Case management helps prevent criminal justice recidivism for people with serious mental illness

Extra responsibility and limited nursing: a review of community mental health nurses as care coordinators within a multidisciplinary team

A multidisciplinary approach has been identified as the optimal strategy for addressing the complex health and social needs of community mental health service users. Designating a care coordinator within the multidisciplinary team has been suggested to improve cooperation and communication. However, evidence on the experiences of community mental health nurses (CMHNs) as care coordinators is limited. This systematic review and thematic synthesis aimed to investigate CMHNs' experiences and identify enablers and obstacles to effective implementation. We searched PubMed, CINAHL, Scopus, and Web of Science for peer-reviewed primary papers published in English between 1990 and 2022, as well as gray materials from ProQuest Dissertations and Theses, and Google Scholar. After the screening process, only nine studies were deemed eligible for inclusion in the review. The quality of the included studies was assessed using the JBI critical evaluation checklist for qualitative studies, and data were analyzed using NVivo software and thematic synthesis based on Thomas and Harden's method. Our analysis reveals that CMHNs perceive the care coordinator role as a link to service users and as an added burden, including high demand for administrative tasks. CMHNs reported a lack of role clarity, leading to blurred boundaries within the multidisciplinary team, loss of professional identity, and decreased confidence. Role ambiguity and variability in team collaboration were significant contributors to role conflict. These findings indicate a critical need for role definition and clarity within community mental health multidisciplinary teams as it affects team functioning and the professional identities and confidence of CMHNs. It is recommended that healthcare management, clinical leaders, and professional nursing bodies reconsider their vision for the care coordinator role. This could be done through clear role definitions, training programs, and policy changes that ultimately enhance CMHNs' confidence and reaffirm their professional identities.

Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes

BACKGROUND

Social determinants of health (SDoHs) are receiving growing attention and are particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk of comorbidities, cognitive and functional decline, and early mortality. Yet, we did not find any comprehensive review of multiple SDoHs in SSPD.

STUDY DESIGN

We conducted a scoping review of meta-analyses and systematic reviews of nine major SDoHs in SSPD.

STUDY RESULTS

Childhood abuse, parental psychopathology, parental communication problems, bullying, and urban settings with lower socioeconomic status were major risk factors for the greater incidence of SSPD and/or worse health. Social network size was inversely associated with overall psychopathology and negative symptoms. Experiences of racial/ethnic discrimination correlated with the prevalence of psychotic symptoms and experiences. Compared to native populations, the risk of psychosis was higher in immigrants, refugees, and asylees. Social fragmentation was associated with an increased prevalence of schizophrenia. Homeless populations had a 30-fold higher prevalence of schizophrenia than the general population. Seriously mentally ill people were 2.7 times more likely to report food insecurity than controls. The prevalence of non-affective psychosis in prisoners was 2.0%-6.5%, compared to 0.3% in the general population. Certain potentially positive factors like family and community resilience remain poorly studied.

CONCLUSIONS

SDoHs are associated with higher rates of and worse outcomes in SSPD. Well-designed longitudinal studies are needed to understand SDoHs' contribution to health in persons with SSPD, to develop interventions, and to implement changes in clinical care and public health policies that would reduce adverse health impacts of SDoHs. Positive SDoHs deserve greater attention.

Influence of Case Management Model Combined with Continuous Nursing Care on Compliance Behavior and Adverse Emotions in Elderly Patients with Lung Cancer: A Prospective Single-Center Case-Control Study

Aims

To ask lots of questions about finding the truth about the influence of the case management model combined with continuous nursing care on following the law behavior and negative feelings of love, hate, fear, etc. in old patients with lung scale-like cell cancer.

Materials and Methods

One hundred and forty-three elderly patients with squamous cell carcinoma of the lung were selected for this prospective study, 10 cases were shed due to epidemic and transfer, and finally 68 cases were in the control group and 65 cases in the observation group. The differences in anxiety and depression scores, quality of life, and compliance behavior between the two groups were observed and compared.

Results

After nursing, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) of the observation group were lower than those of the control group, while the social support score was significantly higher than that of the control group. The scores of psychological behavior, exercise status, drug taking, and balanced diet of the two groups were significantly improved, and the observation group was significantly improved. The scores of medical compliance behavior in the observation group were significantly higher than those in the control group, and the mental vitality score, social interaction score, emotional restriction score, and mental status of the patients in the observation group were significantly higher than those in the control group, and the above statistics showed that the difference was statistically significant (P < 0.05).

Conclusion

The use of a case management model combined with extended care significantly improved the compliance behavior and anxiety and depression of elderly patients with squamous cell carcinoma of the lung and improved the quality of life and social support.

Initiation of a multidisciplinary telemental health clinic for rural justice-involved populations: Rationale, recommendations, and lessons learned

Videoconferencing technology (VCT) is rapidly increasing in the mental healthcare industry and is becoming an attractive option to reach justice-involved populations. This paper first highlights the need for alternative service delivery solutions and reviews current literature on the use of VCT for correctional clients. We then outline the specific timeline, procedures, and barriers associated with the initiation of a virtual, multidisciplinary telemental health clinic for jailed and community-released offenders in a rural Mississippi county aimed at reducing criminogenic and psychiatric risks. Finally, we summarize generalizable recommendations for establishing community partnerships, developing structural and logistical processes, and delivering VCT while accounting for unique client factors and integrating evidence-based intervention strategies. We hope other community leaders will feel empowered to initiate similar programs that address needs within in their own jurisdictions.

Mental Health Treatment Among Individuals Involved in the Criminal Justice System After Implementation of the Affordable Care Act

OBJECTIVE

The objective of this study was to assess changes in health insurance coverage and mental health treatment among individuals with and without involvement in the criminal justice system after implementation of key provisions of the Affordable Care Act (ACA).

METHODS

Data from the National Survey on Drug Use and Health were used to assess changes in coverage, mental health treatment, and payer between 2011-2013 and 2014-2017 for nonelderly adults (ages 19 to 64) with and without criminal justice involvement in the past year who reported serious psychological distress. Multivariable logistic regression was used to obtain adjusted estimates.

RESULTS

The weighted sample represented, on average, 2.0 million individuals with criminal justice involvement (total unweighted N=3,688) and 20.9 million without criminal justice involvement (total unweighted N=33,872) in each study year. Following implementation of the ACA's key provisions, health insurance coverage increased by 13.4 percentage points (95% CI=8.5-18.3) among individuals with past year criminal justice involvement and by 8.1 percentage points (95% CI=6.9-9.4) among those without. Receipt of any mental health treatment did not change significantly among individuals with criminal justice involvement (-3.4 percentage points [95% CI=-8.0 to 1.1]), whereas it increased significantly in the general population (2.2 percentage points [95% CI=0.4-3.9]).

CONCLUSIONS

Despite an increase in health insurance coverage for people with criminal justice involvement, there was no increase in mental health treatment following implementation of the ACA's key provisions. Health insurance coverage is necessary, but not sufficient, to expand access to mental health treatment for individuals involved in the criminal justice system.

Sociodemographic, Clinical, and Therapeutic Aspects of Penitentiary Psychiatric Consultation: Toward Integration Into the General Mental Health Services

The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.