Exploring Illicit Drug Use Among Individuals with Schizophrenia

Article 1: Reasons for illicit drug use in people with schizophrenia

Background: The aspect of drug related misuse is termed as a vital clinical problem linked with poor health related outcomes among the patients. The research in the current context works on exploring the possible context of illicit drug use among people suffering from schizophrenia. There remains a dearth of qualitative studies underlying the impact of illicit use of drugs among the chosen population (Asher and Gask, 2010).

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Methods: The research makes use of primary qualitative study with the help of seventeen research participants. These research participants are diagnosed with schizophrenia and made use of illicit drugs. The participants were interviewed and asked to describe their experience related to the use of drugs in the mentioned scenario. The obtained transcript was analysed and presented through the use of grounded theory for better understanding about the experience and the perception of the research participants.

Results: The research evaluated the five potential causes of making use of drugs among the target population. The reason identified in the following case can be termed as “identity defining vocation”, “creating a sense of belonging to a specific peer group”, due to reasons of feeling hopeless coupled with the possible belief of the ways how street drugs influence them. In the worst case scenario, the studied population perceived the use of illicit drugs as a mode of psychotic medication. This prevailing practice can be blamed on the lack of knowledge of the patients. However, Asher and Gask (2010), argued the fact, schizophrenia is an acute psychotic disorder and the patient cannot take care of themselves due to incidents of hallucination and recurrent relapses that makes it difficult for them to support the event of self care. Conclusively, the use of qualitative methods pertaining to dual diagnosis is supported in the current research. The study in the mentioned context works on identifying the possible novel factors that can maintain the proper use of drugs among the chosen group of patients, as well as usefully confirming series of findings of recent qualitative research with individuals suffering from psychosis. Carrà et al argued (2016), schizophrenic individuals make use of illicit drugs to relieve physiological symptoms. The familiarity with the existing five themes generated from the current research study could work on helping the mental health professionals to carry out clinical assessment of dual diagnosis patients in gathering the relevant client information, while being equally sensitive of the perspective exhibited by the research subjects (Asher and Gask, 2010). The implementation of empathy and profound understanding can help in forming a management plan to treat the chosen population

Strength and weakness: The uniqueness of the study remains in the use of qualitative analysis for investigating the use of drugs among schizophrenic patients. Previous studies had mixed population leaving people in doubt about the emerging themes. The sample size of the current population was limited and it failed to include the female participants and ethnic minorities where the prevalence of psychotic disorder tends to be on the higher side (Asher and Gask, 2010). The study paid no specific attention to explore the research diagnostic criteria pertaining to schizophrenia or the impact of drugs on such co morbid condition

Article 2: Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder

Background: The current research papers aims to understand and evaluate the response provided by the mental health nurses while being subjected to educational intervention. The research thus works on assessing the perception of nurses after the implementation of education and the way they would diagnose and treat patients with borderline personality disorder (BPD). As stated by Dickens et al. (2019), the attribute towards individuals diagnosed with BPD continues to be poorer for people with other psychotic disorders. There exists limited evidence about the chances of improvement in the mentioned scenario.

Methods: The research in the mentioned context makes use of mixed methods. The mentioned intervention was at a single NHS site in Scotland. The mixed method works on providing a better perspective about the research participants. The measurement of emotional and cognitive attitudes of the people with BPD can influence the results (Dickens et al. 2019).

Results: The participants are reported to give mixed responses to the science related to borderline personality disorder. Those who valued the research study expressed and appreciated the perception. The result claimed the fact that level of education among the nurses can work on improving adherence to the better chances of positive health outcomes. However, Day et al. (2018) argued the fact that educational intervention among the senior nurses may emerge as a potential problem. The nurses, especially the senior nurses are often burdened with work making the nature of the experiment seem redundant. Suitable for the level of undergraduate nurses, the validity of the underlying premises is often questioned. The result revealed a perception that people are often born with certain personality related disorders, it remains within their genes; however such theory has been discarded (Day et al. 2018). In addition to that few nurses exhibited proactive nature in ensuring that the mentioned session goes well and there remains a culture for learning. Thus, it becomes important to understand the fact that the nurses are in dual mind of accepting the change. The change is often accepted during the course of less work pressure and the nurses need to embrace a proactive attitude to make sure that the expected outcomes are obtained

The evidence obtained through the current study is a statistically significant change with four or five domains. The thematic analysis reports the series of antagonistic judgements exhibited by the research participants. The positive change in the characteristics of individuals with a diagnosis of bipolar disorder and the associated perception related to tendency to commit suicide as negative attitudes has been pursued at 4 month follow-up (Dickens et al. 2019). The nurses found no change in the level of perception within the chosen group as they were difficult to be treated (Lanfredi et al. 2019). However, it would be conclusively stated the results were mixed but positive

Strengths and limitations: The study is small with interventions delivered on two instances. The contribution of the second part of the study is of special interest as it appears to be the qualitative analysis from the perspective of the attendees receiving educational intervention aimed at shifting attitudes towards people diagnosed with bipolar disorder diagnosis (Dickens et al. 2019). The research in the mentioned context did not evaluate the distinct parts of borderline intervention on a separate basis, thus the research cannot say whether the aspect of educational intervention can have unique differential impact, positive and negative. The suggested qualitative data suggested that the attendees welcomed the expert as per the experience

Article 3: Organizational Climate Partially Mediates the Effect of Culture onWork Attitudes and Staff Turnover in Mental Health Services

Background: The aspect of staff turnover within the mental health service organization is termed as an ongoing issue with severe implication on organizational cultures. The implication is related to levels of productivity, staff morale, organizational effectiveness and implementation of innovation (Manyisa and van Aswegen, 2017). Recent studies within the public sector have worked on exploring the influence of the organizational culture and work based attitudes.

Methods: The research in the mentioned context makes use of primary quantitative data. The data is collected from a series of 322 case management and clinical service providers across 49 public mental healthcare sectors (Aarons and Sawitzky, 2006). The research worked on predicting one year follow-up upon the work behaviour and attitudes of the chosen population and the possible factors that can work on influencing the rates of turnover among the chosen population

Results: The multi-factorial response to healthcare related turnover issues can be termed as a leading cause of concern. The research in the mentioned context found out the possible factors of concern related to low wages of the employees. In addition to that the research additionally pointed out the fact that unsatisfactory levels of benefits provided to the employees can be termed as another cause of concern leading to employee turnover. As stated by Manyisa and van Aswegen (2017), poor working conditions are a major barrier to work. The instance of poor barrier at work is evident within the mentioned mental health care sectors. As observed by Aarons and Sawitzky (2006), there remains a dearth of understanding among the patients and the service providers often making the care job burdensome, tedious and critical. In similar regards, the work culture in the mentioned context fails to recognise the job done well (Aarons and Sawitzky, 2006). The lack of suitable appreciation makes it increasingly difficult for the people to continue their job and thus leading in increased rates of turnover among the employees. Thus, it becomes important to state the fact that employee turnover is highly subjective in nature and dependent on several factors (Bukach et al. 2017).

Strengths and limitations: The study works on exploring the possible reasons of employee turnover, the quantitative study works on gathering the actual perception of the research participants. The limitation in the mentioned study remains in the examination of the dearth of examining the job characteristics. Furthermore, the organizational change may often lead to change in roles not consistent with the professional identity thus resulting in poor rates of job satisfaction. However, the current study failed to understand the organizational change. The study was exclusively undertaken to understand the impact of employee turnover on the chosen healthcare service

Article 4: Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting

Background: The aspect of crisis theory represents a threat towards the mental well being of the patients. However, Ashman, Halliday and Cunnane (2017), proposed the fact that crises are additionally termed as probable scope provided that successful intervention can lead to fruitful outcomes. The UK mental health team works on reducing the rates of hospital admission by treating people at homes, while building resilience with simultaneous learning from crisis. However, the data on repeated crisis related episodes suggest the current condition can be highly improved.

Methodology: The research in the mentioned context makes use of qualitative study. The research is inclusive of participants who are above the age of 18 years and have at least one episode of crisis care. The data was collected through the use of semi-structured interview and the transcript is analysed through the use of NVivo 10 software. The research makes four themes after analysing the results obtained. There was a single inclusion criteria for this research that stated the research participants should be well versed in English so that they can take part in the interview.

Results: The thematic analysis reports the series of antagonistic judgments exhibited by the research participants. The uniqueness of the study remains in the use of qualitative analysis for investigating the use of care among the mental healthcare patients. The critical aspect of WRAP’s action provided a clear understanding about the continuous care and importance of following up the patient with care (Ashman, Halliday and Cunnane, 2017). The continuous process of becoming comfortable is not limited to the aspect of personal confidence; an important feature related to “WRAP” learning can give better sense of identification to the participants. Overall, the aspect of WRAP is reported to have a transformational impact on the research participants and lives of the professional. The mental health self management capacity is additionally seen to undergo a transformational effect which may further have a potential to impact on continuous crisis presentation. The study provides clear idea pertaining to the fact that WRAP as a recovery program exhibits a great deal of potential (Ashman, Halliday and Cunnane, 2017). The mentioned research provides an idea that the rate of hospital admission is greatly reduced due to the stated intervention. However, Bukach et al. (2017), employees performing in mental health organizations need constant motivation for ensuring better working conditions

Strength and limitation: The uniqueness of the study remain in the use of qualitative analysis for investigating the use of care among the mental health care patients. The limitation in the mentioned study can be attributed to the study settings. The one to one setting of interview may appear to be redundant in nature and make things difficult. The use of a focus group with interview can provide better results in the studies. The study incorporates a growing body of service (Ashman, Halliday and Cunnane, 2017). The user led study contributes to a high level of openness. The findings reflect expectations rose through the series of quantitative research.

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Reflection

The aspect of mental health has been laced with controversies. The act of care within the domain of mental health needs special attention. After analysing the current research articles I realised that the psychotic issues are profound in nature. The analysis of the chosen papers provided me with a holistic understanding of mental health. The aspect of mental health is not related to medication alone. A holistic approach is a much needed intervention aimed to ensure positive health outcomes. As per my understanding the provision of care in the domain of mental health is dependent on the service providers. The rate of staff burnout can be termed as a significant blow to the healthcare industry. Schizophrenia is an intense insane issue and the patient can't deal with themselves because of episodes of mental trip and repetitive backslides that makes it hard for them to help the occasion of self consideration. Decisively, the utilization of subjective strategies relating to double determination is upheld in the ebb and flow investigation. The examination in the referenced setting takes a shot at recognizing the conceivable novel factors that can keep up the best possible utilization of medications among the picked gathering of patients, just as conveniently affirming arrangement of discoveries of late subjective research with people experiencing psychosis. The nature with the current five topics produced from the flow look into study could deal with assisting the psychological wellness experts with carrying out clinical appraisal of double determination patients in social events and the important customer data, while being similarly sensitive to the point of view shown by the exploration subjects.

On the basis of the analysis conducted it can be easily stated that holistic care is important that can ensure positive health outcomes. I realised that mental health care services are laced with challenges and gaps in knowledge and service making the domain equally challenging for the patients and the professionals alike. There remains a dearth of research study that makes the domain hard to explore. I realised that medication is important in treating poor mental health conditions. The area of medication in mental health is varied. For instance the field of psychotic medicine is varied for different kinds of diseases like depression and schizophrenia. For instance I did realise that psychotic medication is often seen to have synergistic effects that often expands to hallucinations. Citing example of schizophrenia I did realise that the patients are often seen to make use of illicit or street drugs for the sole reason that they make them feel confident. In certain cases people had no idea that those drugs being consumed are illegal. In future I plan to keep a journal and document my future experience for better understanding.

Reference list

Aarons, G.A. and Sawitzky, A.C., 2006. Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and policy in mental health and mental health services research, 33(3), p.289.

Asher, C.J. and Gask, L., 2010. Reasons for illicit drug use in people with schizophrenia: Qualitative study. BMC psychiatry, 10(1), p.94.

Ashman, M., Halliday, V. and Cunnane, J.G., 2017. Qualitative investigation of the wellness recovery action plan in a UK NHS crisis care setting. Issues in mental health nursing, 38(7), pp.570-577.

Bukach, A.M., Ejaz, F.K., Dawson, N. and Gitter, R.J., 2017. Turnover among community mental health workers in Ohio. Administration and Policy in Mental Health and Mental Health Services Research, 44(1), pp.115-122.

Carrà, G., Johnson, S., Crocamo, C., Angermeyer, M.C., Brugha, T., Azorin, J.M., Toumi, M. and Bebbington, P.E., 2016. Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe. Psychiatry research, 239, pp.301-307.

Day, N.J., Hunt, A., Cortis‐Jones, L. and Grenyer, B.F., 2018. Clinician attitudes towards borderline personality disorder: A 15‐year comparison. Personality and mental health, 12(4), pp.309-320.

Dickens, G.L., Lamont, E., Mullen, J., MacArthur, N. and Stirling, F.J., 2019. Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder. Journal of clinical nursing, 28(13-14), pp.2613-2623.

Lanfredi, M., Ridolfi, M.E., Occhialini, G., Pedrini, L., Ferrari, C., Lasalvia, A., Gunderson, J.G., Black, D.W. and Rossi, R., 2019. Attitudes of Mental Health Staff Toward Patients With Borderline Personality Disorder: An Italian Cross-Sectional Multisite Study. Journal of personality disorders, pp.1-16.

Manyisa, Z.M. and van Aswegen, E.J., 2017. Factors affecting working conditions in public hospitals: A literature review. International journal of Africa nursing sciences, 6, pp.28-38.

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