Academic liaison librarians have traditionally supported reference, instruction, and research support. Many aspects of these activities are demand driven and hence, easily capture the attention and ...priorities for the busy academic liaison librarian with multiple subject assignments. Pro-actively supporting faculty's and students' research needs can vary widely by subject area/discipline, departmental culture, and even individual professors' and researchers' practices, and requires creativity and experimentation to develop and sustain successfully. This presentation will detail activities and strategies that librarians can use to better assess needs, gain skills, identify unmet challenges, and better equip themselves for strategic interventions throughout the research cycle. Audience participation, discussion, and suggestions will be integrated throughout this presentation.
The COVID-19 pandemic posed new challenges for integrated health care worldwide. Our study aimed to describe newly implemented structures and procedures of psychosocial consultation and liaison (CL) ...services in Europe and beyond, and to highlight emerging needs for co-operation.
Cross-sectional online survey from June to October 2021, using a self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies, working groups, and heads of CL services.
Of the participating 259 CL services from Europe, Iran, and parts of Canada, 222 reported COVID-19 related psychosocial care (COVID-psyCare) in their hospital. Among these, 86.5% indicated that specific COVID-psyCare co-operation structures had been established. 50.8% provided specific COVID-psyCare for patients, 38.2% for relatives, and 77.0% for staff. Over half of the time resources were invested for patients. About a quarter of the time was used for staff, and these interventions, typically associated with the liaison function of CL services, were reported as most useful. Concerning emerging needs, 58.1% of the CL services providing COVID-psyCare expressed wishes for mutual information exchange and support, and 64.0% suggested specific changes or improvements that they considered essential for the future.
Over 80% of participating CL services established specific structures to provide COVID-psyCare for patients, their relatives, or staff. Mostly, resources were committed to patient care and specific interventions were largely implemented for staff support. Future development of COVID-psyCare warrants intensified intra- and inter-institutional exchange and co-operation.
•The COVID-19 pandemic has exposed shortcomings in our health care systems.•Over 80% of participating consultation-liaison (CL) mental health services established specific structures.•Among the participating CL services, 61% offered specific interventions for patients, 38% for relatives, and 77% for staff.•Most of the time resources were committed to patient care.•Intra- and interinstitutional exchange and cooperation should be intensified.
As part of a larger multi‐site translational research project this study explored patient and staff experiences, perspectives, and recommendations in relation to a mental health liaison nursing ...(MHLN) team established in the emergency department (ED) of a metropolitan hospital in New South Wales, Australia. Semi‐structured interviews were conducted with a sample of ED patients (n = 26), ED nurses (n = 10), ED consultants (n = 9), and members of the consultation–liaison psychiatry team (n = 5). Data were analysed thematically. Patients emphasized the numerous therapeutic qualities of the MHLN role, the promptness with which they were seen and the value of follow‐up. Privacy was identified as important, and some negative experiences were reported. Staff identified that the MHLN team are able to respond to a variety of ED presentations in a timely manner. There was recognition that the MHLN team needs to be integrated within the ED as a specialist resource that builds ED capacity. Consistent staffing of the MHLN team with designated clinicians was also considered essential. Integrating a nurse practitioner‐led MHLN team within the ED has demonstrated multiple benefits for patients, ED staff, and overall service provision. Incorporating a specialist mental health nursing service within the ED builds confidence in ED clinicians. Members of the psychiatry team also acknowledge the value of aligning the clinical governance of the MHLN team within the ED and the reduced workload this model of care has on their service provision to ED, freeing them up to concentrate on their broader general hospital role.
Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.
To evaluate the performance of risk scales (Manchester Self-Harm Rule, ...ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.
A multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale
cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy.
In total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (
= 145). Sensitivity ranged from 1% (95% CI 0-5) for the SAD PERSONS scale, to 97% (95% CI 93-99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2-47) for the Modified SAD PERSONS Scale to 47% (95% CI 41-53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50-0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69-0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (
<0.001).
Risk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm.
Au chapitre 2, Denise Couture aborde la mutation actuelle des relations qui se produisent « devant nous, en nous et par nous » pour créer la justice (p. 11). Ensuite l'auteure en appelle a la ...décolonisation des relations et a la connaissance des conditions de vie passées et actuelles de ces trois autres, notamment celles des Autochtones qui ont subi le christianisme colonisateur, afin de « maintenir des relations de respect réciproque et de reconnaissance mutuelle entre les peuples autochtones et non autochtones du Canada » (p. 68). L'auteure se réfere au Groupe de théologie contextuelle québécoise qui invite a « opérer une " re-liaison " avec le sol sur lequel nous avons les pieds, jusqu'a devenir capables de prononcer la phrase Nous sommes le territoire! ». La théologie féministe y est caractérisée par huit jeux de l'esprit des femmes comme le souligne la womanist Serene Jones (p. 132) : 1) l'option préférentielle pour les femmes, qui part de leurs expériences; 2) la conscience que notre propre pensée est située; 3) la conscience de la diversité de comprehension par les femmes de ce qu'est une femme; 4) la conscience du caractere construit du concept de religion et de la non-existence d'une expérience religieuse universelle.
Abstract
Background
The Mental Health Service for Older People (MHSOP) Liaison Service in North Dublin noted an exponential increase in suicide attempts in those over 65 over a period of 3 years ...(2020–2022). Annually in Ireland, more than 400 people die by suicide and a further 12,500 present to hospital following self-harm, of which approximately 15% are older adults (aged >60). Worldwide, the age group that is most likely to die by suicide is represented by older adults, in particular men.
Methods
Analysis of referrals to the service from an established clinical database was performed to include those referred post suicide attempt or those referred for suicidal ideation or expressing a Passive Death Wish (PDW). Data was anonymized and recorded using Microsoft excel.
Results
There was a highly significant difference between the number of males who were referred post suicide attempt between 2021 (n = 1) and 2022 (n = 13), with z = +3.21 p < 0.001. Referrals post suicide attempt in 2021 consisted of 2% (n = 6) of all referrals to the service, and 6% (n = 20) in 2022. In 2021 the mean age of those referred was 75.16, and in 2022 was slightly lower at 72.65, with 60% of those in the 65–72 year age range. Alcohol was involved in 45% of all suicide attempts in 2022. The overall referrals to the service for suicidality (post suicide attempt and PDW) increased from 5% to 16% from 2021 to 2022 of all those referred.
Conclusion
A Suicide prevention working group was established to include members of: MHSOP, Older Persons Services, Public Health and the National Office for Suicide Prevention (NOSP) to explore evidence based suicide and self-harm prevention strategies and guidelines in order to address the multiple precipitative factors for suicidality in older persons by developing improved care pathways and integration of services.
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