RESUMEN
Individuals with psychiatric illness believe that voting is important. However, these individuals have lower rates of voting when compared to the general population. A survey of psychiatrically hospitalized adult patients was conducted to assess perceptions of and barriers to voting in patients with psychiatric illness. Data from 113 surveys was analyzed. A majority of survey participants agreed that they cared about voting, that their vote made a difference, and that their vote was important. 74% of individuals reported previously experiencing at least one barrier when exercising their right to vote. The most commonly experienced barriers reported were not having enough information to make an informed choice, not knowing where to vote, not having transportation, and not being registered to vote. Individuals who encountered a higher number of barriers in the past had a higher chance of encountering barriers more often. In conclusion, a high percentage of individuals with mental illness severe enough to warrant hospitalization have experienced barriers to voting, with many experiencing multiple barriers. Reduction of these barriers is important, as voting and the resultant public policies can directly affect this population's mental health and access to both mental and physical healthcare services.
Asunto(s)
Pacientes Internos , Trastornos Mentales , Política , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Pacientes Internos/psicología , Encuestas y Cuestionarios , Poder Psicológico , Anciano , Adulto Joven , VotaciónRESUMEN
The American Medical Association adopted a resolution in June 2022 recognizing voting as a social determinant of health. As psychiatric professionals and trainees with experience in civic health, the authors argue that psychiatrists must consider the relationship between voting and mental health as part of care delivery. People with psychiatric illness can experience unique barriers to voting and garner mental health benefits from civic engagement. Provider-led activities to promote voting are accessible and simple. Given the benefits of voting, and the availability of interventions to foster voter engagement, psychiatrists have an obligation to promote voting access among their patients.
Asunto(s)
Trastornos Mentales , Psiquiatría , Estados Unidos , Humanos , Trastornos Mentales/terapia , Salud Mental , PolíticaRESUMEN
Individuals with mental illness often face barriers to voting. One of the primary barriers is not being registered to vote. This paper describes voter support activities (VSAs) provided to hospitalized adults on the acute inpatient psychiatric units at Pennsylvania Psychiatric Institute. During the six weeks preceding the 2020 general election, adult inpatients were offered six VSAs and an optional survey examining previous voting behaviors and barriers encountered to voting. VSAs included checking voter registration status and polling location, completing a paper or electronic voter registration application, and requesting a mail-in ballot. Of 189 patients approached, 119 individuals participated in the survey and 60 individuals utilized at least one VSA. This project demonstrates that VSAs are a welcome and feasible resource for psychiatrically hospitalized adults. Psychiatric providers can serve an important role in promoting access to voting-related activities for their patients.
Asunto(s)
Equidad en Salud , Trastornos Mentales , Adulto , Humanos , Pacientes Internos , Política , Trastornos Mentales/terapia , PennsylvaniaRESUMEN
In the medical field, the implementation of Milestones by the Accreditation Council for Graduate Medical Education (ACGME) has provided a common understanding among clinical and academic supervisors and trainees related to the development of core competencies during graduate medical training. These Milestones help establish developmental trajectories and aspirational goals for the trainee. Unfortunately, training in graduate and postgraduate neuroscience lacks a standardized developmental progression of competencies or outcomes expected of trainees. Without such standardizations, it may be difficult for both the mentor and trainee to identify levels of improvement, which may impact the trainee's future success. Here, we discuss the value of developing a nonexhaustive framework that may be used to evaluate trainees with the expectation that it will provide a template to help with the development of future neuroscientists.
Asunto(s)
Catatonia , Disfunción Cognitiva , Catatonia/complicaciones , Catatonia/tratamiento farmacológico , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/tratamiento farmacológico , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Humanos , Lorazepam , Memantina/uso terapéuticoRESUMEN
BACKGROUND: Telepsychiatry is becoming more commonplace in the provision of psychiatric care. Most commonly used in the outpatient setting, there is little information available in the literature as to the use of telepsychiatry for inpatient medical/surgical consultation. OBJECTIVE: We review the University of Pittsburgh Medical Center's telepsychiatry consultation program that provides consultation to an outlying community-based rural hospital. METHODS: This article examines the 69 telepsychiatry consultations that were performed from November 2014 through February 2016, looking at the patients served, common consultation questions, and patterns of diagnoses and recommendations. RESULTS: The median age of individuals undergoing telepsychiatry evaluations was 67 years, and the most common reason for consultation was for delirium. Over half of the patients consulted had a primary diagnosis of delirium, dementia, or a cognitive disorder not otherwise specified, using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnoses. In most patients, additional laboratory studies or imaging or both were requested and medication changes recommended (initiation, dose changes, and discontinuation). CONCLUSION: This report provides one of the first detailed views of the use of telepsychiatry in a remote inpatient medical setting. Findings will guide education to primary teams and will shape the development of future telepsychiatry interventions.
Asunto(s)
Pacientes Internos/psicología , Trastornos Neurocognitivos/diagnóstico , Trastornos Neurocognitivos/terapia , Psiquiatría/métodos , Derivación y Consulta , Telemedicina/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Neurocognitivos/psicología , Pennsylvania , Estudios Retrospectivos , Servicios de Salud Rural , Adulto JovenRESUMEN
OBJECTIVE: To examine the relationships over time between dual trajectories of depressive symptoms and several cognitive domains. METHODS: In a 5-year longitudinal study, 1,978 randomly selected individuals aged 65+ years at recruitment were assessed annually. Repeated measures were of depressive symptoms on the modified Center for Epidemiologic Studies Depression Scale and composite scores in the cognitive domains of attention, executive function, memory, language, and visuospatial function. Latent class trajectories were identified for depression and for each cognitive domain and their associations investigated using dual trajectory modeling. Cognitive trajectories with z scores below -1 were designated as persistently low. RESULTS: Five depressive symptom trajectories were observed: rarely depressed (60.5%); low-grade, decreasing symptoms (18.5%); low-grade, increasing symptoms (9.6%); moderate-grade symptoms (7.4%); and consistent higher-grade symptoms (4.0%). For each cognitive domain six trajectories were observed. The rarely depressed and low-grade decreasing symptom groups were the least likely to have persistently low cognition. The symptom trajectory most strongly associated with persistently low functioning in each domain was not the higher-grade group but rather the low-grade increasing group in the case of attention and the moderate-grade trajectory in the other four domains. CONCLUSION: Consistently higher-grade depressive symptoms are less strongly associated with poor cognitive functioning than with either moderate- or low-grade increasing depressive symptom trajectories, over time and across different domains. Examining both depression and cognition longitudinally allows heterogeneity of both to be addressed, revealing latent groups with potential diagnostic and prognostic implications.