Reflecting on tragedy: a commentary on deaths of children in restraints.
Explore the source record for details and available documents.
Accidents↗
Biomedical subjects
Wanda K Mohr
Publications and source records attributed to Wanda K Mohr.
Spiritual issues in psychiatric care.
This article differentiates between the concepts of spirituality and religion and analyzes the strengths and weaknesses of the research findings related to spirituality, religion, and mental health. To discuss the importance of clarifying values and becoming self-aware in relation to implementing spiritual and religious interventions. The components of spiritual assessment are presented as well as spiritual coping practices and interventions the nurse might use when working with clients. Review of literature from MEDLINE, CINAHL, and current texts. Spirituality and religion are too often neglected foci of psychiatric mental health assessment and intervention. In order to maximize therapeutic effectiveness, nurses should be aware that for many patients spirituality is a critical life factor. Accordingly, they should screen patients and strive to meet patient needs for spiritual expression, while recognizing that there are important boundary and ethical issues in psychiatric mental health settings.
Adaptation, Psychological↗
Surfacing the life phases of a mental health support group.
Support groups have increased rapidly in number and become a viable alternative to formal treatment in the United States. However, little is known regarding how mental health advocacy or support groups start and develop, or about challenges that can threaten their survival. In this 2 1/2-year ethnography, the author studied the culture of a developing family support program associated with a system of care. Several phases emerged, reflecting an organizational dynamic. The group dynamics and response to challenges have implications for organizers and parent organizations about the need for technical assistance necessary for survival of the group. Participant observation and immersion in the culture of such groups can provide a deeper understanding of the ideologies and values around which they organize and the kinds of tensions that members can experience during the group's cycle.
Anthropology, Cultural↗
The Dawn Project: a model for responding to the needs of children with emotional and behavioral challenges and their families.
Systems of care represent a fundamental departure from traditional service provision by espousing genuine family-centered, culturally competent philosophies and blending the funding streams of multiple payers (e.g., education, mental health, child welfare). In Marion County, Indiana, local leaders created a system of care based on these principles called the Dawn Project. Currently, a comprehensive, multidisciplinary evaluation is being implemented to evaluate the program. Preliminary findings from initial evaluation efforts suggest that for youth in the project, there is significant clinical improvement during the first year of receiving services, a reduction in the use of more restrictive settings, and a decrease in recidivism among those who successfully complete the program.
Child↗
The substance of a support group.
This ethnographic research constitutes a study of the culture of a family-run advocacy organization for families of children and youth with mental health needs. Data collection includes 703 pages of interview transcripts, observations, field notes, and archival material collected by the principle investigator during 2.5 years of participant observation with this support group. This article provides the context for the study and describes the support group's cultural ideologies and cultural forms that are a concrete expression of those ideologies: There are four major categories of cultural forms as follows: symbols, language, narratives or stories, and practices. Manifestations of each form are discussed and described. The proliferation of support and advocacy groups in the mental health arena promises a rich source of understanding of the needs of families in distress as well as inspiration for new and practical interventions.
Adolescent↗
Adverse effects associated with physical restraint.
OBJECTIVE: Restraint use is not monitored in the US, and only institutions that choose to do so collect statistics. In 1999, investigative journalists reported lethal consequences proximal to restraint use, making it a life-and-death matter that demands attention from professionals. This paper reviews the literature concerning actual and potential causes of deaths proximal to the use of physical restraint. METHOD: Searching the electronic databases Medline, Cinahl, and PsycINFO, we reviewed the areas of forensics and pathology, nursing, cardiology, immunology, psychology, neurosciences, psychiatry, emergency medicine, and sports medicine. CONCLUSIONS: Research is needed to provide clinicians with data on the risk factors and adverse effects associated with restraint use, as well as data on procedures that will lead to reduced use. Research is needed to determine what individual risk factors and combinations thereof contribute to injury and death.
Asphyxia↗
Reconsidering punitive and harsh discipline.
Corporal punishment and other harsh interventions continue to be widespread despite the fact that the leading theories or models of behavioral management do not support their effectiveness. There is overwhelming evidence that harsh interventions are damaging to children, both emotionally and physically. The effects of such trauma may be compounded when a child has preexisting learning difficulties. When schools respond to these challenges using harsh methods, children can be further traumatized. The authors review principles of childhood neurodevelopment, describe a model to understand children in context, and discuss how exposure to certain noxious sensory experiences can affect children's responses to threat or perceived threat. They also describe implications for school nurses.
Child↗
Learning from extremism in the history of mental health. The example of multiple personality disorder.
This article reviews some of the history of the cultural forces that shaped the diagnosis of multiple personality disorder/dissociative identity disorder and the subsequent abuses that occurred at the time of its popularization. Some of the implications that can be drawn from these kinds of historical excesses in the field of mental health will be discussed. The article concludes by underscoring the ethical obligation inherent in maintaining healthy professional skepticism toward ideas driven by ideology and fad, rather than scientific empiricism.
Diagnosis, Differential↗
Accuracy in communication. A contextual approach to child behavior assessment.
This article analyzes the problem of accuracy of communication in clinical settings and argues that clinical language is replete with theoretical constructs that may not have shared meaning among speakers and listeners in mental health settings. It is suggested that mental health providers be trained in a contextually based data language. The value of such a data language employed in behavioral assessment is emphasized. The authors contend that events and behavior are products of the contextual environment; contextual variables are more accurately identified and agreed on; and the use of contextual variables in treatment intervention increases consequential validity. A developmental ecological approach, coupled with applied behavior analysis, are discussed and offered as a foundation on which clinical interventions should be planned and assessed. Using objective methods that yield demonstrable and meaningful outcomes can help improve children's mental health service delivery and the lives of children.
Adolescent↗
Discarding ideology: the nature/nurture endgame.
TOPIC: The concepts and research that underpin our understanding of how the brain is the organ of the mind. PURPOSE: To describe the dynamic nature of nervous system functioning and development; to discuss how the nervous system changes anatomically throughout the lifespan; to examine the vital role and interaction of genetics and environment; and to discuss the relationship among the brain, neurotransmission, genes, and psychiatric illness. SOURCES: Published literature. CONCLUSIONS: The latest research from the neurosciences lays to rest any suggestion that psychiatric illnesses are psychologically induced.
Brain↗
Level systems: inpatient programming whose time has passed.
TOPIC: Structuring of inpatient behavioral programming in child-adolescent psychiatric, residential treatment, and juvenile justice settings. PURPOSE: To review the underlying theory underpinning current practices and recommend remedies to the uncovered problems. SOURCES: A review of the literature from 1965 to 2001 from selected nursing and medical psychiatric and mental health publications. CONCLUSIONS: Intensive professional and staff education and greater precision in communication about patients' behaviors are needed in many settings. There is also a need to move away from generic treatment approaches and return to individual treatment planning based on individual assessments and the unique needs of an increasingly volatile and complex in-patient population.
Adolescent↗