Intersection of homelessness and mental health: A mixed methods study of young adults who accessed psychiatric emergency services

2017 ◽  
Vol 81 ◽  
pp. 54-62 ◽  
Author(s):  
Sarah Carter Narendorf
2020 ◽  
Author(s):  
Daniel Poremski ◽  
Peizhi Wang ◽  
Josephine Tham ◽  
Jayaraman Hariram ◽  
Doris Koh ◽  
...  

Background: Frequent psychiatric emergency service users eventually cease their frequent use. However, less is known about the events that lead to reduced use. The current project seeks to determine what events happen in the lives of frequent users to reduce their patterns of frequent psychiatric ES use.Methods: This convergent mixed methods study had retrospective and prospective components. It was conducted at Singapore’s only tertiary mental health hospital and its emergency services. It focuses on a group of 327 frequent service users who made 5 or more visits over the index year to the hospital’s emergency service. They made 6,746 individual visits over the 7-year observation period. Administrative data from June 2010 to June 2015 was used to reconstruct historic trends, June 2015 to June 2016 was the index year, and data from June 2016 to June 2017 was used to explore the pattern of use after the index year. Qualitative interviews were done with a subset of 44 frequent service users after the index year. Three interviews were conducted over a year to determine if and why they reduced their frequent use. Results: Over the 12 months following a 12-month period of frequent use, 76% (235/309) of people no longer met the criteria for frequent use. People had positive (recovery, right siting) or negative (disengagement, poor satisfaction) reasons for reducing their use of psychiatric emergency services. Administrative data could not differentiate those who ceased their frequent use for negative reasons from those that ceased their use due to positive reasons. Qualitative differences exist between the narratives of those who ceased their frequent use compared with those who continued their patterns of service use in the subsequent year. Conclusion: The majority of frequent psychiatric emergency service users are frequent users only within the index year. Very few people have sustained frequent use for more than a year. Recovery is not the sole reason service users cease their patterns of frequent use and negative experiences with services lead to disengagement, even if there are very few sources of psychiatric care.


2001 ◽  
Vol 52 (11) ◽  
pp. 1494-1501 ◽  
Author(s):  
Dane Wingerson ◽  
Joan Russo ◽  
Richard Ries ◽  
Christos Dagadakis ◽  
Peter Roy-Byrne

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S235-S235
Author(s):  
Dhruba Bagchi ◽  
George Tadros ◽  
Opeyemi Odejimi

AimsThis study aims to provide a detailed literature review of the different forms of Psychiatric Emergency Services currently available within the UK.Background1 in 6 individuals have one form of mental health disorders. Mental health crisis resulting in an individual requiring access to Psychiatric Emergency Service (PES) can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 hours. Presently, several PESs are available in the UK with the aim of providing prompt and effective assessment, management and in some cases treatment and/or referral. Over the years, economic and political influences have greatly determined the service delivery models of PES. Indeed, these services vary in name, accessibility, structure, professionals involved, outcomes and many more.MethodElectronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was carried out to identify various models of PES in the UK. Various combinations of search terms were used and studies which met the inclusion criteria were selected. Studies were included if they were written in English, conducted within the United Kingdom, and described a form of PES. Search was not limited by years and this is to help have a comprehensive overview as well as show changes over time of the various models of psychiatric emergency services. Studies which did not meet any of the criteria detailed above were excluded.ResultIn total, 59 relevant studies were found which identified nine type of PES-Crisis resolution home treatment, police officer intervention, street triage, mental health liaison services in the Emergency Department, psychiatric assessment unit, integrated services, voluntary services and crisis house. There were more papers describing Crisis resolution home treatment services than the others. Furthermore, majority of the papers reported services within England than other countries within the UK.ConclusionAll forms of PES are beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of all models of PES. This will inform researchers, educationist, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PES meet the needs as well as aid recovery of mental health service users.


Author(s):  
F. Bernardini ◽  
L. Attademo ◽  
R. Trezzi ◽  
C. Gobbicchi ◽  
P.M. Balducci ◽  
...  

Abstract Aims Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). Methods We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. Results A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. Conclusions Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health.


Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.


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