Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

The marked impact of the welfare gap on total welfare within collectives has rarely, if at all, been addressed in traditional welfare theories and in Amartya Sen's theory of welfare functioning and capabilities.With this observation as our starting point, we constructed a research framework that combined welfare functioning, the welfare gap, and welfare capability to assess and analyze changes in the welfare of farmers whose land was requisitioned in Zhejiang province. The findings of our study were as follows. (1) The total welfare functioning of farmers whose land was requisitioned increased by 11.8% as a result of improvements in economic and dwelling conditions and community surroundings. However, social security and psychological conditions deteriorated. (2) Although total welfare functioning has improved, gaps are widening in the distribution of welfare functioning among farmers who underwent land requisition. This was evidenced by the increase of the weighted Gini coefficient, which rose from 0.26 to 0.32 after land requisition.(3) As a result of the improvement in welfare capability, a judgmental bias is evident when farmers assess whether they have gained or lost welfare after land requisition. We conclude that welfare studies should focus not only on the quantitative aspects of welfare distribution, but should also pay more attention to its fairness and impartiality. This can prevent social problems posed by an oversized welfare gap. Moreover, after land requisition, the government and community should provide education and training services, and the current one-time compensation model should be replaced by a lifelong compensation model. At the same time, endowment insurance should be extended in rural areas and urban medical insurance should be progressively incorporated into the social security benefits of farmers who have undergone land requisition.

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“…When people stay in a strange environment, they will psychologically experience repression (Sands, 2012).…”

Section: Psychological Conditionsmentioning

confidence: 99%

Changes in farmers’ welfare from land requisition in the process of rapid urbanization

Huang

Kwan

et al. 2015

Land Use Policy

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“…The ability to identify the signs of acute psychosis and appropriately assess urgency at triage is an important component of emergency mental health care (Sands et al ., ). Early identification of the signs of acute psychosis and impending psychiatric emergency provides opportunities for rapid intervention, potentially reducing adverse patient outcomes, such as absconding, violence, and restraint (Sands et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Investigating the predictive validity of an emergency department mental health triage tool

Sands

Elsom

Berk

et al. 2013

Nursing & Health Sciences

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Emergency department mental health triage is a complex clinical task for which the evidence base is minimal.Research in the past decade has consistently identified issues associated with the accuracy and consistency of mental health triage assessment. In this study, we investigated the predictive validity of the clinical descriptors in the Victorian Emergency Department Mental Health Triage Tool. Using a naturalistic, retrospective study design, an audit of the emergency department triage database was undertaken on 12 months of continuous data for all mental health presentations (n = 1718). The main outcome measure was urgency categorization. The study findings indicate that triage nurses can accurately identify the urgency of mental health presentations using defined clinical criteria. A significant finding was that patients with acute psychotic symptoms were more likely to be triaged as high urgency (code 2); however, the Australasian Triage Scale, in use in all Australian and many international emergency departments, provides no mental health-specific descriptors in high-urgency categories (1 and 2).

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“…Even if agitation or violence are not common symptoms of all psychiatric disorders, and the majority of persons with such disorders are not violent [2], it is undoubtable that these manifestations may more often occur in some psychiatric disorders (e.g., schizophrenia or bipolar disorders) [3,4], when there are comorbid conditions (e.g., substance and alcohol abuse or dependence, some personality disorders) [5], or lack of medication compliance [6]. …”

Section: Introductionmentioning

confidence: 99%

The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review

Berardis

Fornaro

Orsolini

et al. 2017

IJMS

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Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders. The efficacy of inhaled loxapine has been evaluated in one Phase II trial on patients with schizophrenia, and in two Phase III trials in patients with schizophrenia and bipolar disorder. Moreover, there are two published case series on patients with borderline personality disorder and dual diagnosis patients. Inhaled loxapine has proven to be effective and generally well tolerated when administered to agitated patients with schizophrenia and bipolar disorder. Two case series have suggested that inhaled loxapine may also be useful to treat agitation in patients with borderline personality disorder and with dual diagnosis, but further studies are needed to clarify this point. However, the administration of inhaled loxapine requires at least some kind of patient collaboration, and is not recommended in the treatment of severe agitation in totally uncooperative patients. Moreover, the drug-related risk of bronchospasm must always be kept in mind when planning to use inhaled loxapine, leading to a careful patient assessment prior to, and after, administration. Also, the higher costs of inhaled loxapine, when compared to oral and intramuscular medications, should be taken into account when selecting it for the treatment of agitation.

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Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

Cited by 22 publications

References 86 publications

Changes in farmers’ welfare from land requisition in the process of rapid urbanization

Changes in farmers’ welfare from land requisition in the process of rapid urbanization

Investigating the predictive validity of an emergency department mental health triage tool

The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review

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