Mental Health Europe's “beyond the bio-medical paradigm task force” issues on ICD-10

2017 ◽  
Vol 41 (S1) ◽  
pp. S460-S460 ◽  
Author(s):  
P. Kinderman ◽  
P. Pini ◽  
S. Wooley
Keyword(s):  
Mental Health ◽  
Psychiatric Diagnosis ◽  
Mental Health Problems ◽  
Social Research ◽  
Task Force ◽  
Classification Systems ◽  
Local Context ◽  
Personal Recovery ◽  
Icd 10 ◽  
Medical Paradigm

IntroductionRecent developments in psychiatric diagnosis risk downgrading psychological and social aspects of personal recovery and marginalise the individual needs and aspirations of people, considered in their local context. The publication of the fifth edition of the Diagnostic and Statistical Manual for Mental Health Disorders (DSM-5) by the American Psychiatric Association (APA) prompted MHE to establish the Beyond the Biomedical Paradigm Task Force (BBPtf) to investigate, debate and report on these issues.ObjectivesMental Health Europe (MHE) – along with others both within and outside mainstream psychiatry – has noted with concern the increasing dominance of a biological approach to mental health problems. We see a risk of diagnoses being misused when they become part of a complex managerial health system responding mainly to the economic and issues of safety or social control. This kind of misuse could breach the principles of the UN CRPD. MHE welcomes the role of the WHO in coordinating internationally appropriate classification systems. However, we want to ensure that systems based on biomedical, economic and managerial issues are balanced with systems based on knowledge of personal experiences, life stories and direct relationships, which have proven outcomes and which respect human rights and dignity.AimsThis workshop will explore the complex philosophical issues associated with psychiatric diagnosis and, in particular, the ICD-10 revision process.Disclosure of interestI am President of the British Psychological Society and a member of both Mental Health Europe's “Beyond the Bio-Medical Paradigm Task Force” and the Council for Evidence Based Psychiatry. I am currently in receipt of funding from the National Institute for Health Research (NIHR) and the Economic and Social Research Council (ESRC), and I have previously received funding from a variety of sources.The others authors have not supplied their declaration of competing interest.

Detained – what's my choice? Part 1: Discussion

2008 ◽  
Vol 14 (3) ◽  
pp. 172-180 ◽  
Author(s):  
Glenn Roberts ◽  
Eluned Dorkins ◽  
James Wooldridge ◽  
Elaine Hewis
Keyword(s):  
Mental Health ◽  
Personal Experience ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
Personal Responsibility ◽  
Health Problems ◽  
Psychiatric Services ◽  
Psychiatric Practice ◽  
Personal Recovery ◽  
Collaborative Dialogue

Choice, responsibility, recovery and social inclusion are concepts guiding the ‘modernisation’ and redesign of psychiatric services. Each has its advocates and detractors, and at the deep end of mental health/psychiatric practice they all interact. In the context of severe mental health problems choice and social inclusion are often deeply compromised; they are additionally difficult to access when someone is detained and significant aspects of personal responsibility have been temporarily taken over by others. One view is that you cannot recover while others are in control. We disagree and believe that it is possible to work in a recovery-oriented way in all service settings. This series of articles represents a collaborative dialogue between providers and consumers of compulsory psychiatric services and expert commentators. We worked together, reflecting on the literature and our own professional and personal experience to better understand how choice can be worked with as a support for personal recovery even in circumstances of psychiatric detention. We were particularly interested to consider whether and how detention and compulsion could be routes to personal recovery. We offer both the process of our co-working and our specific findings as part of a continuing dialogue on these difficult issues.

Depression, Substance Use and Suicidality in Help-Seeking Adolescents: A Survey of Prevalence

2004 ◽  
Vol 14 (2) ◽  
pp. 162-175 ◽  
Author(s):  
Elizabeth Cosgrave ◽  
Eóin Killackey ◽  
Alison Yung ◽  
Joe Buckby ◽  
Katherine Godfrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Depressive Symptoms ◽  
Substance Use Disorders ◽  
Psychiatric Diagnosis ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
School Setting ◽  
Public Mental Health

AbstractMental health problems affect a sizeable minority of Australian adolescents. Depression and substance use disorders are common mental disorders reported in this age group. Difficulties of this nature that manifest in adolescence will often continue into adulthood. This report describes a sample of adolescents referred to a public mental health service with respect to their psychiatric diagnoses, depressive symptoms, patterns of substance use and level of suicidality. Mood disorders and substance-use disorders were both prevalent in the sample of participants, with sizeable comorbidity reflected in the number ol participants meeting criteria for both of these diagnoses. Data revealed participants with a psychiatric diagnosis were significantly more likely to have made a suicide attempt than those with no diagnosis. High levels of depressive symptoms were associated with suicidality, illicit substance use, and the likelihood of having a psychiatric diagnosis. Heavy use of alcohol was prevalent in this group, but unrelated to the other variables of interest to the study. These results are discussed with respect to the importance of early detection of vulnerable students in a school setting.

scholarly journals Writing letters to patients

1998 ◽  
Vol 22 (9) ◽  
pp. 542-545 ◽  
Author(s):  
Phil Thomas
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Mental Health Policy ◽  
Letter Writing ◽  
Process Of Care ◽  
Record Keeping ◽  
Icd 10

Recent changes in the law and mental health policy have forced psychiatrists and other mental health professionals to review the traditional cloak of secrecy that surrounds record keeping and letter writing. This paper establishes what proportion of patients attending a psychiatric out-patient clinic are interested in receiving letters from their psychiatrist. Those who are interested tend to be better educated, whereas those who are not interested are much more likely to have an ICD–10 diagnosis of schizophrenia. Overall, there appear to be high levels of satisfaction with the nature of the letters received. The significance of these findings is discussed in relation to the difficulty of engaging people with the most severe and enduring forms of mental health problems as active participants in the process of care.

scholarly journals 257 The Effect of the COVID-19 Pandemic on Mental Health Associated Trauma, Admissions and Fractures at a London Major Trauma Centre

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M S Jamal ◽  
D Hay ◽  
K Al-Tawil ◽  
A Petohazi ◽  
V Gulli ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Diagnosis ◽  
Major Trauma ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Trauma Centre ◽  
Related Factors ◽  
Number Of Patients ◽  
Major Trauma Centre ◽  
The Impact

Abstract Aim Non-injury related factors have been extensively studied in major trauma and shown to have a significant impact on patient outcomes, with mental illness and associated medication use proven to have a negative effect on bone health and fracture healing. We report the epidemiological effect of COVID-19 pandemic on mental health associated Orthopaedic trauma, fractures, and admissions to our centre. Method We collated data retrospectively from the electronic records of Orthopaedic inpatients in an 8-week non-COVID and COVID period analysing demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient co-morbidities including psychiatric history. Results here were 824 Orthopaedic referrals and 358 admissions (6/day) in the non-COVID period with 38/358 (10.6%) admissions having a psychiatric diagnosis and 30/358 (8.4%) also having a fracture. This was compared to 473 referrals and 195 admissions (3/day) in the COVID period with 73/195 (37.4%) admissions having a documented psychiatric diagnosis and 47/195 (24.1%) a fracture. 22/38 (57.9%) and 52/73 (71.2%) patients were known to mental health services, respectively. Conclusions Whilst total numbers utilising the Orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affected those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled. It is imperative that adequate support is in place for vulnerable mental health patients, particularly as we are currently experiencing the “second wave” of COVID-19.

scholarly journals Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives

2021 ◽  
Vol 12 ◽  
Author(s):  
Norha Vera San Juan ◽  
Petra C. Gronholm ◽  
Margaret Heslin ◽  
Vanessa Lawrence ◽  
Matthew Bain ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Low Income ◽  
Mental Health Problems ◽  
Health Problems ◽  
Social Needs ◽  
Low Income Countries ◽  
Service Development ◽  
Service Users ◽  
Personal Recovery

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised.Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems.Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods.Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence.Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention.Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.

Long-term mental health care for people with severe mental disorders – the importance of workplace rehabilitation

2013 ◽  
Vol 10 (02) ◽  
pp. 87-94
Author(s):  
J. Boardman
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Problems ◽  
Personal Recovery ◽  
Severe Mental Disorders ◽  
Individual Placement And Support ◽  
Meaningful Activity ◽  
Workplace Rehabilitation

SummaryWork and meaningful activity have historically played a key role in rehabilitation services for people with severe mental health problems and continues to do so today. People with long-term and severe mental disorders have low rates of employment. In the last 30 years the increasing emphasis on raising the sights of mental health services to focus on personal recovery and the importance given to social justice and to combating social exclusion has led to a focus on gaining open employment. Individual Placement and Support (IPS) has emerged as an important and evidence-based scheme for getting people with severe mental health problems into open employment. Despite the strong and consistent evidence for the effectiveness of IPS, these schemes are not widely implemented. This paper summarises the background to, and research on, IPS and possible barriers to its wider implementation.

Applied Psychology: Will Psychologists Corner the Market ?

1975 ◽  
Vol 3 (2) ◽  
pp. 28-30
Author(s):  
R. S. Hallam
Keyword(s):  
Mental Health ◽  
Differential Diagnosis ◽  
British Journal ◽  
Experimental Psychology ◽  
Psychiatric Diagnosis ◽  
Mental Health Problems ◽  
Good Reason ◽  
Applied Psychology ◽  
Dynamic Psychotherapy ◽  
Physical Therapies

About 10 years ago, experimental psychology seemed to have little to offer for the analysis and solution of mental health problems. We all remember the joke about the psychologist searching under the lamp-post where the light was strongest. It is not repeated as often nowadays - and with good reason. Concepts from experimental psychology have come to play an increasingly central role in psychiatry. The following is an analysis of the percentage of articles in the British Journal of Psychiatry which were not concerned with psychiatric diagnosis, psychoanalysis, dynamic psychotherapy, physical therapies, neurology, epidemiology, genetics, prognosis and aetiology of syndromes, in the years 1966, 1970, 1973. Psychometric and psychophysiological studies were also excluded if they related to differential diagnosis of psychiatric states. The figures were 11, 13 and 23% for the three years, suggesting a slowly accelerating utilization of concepts derived from experimental psychology. If the rate of growth continues, models derived from experimental psychology will be dominant by 1980.

Mind the Gap

2016 ◽  
pp. 11-32 ◽  
Author(s):  
Valsamma Eapen ◽  
Amelia Walter
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
General Population ◽  
Mental Health Problems ◽  
Accurate Diagnosis ◽  
Classification Systems ◽  
Psychiatric Classification ◽  
Service Delivery Models ◽  
Multiple Challenges ◽  
Delivery Models

Individuals with Intellectual Disability (ID) experience higher rates of psychiatric disorders than the general population, although findings are mixed with regard to the determinants of this increased prevalence. Despite growing recognition of the prevalence of mental health problems among individuals with ID, and the consequences this comorbidity carries for individuals, families and the wider community, there are multiple challenges in identifying and managing these concerns. Accurate diagnosis and effective intervention is currently hindered by factors including the applicability of standardised psychiatric classification systems, gaps in service delivery models and access to such services, as well as unmet training needs.

The needs of older people with mental health problems in a Portuguese psychiatric setting

2017 ◽  
Vol 29 (5) ◽  
pp. 845-853 ◽  
Author(s):  
Joaquim Passos ◽  
Aníbal Fonte ◽  
Cláudia Camila Dias ◽  
Lia Fernandes
Keyword(s):  
Mental Health ◽  
Elderly Patients ◽  
Unmet Needs ◽  
Mental Health Problems ◽  
The Elderly ◽  
Health Problems ◽  
Diagnosis Of Dementia ◽  
Use Of Services ◽  
Icd 10 ◽  
Inpatient Settings

ABSTRACTBackground:This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems.Methods:A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE.Results:The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients’ main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = −8.58, p < 0.001; Z = −11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients.Conclusions:Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients’ perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.

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