Psychiatric and Mental Health Commons^™

Identification And Mitigation Of Environmental Hazards In Psychiatric Patient Suicide Prevention: A Review, Alan Le

DNP Qualifying Manuscripts

Background: Environmental hazards are a factor in the bulk of inpatient suicide cases, which disproportionately impact psychiatric patients. Current measures to minimize suicide risk include process-oriented solutions and environmental safeguards such as breakaway structures.

Aims: To perform a review of the literature that identifies environmental suicide hazards and interventions implemented to abate hazards and reduce suicide risk.

Methods: Electronic databases were searched using relevant keywords. Inclusion criteria consisted of articles published 2009-2020 that identified environmental suicide hazards or examined efficacy of interventions implemented to abate hazards. The Johns Hopkins Research and Non-Research Evidence Appraisal Tools were used for critical appraisal. …

The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez

Master's Projects and Capstones

In efforts to challenge the Western medicine’s determination of nutrition as a holistic approach, this paper represents the intent for mental health facilities in California to improve or implement nutrition education curriculum by enhancing interprofessional teams with dietitians as an important component of recovery for severe mental illness patients. There is concrete evidence proving that individuals who are in facilities recovering from mental illnesses have benefited from optimal nutrition consumption. Nutrition education has become a component among the toolbox of recovery options, but unfortunately it is not encouraged enough. Pharmaceutical companies advertise drug therapy as the most effective way to …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

Three Good Things To Extinguish Caregiver Burnout, Justin Haley

Master's Projects and Capstones

Caregiver burnout is a widespread issue in healthcare and institutions should be increasingly concerned about burnout because of the significant impact on quality of patient care, employee health, and financial stability. Many interventions and studies regarding burnout are focused on improving systems issues or removing negative stressors on caregivers. Although such interventions may be necessary to attempt, comprehensive systems-wide changes can be cumbersome and expensive, while removing negative stressors may be an unrealistic goal in a fast-paced, demanding healthcare environment. The Three Good Things method is an evidence-based, effective, simple, low-cost intervention to improve feelings of caregiver burnout in which …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Grounding Frequent Flyers: Understanding High Er Utilization And Developing Primary Care Solutions, Jillian Millares

Master's Projects and Capstones

Background: Regular access to primary care can positively impact long-term, chronic conditions. However, medically underserved individuals, particularly individuals with Severe Mental Illnesses(SMI), typically underutilize primary care. Root causes include client level factors such as socioeconomic barriers, provider level issues such as lack of training or general knowledge of SMI issues, and system level factors such as a lack of coordinated services. Methods: The present study conducted a needs assessment to identify the most influential of these factors on clients at an Acute Residential Treatment Center in San Francisco, California. The needs assessment consisted of semi-structured client and staff interviews. Results: …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis

Master's Projects and Capstones

Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.

Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.

Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …

Symptoms, Contributing Factors, And Screening For Perinatal Mood And Anxiety Disorders In U.S. Latinas: A Literature Review, Jennifer N. S. Massie

Master's Projects and Capstones

This literature review was conducted to gather the published information on the topic of perinatal mood and anxiety disorders in the Latina population in the United States. Academic databases were searched for articles published between 2005 and 2016. 60 articles were considered, and a final sample of 36 articles and websites was included in this review.

Evidence suggests that Latina women in the perinatal period (pregnant and up to one year postpartum) in the United States of America tend to have a higher risk and incidence of perinatal mood and anxiety disorders than White women, and a higher risk and …

The Importance Of Treatment For Foster Youth, Lyl T. Cartagena

Creative Activity and Research Day - CARD

This presentation provides an overview of mental health interventions including highlights of their outcomes.The summary of the extant findings helps identify the strengths and deficits of what has been done, and supports a call for further research in order to change current methods of care provided along with developing an improved method of treatment for foster care youth.

The Association Between Self-Rated Mental Health Status And Total Health Care Expenditure: A Cross-Sectional Analysis Of A Nationally Representative Sample, Muoi T. Nguyen, Winnie Y. Chan, Courtney Keeler

Nursing and Health Professions Faculty Research and Publications

Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.

This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).

Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ² tests and a 2-part model (logistics regression and …

Disseminating An Evidence-Based Course To Teach Self-Management Of Auditory Hallucinations, M Buffum, Robin Buccheri, L Trygstad, G Dowling

Nursing and Health Professions Faculty Research and Publications

This multi-site project extended course dissemination of the 10-session Behavioral Management of Auditory Hallucinations Course to U.S. Department of Veterans Affairs (VA) mental health outpatient settings. The VA Quality Enhancement Research Initiative (QUERI) model and Rogers' theory of diffusion of innovations served as the theoretical framework. The course was taught to mental health professionals using teleconferencing, electronic media, and monthly conference calls across 24 VA mental health outpatient sites. Twenty course leaders provided feedback. One hundred percent reported being better able to communicate with patients about their voices and 96% reported improved understanding of the voice-hearing experience. Thirty-three course participants …

Self-Management Of Unpleasant Auditory Hallucinations: A Tested Practice Model, Robin Buccheri, L Trygstad, M Buffum, P Birmingham, G Dowling

Nursing and Health Professions Faculty Research and Publications

Individuals who experience auditory hallucinations (AH) frequently report hearing unpleasant voices saying disturbing things to them, making derogatory remarks about them, or commanding them to do something, including harming themselves or someone else. The Self-Management of Unpleasant Auditory Hallucinations Practice Model was developed to help psychiatric-mental health nurses in both inpatient and outpatient settings implement evidence-based nursing care for voice hearers who are distressed by unpleasant voices. The model's utility extends to nursing education, administration, and research. The model is comprised of three parts: (a) Assessment of Voice Hearer's Experience, (b) Nursing Interventions, and (c) Voice Hearer's Expected Positive Outcomes. …

Comprehensive Evidence-Based Program Teaching Self-Management Of Auditory Hallucinations On Inpatient Psychiatric Units, Robin Buccheri, L Trygstad, M Buffum, K Lyttle, G Dowling

Nursing and Health Professions Faculty Research and Publications

Patients hearing command hallucinations to harm whose only self-management strategies are to obey these commands, can represent serious safety concerns on inpatient psychiatric units. A comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units is described that includes five components: suggestions for staff education; patient self-assessment tools; an interview guide and safety protocol; a course to teach strategies for managing distressing voices and commands to harm; suggestions to improve staff communication; and a plan to extend the program from inpatient care settings into the community by sharing materials with community case managers and caregivers when patients are …

Behavioral Management Of Auditory Hallucinations: Implementation And Evaluation Of A 10-Week Course, M D. Buffum, Robin Buccheri, L Trygstad, A A. Gerlock, P Birmingham, G A. Dowling, G J. Kuhlman

Nursing and Health Professions Faculty Research and Publications

A 10-session behavioral course for self-management of auditory hallucinations in patients with schizophrenia has demonstrated positive outcomes. This article evaluates both the course’s implementation and benefits to patients attending the course. Teleconferencing, electronic media, and 26 monthly conference calls were used to educate six advanced practice nurses (APNs) at six sites about the course implementation. Thirty-two patients within the U.S. Department of Veterans Affairs participated in the course. All of the APNs reported course helpfulness, improved communication with patients about voices, and improved harm assessment. Of the patients, 96% found the course helpful: 67% no longer heard voices to harm …

Integrating Primary Care And Mental Health Services: Final Evaluation Report On The Icare Integration Pilot Sites, Joseph P. Morrissey, Marisa Domino, Courtney Keeler, Mona Kilany, Bradley Gaynes

Nursing and Health Professions Faculty Research and Publications

No abstract provided.

Behavioral Management Of Command Hallucinations To Harm In Schizophrenia, Robin Buccheri, L Trygstad, G Dowling

Nursing and Health Professions Faculty Research and Publications

The study objective was to evaluate changes in prevalence of command hallucinations to harm self or others, characteristics and intensity of auditory hallucinations, and levels of anxiety and depression after attendance at a 10-session course teaching behavioral strategies for managing persistent auditory hallucinations to adult outpatients with schizophrenia. Prevalence of command hallucinations to harm self or others was measured at baseline, end of course, and 1-year post-course. Pre-course scores on the Characteristics of Auditory Hallucinations Questionnaire, Unpleasant Voices Scale, tension-anxiety subscale of Profile of Mood States, and Beck Depression Inventory-II were compared with scores immediately post-course and 1 year later. …