The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform
Philip E Klassen - One of the best experts on this subject based on the ideXlab platform.
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multidimensional approach to restraint minimization the journey of a specialized Mental Health Organization
International Journal of Mental Health Nursing, 2017Co-Authors: Alexandra Hernandez, Sanaz Riahi, Melanie I Stuckey, Barbara Mildon, Philip E KlassenAbstract:The executive-level witnessing and review of restraint events has been identified as a key strategy for restraint minimization. In the present study, we examined the changes in restraint practices at a tertiary-level Mental Health-care facility with implementation of an initiative, in which representatives from senior management, professional practice, peer support, and clinical ethics witnessed seclusion and restraint events, and rounded with clinical teams to discuss timely release and brainstorm prevention strategies. Interrupted time series analysis compared the change from pre-implementation (14 months prior) to postimplementation (35 months’ following) in the number of incidents/month, total hours/month, and average hours/incident/month for each of seclusion and mechanical restraint. With implementation, there was a step decrease in average hours/seclusion (–28.3 hours/seclusion, P < 0.001) and total seclusion hours (–1264.5 hours, P = 0.002). The postimplementation rate of decrease of –0.9 hours/incident/month was different than the pre-implementation rate of increase of 0.7 hours/incident/month for mechanical restraint (P = 0.03). Pre-implementation, there was a rate of decrease of 6.1 incidents/month (P < 0.001) and 4.5 incidents/month (P = 0.001) for seclusion and mechanical restraint, respectively. Postimplementation, there was a rate of increase of 0.3 incidents/month and a rate of decrease of 0.05 incidents/month for seclusion and mechanical restraint, respectively, both of which were different than pre-implementation (seclusion: P < 0.001, mechanical restraint: P = 0.002). In conclusion, the total hours of seclusion and average hours per seclusion and per restraint incident were reduced, demonstrating the value of leadership witnessing and daily rounds in promoting restraint minimization in tertiary-level Mental Health care.
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Multidimensional approach to restraint minimization: The journey of a specialized Mental Health Organization.
International Journal of Mental Health Nursing, 2017Co-Authors: Alexandra Hernandez, Sanaz Riahi, Melanie I Stuckey, Barbara Mildon, Philip E KlassenAbstract:The executive-level witnessing and review of restraint events has been identified as a key strategy for restraint minimization. In the present study, we examined the changes in restraint practices at a tertiary-level Mental Health-care facility with implementation of an initiative, in which representatives from senior management, professional practice, peer support, and clinical ethics witnessed seclusion and restraint events, and rounded with clinical teams to discuss timely release and brainstorm prevention strategies. Interrupted time series analysis compared the change from pre-implementation (14 months prior) to postimplementation (35 months’ following) in the number of incidents/month, total hours/month, and average hours/incident/month for each of seclusion and mechanical restraint. With implementation, there was a step decrease in average hours/seclusion (–28.3 hours/seclusion, P
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implementation of the six core strategies for restraint minimization in a specialized Mental Health Organization
Journal of Psychosocial Nursing and Mental Health Services, 2016Co-Authors: Sanaz Riahi, Melanie I Stuckey, Ian C Dawe, Philip E KlassenAbstract:Implementation of the Six Core Strategies to Reduce the Use of Seclusion and Restraint (Six Core Strategies) at a recovery-oriented, tertiary level Mental Health care facility and the resultant changes in mechanical restraint and seclusion incidents are described. Strategies included increased executive participation; enhanced staff knowledge, skills, and attitudes; development of restraint orders and decision support in the electronic medical record to enable informed debriefing and tracking of events; and implementation of initiatives to include service users and their families in the plan of care. Strategies were implemented in a staged manner across 3 years. The total number of mechanical restraint and seclusion incidents decreased by 19.7% from 2011/12 to 2013/14. Concurrently, the average length of a mechanical restraint or seclusion incident decreased 38.9% over the 36-month evaluation period. Implementation of the Six Core Strategies for restraint minimization effectively decreased the number and length of mechanical restraint and seclusion incidents in a specialized Mental Health care facility. [Journal of Psychosocial Nursing and Mental Health Services, 54(10), 32-39.].
Aduel Joachin - One of the best experts on this subject based on the ideXlab platform.
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transforming child and youth Mental Health care access open minds new brunswick in the rural francophone region of the acadian peninsula
Early Intervention in Psychiatry, 2019Co-Authors: Anik Dube, Penelopia Iancu, Carole C Tranchant, Danielle Doucet, Aduel JoachinAbstract:AIM: This paper describes how the transformation of youth Mental Health services in the rural Francophone region of the Acadian Peninsula in New Brunswick, Canada, is meeting the five objectives of ACCESS Open Minds. METHODS: Implementation of the ACCESS Open Minds framework of care in the Acadian Peninsula of New Brunswick began in 2016 at a well-established volunteer centre and community-based Mental Health Organization. Through focus groups with youth aged 14 to 22 (n = 13), community mapping was used to describe the youth-related Mental Health service transformation, followed by thematic analysis, validation by member checking and triangulation. RESULTS: Preliminary results show a generally successful implementation of the ACCESS Open Minds model, as evidenced by the transformation of Mental Health service provision, the enhancement of capacity in human resources and the participation of youth. Transformation was evidenced across the five objectives of Mental Healthcare of ACCESS Open Minds, albeit to variable extents. Several facilitating factors and challenges are identified based on youths' accounts. CONCLUSIONS: It is possible to successfully implement the ACCESS Open Minds model among francophones living in a minority setting and despite the constraints of a rural area. Most key components of the framework were implemented with high program fidelity. The rural context presents unique challenges that require creative and effective use of resources, while offering opportunities that arise from a culture of resourcefulness and collaboration.
Anik Dube - One of the best experts on this subject based on the ideXlab platform.
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transforming child and youth Mental Health care access open minds new brunswick in the rural francophone region of the acadian peninsula
Early Intervention in Psychiatry, 2019Co-Authors: Anik Dube, Penelopia Iancu, Carole C Tranchant, Danielle Doucet, Aduel JoachinAbstract:AIM: This paper describes how the transformation of youth Mental Health services in the rural Francophone region of the Acadian Peninsula in New Brunswick, Canada, is meeting the five objectives of ACCESS Open Minds. METHODS: Implementation of the ACCESS Open Minds framework of care in the Acadian Peninsula of New Brunswick began in 2016 at a well-established volunteer centre and community-based Mental Health Organization. Through focus groups with youth aged 14 to 22 (n = 13), community mapping was used to describe the youth-related Mental Health service transformation, followed by thematic analysis, validation by member checking and triangulation. RESULTS: Preliminary results show a generally successful implementation of the ACCESS Open Minds model, as evidenced by the transformation of Mental Health service provision, the enhancement of capacity in human resources and the participation of youth. Transformation was evidenced across the five objectives of Mental Healthcare of ACCESS Open Minds, albeit to variable extents. Several facilitating factors and challenges are identified based on youths' accounts. CONCLUSIONS: It is possible to successfully implement the ACCESS Open Minds model among francophones living in a minority setting and despite the constraints of a rural area. Most key components of the framework were implemented with high program fidelity. The rural context presents unique challenges that require creative and effective use of resources, while offering opportunities that arise from a culture of resourcefulness and collaboration.
Jose Ornelas - One of the best experts on this subject based on the ideXlab platform.
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recovery assessment scale testing validity with portuguese community based Mental Health Organization users
Psychological Assessment, 2016Co-Authors: Maria Fatima Jorgemonteiro, Jose OrnelasAbstract:The aim of the present study was to develop the Portuguese version of the Recovery Assessment Scale (RAS-P), and to assess the validity of the findings using the revised test, with 213 users from 5 nonprofit community-based Mental Health Organizations. Participants in the assessment completed a self-reported survey investigating their sense of personal recovery, personal empowerment, capabilities achievement, psychiatric symptoms’ frequency, and demographic data. Evidence from exploratory and confirmatory factor analyses using the 24-item version of the test, validated a 4-factor structure for the RAS-P model based on the dimensions of Personal Goals and Hope, Managing Help Needs, Supportive Interpersonal Relationships, and Life Beyond Symptoms, consistent with components of the recovery process. Convergent and discriminant validity was also achieved using bivariate correlation coefficients among the 4 subscales’ scores, between the overall scale and the subscales, and in relation to external variables. Findings allowed for the interpretation that the RAS-P is measuring a particular psychological construct, which is different from symptoms of the Mental illness. A hypothesized significant association with personal empowerment and with capabilities achievement was demonstrated. Positive association was also found between participants’ use of recovery-oriented services such as independent housing or supported employment programs. The RAS-P scores also revealed excellent internal consistency for the overall scale ( .90), and good consistency for the subscales (.75), which attest to its precision in measurement. In conclusion, the study proved the RAS-P a reliable and useful tool in the context of the community Mental Health practice.
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properties of the portuguese version of the empowerment scale with Mental Health Organization users
International Journal of Mental Health Systems, 2014Co-Authors: Maria Fatima Jorgemonteiro, Jose OrnelasAbstract:Background This study examines the reliability and validity of the Portuguese version of the Empowerment Scale (ES) to be used in the community/psychosocial Mental Health field. Authors also reviewed the properties of the development and cross-cultural adaptation of the ES. Because Mental Health services are required to encourage empowerment and recovery-oriented interventions, adequate empowerment-oriented outcome measures are needed to evaluate services and study interventions across countries.
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What transformation? A qualitative study of empowering settings and community Mental Health Organizations
Global Journal of Community Psychology Practice, 2014Co-Authors: Maria Fátima Jorge Monteiro, Rita Aguiar, Beatrice Sacchetto, Maria João Vargas Moniz, Jose OrnelasAbstract:This article is based on empowering settings research and has a two-fold objective: to propose an adaptation of the empowering community settings framework to community Mental Health Organizations practice to foster recovery and community integration; and to discuss how the adapted framework is a relevant tool to challenge community Mental Health transformation at multiple levels of analysis. The current study was anchored in a larger qualitative research project. It used a case study approach, with 8 in-depth interviews with diverse participants from one community Mental Health Organization. The adapted model proved useful to guide transformational practice in community Mental Health programs and for evaluation of Organizational empowerment and multilevel community-oriented interventions. Suggestions and implications for future research are also presented.
Manderscheid Rw - One of the best experts on this subject based on the ideXlab platform.
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The effect of inflation on expenditures by Mental Health Organization between 1969 and 1990.
Mental health statistical note, 1994Co-Authors: Michael J. Witkin, Atay Je, Manderscheid RwAbstract:: At first glance, the rise in current dollar expenditures for all Mental Health Organizations from $3.3 billion in 1969 to $28.4 billion in 1990 seems enormous. However, if the annual expenditures are adjusted for inflation and expressed in constant dollars, the rise in expenditures is only from $3.3 billion in 1969 to $5.6 billion in 1990. Thus, most of the increase in expenditures by Mental Health Organizations over the past two decades is due to inflation, with less than 10 percent due to increases in real purchasing power. Since both the number of private psychiatric hospitals and the expenditures they incurred increased dramatically between 1969 and 1990, these hospitals showed gains in absolute dollar amounts and in dollar amounts per capita, even if the expenditures are expressed in constant dollars. To a lesser extent, the same was true of RTCs. Although both VA medical centers and State Mental hospitals showed increases in expenditures as measured in current dollars, if expenditures are expressed in constant dollars, these Organizations showed net decreases. Their inpatient populations also decreased during this period. However, if expenditures per inpatient under care are examined, the reverse is true. The per patient expenditures for State Mental hospitals increased between 1969 and 1990, even if the results are stated in constant dollars.(ABSTRACT TRUNCATED AT 250 WORDS)
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Expenditures and sources of funds for Mental Health Organizations: United States and each state, 1988.
Mental health statistical note, 1991Co-Authors: Sunshine Jh, Michael J. Witkin, Atay Je, Manderscheid RwAbstract:: Expenditures. Expenditures by the 8 types of Mental Health Organizations covered in this report totaled $23.1 billion in 1988 in the United States and territories. Three States (California, New York, and Pennsylvania) accounted for 30 percent of this total. Nationally, State and county Mental hospitals (hereafter called State Mental hospitals) accounted for the largest proportion of all expenditures (30 percent, down from 34 percent in 1986). Private psychiatric hospitals and multiservice Mental Health Organizations had the next largest expenditures, each accounting for 20 percent of the total, followed by the separate psychiatric services of non-Federal general hospitals at 16 percent. Department of Veterans Affairs (VA) Mental Health services, residential treatment centers (RTCs) for emotionally disturbed children, freestanding psychiatric outpatient clinics, and freestanding psychiatric partial care Organizations accounted for 6 percent, 6 percent, 3 percent, and less than one-half percent of total expenditures, respectively. State Mental hospitals represented the largest expenditures of any single type of Mental Health Organization in 23 States; expenditures of private psychiatric hospitals were largest in 12 States; and expenditures of multiservice Mental Health Organizations were the largest in 10 States. The $23.1 billion total for 1988 represented a 25 percent increase over the 1986 figure but, when adjusted for inflation, the estimated increase (expressed in constant dollars) was only 10 percent overall and 8 percent on a per capita basis. Constant dollar expenditures of most types of Mental Health Organizations increased between 1986 and 1988, with the largest increase occurring among private psychiatric hospitals (54 percent). In contrast, constant dollar expenditures decreased for State Mental hospitals and VA Mental Health services. Sources of Funds In 1988, the funds received by Mental Health Organizations totaled $23.4 billion. Of this total, $8.8 billion (38 percent) was provided directly by State governments, predominantly by State Mental Health agencies. Direct Federal funds, plus Medicare and Medicaid (including the State and local share of Medicaid), provided $6.5 billion (28 percent) of total funding. Fees from clients (including private insurance) provided $5.2 billion (22 percent); direct local government funds provided 7 percent; and all other sources, 5 percent. State governments provided 77 percent of the funds received by State Mental hospitals and were also the largest single source of funds for multiservice Mental Health Organizations (51 percent) and freestanding psychiatric partial care Organizations (44 percent). VA Mental Health services were funded by the Federal government, while 62 percent of funding for private psychiatric hospitals came from client fees (including private insurance).(ABSTRACT TRUNCATED AT 400 WORDS)
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Psychiatric outpatient care services in Mental Health Organizations, United States, 1986.
Mental health statistical note, 1991Co-Authors: Sunshine Jh, Michael J. Witkin, Atay Je, Manderscheid RwAbstract:In 1986, 2,967 Mental Health Organizations, or 62 percent of all Mental Health Organizations in the United States (including territories), offered psychiatric outpatient care services. A total of 5.6 million patient care episodes were provided by these organized outpatient services. These episodes involved a total of 47 million visits and 2.8 million additions, and represented 69 percent of all psychiatric patient care episodes in organized settings that year. Both the number of Organizations with psychiatric outpatient care services and the number of outpatient additions to these Organizations increased by approximately 4 percent between 1983-84 and 1986. Multiservice Mental Health Organizations were the most prominent type of Mental Health Organization in the provision of psychiatric outpatient care. They comprised 42 percent of the 2,967 Organizations offering this type of care and were responsible for 54 percent of the outpatient additions, 53 percent of the episodes, and 54 percent of the visits. Next in importance were freestanding psychiatric outpatient clinics and separate psychiatric services in non-Federal general hospitals. They accounted for 26 percent and 17 percent, respectively, of Organizations providing psychiatric outpatient care. Each provided 12 to 18 percent of outpatient additions, episodes, and visits. Over 90 percent of multiservice Mental Health Organizations and Veterans Administration psychiatric Organizations offered outpatient psychiatric care. In contrast, this form of care was offered by only 29 percent of State and county Mental hospitals, 36 percent of private psychiatric hospitals, 37 percent of nonFederal general hospitals with psychiatric services, and 23 percent of residential treatment centers for emotionally disturbed children.(ABSTRACT TRUNCATED AT 250 WORDS)
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Staffing of Mental Health Organizations, United States, 1986.
Mental health statistical note, 1991Co-Authors: Redick Rw, Michael J. Witkin, Atay Je, Manderscheid RwAbstract:: Between 1984 and 1986, the number of full-time equivalent (FTE) staff employed in specialty Mental Health Organizations in the United States increased 12 percent from 440,925 to 494,591. Much of this increase could probably be attributed to the increase in the number of Mental Health Organizations during this period from 4,438 to 4,747. With the exception of freestanding psychiatric outpatient clinics, which showed a 1 percent decrease, all of the other Mental Health Organization types showed varying amounts of increase in FTE staff, with the most notable gains reported by private psychiatric hospitals, RTCs for emotionally disturbed children, and multiservice Mental Health Organizations. Of the 494,591 FTE staff employed in Mental Health Organizations in 1986, 70 percent were classified as patient care staff and 30 percent as administrative and support staff. Private psychiatric hospitals, State Mental hospitals, and freestanding psychiatric outpatient clinics had slightly higher percentages of administrative and support staff (40, 35, and 33 percent, respectively), with consequent smaller percentages of patient care staff (60, 65, and 67 percent, respectively). For all other Organization types, the percentages of patient care staff were higher, varying from 70 to 87 percent. Professional patient care staff constituted 47 percent of all FTE staff in Mental Health Organizations in 1986, and other Mental Health workers (less than B.A.) represented only 23 percent of the total. Among each of the Organization types, however, the percentages of professional patient care staff were generally higher, and the percentages of other Mental Health workers lower, with the major exception of State Mental hospitals. Seventy-five percent or more of the staff employed in the various types of specialty Mental Health Organizations in 1986 worked on a full-time basis, with the exception of freestanding psychiatric outpatient clinics and the separate psychiatric services of non-Federal general hospitals in which full-time staff represented only 53 and 67 percent of all staff, respectively. For the most part, a majority (50 percent or more) of each of the staff disciplines employed in specialty Mental Health Organizations worked on a full-time basis. The major exceptions were psychiatrists and other physicians, most of whom worked either on a part-time or a trainee basis.
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Expenditures and sources of funds for Mental Health Organizations: United States and each state, 1986.
Mental health statistical note, 1990Co-Authors: Sunshine Jh, Michael J. Witkin, Manderscheid Rw, Atay JeAbstract:: EXPENDITURES: Expenditures by the 8 types of Mental Health Organizations covered in this report totaled $18.5 billion in 1986, for the United States and the Territories. Three States (California, New York, and Pennsylvania) accounted for one-third of this total. Nationally, the largest proportion of total expenditures were the expenses of State and county Mental hospitals (34 percent, down from 38 percent in 1983) and those of multiservice Mental Health Organizations (20 percent). In all but 19 States, State and county Mental hospitals (hereafter called State Mental hospitals) had the largest expenditures of any type of Mental Health Organization; in 10 of the remaining 19 states, expenditures of multiservice Mental Health Organizations were largest. Nationally, separate psychiatric services of non-Federal general hospitals, private psychiatric hospitals, and VA psychiatric Organizations ranked next, with 16, 14, and 7 percent of total Mental Health expenditures, respectively. At the other extreme, residential treatment centers (RTCs) for emotionally disturbed children, freestanding psychiatric outpatient clinics, and freestanding psychiatric partial care Organizations accounted for 5 percent, 3 percent, and less than 1 percent of national total expenditures, respectively. The $18.5 billion expenditure in 1986 was a 28 percent increase over the 1983 figure, but when adjusted for inflation, the estimated increase was only 5 percent overall and 3 percent on a per capita basis. Constant dollar expenditures (1983 = 100) of most types of Mental Health Organizations increased between 1983 and 1986, but those of freestanding psychiatric outpatient clinics were virtually unchanged, and those of State Mental hospitals and VA psychiatric Organizations actually decreased. SOURCES OF FUNDS: In 1986, the funds received by Mental Health Organizations totaled $19.0 billion. Of this total, $7.9 billion (41 percent) was provided directly by State governments, predominantly by the State Mental Health agencies. Direct Federal funds plus Medicare and Medicaid (including the State and local share of Medicaid) provided $4.8 billion, or one-fourth, of total funding. Fees from clients (including private insurance) provided $4 billion, or 21 percent, of total funding; direct local government funds provided 8 percent and all other sources 5 percent. State governments provided 78 percent of the funds received by State Mental hospitals and were also the largest single source of funds, although not so dominant, for multiservice Mental Health Organizations, freestanding psychiatric partial care Organizations, and freestanding psychiatric outpatient clinics. VA medical centers were funded by the Federal Government, while two-thirds of funding for private psychiatric hospitals came from client fees...