Objective: To identify the prevalence and predictors of (a) thoughts of suicide or self-harm among healthcare workers during the COVID-19 pandemic and (b) help-seeking among those healthcare workers with thoughts of suicide or self-harm. Method: Analysis of data from the Australian COVID-19 Frontline Healthcare Workers Study, an online survey of healthcare workers conducted during the second wave of the COVID-19 pandemic in Australia. Outcomes of interest were thoughts of suicide or self-harm as measured through the Patient Health Questionnaire for depression and help-seeking behaviours. Results: Overall, 819 (10.5%) of 7795 healthcare workers reported thoughts of suicide or self-harm over a 2-week period. Healthcare workers with these thoughts experienced higher rates of depression, anxiety, post-traumatic stress disorder and burnout than their peers. In multivariable models, the odds of suicide or self-harm thoughts were higher among workers who had friends or family infected with COVID-19 (odds ratio = 1.24, 95% confidence interval = [1.06, 1.47]), were living alone (odds ratio = 1.32, 95% confidence interval = [1.06, 1.64]), younger (⩽30 years cf. >50 years; odds ratio = 1.70, 95% confidence interval = 1.36-2.13), male (odds ratio = 1.81, 95% confidence interval = [1.49, 2.20]), had increased alcohol use (odds ratio = 1.58, 95% confidence interval = [1.35, 1.86]), poor physical health (odds ratio = 1.62, 95% confidence interval = [1.36, 1.92]), increased income worries (odds ratio = 1.81, 95% confidence interval = [1.54, 2.12]) or prior mental illness (odds ratio = 3.27, 95% confidence interval = [2.80, 3.82]). Having dependent children was protective (odds ratio = 0.75, 95% confidence interval = [0.61, 0.92]). Fewer than half (388/819) of the healthcare workers who reported thoughts of suicide or self-harm sought professional support. Healthcare workers with thoughts of suicide or self-harm were more likely to seek support if they were younger (⩽30 years cf. >50 years; odds ratio = 1.78, 95% confidence interval = [1.13, 2.82]) or had prior mental health concerns (odds ratio = 4.47, 95% confidence interval = [3.25, 6.14]). Conclusion: One in 10 Australian healthcare workers reported thoughts of suicide or self-harm during the pandemic, with certain groups being more vulnerable. Most healthcare workers with thoughts of suicide or self-harm did not seek professional help. Strong and sustained action to protect the safety of healthcare workers, and provide meaningful support, is urgently needed.
Background Healthcare workers are at higher risk of suicide than other occupations, and suicidal thoughts appear to have increased during the COVID-19 pandemic. Aims To understand the experiences of healthcare workers with frequent thoughts of suicide or self-harm during the pandemic, including factors that contributed to their distress, and the supports that they found helpful. Method We used content analysis to analyse free-text responses to the Australian COVID-19 Frontline Healthcare Workers Study, from healthcare workers who reported frequent thoughts that they would be better off dead or of hurting themselves, on the Patient Health Questionnaire-9. Results A total of 262 out of 7795 healthcare workers (3.4%) reported frequent thoughts of suicide or self-harm in the preceding 2 weeks. They described how the pandemic exacerbated pre-existing challenges in their lives, such as living with a mental illness, working in an unsupportive environment and facing personal stressors like relationship violence or unwell family members. Further deterioration in their mental health was triggered by heavier obligations at home and work, amid painful feelings of loneliness. They reported that workplace demands rose without additional resources, social and emotional isolation increased and many healthful activities became inaccessible. Tokenistic offers of support fell flat in the face of multiple barriers to taking leave or accessing professional help. Validation of distress, improved access to healthcare and a stronger sense of belonging were identified as helpful supports. Conclusions These findings highlight the need for better recognition of predisposing, precipitating, perpetuating and protective factors for thoughts of suicide and self-harm among healthcare workers.
A community oriented Crisis Unit was introduced in a mental hospital as an integral part of a comprehensive Clinical Service. The unit is doing crisis assessment and intervention for patients referred to this Clinical Service and a 72-hour inpatient or day-care crisis oriented therapy. The locale, the organization of the team and the work of the unit are described. Data are given regarding the number of patients seen during the first six months, of those admitted and of those discharged within 72 hours or transferred to another unit of the service. Additional data referring to the patients admitted to the Crisis Unit and during a corresponding six-month period of the previous year when the Unit was not operating are also given. The reduction of the inpatient population of the service and the associated financial savings are outlined. The management of the Unit on an open-door policy is described. The impact of the Unit on the treatment programs of the other units of the service is discussed. It is suggested that crisis therapy oriented units should be considered an essential and integral component of the psychiatric services offered by mental or general hospitals. Comparative studies of patient populations before and after the introduction of such units and long-term follow-up evaluative studies are required.
In an effort to improve rehabilitation devices, the applications of soft robotics technologies to prosthetics and physical therapy was explored, particularly due to the benefits of the inherent properties of soft materials. A conceptual design for a soft robotics device prototype is proposed to assist with physical therapy for wrist tendonitis and arthritis, carpal tunnel syndrome, fractures and sprains, and compromised motor skills due to chronic stroke. The device assists in four motions that are commonly performed in wrist therapy: flexion, extension, and rotation (clockwise and counterclockwise) using soft pneumatic actuators to guide movements. The distinct directions were achieved by varying the lateral and radial strain limiting layers. The device uses embodied intelligence to make the device dynamically adaptable in real time, allowing for a customizable recovery process. A detailed model of the device was developed and the viability of the design was assessed using a suite of state-of-the-art simulation tools and limited hardware prototyping. Simulations were performed through integration of Rhinoceros 3D, Grasshopper 3D, Firefly, an Arduino microcontroller, biosensors, Python scripting, and visual parametric programming. Pressure and materials were simulated and tested in Simulia Abaqus and Autodesk Fusion 360. Several parametric variations were tried using simulations and the predictions revealed that rubber silicone at a pressure of 10 kiloPascals is the optimal choice.
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