The Psychiatric quarterly
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The Psychiatric quarterly · Mar 2009
"Unfortunately, we treat the chart:" sources of stigma in mental health settings.
Stigma within mental health settings may be equally detrimental to people with mental illnesses as societal stigma. ⋯ These data suggest that stigma in mental health settings may be due to structural, systemic pressures on practitioners, with practitioners' emphasis on symptoms and deficits as a secondary factor.
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The Psychiatric quarterly · Dec 2007
State prison mental heath services recipients perception of care survey.
Studies have demonstrated the importance of patient perceptions' of mental health service quality. No studies, however, could be found that surveyed recipients in prison, despite the rapid growth of patients, and litigation in these settings. ⋯ Random samples were requested, but likely only a convenience sample was obtained. However, the positive results suggest the need to strive to enhance patient quality of care ratings.
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The Psychiatric quarterly · Jan 2005
Reducing restraints: alternatives to restraints on an inpatient psychiatric service--utilizing safe and effective methods to evaluate and treat the violent patient.
This paper describes the violence safety program instituted at Elmhurst Hospital Center in Queens, New York City in 2001, which significantly reduced the use of restraints and seclusion department wide, while providing a safe and therapeutic environment for patient recovery. The hospital service and program instituted is described, followed by restraint and seclusion data since 1998, and the program's results through 2003. Concurrent data in areas that could be affected by a reduction in restraint and seclusion such as self-injurious behaviors and altercations; use of emergency medication; use of special observation and length of stay data are also presented. In addition, types and frequency of alternative methods utilized to avoid restraints and seclusion are described.
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The Psychiatric quarterly · Jan 2004
ReviewMentally ill persons in the criminal justice system: some perspectives.
There is an increasing number of severely mentally ill persons in the criminal justice system. This article first discusses the criminalization of persons with severe mental illness and its causes, the role of the police and mental health, and the treatment of mentally ill offenders and its difficulties. The authors then offer recommendations to reduce criminalization by increased coordination between police and mental health professionals, to increase mental health training for police officers, to enhance mental health services after arrest, and to develop more and better community treatment of mentally ill offenders. The necessary components of such treatment are having a treatment philosophy of both theory and practice; having clear goals of treatment; establishing a close liaison between treatment staff and the justice system; understanding the need for structure; having a focus on managing violence; and appreciating the crucial role of case management, appropriate living arrangements, and the role of family members.
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The QTc prolongation by antipsychotic drugs is of major concern, especially in light of the data indicating an increased risk of sudden death in psychiatric patients taking these drugs. Sudden death in psychiatric patients could be partially attributed to drug-induced torsades de pointes and for this reason careful evaluation of QTc prolonging properties of antipsychotic drugs is needed. Antipsychotic drugs prolong QT interval usually by blocking the potassium IKr current. ⋯ Currently prescribed antipsychotics might cause QT prolongation ranging from 4-6 ms for haloperidol and olanzapine to 35 ms for thioridazine. The response of a patient to a drug is very individual and therefore an individualized system of drug administration and monitoring needs to be developed which takes into account baseline QTc duration and its changes after a drug was introduced. A systematic approach while stratifying psychiatric patients as those with short QTc (QTc < or = 0.41 sec), borderline QTc (QTC = 0.42-0.44 sec), and prolonged QTc (0.45 sec) is being proposed to improve the safety of administering antipsychotic drugs and to decrease the risk of drug-related sudden death in psychiatric patients.