Training health professionals in the recognition and treatment of depression

A total of 423 health professionals, including physicians, psychologists, counselors, social workers, and nurses, attended a two-day program to increase awareness, recognition, and treatment of depression. In a preprogram opinion survey, nurses and social workers reported less perceived ability to recognize mood disorders compared with physicians and psychologists. In a group of 274 respondents who took a 20-item test of their knowledge about depression before and after attending the program, scores for all professions increased after the program and pretest differences in scores between professions decreased. The results suggest that training was successful in increasing knowledge about depression among a diverse group of health professionals.     

Supporting children's mental health in schools: Teacher perceptions of needs, roles, and barriers.

There is a significant research to practice gap in the area of mental health practices and interventions in schools. Understanding the teacher perspective can provide important information about contextual influences that can be used to bridge the research to practice gap in school-based mental health practices. The purpose of this study was to examine teachers' perceptions of current mental health needs in their schools; their knowledge, skills, training experiences and training needs; their roles for supporting children's mental health; and barriers to supporting mental health needs in their school settings. Participants included 292 teachers from 5 school districts. Teachers reported viewing school psychologists as having a primary role in most aspects of mental health service delivery in the school including conducting screening and behavioral assessments, monitoring student progress, and referring children to school-based or community services. Teachers perceived themselves as having primary responsibility for implementing classroom-based behavioral interventions but believed school psychologists had a greater role in teaching social emotional lessons. Teachers also reported a global lack of experience and training for supporting children's mental health needs. Implications of the findings are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Making sense of posttraumatic stress disorder: Illness perceptions among traumatic injury survivors.

More than 1.5 million persons in the United States sustain traumatic physical injuries each year. A significant proportion of traumatic injury survivors develop serious mental health problems, such as posttraumatic stress disorder (PTSD), yet few obtain professional mental health care. According to the commonsense model of self-regulation (Leventhal, Diefenbach, & Leventhal, 1992), illness-related perceptions can influence coping responses, including the use of professional treatment. Using the commonsense model as a guiding framework, we conducted semistructured interviews with nontreatment-seeking trauma injury survivors with PTSD (N = 23). Illness perceptions regarding the following key conceptual dimensions were examined: PTSD symptoms (identity), experienced or perceived consequences of PTSD symptoms, and beliefs about the causes, controllability, and course of PTSD symptoms. Results revealed that no respondents identified their symptoms as indicative of PTSD. Common illness perceptions included believing that symptoms would be short-lived, that symptoms were reflective of poor physical health or were a natural reaction to life in a violent community, and that symptoms were functionally adaptive. Respondents also reported exerting some limited control over symptoms by relying on religious forms of coping. None of the respondents perceived professional treatment as being able to completely control symptoms. Findings indicated that respondents' conceptualizations of PTSD symptoms might have inhibited the recognition of symptoms as a serious mental health condition that warrants professional treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mental health nurses working purposefully with people with serious and enduring mental illness--an international perspective

There has been a world-wide refocus on people with serious and enduring mental health problems. This has provided major challenges for all those involved in mental health care, as the last two decades have produced radical changes in service delivery and a range of new interventions. Mental health nurses are playing a central role as community based clinical case managers and are beginning to use a range of psychosocial interventions. They are also revitalizing skills in the more traditional areas of medication management and residential care. In addition, there are growing problems of substance abuse and violence which needs to be addressed. Mental health nursing is responding in this new era by various training initiatives. However, these programmes need rapid expansion as mental health nurses will continue to play a key role in the services of the future and therefore need these new skills.     

Workers' perceptions of how jobs affect health: A social ecological perspective.

A national sample of 2,048 workers was asked to rate the impact of their job on their physical and mental health. Ordered logistic regression analyses based on social ecology theory showed that the workers' responses were significantly correlated with objective and subjective features of their jobs, in addition to personality characteristics. Workers who had higher levels of perceived constraints and neuroticism, worked nights or overtime, or reported serious ongoing stress at work or higher job pressure reported more negative effects. Respondents who had a higher level of extraversion, were self-employed, or worked part time or reported greater decision latitude or use of skills on the job reported more positive effects. These findings suggest that malleable features of the work environment are associated with perceived effects of work on health, even after controlling for personality traits and other sources of reporting bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does coping help? A reexamination of the relation between coping and mental health.

In a longitudinal community survey of 291 adults, we explored the relation between coping strategies and psychological symptoms. Respondents completed the revised Ways of Coping Scale (Folkman & Lazarus, 1985) for a self-named stressful episode. Factor analysis produced eight coping factors: three problem focused, four emotion focused, and one (support mobilization) that contained elements of both. Multiple regression analyses indicated bidirectionality in the relation between coping and psychological symptoms. Those in poorer mental health and under greater stress used less adaptive coping strategies, such as escapism, but coping efforts still affected mental health independent of prior symptom levels and degree of stress. We compared main versus interactive effects models of stress buffering. Main effects were confined primarily to the emotion-focused coping scales and showed little or negative impacts of coping on mental health; interactive effects, though small, were found with the problem-focused scales. The direction of the relation between problem-focused scales and symptoms may depend in part on perceived efficacy, or how the respondent thought he or she handled the problem. Implications for the measurement of adaptive coping mechanisms and their contextual appropriateness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental and physical health of spouse caregivers: The role of personality.

Although personal resources of caregivers, such as coping skills and social support, have been shown to be important in understanding caregiver stress and health outcomes, personality traits have not previously been considered. The purpose of this study was to examine the association between the personality traits of neuroticism and dispositional optimism and mental and physical health outcomes. It was predicted that personality would have direct effects, and indirect effects through perceived stress, on health outcomes. Participants were spouse caregivers of patients diagnosed with Alzheimer's disease (AD). Results show that neuroticism and optimism were significantly related to mental and physical health. Furthermore, neuroticism had significant direct effects on all of the health outcomes, and substantial indirect effects, through perceived stress, on mental health outcomes. Optimism showed stronger indirect than direct effects on all health outcomes. These findings demonstrate the importance of including personality of the caregiver in theoretical and empirical models of the caregiving process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

District nurses' perceptions of palliative care at home

A postal survey of 148 district nurses (DNs) was carried out to explore their experiences of terminal care and their views of the palliative care team. Information was also gathered on DNs' perceived educational needs in relation to palliative care. The high response rate of 87% and the additional comments that many nurses offered illustrates their desire to provide high-quality care. Factors that appeared to hinder achievement of this goal and led to stress included size of caseload, lack of knowledge and experience in managing difficult symptoms as well as time constraints. High levels of satisfaction with the palliative care team were recorded but a need for further education and improved communication were identified.     

Peripheral blood monocytes in psoriatic patients overproduce cytokines

This article reports findings from a national survey that questioned school social workers on school violence. The article focuses on personal reports of victimization, precautions taken to avoid victimization, training needs to deal with school violence, programs in schools, and social workers' involvement with violence intervention. Findings suggest that many respondents believe social skills programs are not as effective as ecological interventions. Findings also indicate that the majority of school social workers have received school violence prevention training. These skills could be used in a national effort to reduce school violence. The authors recommend specific strategies for increasing the school social workers' role in school-based violence prevention efforts.     

Basal expression, subcellular distribution, and up-regulation of the proto-oncogene c-JUN in the rat dentate gyrus after unilateral entorhinal cortex lesion

OBJECTIVE: To compare perceived current mental health and disablement between primary care and end-stage renal disease (ESRD) patients, and to study social support and stress and severity of illness as possible determinants of mental health and disablement. METHOD: Observational cross-sectional analysis of 414 primary care patients in a rural community health center and 125 ESRD patients requiring hemodialysis in two community dialysis units. The Duke Health Profile (DUKE) anxiety-depression scale was used to assess mental health; the DUKE disability scale, to indicate disablement; the Duke Social Support and Stress Scale, to measure support and stress; and the Duke Severity of Illness Scale, to rate severity of illness. RESULTS: Perceived current mental health in terms of anxiety and depression symptoms was worse for primary care than for ESRD patients, and perceived current disablement was no different for the two groups. Patients' perception of their health status and of stress from family members were more closely associated with their level of anxiety and depression symptoms than were their diagnostic profiles or overall severity of illness. In turn, their level of anxiety and depression symptoms was the principal correlate of their disablement. CONCLUSIONS: The demonstration of strong relationships among anxiety and depression symptoms, disablement, and family stress in these two very different patient populations should stimulate further research and motivate clinicians to evaluate all three parameters as part of routine patient care.     

Psychologists in practice with older adults: Current patterns, sources of training, and need for continuing education.

Rapid population growth among older adults means an increased need for psychologists prepared to provide mental health services to this population. A representative survey of 1,227 practitioner members of the American Psychological Association yielded information about current patterns of practice with older adults, sources of training in geropsychology, perceived need for continuing education (CE) in geropsychology, and preferred CE formats. Most respondents provided some services to older adults, but typically very little. The services provided are inadequate to meet projected demand. Most respondents lacked formal training in geropsychology and perceived themselves as needing additional training. CE workshops at the regional level and distance education were the most popular formats. These data serve as a call to the field to expand training opportunities at all levels of training, with an emphasis on the need for empirically based, broadly accessible CE offerings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A cross-cultural tool to identify continuing education needs

Cost-controlled health reforms have created the need for training nurses to provide evidence-based care in new contexts. Planing for nurses' continuing education must thus target the appropriate personnel and simultaneously consider local healthcare needs and training requirements. To plan such educational programmes, a training needs analysis instrument was developed in the UK and used to compare the training needs of nurses in Australia, the USA and the UK. Below, the findings of this survey.     

The role of familism in stress and coping processes among African American and White dementia caregivers: Effects on mental and physical health.

Objective: To explore how familism, burden, and coping styles mediate the relationships between ethnicity and the mental and physical health of caregivers. Design: A probability sample of 65 White and 95 African Americans respondents caring for an older family member with dementia was used to test hypotheses from a sociocultural stress and coping model using path analysis. Main outcome measures: Measures of caregivers' health included subjective health, self-reported diseases, blood pressure, and heart rate. Mental health measures included self-reported depression and psychological symptoms. Results: Contrary to the hypothesis, familism had an adverse effect on outcomes and was related to low education levels rather than to African American ethnicity. A buffering effect of active coping between being African American and diastolic blood pressure was found even after controlling for levels of education. Conclusions: Findings supported a core stress and coping model in which more behavior problems of care recipients were associated with poorer mental health of caregivers via greater burden and more use of avoidant coping. Results also demonstrate that this core model can be extended to physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interdisciplinary collaboration and discharge planning communication for elders

The effects of personal characteristics and perceptions of interdisciplinary collaboration on discharge planning communication were examined for nurses, physicians, and social workers in two hospitals. The model for the study explained 61.7% of the variance in discharge planning communication for nurses. For all 142 health professionals, communication openness with social workers, problem solving between nurses and physicians, and collaboration with social workers were important to discharge planning communication. For nurses, communication satisfaction with patients and families also was important.     

Description and evaluation of the Iowa Depression Awareness, Recognition, and Treatment Program

OBJECTIVE: The National Institute of Mental Health developed the Depression Awareness, Recognition, and Treatment Program to provide up-to-date information and training to health, mental health, and social service professionals regarding the identification and treatment of depression. This study was undertaken to evaluate a series of these programs for professionals who provide services to rural residents in the Midwest. METHOD: The 18 2-day training programs were attended by a total of 1,221 participants, physicians, psychologists, social workers, and nurses. Participants' knowledge regarding depression was assessed both before and after each program. Practice characteristics and perceived ability to assess and treat depression were assessed. Finally, 6-month follow-up evaluations of the usefulness of the training to the participants were undertaken. RESULTS: Following the programs, participants evidenced significant increases in levels of knowledge of depression and a high degree of satisfaction with most elements of the program. Six-month follow-up evaluations indicated a continued positive evaluation of the program. CONCLUSIONS: These outcomes suggest that the goals of the Depression Awareness, Recognition, and Treatment Program were met and provide support for the wider dissemination of these training programs.     

The variants and potentials of reconstructive surgery of the penile skin

This paper is part of a larger study examining the role of the nurse practitioner and its potential utility in mental health nursing. Two methods were employed for data collection: a focus group interview with eight RCN qualified nurse practitioners, the result of which informed the development of a postal questionnaire which was distributed to the remaining RCN qualified nurse practitioners (n = 130). Forty seven respondents did not feel adequately equipped to assess a mental health problem, despite nearly a third identifying mental health issues as a primary problem with which their patients presented. Just over 40 per cent of respondents stated that mental health needs were not met within their community and 78.7 per cent of respondents supported the development of a mental health nurse practitioner. In light of these findings the concept of a mental health nurse practitioner is discussed, alongside the need to clarify other advanced nursing roles.     

Two little magic words.

Discusses the importance of perceived program need and agency and consultant contracts to the development of agency-based community mental health programs. For programs that depend significantly on the contributions of an outside consultant, 2 steps must be taken. First, the nature of the perceived program need and the relevance of the consultants' interests and skills to that need must be established. Second, contracts clarifying the agency's and the consultant's specific roles and responsibilities in the prospective program must be developed. Problems in need determination may involve misidentification of need or disagreement among agency staff about needs. A hypothetical program for training volunteers as companions of discharged mental patients is described to illustrate the steps taken in establishing contractual responsibilities. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding stress and burnout in shelter workers.

Crisis intervention workers and other front-line mental health workers often face excessive stress and seek psychotherapy or supervision and support from professional psychologists. The authors sought information on job-related stressors, coping mechanisms, and burnout levels and found that shelter workers who reported high job-related stress and low social support may be most vulnerable to experiencing burnout symptoms. Psychologists providing clinical or consultation services to domestic violence shelter staff should emphasize the importance of creating a supportive work environment, developing a sense of personal accomplishment related to one's work, and teaching and modeling helpful coping strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)