Mom Power (MP) is a trauma-informed parenting intervention which aims to break the cycle of intergenerational risk transmission by promoting enhanced parent-child attachment, increased social support, connection to community services, and utilization of self-care skills. MP was developed to engage vulnerable families (e.g., mothers with trauma histories, low income, single mothers) and seeks to mitigate common treatment accessibility barriers for underserved populations through provision of childcare, transportation, and a trauma-informed/culturally sensitive milieu. Results from a community-based randomized control trial (RCT) in Michigan (MI) have shown that MP is effective at reducing maternal psychopathology, lowering parenting stress, decreasing parental hopelessness, and promoting reflective parenting; however, no studies have examined the feasibility of implementing MP outside of MI, nor the effectiveness of MP with additional samples (Rosenblum et al., 2017). The present study is a hybrid implementation/effectiveness design that is two-fold: (1) Implementation design to assess the feasibility of training rural, Appalachian community-based providers in the MP model, recruiting high risk mothers, retaining mothers in this 10-week intervention, and implementing MP groups with community-based partners (2) An effectiveness oriented, pre-post, within subjects design with mothers of young children who are attending MP groups in the community [n = 33 mothers; M maternal age = 26 (SD = 5) years; M child age = 12 months (SD = 15)]. Regarding implementation results, the MP training involved n = 31 community-based providers from 5 agencies (e.g., community mental health, foster care agency) and 3 university-based mental health training programs. In the 18 months since training, three 10-week MP groups have been completed (n = 25 mother-child dyads), and one group is currently being held (n = 8 dyads). Regarding recruitment, we have had great success reaching high risk families, having more family referrals than available group slots. Of the families served in TN thus far, 60% had DCS involvement, 46% were in substance abuse treatment, 68% endorsed ≤ 4 ACEs, 77% had clinically significant depression, 58% had clinically significant anxiety, 78% were single/had no co-parent, 81% had low educational attainment, and 100% were below the federal poverty level. Regarding effectiveness, following completion of the current group, we will present pre-/post- differences in maternal PTSD symptoms, emotion regulation, and parenting behavior, as well as examine the relationship between attendance and change scores.

No description available.

Polypharmacy is broadly defined as the administration of more than one medication in a single patient, with the most commonly used definition indicating the concurrent use of five or more medications. Polypharmacy occurs in most clinical settings, particularly inpatient settings and treatment settings for persons with chronic illness and the elderly. Reasons for receiving more than one medication include ineffective treatment with monotherapy, targeting specific but varied symptoms, treating two distinct but co-morbid illnesses, addressing unremitting symptoms, and treating extrapyramidal side effects. Research indicates that each medication added to the patient’s regimen increases the likelihood of an adverse outcome, as well as the risk of adverse drug reactions, drug-to-drug interactions, cumulative toxicity, medication errors, patient non-compliance, patient morbidity, and patient mortality. The current study seeks to investigate the rates of polypharmacy and related characteristics predictive of polypharmacy within a forensic psychiatric setting. A total of 182 patients residing in a secure forensic psychiatric hospital were selected. The sample is predominantly male (80.8%, n=147) and majority Caucasian (55.5%, n=101), African American (40.1%, n=73), and Hispanic (2.2%, n=4), with a mean age of 43.5 (SD=13.2). Participants range from persons with at least one mental health disorder (100%, n=182) to persons with at least one chronic illness (74.5%, n=132). Of those currently taking medications, 99.2% have been prescribed more than one type of medication, with 93.1% of those individuals being prescribed four or more. Polypharmacy was observed in 91% of participants. Of those diagnosed with a mood or psychotic disorder, an average of 3.6 different types of psychotropic medications were prescribed. Co-morbidity of mental illness was predictive of polypharmacy trends, F(1,181)=5.28, p<.05. Additionally, individuals with at least one chronic illness also were subjected to polypharmacy practices, with rates increasing for those with more than one chronic illness. As a measure of onset and severity of symptoms, age at first hospitalization and age of onset of aggressive behaviors were measured, and, interestingly, both measures were predictive of polypharmacy within these patients, F(1, 181)=13.45, p<.01. Results indicate that perceived severity of symptomology, aggression, and complex health problems all contribute to polypharmacy practices among prescribing physicians. The high rates of polypharmacy observed are concerning because of the potential for increased aversive health outcomes. Understanding the predictive factors, rates, and trends of polypharmacy has valuable implications for the future treatment and rehabilitation of individuals residing in a forensic psychiatric setting.

No description available.

No description available.

No description available.

Background: Approximately twenty percent (20%) of children and adolescents have mental health disorders and between 50–75% of all adult mental illness has its onset before the age of 18. Few under 18-year-olds with mental health disorders are, however, admitted for psychiatric inpatient care. The majority of those are adolescents who present with emerging serious mental health disorders. Very little is known about inpatient admission of preadolescent children (under 13 years) with mental health disorders. A review in 2000 showed mixed results about outcomes from admissions and highlighted a number of challenges with outcome studies. Objectives: The purpose of this study was to investigate the outcomes of preadolescents (hereafter referred to as ‘children') after inpatient admission, both locally and internationally. Methods: To meet the first aim, we performed a scoping review. Two reviewers independently searched EBSCOhost and Scopus (January 2000 – February 2017), using keywords ‘inpatient'; ‘psychiatry'; ‘psychiatric unit'; ‘mental health'; ‘children'; ‘treatment outcome/s'; ‘follow-up'; ‘secondary care'; to identify studies examining child (0–12 years) psychiatric inpatient outcomes. To meet the second aim, perspectives of convenience sampled parent-child dyads, who were previously patients at an inpatient psychiatric unit for under 13-year-olds in Cape Town, South Africa, were gathered using in-depth individual interviews. Data generated from the interviews were transcribed and analysed using thematic analysis. Results: Seventeen studies were identified by the PRISMA-guided search strategy in the scoping review. Measurements used differed widely. Significant improvements were reported at discharge and was maintained in short-term follow-up (1–4 months) studies. However, medium-term (5–11 months) and long-term (1 year or more) follow-up studies showed mixed results, with marked deterioration in very long-term studies. The qualitative study showed that most families found inpatient admission helpful, and indicated positive outcomes, but with ongoing difficulties over time. Two main themes related to outcomes emerged from the 10 parent-child dyads included in the study. The first theme (“A turn in the road”) highlighted inpatient admission as the catalyst of positive outcomes. Diagnostic certainty; newly acquired cognitive and behavioural skills; improved parent-child relationships; appropriate school placements; development of peer relationships; as well as follow-up psychiatric care and medication, were seen as contributing to positive outcomes. Conversely, the second theme (“Still a rough journey”) described ongoing difficulties including lingering problems despite improvement; minimal improvement when lacking a diagnosis; regression with transition to mainstream secondary school; and negative outcomes associated with lack of peer relationships and discontinuation of psychiatric care and medication. Conclusion: Taking together findings from our work, inpatient stay for child psychiatric patients was found to result in substantial short-term improvement. Medium-term outcomes were less clear, while long-term outcomes appeared mixed, with potential deterioration in the very long-term. However, the relatively few and diverse studies found in the scoping review made interpretation of the findings difficult. One striking finding from the research, was the absence of internationally agreed outcome measures to inform such research. In this study, qualitative data from families and children who had received inpatient treatment provided several functional outcomes that may be important, both for outcomes research and for post-discharge clinical practice.

Abstract Missed appointment, referred to as “no-shows,” are appointments that were not attended or previously cancelled at least 24-hours prior to the scheduled time. Missed appointments negatively impact patients as well as health care systems. According to Ullah et al. (2018), the financial impact of missed appointments on the healthcare system is more than $150 billion a year. Also, patients with chronic health problems (who are noncompliant with their scheduled appointments) may cause their conditions to worsen. Researchers have implemented several strategies to reduce the negative effects of no-shows. The purpose of this literature review was to explore the effectiveness of appointment reminders. The question driving this literature review was whether the implementation of appointment reminders via other means were more effective in reducing no-show rates, compared to the standard appointment reminder via telephone call. An electronic search was conducted using CINAHL and PubMed. Inclusion criteria consisted of English language, peer-reviewed, academic journal articles published from 2017 to the present. A variety of articles were found, and five of those were critiqued for this review. The literature was synthesized using the John Hopkins Nursing Evidence-Based Practice Model. The key finding of this review is that telephone calls are the most efficient and feasible form of appointment reminders (Lance et al., 2021 & Lavin et al., 2017). Since phone bills are a normal expense for most businesses, health systems should be able to implement the use of this strategy. Keywords: appointment adherence, no-show, missed appointments, appointment attendance

ABSTRACTJonasson Anna (2015). Educational background in forensic psychiatric patients – judged according to the LRV and LRV: sup. School Improvement and Leadership, Master, Learning and Society, Malmö University.The intention of the research in forensic psychiatry and special education is an improvement of psychiatric care, but also to contribute knowledge to prevention work in the community that lead to benefits for individuals` health and by extension economic gains. The aim of this study was to investigate forensic psychiatric patients´ needs of special education. The first question was how forensic psychiatric patients’ preschool and school background looked like. The second question was, wherein sessions of information, which would give possibilities to increase the patients´ information comprehension by special education during their treatment process. The theoretical base is socio-cultural perspective. By using a qualitative approach two qualitative studies were developed. In the first study a content analysis was conducted regarding pre-school and school background on 102 forensic psychiatric examinations. In the second study, the reader can follow a fictional patient through the forensic psychiatric treament process. The results show that 50 % of patients documented to have family-related problems. The most common measures were contact with BUP, Swedish child and adolescent psychiatry, and measures among the Care of Young Persons. 65 % attended at least 9 years of school and half of the patients have, received some form of grades. The enrollment, change of ward, distributing folders are some of the sessions of information, which would give possibilities to increase the patients´ information comprehension by using special education during the treatment process. Special education support involves consideration of the literacy level. The importance of the patients to have a realistic self-image regarding their cognitive abilities is emphasized. Tailor-made training programs in information literacy are proposed, also the importance of training non-cognitive abilities are recognized. Access to illustrative pictures and follow-up discussions at information sessions are also proposed as special education support.

As students continue to pursue higher education, the potential for them to experience mental health issues will exist (National Alliance on Mental Illness, 2011; Center for Collegiate Mental Health, 2012; Gruttadaro & Crudo, 2012; Salzer, 2012; Center for Collegiate Mental Health, 2013). When entering a new environment, students will look to make connections with the institution; one of these connections can be with an academic advisor (Harper & Peterson, 2005; Harper & Wilson, 2010; Kuh, 2011; Pearson, 2012). It is important for individuals experiencing mental health issues to make connections to the institution so that they are more likely to remain and feel a sense of connection (Kadison & DiGeronimo, 2004). This dissertation outlines a quantitative study to examine the attitudes of academic advisors towards mental health. Using the Relational-Cultural Theory (Miller 1986; Jordan, 2000) as a framework, this study sought to determine attitudes of academic advisors and how this may affect their relationship with students. Results from 133 participants revealed that attitudes toward mental health issues do not impact the building of a mutual relationship between student and academic advisors from the academic advisors' perspective. However, characteristics such as age and personal experience with mental health issues impacted this type of relationship between the academic advisor and student.