Post traumatic stress rises among war zone soldiers

By: Martha Linden, PA, The Independent
Tuesday, 4 November 2008

Nearly 4,000 new cases of mental health disorder were diagnosed last year among armed services personnel, according to figures published today.

Mental health statistics released by the Ministry of Defence showed 3,917 new cases of armed services personnel assessed to have a mental disorder in 2007 by the MoD’s department of community mental health.

A breakdown of the statistics showed that, in line with the first nine months of last year, there were no statistically significant differences in the rates of overall mental disorder between those who had deployed to Iraq or Afghanistan and those who had not deployed during the last quarter of 2007.

But the figures showed a significantly higher rate of post-traumatic stress disorder (PTSD) among those who had deployed to Iraq and Afghanistan compared with those who had not deployed to these countries.

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‘Unacceptable’ levels of violence on mental wards

By: Jeremy Laurance, Health Editor, The Independent
Wednesday, 23 July 2008

Thousands of seriously-ill mental patients are enduring “unacceptable” levels of violence on overcrowded NHS wards where they are vulnerable to sexual predators, an investigation has found.

The most comprehensive survey of mental health hospital care in England, published today by the Healthcare Commission, paints a picture of a dysfunctional service where patients feel threatened and unsafe with:

1. high levels of drug and alcohol abuse,
2. a lack of therapeutic activities
3. and a heavy dependence on temporary staff.

Almost 5,000 patients reported being physically assaulted in 2006-7 – 15 per cent of the total – and one in six trusts had levels of violence “significantly above” this average. “This is simply not acceptable in a 21st-century service and would not be tolerated in other walks of life,” the report says.

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Rimonabant, a controversial weight-loss drug, has been approved for use in the NHS

By: Jane Kirby, PA, The Independent
Wednesday, 25 June 2008

A controversial weight-loss drug has been approved for use on the NHS, it was announced today.

Rimonabant will be made available to overweight or obese patients who cannot take, or who have had no success with, two other drugs, orlistat and sibutramine.

It comes after concerns about rimonabant’s side-effects, including suicidal thoughts and depression.

Today’s news comes after the medicines watchdog said last month that it had received 720 reports of adverse drug reactions (totalling 2,123 individual reactions) in the UK since the drug launched in 2006.

Five resulted in death (one suicide, one from infection, one sudden death from an unknown cause and two heart attacks), the data, from the Medicines and Healthcare products Regulatory Agency (MHRA), showed.

Of the total number of reactions, 974 involved psychiatric disorders, of which 48 reports involved suicidal thoughts.

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Violent patients

BMJ Careers:
Author: Ingrid Torjesen
Publication date: 28 May 2008

One in three doctors is attacked at work every year, yet few of these will have been trained on how to handle the situation. General practitioners, doctors working in accident and emergency departments, psychiatrists, and doctors in training are the most at risk.

Dealing with abusive behaviour:

• Avoiding incidents
• Be prepared
• Get training in dealing with abusive behaviour for yourself and other staff who have face to face patient contact
• Make sure you are not alone in a surgery building
• Make sure you have an exit strategy—the patient is not between you and the door
• In the surgery do not leave anything that could be used as a weapon lying around
• When visiting make sure people know where you are, what you are doing, and when you should be back

Assessing risk:

• If you are visiting someone with a history of violence or if you are concerned about going alone, take someone with you or get a police escort
• Be aware that situations can develop rapidly, particularly if a patient is mentally ill, drunk, or a drug abuser
• Be aware that patients and their relatives may be stressed and afraid, so their threshold for aggression might be lower than normal

In an incident:

• Call for help
• Keep a barrier such as a desk between you and the patient
• Try not to escalate the situation, keep calm, and do not mirror the patient’s behaviour

For comprehensive advice go to www.cfsms.nhs.uk/training/crt.html

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Proliferation of firearms is growing global health problem

BMJ  2007;335:470-471 (8 September):

News

Proliferation of firearms is growing global health problem

John Zarocostas

The growing number of civilians holding firearms is fuelling gun crime worldwide and is putting healthcare systems, especially in poor countries, under stress, an expert report says. Gun crime kills about 250 000 people a year and injures many more.

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