Mental Health Needs of Inpatient Psychiatric Nurses During the COVID-19 Pandemic.

INTRODUCTION: The lack of mental health supports and resources for psychiatric nurses during the COVID-19 pandemic contributed to stress, burnout, and reduced mental wellness. Simultaneously, the pandemic's safety mitigation measures made significant changes to the inpatient psychiatric population environment making it difficult to maintain a therapeutic milieu and increased mental health challenges among staff and patients. AIMS: This study aimed to identify external and internal resilience factors, mental health support, and resources provided by organizations, and additional mental health support and resources inpatient psychiatric nurses felt would have been beneficial during the pandemic. METHODS: An anonymous web-based survey was administered via American Psychiatric Nurses Association Member Bridge. Notably, 68 respondents represented 23 states across the United States. RESULTS: Interpersonal peer relationships, self-awareness, self-care, mindfulness, and purpose were identified resilience factors. Free counseling, decompression rooms, pastoral support, self-care discounts, and support groups were top support and resource options. Policies, time-off, personal protective equipment (PPE) availability, counseling and self-care, and appreciation were major themes reflecting what participants thought would have been beneficial. Coping strategies, organizational support, resilience, altruism, and family and peer support were instrumental in psychiatric nurses' survival during the pandemic. CONCLUSION: Identifying factors of resilience is key to supporting and protecting the mental health of psychiatric nurses. Organizations can better support their nurses when they understand what mental health support and resource options are perceived as most beneficial by inpatient nurses.

Characteristics of Calls to a COVID-19 Mental Health Hotline in the First Wave of the Pandemic in New York.

This report describes the development, implementation and outcomes of a "COVID-19 Anxiety Hotline," designed to address the community's mental health crisis provoked by the coronavirus pandemic. The service was specifically designed using survey data regarding the effects of the COVID-19 pandemic on its staff and community members. Callers had around-the-clock direct access to mental healthcare providers at no cost. Quantitative analysis showed that nearly three out of four callers experienced new onset anxiety and insomnia driven by fear of exposure, and had difficulty accessing mental health care. In addition to immediate support, referral to tele-mental health care was provided to 86% of callers. Qualitative analysis indicates the effectiveness of immediate support and appropriate referrals using a tele-health platform. Our report indicates that the service was utilized by the general population, by health care workers, and rapidly provided referrals to individuals with limited access to mental health care during the pandemic.

Roadmap to strengthen global mental health systems to tackle the impact of the COVID-19 pandemic.

BACKGROUND: The COVID pandemic has been devastating for not only its direct impact on lives, physical health, socio-economic status of individuals, but also for its impact on mental health. Some individuals are affected psychologically more severely and will need additional care. However, the current health system is so fragmented and focused on caring for those infected that management of mental illness has been neglected. An integrated approach is needed to strengthen the health system, service providers and research to not only manage the current mental health problems related to COVID but develop robust strategies to overcome more long-term impact of the pandemic. A series of recommendations are outlined in this paper to help policy makers, service providers and other stakeholders, and research and research funders to strengthen existing mental health systems, develop new ones, and at the same time advance research to mitigate the mental health impact of COVID19. The recommendations refer to low, middle and high resource settings as capabilities vary greatly between countries and within countries. DISCUSSION: The recommendations for policy makers are focused on strengthening leadership and governance, finance mechanisms, and developing programme and policies that especially include the most vulnerable populations. Service provision should focus on accessible and equitable evidence-based community care models commensurate with the existing mental health capacity to deliver care, train existing primary care staff to cater to increased mental health needs, implement prevention and promotion programmes tailored to local needs, and support civil societies and employers to address the increased burden of mental illness. Researchers and research funders should focus on research to develop robust information systems that can be enhanced further by linking with other data sources to run predictive models using artificial intelligence, understand neurobiological mechanisms and community-based interventions to address the pandemic driven mental health problems in an integrated manner and use innovative digital solutions. CONCLUSION: Urgent action is needed to strengthen mental health system in all settings. The recommendations outlined can be used as a guide to develop these further or identify new ones in relation to local needs.

Investigation and analysis of mental health service resources in Jiangsu Province in 2014-2020 / 公共卫生与预防医学

Objective To analyze and compare the mental health service resources in Jiangsu Province in 2014 and 2020, and to provide suggestions for the rational allocation and setting of mental health resources. Methods The national mental health resource questionnaire compiled by National Health Commission and the information system of Jiangsu provincial severe mental disorders were used to investigate the number, beds, mental health personnel of mental health institutions, and to evaluate the management and service situation of patients with severe mental disorders in Jiangsu Province in 2014 and 2020. The data was analyzed by SPSS 19.0 software. Results Compared with the mental health service resources in 2014, the number of mental health medical institutions increased by 9 in 2020; The number of psychiatric beds increased by 5,936, and the growth rate was 39.55%; The number of psychiatric open beds increased by 5,311, and the growth rate was 27.41%. The bed density increased from 2.43 beds / 10,000 people to 3.08 beds / 10,000 people, with an increase rate of 26.75%. The number of mental health practitioners increased from 8.08/100,000 to 12.27/100,000. In 2020, 37.28% of the hospitals of the second class and above set up psychiatric or psychological clinics in Jiangsu Province. In terms of management services for patients with severe mental disorders, the prevalence rate in 2020 was 0.43%, higher than 0.34% in 2014 (χ2=8441.60, P＜0.05), and the management rate in 2020 was 95.22%, higher than 90.97% in 2014 (χ2=5520.13, P＜0.05). The drug taking rate in 2020 was 81.22%, higher than 57.18% in 2014 (χ2=37254.45, P＜0.05), and all the differences were statistically significant. Conclusion The resources of mental health services in Jiangsu Province have increased, but the number of medical personnel cannot meet the requirements of regional development, and the distribution of mental health resources is unbalanced. It is necessary to reasonably distribute resources and strengthen the training of mental health practitioners.

Mental health resources and awareness of anxiety and depressive disorders in general hospitals in China

Abstract Background Mental health disorders are common in China. There is a lack of knowledge and resources of mental health in China. Objectives To assess the levels of psychiatric resources and services in general hospitals in China. Methods Data regarding psychiatric departments, wards and staff were collected from 57 general hospitals in four provinces of China (Hubei, Zhejiang, Heilongjiang and Yunnan) between April 2014 and June 2014. Questionnaires were distributed to 1,200 non-psychiatric clinicians. Results Among the 57 hospitals, 50 provided mental health services, 36 had mental health wards, and seven had neither mental health clinics nor wards. The median number of mental health clinicians was six per hospital. The median number of specialized nurses was 42 per hospital. A total of 1,152 non-psychiatric clinicians with a career duration of 9.4 ± 8.9 years returned completed questionnaires. Only 6.9% reported a good understanding of the manifestation of anxiety and depressive disorders, 4.5% reported a good understanding of the diagnostic criteria, and 3.8% reported a good understanding of the treatment protocols. Discussion There is inadequate awareness of anxiety and depressive disorders among non-psychiatric clinicians in general hospitals in China. This awareness/understanding increased with increasing hospital level.

Attrition in Graduate School Versus Other Health Professional Programs: Etiologies and Solutions.

Data suggests significantly higher attrition rates of graduate students compared to other health professional programs. Several key differences exist between the training paradigm of Ph.D. programs and other health professional fields, such as the dynamics of group training, differences and frequency of mentor and mentee feedback, and awareness of mental health resources. Many reasons contribute to graduate school attrition, including inadequate mentorship, a paucity of mental health resources, and increasing expenses to attend graduate school. Conversely, failing to adequately train graduate students is a failure to trainees, universities, and the broader public in terms of finances, invested time, and intellectual commitments. Diverse approaches to ensure mentor accountability, supporting emotional health, and increasing financial resources may help raise the graduate rates among graduate students.

Mental health policies in South-East Asia and the public health role of screening instruments for depression

The World Health Organization (WHO) South-East Asia Region, which contributes one quarter of theworld’s population, has a significant burden due to mental illnesses. Mental health has been a low priorityin most countries of the region. Although most of these countries have national mental health policies,implementation at ground level remains a huge challenge. Many countries in the region lack mentalhealth legislation that can safeguard the rights of people with mental illnesses, and governments haveallocated low budgets for mental health services. It is imperative that concerned authorities work towardsscaling up both financial and human resources for effective delivery of mental health services. Policymakers should facilitate training in the field of mental health and aim towards integrating mental healthservices with primary health care, to reduce the treatment gap. Steps should also be taken to developa robust mental health information system that can provide baseline information and insight aboutexisting mental health services and help in prioritization of the mental health needs of the individualcountries. Although evidence-based management protocols such as the WHO Mental Health Gap ActionProgramme (mhGAP) guidelines facilitate training and scaling up of care in resource-limited countries,the identification of mental disorders like depression in such settings remains a challenge. Developmentand validation of brief psychiatric screening instruments should be prioritized to support such models ofcare. This paper illustrates an approach towards the development of a new culturally adapted instrumentto identify depression that has scope for wider use in the WHO South-East Asia Region.

"In our community, a friend is a psychologist": An ethnographic study of informal care in two Bhutanese refugee communities.

The recent rise in suicide among Bhutanese refugees has been linked to the erosion of social networks and community supports in the ongoing resettlement process. This paper presents ethnographic findings on the role of informal care practiced by relatives, friends, and neighbors in the prevention and alleviation of mental distress in two Bhutanese refugee communities: the refugee camps of eastern Nepal and the resettled community of Burlington, Vermont, US. Data gathered through interviews ( n = 40, camp community; n = 22, resettled community), focus groups (four, camp community), and participant observation (both sites) suggest that family members, friends, and neighbors were intimately involved in the recognition and management of individual distress, often responding proactively to perceived vulnerability rather than reactively to help-seeking. They engaged practices of care that attended to the root causes of distress, including pragmatic, social, and spiritual interventions, alongside those which targeted feelings in the "heart-mind" and behavior. In line with other studies, we found that the possibilities for care in this domain had been substantially constrained by resettlement. Initiatives that create opportunities for strengthening or extending social networks or provide direct support in meeting perceived needs may represent fruitful starting points for suicide prevention and mental health promotion in this population. We close by offering some reflections on how to better understand and account for informal care systems in the growing area of research concerned with identifying and addressing disparities in mental health resources across diverse contexts.

A comparative study of attitudes toward psychiatry among nursing students across successive training years.

CONTEXT: Psychiatry nurses are an integral component of a multidisciplinary mental health-care team. AIM: The current study aimed at understanding the attitude of undergraduate nursing students toward psychiatry. Additionally, the attitudes toward psychiatry have been compared across the training years among these students. MATERIALS AND METHODS: The study was carried out at a tertiary care nurse-training institute. All the nursing students enrolled with the institute at the time of the study constituted the sample frame. The study questionnaire used in the current study was a 29-item questionnaire that assessed attitudes toward psychiatry. STATISTICAL ANALYSIS: The data were analyzed using SPSS ver 17. RESULTS: Overall, the majority of the nursing students from all four groups had a favorable response to the statements of the Likert scale. Most of the significantly positive responses (as assessed by the Kruskal-Wallis analysis of variance of the rank order) were from the third-year and internship students. These findings were supported by the significant correlation between these statements and ranked order of the nurse-training years. CONCLUSIONS: The findings of the current study present some interesting insights into the attitude of nursing students toward psychiatry.