Brief Interventions for Patients Presenting to the Psychiatric Emergency Service (PES) with Major Mental Illnesses and At-risk Drinking

Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health behaviour interventions to improve the physical health of individuals diagnosed with a mental illness. A systematic search strategy was undertaken using four of the major electronic databases. Identified articles were screened for inclusion, included articles were coded, and data were extracted and critically reviewed. A total of 42 articles were identified for inclusion. The most commonly targeted physical health behaviour was weight management. The majority of studies reported improvements in health behaviours following interventions. The findings provide evidence for the positive effect of health behaviour interventions in improving the physical health of individuals diagnosed with a serious mental illness. A focus on health behaviour interventions within the mental health nursing profession might lead to improvements in health behaviours and general health in consumers of mental health services.

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“…2007), drinking days (Graeber et al . 2003), drinks per week (Milner et al . 2010), alcohol use per month (Herman et al .…”

Section: Resultsmentioning

confidence: 99%

“…2000), concurrent drug and alcohol misuse (Archie et al . 2007), and binge drinking (Milner et al . 2010) were observed, along with increases in abstinence from alcohol (Graeber et al .…”

Section: Resultsmentioning

confidence: 99%

Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review

Happell

Davies

Scott

2012

Int J Mental Health Nurs

102

119

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“…Furthermore, the PES, as a front-line system in mental health care delivery, is called upon to assess and, increasingly, to treat a very broad range of psychopathology. 25 , 26 This broad range in itself would tend to dilute the importance of any one diagnostic category. Third, diagnostic stability may be a possible limiting factor in this study.…”

Section: Discussionmentioning

confidence: 99%

Aggressive behaviors in the psychiatric emergency service

Chaput¹,

Beaulieu²,

Paradis³

et al. 2011

OAEM

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Introduction:Studies of aggressive behaviors in a nonforensic mental health setting have focused primarily on the inpatient ward and, on event prediction, using behavior-based clinical rating scales. Few studies have specifically targeted aggressive behaviors in the psychiatric emergency service or determined whether assessing the demographic and clinical characteristics of such patients might prove useful for their more rapid identification.Methods:We used a prospectively acquired database of over 20,900 visits to four services in the province of Quebec, Canada, over a two-year period from September 2002 onwards. A maximum of 72 variables could be acquired per visit. Visits with aggression (any verbally or physically intimidating behavior), both present and past, were tagged. Binary logistic regressions and cross-tabulations were used to determine whether the profile of a variable differed in visits with aggression from those without aggression.Results:About 7% of visits were marked by current aggression (verbal 49%, physical 12%, verbal and physical 39%). Including visits with a “past only” history of aggression increased this number to 20%. Variables associated with aggression were gender (male), marital status (single/separated), education (high school or less), employment (none), judicial history (any type), substance abuse (prior or active), medication compliance (poor), type of arrival to psychiatric emergency services (involuntary, police, judiciary, landlord), reason for referral (behavioral dyscontrol), diagnosis (less frequent in anxiety disorders), and outcome (more frequently placed under observation or admitted).Conclusion:Our results suggest that many state-independent variables are associated with aggressive behaviors in the psychiatric emergency service. Although their sum may not add up to a specific patient profile, they can nevertheless be useful in service planning, being easily integrated alongside state-dependent rating scales in a triage and/or observation instrument for daily use in the psychiatric emergency service.

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“…(It should be noted, however, that each was based on patient samples of ≤30 people.) Finally, two additional studies explored the feasibility of interventions for alcohol misuse among people with mental illness, the first testing the efficacy of SBIRT among patients presenting to a psychiatric emergency service [19] and the second examining the efficacy of BI conducted by telephone among psychiatric outpatients [20]. Although neither study employed a comparison group, both reported reduced alcohol consumption at six-month follow-up.…”

Section: Introductionmentioning

confidence: 99%

Self-reported alcohol and drug use six months after brief intervention: do changes in reported use vary by mental-health status?

Krupski

Sears

Joesch

et al. 2012

Addict Sci Clin Pract

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BackgroundAlthough brief intervention (BI) for alcohol and other drug problems has been associated with subsequent decreased levels of self-reported substance use, there is little information in the extant literature as to whether individuals with co-occurring hazardous substance use and mental illness would benefit from BI to the same extent as those without mental illness. This is an important question, as mental illness is estimated to co-occur in 37% of individuals with an alcohol use disorder and in more than 50% of individuals with a drug use disorder. The goal of this study was to explore differences in self-reported alcohol and/or drug use in patients with and without mental illness diagnoses six months after receiving BI in a hospital emergency department (ED).MethodsThis study took advantage of a naturalistic situation where a screening, brief intervention, and referral to treatment (SBIRT) program had been implemented in nine large EDs in the US state of Washington as part of a national SBIRT initiative. A subset of patients who received BI was interviewed six months later about current alcohol and drug use. Linear regression was used to assess whether change in substance use measures differed among patients with a mental illness diagnosis compared with those without. Data were analyzed for both a statewide (n = 828) and single-hospital (n = 536) sample.ResultsNo significant differences were found between mentally ill and non-mentally ill subgroups in either sample with regard to self-reported hazardous substance use at six-month follow-up.ConclusionThese results suggest that BI may not have a differing impact based on the presence of a mental illness diagnosis. Given the high prevalence of mental illness among individuals with alcohol and other drug problems, this finding may have important public health implications.

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Brief Interventions for Patients Presenting to the Psychiatric Emergency Service (PES) with Major Mental Illnesses and At-risk Drinking

Cited by 8 publications

References 39 publications

Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review

Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review

Aggressive behaviors in the psychiatric emergency service

Self-reported alcohol and drug use six months after brief intervention: do changes in reported use vary by mental-health status?

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