Stress managment techniques in prison

I have been doing my "plan b" on the subject of stress managment techniques in prison. I reviewed the literature on this subject and examined the evidence base for managing stress through specific interventions in prisons.

Alot of cool stuff has been done in this field, especially when it comes to meditation in prisons. The entire Senegalese prison system adopted Transcendental Meditation as an intervention in their prisons.

Large meditation retreats have been held in India and the US with great anecdotal success.

No all we need is some evidence...

APNA 6th Annual Clinical Psychopharmacology Institute Conference

Psychopharmacology Across the Lifespan
June 20-22, 2008
On-Site Registration opens June 19, 2008
Hyatt Regency Reston

CLICK HERE FOR REGISTRATION FORM

This session below seems especially interesting. From my limited experience during my clinical internship this seems to be a huge issue. If our patients are suffering sexual side effects from , e.g. anti-depressants, adherence will not be high.

Sex, Drugs and Rock & Roll
Dr. Mary Gutierrez, board certified in psychiatric pharmacy practice and
seven-time Professor of the Year at the University of Southern California, will be
speaking about good sexual function and what can go wrong.
I encourage everybody who can to register ASAP. This is definitely an opportunity not to be missed.

PRICES
Early Bird Registration
Register Early and Save
only $745 until May 23, 2008:
APNA Members save $200 off the Early Bird Price
only $545until May 23, 2008
Regular Registration Fee $795 until June 2, 2008:
APNA Members save $200 off the Regular Price
$545 from May 24 - June 2
One Day Fee $290 for members/$390 for non-members

Happy Friday!

Don't forget. There is still beauty in the world...

Depression and Excercise

There are some strong indications that excercise seems to help reduce symptoms of depression. It can possibly help people on anti-depressants reach full remission and help prevent relapse into depression too.

Some studies on the possible benefits of exercise for the treatment of depression show that 2½ hours per week of moderate activity could signifcantly reduce symptoms of depression.

The research indicates that it does not matter if the exercise is frequently for a briefer time, or less frequently for a longer time. 50 minutes 3 times per week (2½ hours) and 30 minutes 5 times per week (2½ hours) are thus thought to have the same positive effect.

Excercise can include, gardening, jogging, walking, sex, biking or any other similiar activity.


Are your patients aware of this?

Restraints

One of the saddest things we psych nurses do in our jobs is to restrain our patients. We do this when there is danger of patients harming themselves or others. Nobody likes to participate in such an operation, neither the patient nor the staff. And such incidents can be drastically reduced with proper de-esculation methods, approach to patients and other methods.

The fact remains that placing patients in restraints is a part of most psych nurses job in the inpatient setting. Although, in many cases not a big part, fortunately.

In Iceland we only use "human restraints", we do not tie people down or restrain them using anything else but the human body, usually our arms. So coming here and seeing these chairs and tables used to "tie" people down was somewhat shocking. I am unsure if it is wrong though.

In Landspitali:University hospital in Iceland we work in teams, usually of three or four, to overcome and restrain a patient. All staff working inpatient psych are required to attend a week long course learning how to do this in a safe and efficient manner, and then are required to take a recap course for a day, every 6-12 months. The method used originates from the UK, but I have failed to retrieve material concerning its evidence base.

Somehow it feels more humanistic to restrain patients like this. It reduces the risk of staff being overly "trigger happy" since we will be with the patient each moment restraints are necessary. It also secures proper assessment and monitoring reducing the risk for adverse events like asphyxiation, or unnoticed heart attacks.

On the other hand it does take training and certain staffing levels to achieve this, and in certain patient populations, the intimacy of this procedure could be detrimental (e.g. sexually abused women, anti-social patients)either towards patients or staff.

As I said, I am unsure what is best. I would like to hear any input you might have. E.g. on the evidence base of "human restraints" vs. the other kind, your personal experience with either kind, and what you think is most important when approaching this delicate subject.