Reliance on Community Emergency Departments by People Ever Detained in Jail: Retrospective Cross-Sectional Study.

Millions are confined in U.S. jails each year, often with unmet health and social needs. After release, many will visit the emergency department (ED). To illuminate their patterns of ED use, this study linked records from all individuals detained at a Southern urban jail over a 5-year period with health records from a large health care system with three EDs. Over half used the ED at least once, and of those who received care at the health system, 83% visited the ED. Jail-involved people made up 4.1% of the health care system's ED users but 21.3% of its chronic frequent ED users. Frequent ED use was associated with more frequent jail bookings and with co-occurring serious mental illness and substance use disorder. Health systems and jails have a common interest in addressing the needs of this population. Individuals with co-occurring disorders should be prioritized for intervention.

Intersectionality of Race and Question-Asking in Women After Right Hemisphere Brain Damage.

PURPOSE: Atypical pragmatic language can impede quality health care access. Right hemisphere brain damage (RHD) results in changes in pragmatic language use; however, little is known about whether there are racial/ethnic influences. Recent research indicated differences in question-asking when RHD survivors were compared with healthy controls, prompting the current examination of question production in women by race/ethnicity and the presence of RHD. METHOD: Participants were eight Black and eight White women who sustained a single right hemisphere stroke at least 6 months prior to data collection (2016-2020), and eight Black and eight White control participants from the Right Hemisphere Damage Bank (https://rhd.talkbank.org). Videos of informal, first-encounter conversational discourse tasks were transcribed and coded. Analyses were conducted for frequency of questions and question type. RESULTS: Race/ethnicity had a statistically significant effect on the total number of questions and number of content and polar questions. The mean total of questions, number of content questions, and mean number of polar questions for Black participants was significantly less than White participants. There was less variability in question type for Black participants than White participants, and a tendency for Black participants to ask fewer questions regardless of RHD or control status. CONCLUSIONS: Acquisition of health information and ensuing health care might be less fruitful for Black women communicating with someone who may not know to conduct comprehension checks and be proactive in provision of information. To be culturally responsive to Black patients with communication disorders, providers might apply this awareness of reduced question-asking to their strategies to improve patient-provider communication. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21809475.

Relationships between substance use disorders, 'severe mental illness' and re-arrest in a county detention facility: A 4-year follow-up cohort study.

BACKGROUND: A growing body of literature demonstrates strong association between poor mental health and criminal recidivism, but research from county jails is limited. AIMS: Our aim was to examine the relationship between re-arrest and severe mental illnesses-schizophrenia, bipolar disorder and major depressive disorder-together and separately and with substance use disorders, separately and as comorbid conditions, in a mid-sized county jail cohort in the southeastern United States. METHODS: We examined the full cohort of 8097 individuals who were booked into the County Detention Facility between 31 January 2014 and 31 January 2015. Their incarceration data were merged with data from the local health system to investigate the presence of severe mental illness and substance use disorder diagnoses. Re-arrest data were tracked for 4 years after the index arrest. RESULTS: Approximately 60% of the cohort was re-arrested within 4 years. People with substance use disorders, with or without severe mental illness, had higher re-arrest rates than those with severe mental illness alone or neither diagnosis. Drug-associated arrests did not explain this finding. CONCLUSIONS: Using detailed mental illness diagnosis data with a complete cohort of detained arrestees, we have shown the wide range of need among such individuals. By demonstrating that drug-associated crimes per se do not drive repeated arrest, we underscore a need to examine other factors that promote the cycle of repeated arrest in this population. Each individual requires treatment tailored to their personal psychiatric and criminogenic needs.

COVID-19-Mediated Strengths and Challenges for 2021 Nursing Graduates: Implications for Nurse Leaders and Educators.

The purpose of this hospital-based quality improvement project was to ascertain 18 clinical instructors' perceptions regarding senior nursing students' strengths and challenges in the time of COVID-19. Constant comparative method yielded 4 themes suggesting 2021 diversity in senior nursing students' clinical strengths and challenges, as well COVID-19's implications for students' professional identity development and transition to professional practice. Findings also suggested significant implications for nurses in professional development roles.

Non-Psychiatric Nurses' Perceived Self-Efficacy After an Educational Intervention on Suicide Prevention and Care.

Potential for suicide risk can be a safety concern for patients in all health care settings. Inadequate training of nurses in suicide assessment and prevention is a serious patient safety concern. A non-randomized pre-/postintervention research design was used to measure the effects of education on non-psychiatric nurses' perceived self-efficacy in assessment and inquiry about suicide risk and in implementing suicide prevention strategies. The intervention was an educational module about suicide prevention and care delivered to non-psychiatric nurses employed on a neuro-trauma unit in an acute care urban hospital setting. Statistically significant increases occurred in the non-psychiatric nurse's self-efficacy in caring for the patient at risk for suicide. The outcomes of this project offer an important contribution to future research in the area of education about suicide prevention and care for non-psychiatric nurses, promoting safer outcomes for patients. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 43-51.].