Psychosocial Wellbeing of Nigerian Teachers in Special Education Schools.

While there is evidence that impaired psychosocial wellbeing can compromise the effective performance of work-related roles, little is known about the wellbeing of teachers working with children with developmental disabilities. We interviewed 68 special education schoolteachers (response rate = 70.8%) in a Nigerian state with 12-item General Health Questionnaire and an adapted Zarit Burden Interview. About four in every ten teachers had psychological distress, representing many-fold the rates reported in the general population, and significant burden was prevalent in 51.5%. Perceived burden correlated significantly with psychological distress, anxiety/depression and social dysfunction (rs = .3). While increased burden predicted psychological distress, longer teaching experience was protective against distress. These findings underscore the need for psychosocial support for special education schoolteachers to enhance their wellbeing and roles.

The duty to warn and protect--impact on practice.

OBJECTIVE: To discuss the concepts of the duty to protect and the associated threat to confidentiality and their impact on practice for Canadian psychiatrists. METHOD: We review these concepts and provide a synthesis of legal cases impacting psychiatric practice. CONCLUSION: The onus is on the psychiatrist to make him or herself aware of the current state of the legal obligation with respect to duty to protect. The evolving concept of duty to protect has and will continue to have significant impact on the practice of psychiatry.

Cost savings associated with fitness-to-stand-trial assessments in detention centres: a pilot program.

OBJECTIVE: To determine whether fitness-to-stand-trial assessments "in detention" offer cost benefit over inpatient assessments. METHOD: The development of a pilot "fitness clinic" in a detention centre is described, and the results of 1 year of assessments are presented. The cost benefit of fitness assessments conducted in detention centres is outlined. RESULTS: Significant cost savings were realized by operating fitness clinics in detention centres. CONCLUSION: Fitness clinics in detention centres offer important benefits and are recommended as an adjunct to forensic programs.

Treatment-resistant depression: a survey of practice habits of Canadian psychiatrists.

Treatment-resistant depression is a fascinating yet poorly defined condition. The various management strategies in use are a source of controversy. The objective of this survey was to determine how Canadian psychiatrists treat patients with "intractable depression." This information may be used to plan future research into the management of treatment-resistant depression. It may also provide information about the practices of Canadian psychiatrists and help direct residency training. Confidential questionnaires were mailed to all psychiatrists residing in Canada registered with the Canadian Psychiatric Association. Respondents indicated that 12.4% of their depressed patients were "resistant to treatment." Respondents were asked to rank a list of treatment choices in the order they would use them to treat patients with treatment-resistant depression. Ninety-five point eight percent of respondents used tricyclics as the first treatment of choice. Almost equal portions of respondents chose a second tricyclic, a monoamine oxidase inhibitor (MAOI) or a combination of lithium and tricyclics as their treatment of second choice.

Homophobia among psychiatric residents, family practice residents and psychiatric faculty.

As the number of AIDS cases has continued to increase, psychiatric research has focused on the victims of this disease. Little has been written about the caregivers and the impact that their attitudes have on patients. There have been a few studies measuring attitudes of health care providers to homosexuals and AIDS patients, but to the best of our knowledge, none have looked at the attitudes of psychiatrists or residents in psychiatry. Psychiatric residents, family practice residents and psychiatric faculty in a medium-sized Canadian medical school completed a questionnaire measuring attitudes toward homosexuals. We report on the results of this questionnaire and comment on the impact of the attitudes of health care professionals on the quality of patient care.

Patient assaults on psychiatric residents: the Canadian experience.

There have been fairly limited reports in the literature of assaults on residents in psychiatric facilities. Assaults on residents and staff tend to be underreported and, for a variety of reasons, not adequately dealt with by the administration. For this reason, security in psychiatric facilities may be lacking in many instances. In order to prepare a position paper of guidelines specifying minimum security requirements for psychiatric facilities in Canada, the Residents' Section of the Canadian Psychiatric Association gathered data on this issue from psychiatric residents. We present the results of a questionnaire sent to all psychiatric residents who are members of the Canadian Psychiatric Association. Results indicate that 40.2% of residents have been assaulted at least once. We present some interesting findings that relate to the residents' perception of their training and the appropriateness of the facilities for assessing patients. Requests for improved security were made by 36.9% of the residents, but only 22.9% of this group found the response by acceptable. Some of the residents' explanations for the assaults suggest interesting dynamics. These and other findings suggest an urgent need to address this issue.