To investigate whether the smoking ban has led to an increase in adverse events in adult psychiatry wards on the Wirral.

We compared the number of violent incidents reported on the adult psychiatry wards in the 6 months before and after the smoking ban. We also compared the number of emergency detentions (section 5.2 and 5.4 of the mental health act) implemented in the 6 months before and after the smoking ban.

There was a 36% reduction in violent incidents in the 6 months after the smoking ban compared to the 6 months before the ban (70 in the 6 months before the ban and 45 in the 6 months after the ban). There was a 64% reduction in emergency detentions in the 6 months after the smoking ban compared to the 6 months before the ban (25 in the 6 months before the ban and 9 in the 6 months after the ban).The number of admissions during each 6 month period that we looked at were very similar (288 admissions in the 6 months before the ban and 299 in the 6 months after the ban).

Prior to the smoking ban there were concerns that it would lead to an increase in the number of violent events and patients who required emergency detention (under Section 5.2 or Section 5.4 of the Mental Health Act). This study shows that there was a reduction in the incidence of adverse events following the smoking ban.

The chronic worldwide shortage of psychiatrists has impaired the delivery of first class mental health care (WHO 2008). This international project funded by a World Psychiatric Association grant proposes to examine and compare the effects of country-specific undergraduate and postgraduate factors involved in medical student choice of a psychiatric career. Phase 1 focussed on identifying published proven and novel modifiable factors to improve psychiatric recruitment.

We searched EMBASE, PsychInfo and Medline using the keywords ‘career psychiatry’, ‘medical education’, and ‘career choice’. All 206 papers retrieved using the combined search were reviewed and categorized thematically.

Findings are summarised under three themes:

1. · Pre-medical school factors: arts & social sciences qualifications, attitudes towards mental illness, high uncertainty tolerance, liberal political views, gender and life goals.

2. · Medical school factors: availability of psychology/sociology/special-studies modules, electives; length of clinical placement; exposure to motivated patients and effective treatment; quality of teaching and good role models; and conversely negative attitudes from other specialities.

3. · Post-graduate factors: availability of early clinical posts in psychiatry, work-life balance, remuneration.

1. · Studies have been limited by small sample sizes, unicentricity, and datedness, given the major reorganisations of mental health services and postgraduate training in many countries.

2. · During the next stage we will generate the first multicountry comparison, with sufficient power to detect differences in factors influencing a psychiatric career choice at personal, institutional and national level. We will focus on factors that may be modifiable by policy to positively influence career choice towards psychiatry.

Burnout is caused by high stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so this process is caused poor relationship with patient. Burnout should be considered in medical students by counseling centers of University for prevention of consequences. This study investigates burnout in senior medical students of Kashan University of Medical Sciences, Kashan,Iran(2008).

This research is a cross sectional study. In this study all of senior medical students (N=56) were answered to demographic questionnaire and Maslach burnout Inventory.

The findings showed that the majority of medical students (91.1%) had burnout and 16% of them had severe burnout. There was not significant relationship between burnout and sex, age, marital status P< 0.05.

Burnout was common problem in medical students and need to be helped. Therefore Medical Student should be encouraged to seek help and adequate facilities should be available.

Improving adherence in mental patients, growing up insight and reducing stigmatization.

Giving simple and clear messages to families and patients for learning about symptoms and the management of daily difficulties.

Three were the main pillars of our work: patients’ opinion, professional knowledge and families contributions. First, patients were questioned about “What is for you mental illness?” “May you explain your illness?” and the answers were completed with a collage/picture. Those opinions were evaluated by the group and the therapist. We already made reunions with a mental patients association and family groups to expose their opinions and daily life difficulties.

Analyzing drawing-collage characteristics, medical histories and reflections from patients and families, we achieved an individual management for patients. Families could expose doubts and suggestions about patients care. We offered a multidisciplinary management to develop insight and adherence.

“The other shore of mental illness” is a book with a psicoeducative propose about useful concepts of mental illness. It emerges from the professional need to approach to the other shore, families and patients’ opinions and feelings.

Drawing has been used as worktherapy, becoming a benefit for diagnosis and evolution in mental illness. In this book we used them as a means in the improvement of insight and adherence.

The work with families, patients and caregivers let therapists to attend the real difficulties in their daily lives.

The book would be not only a vehicle to reduce stigma, but also a reflection on avoiding discriminatory politicals in mental patients assistance.

Mental health policy in the English-speaking world emphasises the the importance of ‘recovery’ as a guiding philosophy. Translating this rhetorical consensus into reality has proved challenging, with some mental health service users reporting that the concept of recovery is being co-opted by professionals without substantive changes in practice. The aims of this talk are (a) to define personal recovery; (b) to present a theoretical framework for understanding personal recovery; and (c) to identify the four ways in which mental health professionals can support recovery.

The most widely cited definition of recovery will be elaborated, and key recovery domains identified from a systematic review of consumer narratives of recovery.

A new theoretical framework for recovery - the Personal Recovery Framework - will be presented, which identifies the centrality of identity, the contribution of clinical models to recovery (and how they can be toxic to recovery), and why hope is necessary. The framework identifies four approaches which mental health professionals can use to support recovery: fostering relationships, promoting well-being, offering treatments, and improving social inclusion. Examples will be given of how actual services around the world are undertaking these tasks to support recovery.

Developing recovery-supporting mental health services will involve a fundamental shift in power, values, attitudes, skills and behaviours. It will require system transformation, and genuine partnership between those using, working in and managing services.

Following the National Review of Mental Health Nursing in Scotland (2006), an action plan was developed to improve recovery focused mental health services. It was advocated that a method of sharing evidence based, positive and innovative practice in mental health be created. NHS Quality Improvement Scotland supported by the Scottish Government, was tasked to develop the database and successfully launched the PIRAMHIDS resource in September 2008, now providing the platform to share information at local, national and international levels.

PIRAMHIDS ensures equitable opportunity to share examples of practice from statutory, non statutory services and the voluntary sector. Contribution to the database is made easy by an intuitive online submission process. A quality assurance process is then followed in achieving publication approval. Submissions are passed to an external review body. External reviewers consist of professionals from a range of disciplines including Psychiatry, Mental Health Nursing, Occupational Therapy, Higher Education, service improvement, etc. The selected reviewers consider the submission in context of the publication criteria which includes:

• Practice summary:

  • Detail of practice deliverable

  • Evidence base-current/existing or potential to inform evidence

  • Challenges and resolves

  • Quality assurance considerations and impact assessment on the patient experience

PIRAMHIDS is the resource to share your practice. In addition there is an online forum encouraging networking, up to date mental health information feeds and direct links to other useful resources such as Integrated Care Pathways for mental health toolkit. Now accessed by thousands world wide, take the credit and share your care.

Contribute today.

This study compares levels of satisfaction of patients and carers in the provision of home-provided acute care with traditional in-patient care, and further compares subjective level of family burden in both treatment settings.

Patients and their carers completed Verona Satisfaction Questionnaires, and carers completed family burden scale. Responses were compared between groups receiving home-delivered acute care and those receiving hospital-based care.

Satisfaction scores for home-care patients are higher for 28 of the 34 questions, and this difference reaches statistical significance (p < 0.05) for four questions, and approaches significance (p< 0.1) for two further questions. Carers in home care group indicate a higher degree of satisfaction on all 18 Verona Questionnaire items, this difference reached significance at p< 0.05 level for 4 items and p< 0.1 level for a further 5 items.

Results from family burden measure indicate consistent lowering of subjective burden in home care group, with lower burden scores in 20 of the 22 questions. This difference reached statistical significance (p< 0.05) for 5 items, including the summative item (Total Family Burden Score), and was close to significance (p< 0.1) for 3 other items.

These results indicate both patients and carers express a consistent preference for home-delivered care for acute psychiatric illness, compared with hospital-based model. In-addition, families report a reduction in burden related to illness episodes. These findings provide evidential support for continued development of community delivered care in meeting the increasing demand for acute psychiatric care services in Ireland.

To investigate need for social support for persons with mental health problems and their families on example of screening-questionnaire of persons, visiting on World Mental Health Day Clinics of Mental Health Research Institute SB RAMSci, Tomsk, Russia.

Screening-questionnaire was carried out anonymously. Questions were answered by 14 persons of various ages, randomly selected by investigator. Respondents had to choose variants of answers for 4 questions:

100% of respondents have come to clinics for their mental health problems, among them 1 person (7%) was a relative of person with mental health problems. 2 persons (14%) had friends with mental health problems. One person said that it is simply interesting for him. Patients and relatives need more information about mental health. They’d like to know about available medication. Overwhelming number of respondents believed that establishment of site and organization for mentally ill and relatives is necessary. % of negative answers was significantly lower and was explained by unwillingness to attract attention of other people. Organization of leisure-time would diversify life of patients and relatives. Of interest is advocacy of patients and their relatives,

Analysis of screening-questionnaire has shown that social support is really needed by persons with mental health problems and it may be rendered by user-led organizations, need for which in Russia has not been still satisfied. Social support is important both for patients and their families because they are often isolated and hardly cope with challenge of poor mental health of ill family member.

Little is known about the physical co-morbidity in mentally ill living in psychiatric and social health care facilities with regard to variation, causes, risk factors and prevention strategies. Aim of this study was to determine patients’ and professionals’ perceptions, attitudes and thoughts of

1. (i) co-morbid physical health problems and illness,

2. (ii) risk factors and causes of somatic problems and

3. (iii) prevention measures across Europe.

A total of 52 focus groups in 14 European countries were conducted. Participants were recruited from psychiatric and social health care facilities. Data were content analyzed deductively and inductively.

The physical health problems that were often mentioned were weight problems, diabetes, cardiovascular and gastrointestinal problems, problems of the circulatory system, and general aches and pains. Regarding the causes of somatic problems and illnesses, focus groups repeatedly emphasized side-effects from medications. Besides treatment-related factors, country-specific aspects also were mentioned, mainly in the field of the living environment. Findings concerning “prevention” demonstrated the greatest distinctions between the participant groups, particularly with regard to the implementation and realization of health promotion interventions. Discussions revealed that patients preferred active learning (hands-on experiences) coupled with group classes for education and social support.

Focus groups identified behavioural, environmental and iatrogenic health risks. Efforts need to be directed toward interventions for physical illness prevention and health promotion on the background of the heterogeneity of mental disorders and the multitude of physical problems, and need to be based on an understanding of residents’ cultural beliefs and life situations.

Of this project was to study the characteristics of stress and depression in mental health professionals and the degree at which they are affected by demographic factors.

The sample of the study includes 62 mental health professionals. An anonymous closed questionnaire by Bedford & Foulds was used. The data analysis was made with the use of SPSS 16.0.

Two factors were found statistically essential; the age[F(5,41)=0,52 p=0,004] and the marital statue [F(5,41)=0.49 p=0.008]. The married people seem to statistically develop higher anxiety (p=0,001), higher tension (p=0,002) and higher insomnia (p=0,001) in comparison to the singles, the divorced and the widows/widowers. The singles seem to keep more calm (p=0.014) in comparison to the married and the divorced (p=0.001).Working people aged 35-49 experience more intense sorrow than the other age groups (p=0,003), more intense feelings of panic (p=0,018) and tension (p=0,049). The age groups in stressful or depression situations diversify their needs as regards smoking, with the 35-49 age group being the heaviest smokers (p=0,029).

It is discovered that a different defense mechanism is used by mental health professionals as regards their marital statue and their age, developing sleeping disorders, increase in smoking and sadness elements indifference for the future, more often.

Little is known about the physical co-morbidity in mentally ill living in psychiatric and social health care facilities with regard to variation, causes, risk factors and prevention strategies. Aim of this study was to determine patients’ and professionals’ perceptions, attitudes and thoughts of (i) co-morbid physical health problems and illness, (ii) risk factors and causes of somatic problems and (iii) prevention measures across Europe.

A total of 52 focus groups in 14 European countries were conducted. Participants were recruited from psychiatric and social health care facilities. Data were content analyzed deductively and inductively.

The physical health problems that were often mentioned were weight problems, diabetes, cardiovascular and gastrointestinal problems, problems of the circulatory system, and general aches and pains. Regarding the causes of somatic problems and illnesses, focus groups repeatedly emphasized side-effects from medications. Besides treatment-related factors, country-specific aspects also were mentioned, mainly in the field of the living environment. Findings concerning “prevention” demonstrated the greatest distinctions between the participant groups, particularly with regard to the implementation and realization of health promotion interventions. Discussions revealed that patients preferred active learning (hands-on experiences) coupled with group classes for education and social support.

Focus groups identified behavioural, environmental and iatrogenic health risks. Efforts need to be directed toward interventions for physical illness prevention and health promotion on the background of the heterogeneity of mental disorders and the multitude of physical problems, and need to be based on an understanding of residents’ cultural beliefs and life situations.

Depression is common in older patients with chronic diseases. Untreated depression leads to poor compliance with medical treatment and increases health care utilization.

We examined the management of depression in patients with COPD, severe osteoarthritis and unspecified symptoms by the general practitioners (GPs).

We assessed a national sample of general practitioners (n = 3956) in England, the management of depression for chronic diseases using a postal survey with three case vignettes.

864 (22%) completed responses were received (Men = 433, Female = 431). The mean (SD) age was 45.8 (8.47). The percentage of GPs who reported that they would explore the diagnosis of depression for each vignette were 95.4% for COPD, 88.3% for severe osteoarthritis and 86.3% for unspecified symptoms. There is significant difference in the percentage of GPs diagnosing depression more COPD patients compared with severe osteoarthritis and unspecified symptoms

(X2 = 76.6; p < 0.001). GPs that offer a diagnosis of depression for patients with COPD are more likely to prefer a combination of antidepressant drugs and psychological therapy as their first line of treatment F (3.00, 2534) = 2.39, p = 0.06. GPs endorse the importance of routinely screening for depression in patients who have COPD F (3.89, 3349) = 5.03, p < 0.0006 and depression impairs patient's self-management of COPD F (3.95, 3404.36) = 5.28, p < 0.0003.

GPs in England report the importance of screening for depression in patients with chronic diseases. Depression interferes on the self-management of COPD.

The purpose of this study was to examine the impact of health variables and work variables on academic performance of undergraduate students. We have two main goals:

1. 1) Examining the relationship between emotional and physical disturbances and academic performance;

2. 2) Investigating the influence of a parallel professional activity on academic performance.

Data was obtained on Superior School of Health Technology of Coimbra, in 2 different times: time 1 (T1), at the beginning of the academic term (195 students) and time 2 (T2), at the end of this term (177 students). A correlational design was used.

Main results suggest that:

1. 1) Students that have a parallel professional activity have a performance academic worst than those who haven’t this activity;

2. 2) From all the variables considered, only age may be considered predictor of the academic performance;

3. 3) Students that have been medically assisted had a worst performance;

4. 4) No statistically relevant differences were found on the academic performances of individuals with and without chronic diseases, and of individuals with and without emotional disturbances;

5. 5) No statistically relevant differences were found either the start and the end of the academic term, on the physical and emotional symptoms under evaluation.

Given the results obtained, the main conclusion can be drawn from this study is: Although the emotional and physical symptoms are not relevant, when they are medically assisted, they report worst academic performance.

In recent years some studies could show that beside the negative effects of the stressful encounters resulting from disorders and handicaps also positive experiences can be made. The aim of our study is to determine which strategies help the hearing impaired to gain positive experiences.

The Trierer Persönlichkeitsfragebogen (Becker 1989) and a german translation of a questionnaire which was designed to measure the positive experiences in life with acquired hearing impairment (Stephens and Kerr 2003) were distributed to persons with aquired hearing impairment, which were recruted at acousticians and ENT-doctors.

Positive experiences are gathered mainly by successful communication behaviour.

(Eisenwort et al. in press)

Successful communication helps the hearing impaired to gain positive experiences.

The purpose of this research is to compare personality traits and mental health in athletes and nonathletes students.

67 athletes and 64 nonathletes students were randomly selected and NEO-PIR inventory and General Health Questionnaire (GHQ)were administered on them. Data were analyzed with independent T formula.

Findings showed significant differences between variables. Nonathletes have more neuroticism personality trait and were high in components of mental illness.

It is concluded sport rehearsals and physical fitness have positive effects on temperament and mood and reduce mental illness symptoms and give sense of happiness and newness in life.

Stress is integral part of human life todays. Stressful situations not only affect on the short-term events such as death or birth, but also it affects on events such as marriage, employment situations and particular political atmosphere that are to long-term events. However, whether these factors are short-term or long-term, individual reaction to cope with situations will be different. So the study aimed to investigate one of problems of 20th century, addiction to internet, and its relation to strss.

In sampling process 100 university students were randomly selected. All participants were requested to complete Coudron's Stress Inventory (CSI) and Addiction to internet inventory (AII).

Analyzing of the data showed that there is significant positive correlation between stress and addiction to internet. It showed people with stress are more dependent to the Internet and have more tendency to overuse of internet.

With regards to results, it is bettter to plan for increasing of skills of cope with stress and decrease addiction to internet in university students.