into question from a rights-based perspective. The literature on the views of affected individuals is limited. We explore the experiences of adults with SMI who have had SDMs to gain more in-depth understanding., Method: We conducted semistructured interviews with 11 consumers of psychiatric services who have had experiences with SDM (range 1-12 years) at an urban hospital in Toronto, Canada., Results: Thematic analysis showed five main themes and related subthemes, including: (1) strong dissatisfaction with and rejection of the SDM's role and purpose; (2) pervasive sense of stigma associated with having a SDM; (3) ongoing struggles to gain autonomy; (4) mixed changes in relationship with and views about SDM; and (5) views on how to improve SDM process., Conclusion and Implications for Practice: Our study highlights substantial dissatisfaction with the current SDM system and approaches among adults with SMI who have had SDMs. Issues of stigma and struggles to regain autonomy are prevalent. We discuss the personal, clinical, and social-legal contexts in which they occur, particularly in light of the United Nations' Convention on the Rights of Persons with Disabilities that calls for replacing SDMs with supported decision making. Rights-based approaches to care carry substantial practice implications and call for thoughtful change management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Cortical folding is essential for healthy brain development. Previous studies have found regional reductions in cortical folding in adult patients with psychotic illness. It is unknown whether these neuroanatomical markers are present in youth with subclinical psychotic symptoms. Methods: We collected MRIs and examined the local gyrification index in a sample of 110 youth (mean age [+ or -] standard deviation 14.0 [+ or -] 3.7 yr; range 9-25 yr) with a family history of severe mental illness: 48 with psychotic symptoms and 62 without. Images were processed using the Human Connectome Pipeline and FreeSurfer. We tested for group differences in local gyrification index using mixed-effects generalized linear models controlling for age, sex and familial clustering. Sensitivity analysis further controlled for intracranial volume, IQ, and stimulant and cannabis use. Results: Youth with psychotic symptoms displayed an overall trend toward lower cortical folding across all brain regions. After adjusting for multiple comparisons and confounders, regional reductions were localized to the frontal and occipital lobes. Specifically, the medial (B = -0.42, [p.sub.FDR] = 0.04) and lateral (B = -0.39, [p.sub.FDR] = 0.04) orbitofrontal cortices as well as the cuneus (B = -0.47, [p.sub.FDR] = 0.03) and the pericalcarine (B = -0.45, [p.sub.FDR] = 0.03) and lingual (B = -0.38, [p.sub.FDR] = 0.04) gyri. Limitations: Inference about developmental trajectories was limited by the cross-sectional data. Conclusion: Psychotic symptoms in youth are associated with cortical folding deficits, even in the absence of psychotic illness. The current study helps clarify the neurodevelopmental basis of psychosis at an early stage, before medication, drug use and other confounds have had a persistent effect on the brain., Introduction Psychosis is marked by hallucinations, delusions and disturbances of affect and behaviour. It manifests in major depressive disorder, bipolar disorder and most notably, schizophrenia. Although psychotic disorders are a [...]

Doris Lessing's The Golden Notebook (1962), The Four-Gated City (1969), and Briefing for a Descent into Hell (1971) engage explicitly and critically with R. D. Laing's 1960s' antipsychiatry movement--an extensive [...]

ObjectiveTo explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even).MethodsA simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program's costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs.ResultsUsing estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees.ConclusionsModelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting.

Este artículo propone una interpretación queer de The Yellow Wallpaper (1989), una adaptación de PBS del relato canónico de Gilman. Consta de tres partes: una aproximación al término queer, una lectura queer (y feminista) del texto de Gilman y un análisis de los aspectos queer (y feministas) del film. La tercera parte también responde al único ensayo académico sobre dicha producción, escrito por Janet Beer, el cual omite el carácter queer de la misma. Esta sección explora el tratamiento queer de los temas--identidad inestable, autoerotismo, tendencias lésbicas, enfermedades mentales, solidaridad entre mujeres y desigualdades de género y clase--a la vez que dialoga con críticas de cine como Linda Hutcheon y Laura Mulvey. Se señala además el uso queer de los recursos formales--luz, planos, sonido, música, simbolismo y motivos escénicos. Mi objetivo principal es demostrar que The Yellow Wallpaper es una innovadora adaptación queer de la obra de Gilman para un público moderno. Palabras clave: teoría queer; estudios de cine; crítica literaria feminista; Charlotte Perkins Gilman This article puts forward a queer interpretation of PBS's The Yellow Wallpaper (1989), adapted from Charlotte Perkins Gilman's canonical story. It is structured in three parts: an approach to the term queer, a reading of the queerness (and feminism) of Gilman's text and an analysis of the queer (and feminist) aspects of the film. The third part also responds to the only academic essay about PBS's production, by Janet Beer, which ignores the movie's queer character. This section discusses the queer treatment of topics--the instability of identity, autoeroticism, lesbian tendencies, mental illness, women's solidarity, and gender and class inequalities--while dialoguing with film critics such as Linda Hutcheon and Laura Mulvey. The queer use of formal resources--light, shots, sound, music, symbolism and scene-motifs--is also highlighted. My ultimate aim is to demonstrate that The Yellow Wallpaper is an innovative queer adaptation of Gilman's piece for a modern audience. Keywords: queer theory; film studies; feminist literary criticism; Charlotte Perkins Gilman, A Queer Eye for Gilman's Text: The Yellow Wallpaper, a Film by PBS I. What is Queer? From Sexuality and Gender to Race and Class An adjective, a noun and [...]

Community-based rehabilitation services in Malaysia have been established with the introduction of the National Mental health Act 2001. The Health Ministry's aims of providing a comprehensive community care encountered difficulties due to the lack of support for the primary and secondary health care services. Given the lack of study into the challenges faced by individuals with mental illnesses, an apparent need has arisen to conduct a qualitative study to better understand the experiences and the psychological well-being of these individuals. The aim of this research is to investigate the psychological distress faced and experienced by these residents with mental illnesses in one of the community-based rehabilitation centres and to explore the problems they encounter. A total of eight residents were interviewed using a semi-structured interview approach. The findings revealed an obvious neglect of the residents' psychological and social well-being. They felt the need for family support and social acceptance, to preserve their integrity and to get the understanding of the caregivers and the stigmatization that comes with mental illnesses. Mental health services should incorporate an integrative approach of public acceptance of these people living with mental illnesses by providing appropriate psychological services and facilities., Author(s): Sew Kim Low [sup.1] , Wan Ying Lee [sup.1] , Christoper Selvaraj Jacob [sup.1] Author Affiliations: (Aff1) 0000 0004 1798 283X, grid.412261.2, Department of Psychology and Counselling, Faculty of [...]

It has been argued that family care contributes to better outcomes for severe mental illness in Africa, and family care is championed as an alternative to institutional treatment; however, poor households are experiencing increasing precarity under global economic changes, which can be exacerbated by chronic illness. This article draws on an ethnographic study in Ghana to explore how families negotiate the tension between the moral imperative to provide care and the challenges of daily life with severe mental illness. Changes in family life, household costs, and migration can threaten the ability to meet the needs of a severely ill relative and fulfill social ideals of solidarity and responsibility. Such challenges raise questions for the viability of community-based models of mental healthcare in low-resource settings., Mental Illness and Family Care in Africa The role of the family in caring for people with mental illness has long been central to discussions regarding mental healthcare in sub-Saharan [...]

While recovery has become a popular framework for mental health services, there is limited understanding of its applicability outside of Western countries. In fact, recent studies in non-Anglophone populations suggest that recovery is contextually dependent and that the implementation of mainstream recovery models risks imposing inappropriate values. We used classic grounded theory to explore the main concerns of mental health service users in a Middle Eastern context and the strategies they use to resolve those concerns. The theory of 'reciprocity membership', a process involving ongoing mutual exchange with a group or community, was developed. Reciprocity membership becomes balanced when an individual is satisfied with their 'contribution to' the group, the 'acknowledgement from' other group members, the 'expectations of' the group, and their 'alignment with' the values of the group. Balance among these conditions is appraised by a sub-process called 'valuing', and developed or maintained by two further sub-processes called 'positioning' and 'managing relationships'. Balanced reciprocity membership seems to be associated with recovery. This study is the first in-depth exploration of people's experience of mental illness in a Middle Eastern context; findings provide evidence for a novel potential pathway towards recovery. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Forensic Medicine / Fayixue Zazhi is the property of Journal of Forensic Medicine Editorial Office 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.)

Background: We aimed to find out the overall reported and intended behavior of the general population of India toward mentally ill persons. Materials and Methods: Participants were included in an online survey using a nonprobability snowball sampling technique. After taking informed consent, sociodemographic details were recorded, and the "Reported and Intended Behaviour Scale" was administered. Results: Out of 818 responses, 684 responses were eligible for study after exclusion. The mean age (standard deviation) of the study population was 31.01 (7.79) years. Maximum participants reported that they did not live (76.6%), did not work (75.7%), did not live nearby (66.4 %), or have not had a close friend (79.8%) with mental health problems. However, most individuals neither agreed nor disagreed to live (48.5%), work (38%), and live nearby (42.7%) a mentally ill person, but maximum individuals strongly agreed to continue a relationship with a friend having mental health problems (34.5%). There were 77.5% males and 32.2% healthcare workers. Regarding intended behavior, there was a significant difference between healthcare workers and persons other than these as well as between males and females. Participants who had previous interaction with the mentally ill person were more willing to interact with the same. Conclusion: Most people do not intend to have stigmatized behavior toward mentally ill persons. Healthcare workers and males have less negative social reactions toward mentally ill persons in different domains of life. However, there is still a need to intensify awareness about mental health. [ABSTRACT FROM AUTHOR]

Copyright of Investigaciones Historicas is the property of Universidad de Valladolid, Facultad de Filosofia y Letras 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.)

Objective: The influence of guideline recommendations and other factors on the utilization of psychosocial interventions in people with severe mental illness was examined., Methods: Data from a cross-sectional study of 397 people with severe mental illness were analysed descriptively., Results: Patients are less likely to receive therapies with a strong recommendation compared to other levels of recommendation. Various other factors are diffusely associated with utilization rates, but no ubiquitous predictors could be identified across all therapies., Conclusion: Current practice in the use of psychosocial interventions does not follow guideline recommendation strength. Interventions with strong recommendations are probably not available across services. Consequently, routine practice is not able to follow guideline recommendations according to their strength. Other consistent predictors could not be identified., Competing Interests: Alkomiet Hasan erhielt Vortragshonorare von AbbVie, Advanz, Janssen, Otsuka, Rovi, Recordati und Lundbeck. Er war Mitglied in Advisory Boards für Boehringer-Ingelheim, Janssen, Otsuka, Rovi, Recordati und Lundbeck. Einladungen zu Kongressen oder Essen wurden nicht angenommen. Er ist Herausgeber der AWMF S3-Leitlinie Schizophrenie, Angestellter des Freistaats Bayern und der Bezirkskliniken Schwaben. Karel Frasch hat Kongressreiseunterstützungen von Janssen erhalten. Er ist stellv. Sprecher von ackpa und Mitglied im Vorstand der DGPPN. Alle anderen Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objectives: Mental illness and homelessness are often associated with each other. The study aim was to describe the care trajectories of psychiatric inpatients admitted from precarious housing or homelessness., Methods: An anonymized data collection was performed at two psychiatric hospitals in North Rhine-Westphalia., Results: Of 76 identified patients, every other was discharged to unsecured housing or homelessness. An unresolved housing situation delayed discharge in almost every third case. Upon discharge outpatient somatic or psychiatric treatment was not secured in more than 30%, and in more than 40% of cases, resp., Conclusion: Improvement of the housing situation is possible in a minority of cases for psychiatric inpatients admitted from unsecured housing. The unresolved housing situation was seen as an obstacle to discharge in every third case., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht, (Thieme. All rights reserved.)

Objectives: To provide a brief biography of Dr Richard Greenup and to explore the legacy he has left to one of Australia's longest operating psychiatric services., Methods: This history was obtained by consulting staff working within Cumberland Hospital, New South Wales and by examining primary and secondary sources., Results: Greenup was the second surgeon superintendent of 'The Parramatta Lunatic Asylum' from 1852 until 1866 when he was fatally stabbed with a pair of scissors by a patient. Greenup was involved in establishing The University of Sydney and advocated for expanded and improved services for people diagnosed with mental disorders., Conclusions: Greenup recognised the needs of the mentally ill and sought to address similar social and demographic determinants of health to those that we face today. The challenges he faced, and his tragic end remind us of the importance of delivering patient-centred care whilst being mindful of associated risks., Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Inpatient psychiatric treatment of prisoners is organized differently in Germany, depending on the structural conditions of the federal state and prison. There are very few findings on the different possibilities of treatment and the view of the hospitals on this issue., Objectives: Our aim was to gain an up-to-date picture of inpatient treatment of prisoners in general psychiatric departments and hospitals and the challenges these institutions face., Methods: We conducted an anonymous online survey of the frequency, extent, and challenges of inpatient treatment of prisoners. Approximately 460 chief physicians of German general psychiatric departments and hospitals were invited to participate in this survey. In addition to descriptive statistics, we calculated group differences by type of hospital and by subjective responsibility for inpatient care of prisoners., Results: A total of 74 chief physicians surveyed participated; 51.4% of the surveyed hospitals provided psychiatric inpatient treatment to prisoners in 2020. Group differences between the different types of hospitals were found only for the presence of anticipated anxiety among regular inpatients. Various differences were found between responsible and non-responsible hospitals, especially with regard to organizational aspects., Discussion: For the treatment of mentally ill prisoners, various organizational challenges as well as fears of hospital staff and fellow patients were mentioned by the participants. The type of hospital appears to play a subordinate role here, whereas the responsibility of the hospital for the inpatient treatment of mentally ill prisoners might be more decisive for anticipated concerns and barriers., Competing Interests: Elias Wagner und Manuela Dudeck berichten keine Interessenskonflikte. Felix Grubbe erhielt Reise- und Kongresskosten-Übernahmen durch Actelion und Indivior. Oliver Pogarell erhielt Vortragshonorare von Lundbeck, Otsuka, Takeda, Medice und Janssen. Alkomiet Hasan erhielt in den letzten drei Jahren Vortragshonorare von Janssen, Lundbeck, Otsuka und Recordati und war Mitglied von Advisory Boards dieser Firmen sowie von Rovi. Er ist Herausgeber der AWMF S3-Leitlinie Schizophrenie., (Thieme. All rights reserved.)

Background: Patients dealing with severe mental illnesses (SMI) often face suboptimal clinical outcomes and higher mortality rates due to a range of factors, including undetected physical health conditions. The provision of care for individuals with SMI is frequently disjointed, as they engage with diverse healthcare providers. Despite this fragmentation, primary care, particularly general practitioners (GPs), assumes a pivotal role in the care of SMI patients. Our study aimed to delve into the first-hand experiences of GPs in delivering somatic care to SMI patients, concentrating on the challenges they encounter and the strategies they employ to navigate these difficulties., Methods: We conducted in-depth interviews with fifteen GPs, utilizing a semi-structured interview guide, supplemented by ethnographic observations during clinical consultations in general practice. Through inductive coding, interview transcripts and observational field notes were systematically analysed using interpretative phenomenological analysis (IPA). The findings were then deliberated upon within the author group., Results: GPs revealed that managing the chronic somatic care of SMI patients posed significant challenges. These challenges encompassed the multifaceted needs of patients, their behavior tied to symptoms, a lack of care continuity, and overarching time constraints. To tackle these challenges, the GPs had devised various strategies. However, all participants underscored the critical importance of having adequate time to properly prepare for, conduct, and follow up on consultations., Conclusion: The GPs' interactions with SMI patients brought numerous challenges, although treating these patients were concurrently acknowledged as vital and fulfilling. The findings suggest that increased allocated time in general practice consultations for patients with SMI is important to support the somatic treatment requirements of this patient group., (© 2024. The Author(s).)

Richard Griffith , Senior Lecturer in Health Law at Swansea University, considers the notion of residual liberty and the need for further authorisation when a detained patient is given treatment for a physical disorder under restraint.

In response to the increasing number of mentally ill people experiencing homelessness, some policy-makers have called for the expanded use of involuntary commitment, even for individuals who are not engaging in behaviors that are immediately life-threatening. Yet there is no evidence that involuntary commitment offers long-term benefits, and significant reasons to believe that expanding the practice will cause harm. In addition, these proposals ignore research showing that most people with mental illness have the capacity to make medical decisions for themselves. Rather than expanding the use of involuntary commitment, policy-makers should support approaches proven to decrease the prevalence of homelessness, such as supportive housing. In addition, states should reevaluate their commitment standards for persons who pose no risk of harm to others. One promising approach is Northern Ireland's Mental Health Capacity Act of 2016, which establishes a uniform standard for imposing nonconsensual health care interventions, without any distinction between mental illnesses and other conditions in which capacity might be compromised., (© 2024 The Hastings Center.)

Background: Medical interaction and exploration techniques are the most important tools that medical students have to acquire in the subject of psychiatry and psychotherapy. The new digital technologies currently available, such as virtual reality (VR), as important supplements can contribute to a significant improvement in the teaching of psychiatric-psychopathological learning content as well as, in particular, the technique of ascertaining the psychiatric history and diagnosis., Objective: Evaluation of the Bochum Avatar Exploration Project (AVEX) as part of the curricular course in medical studies at the Ruhr University Bochum for its possibilities to convey learning content and techniques of anamnesis and diagnosis in the subject of psychiatry and psychotherapy., Methods: In AVEX, a total of 87 medical students in the clinical study section have so far been able to enter into a dialogue with "mentally ill" avatars and gain experience with VR technology as a learning and teaching method in the subject of psychiatry and psychotherapy., Results: Despite the limited possibilities for interaction with the digital avatars, it is possible to achieve a substantial transfer of learning content in psychiatry; however, the students must be well supported by the lecturers., Conclusion: The AVEX project already shows promising possibilities for supplementing the teaching of medical students, even if the fit of questions and replies in dialogue with the virtual avatars still needs to be improved. As advances in the linguistic communication of emotions and the visual effects of the avatar representation can be predicted, the significance of this technology will continue to increase., (© 2024. The Author(s).)

BACKGROUND: Physical therapists provide important services for improving health and function for the general population; however, physical therapy (PT) is infrequently accessed by persons with a primary diagnosis of severe mental illness (SMI). This study examined the attitudes of PT students before and during their participation in a service-learning (SL) program for people with SMI. MATERIALS AND METHODS: A cross-sectional institutional review board approved qualitative study collected 1-h semi-structured qualitative interviews from seven graduates of a doctor of PT program. Participants were from a New Jersey University program in the USA who participated in an SMI SL experience. Participants were asked about participant attitudes toward people with SMI and their observations during a SL experience using an interview guide. All interviews were digitally recorded, transcribed, and coded using interpretive phenomenological analysis by a team of researchers. This type of qualitative analysis aims to explore participants understanding of their experience without pre-conceived theoretical direction. Recordings, transcripts, and field notes were reviewed for recurring ideas that were summarized into codes. Through independent coding, reflexivity memos, and consensus meetings, data were further analyzed to identify themes. Investigator triangulation addressed differences and aided consensus development. RESULTS: Before the SL experience, the students reported negative perceptions about people with SMI and feelings of uncertainty and unpreparedness to work with this population. According to student reports, SL supported their personal and professional development and allowed them to see that PT services are beneficial for people with SMI. CONCLUSIONS: The results of this study indicate that PT students have negative attitudes of people with SMI and feel unprepared to work with this population. The results also support SL as an effective strategy for helping students in their preparation for working with people with SMI.

Mental disorders are widespread among the world's population and place a high burden on both the people affected and the economy. In this area of health care and prevention major deficits can be found. Health-enabling technologies are being developed in order to provide support in the therapy and diagnostics of mental disorders. However, it is not clear whether patients are open to these technologies and what they expect from a suitable usage. The main goal of this study is to find out what opinions, hopes and fears mentally ill persons have towards a supporting treatment with health-enabling technologies. Personal interviews were conducted with psychiatric patients for that purpose. The evaluation of the interview data revealed a predominantly positive mindset of the participants. In addition to the general question according to the acceptance, requirements and expectations for the use of health-enabling technologies were acquired. In this context the concern of an invasion of privacy was exposed as a major barrier. [ABSTRACT FROM AUTHOR]