Assessment of suicide risk is a serious responsibility of psychologists. Best practice instructs use of a standardized instrument and clinical interview to evaluate suicide risk. Six instruments used to assess suicide behavior and symptoms of anxiety and depression were examined. The sample was adults receiving acute psychiatric treatment in a public hospital. The study consisted of 2 groups: 25 patients admitted for suicidal behavior and 42 patients admitted for other reasons. Analyses were conducted to discriminate between the 2 groups on study instruments. No single instrument predicted suicide risk without significant error. Standardized assessments must be used as part of a structured clinical interview. Suicide risk should be assessed with all people admitted to the hospital regardless of admissions criteria.
In the United States there has been an increased interest in the development of treatment programs that admit chemically dependent women with their children. The Salvation Army Family Treatment Services in Honolulu, Hawaii has had a long history of admitting women both with and without their children to long-term residential treatment. This has provided an opportunity to study the differences in treatment retention between these two groups. Subjects were 130 females who participated in treatment between 1988 and 1993. Analyses were conducted to determine whether there were different outcomes for women with children in treatment and women without children in treatment, with regard to type of discharge and length of time in treatment. Results were significant and clearly indicated better retention rates for women who participated in treatment with their children.
This paper focuses on the critical role of nursing in implementing a behaviour plan in a psychiatric hospital. The plan was implemented with a 40-year-old man with a long history of aggression towards others and self. The study used a single-subject research design with baseline and intervention phases (AB Design). Data were collected on (1) frequency of incidents of aggression towards others and self; (2) use of restrictive interventions to manage aggression (i.e. restraints, pro re nata medication, 1:1 special observation); and (3) frequency of staff injury. The data show a decrease in frequency of aggression towards others and self, a concurrent reduction in the use of restrictive interventions to manage aggression, and a decrease in incidents of staff injury. The behaviour plan helped staff maintain a safe and therapeutic milieu. The behaviour plan has given the patient an opportunity to learn positive replacement behaviours and skills, and the opportunity eventually to leave the hospital to live in a less restrictive community home.
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