Psychiatric Quarterly

Despite the clubhouse model’s 60-year existence internationally, the central nature of its core program, the “work-ordered day” (WOH) (Beard et al. in Psychosocial Rehabilitation Journal 5:47–53, 1982), is not well understood; hence, the primary focus of the present study was to explore members’ experiences of the nature and meaning of the WOH. The study drew on qualitative interview data collected in 2009–2013 through open-ended questions and probes with 102 members and 24 staff from 5 Clubhouse International-certified clubhouses (2 US and 3 Finnish). Participant observation supplemented the interviews and all data were analyzed using a grounded theory approach (Charmaz in Rethinking methods in psychology, 1995; Glaser and Strauss in The discovery of grounded theory: strategies for qualitative research, 1967). Two major themes clustered around: (a) WOH in service of autonomy (things to do, sense of accomplishment, respite, development of occupational skills) and (b) WOH in service of relationships (receiving support; collaboration; and making contributions to the clubhouse community). Clubhouse members appeared to experience the WOH as meaningful because it helps them, as its best, reconstruct a life, develop their occupational self and skill sets, and experientially learn and live what parallels a good life in the general community. It appears that these experiences, interconnecting with the fundamental human needs for autonomy and relationship, point to wellbeing and recovery as part of personal growth. These findings can guide clubhouse daily practice in assessing members’ psychosocial strengths and needs pertaining to recovery. Future research should elaborate on influences of sources of meaning, including work designs and the contributions of everyday socio-cultural interactive and reciprocal processes to these meanings.

Pathological gaming (PG) behaviors are behaviors which interfere with other life responsibilities. Continued debate exists regarding whether symptoms of PG behaviors are a unique phenomenon or arise from other mental health problems, including attention problems. Development of attention problems and occurrence of pathological gaming in 144 adolescents were followed during a 1-year prospective analysis. Teens and their parents reported on pathological gaming behaviors, attention problems, and current grade point average, as well as several social variables. Results were analyzed using regression and path analysis. Attention problems tended to precede pathological gaming behaviors, but the inverse was not true. Attention problems but not pathological gaming predicted lower GPA 1 year later. Current results suggest that pathological gaming arises from attention problems, but not the inverse. These results suggest that pathological gaming behaviors are symptomatic of underlying attention related mental health issues, rather than a unique phenomenon.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in human suffering and dollar cost expense. International research through 2012 documented the frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five year period of 2013–2017. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s, even with new policy initiatives in place meant to reduce such violence. Nursing personnel continued to be at greater risk. The findings by continents and an updated methodological inquiry are presented.

Since the 1960s, empirical research has worked toward a better understanding of the characteristics of assaultive psychiatric patients. International research through 2012 indicated that male and female patients with schizophrenia and other diagnoses presented the greatest risk for assault. This present review of studies that presented raw assault sought to assess the latest research findings on assaultive patients for the most recent 5 year period, 2013–2017. It was hypothesized that male patients with schizophrenia would present the greatest risk. The findings indicated a sharp increase in the total number of reported assault incidents over the proceeding decade. These assaults were committed largely by male patients with a diagnosis of schizophrenia. Explanations for these findings and an updated methodological inquiry are presented.

We aimed to assess patients’ utilization of and satisfaction with telemental health (TMH) in the perinatal period. We hypothesized that satisfaction with TMH would be at least equal to, if not greater than, with in-person appointments. We conducted a cross-sectional survey between March 2018–June 2019 to evaluate patient satisfaction with and use of TMH services in the perinatal period. Participants used TMH services across the second and third trimester of pregnancy and the first year post-partum. Nearly half of the patients (8/19, 42%) used TMH to see their provider within the first two weeks post-partum. Participants were most commonly in treatment for anxiety (14/19, 74%) and/or depression (9/19, 47%). Most participants agreed or strongly agreed (13/19, 69%) that TMH improved their access to healthcare and that they could see the clinician as well as if they met in person (14/19, 74%). TMH was a highly accepted and appreciated method of mental health care delivery for perinatal women when offered as an alternative to in-person or telephone sessions.