Social psychiatry and psychiatric epidemiology
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Soc Psychiatry Psychiatr Epidemiol · Oct 2009
Comparative StudyDetecting and predicting self-harm behaviour in prisoners: a prospective psychometric analysis of three instruments.
Research has revealed high levels of suicide and self-harm within young adult prisoners, but many studies have not considered the applicability and validity of its measurement for both male and female prisoners. Previous studies have focused on retrospective evaluations of instruments which are not useful evidence in informing clinical practice and decision making. ⋯ Screening for self-harm and suicidal behaviour in young prisoners has generated a range of cut off points for the identification of those at risk. These serve as a bench mark for service planners and practitioners.
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Soc Psychiatry Psychiatr Epidemiol · Jun 2009
Comparative StudyU.S. military mental health care utilization and attrition prior to the wars in Iraq and Afghanistan.
Health care utilization studies of mental disorders focus largely on the ICD-9 category 290-319, and do not generally include analysis of visits for mental health problems identified under V-code categories. Although active duty service members represent a large young adult employed population who use mental health services at similar rates as age-matched civilian populations, V-codes are used in a larger proportion of mental health visits in military mental health care settings than in civilian settings. However, the utilization of these diagnoses has not been systematically studied. The purpose of this study is to characterize outpatient behavioral health visits in military health care facilities prior to Operation Iraqi Freedom, including the use of diagnoses outside of the ICD-9 290-319 range, in order to evaluate the overall burden of mental health care. This study establishes baseline rates of mental health care utilization in military mental health clinics in 2000 and serves as a comparison for future studies of the mental health care burden of the current war. ⋯ This study establishes baseline rates of pre-war behavioral healthcare utilization among military service members, and the relationship of mental health care use and attrition from service. The research indicates that in the military population the burden of mental illness in outpatient clinics is significantly greater when V-code diagnoses are included along with conventional mental disorder diagnostic codes.
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Soc Psychiatry Psychiatr Epidemiol · May 2009
Randomized Controlled TrialViews of service users and providers on joint crisis plans: single blind randomized controlled trial.
We report participants' and case managers' use of and views on the value of Joint Crisis Plans (JCPs), shown to reduce compulsory hospitalisation and violence. ⋯ The best supported hypothesis was that participants felt more in control of their mental health problem. Together with the previously reported outcomes, this suggests JCPs empower their holders to obtain their preferred care and treatment in a crisis. Further research is needed to more clearly identify the mechanisms of action of JCPs and how their initial positive impact can be sustained.
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Soc Psychiatry Psychiatr Epidemiol · Mar 2009
Perceived need for mental health care among non-western labour migrants.
There is a supposed higher prevalence of common mental disorders among many migrant groups. At the same time, problems are reported regarding underutilisation of mental health services by migrants. Since perceived need for care is a powerful predictor of actual care utilisation, we aimed to study the hypothesis that, given the same level of mental morbidity, non-Western migrants would perceive less need for mental health care than ethnic Dutch residents. Additionally, we studied the extent to which needs are met in both groups, as well as several possible barriers to care. ⋯ In case of similar mental morbidity, perceived need for care was lower than among ethnic Dutch. The results did not support the hypothesis that in case of similar mental distress, needs of migrants were less often met than needs of ethnic Dutch.
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Soc Psychiatry Psychiatr Epidemiol · Oct 2008
Social networks and mental health among a farming population.
The study investigated the associations between mental health and measures of community support, social support networks, sense of place, adversity, and perceived problems in a rural Australian population. There was a specific focus on farming communities due to previous qualitative research by the authors indicating distress by farmers in response to drought (Sartore et al. Aust Fam Phys 36(12), 990-993, 2007). ⋯ This study has highlighted the association between unique rural community characteristics and rural stressors (such as drought) and measures of mental health, suggesting the important mediating role of social factors and community characteristics. The results illustrate the importance of addressing subgroup differences in the role of social capital in mental health.