scholarly journals Irish Travellers and forensic mental health

2002 ◽  
Vol 19 (3) ◽  
pp. 76-79 ◽  
Author(s):  
Sally A Linehan ◽  
Dearbhla M Duffy ◽  
Helen O'Neill ◽  
Conor O'Neill ◽  
Harry G Kennedy
Keyword(s):  
Mental Illness ◽  
Relative Risk ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Adult Population ◽  
Alcohol Problems ◽  
Case Register ◽  
Drugs And Alcohol ◽  
Psychiatric Admissions ◽  
Forensic Psychiatric

AbstractObjectives: To determine whether Irish Travellers are over-represented amongst transfers from prison to psychiatric hospital. If so, to determine whether this represents an excess over the proportion of Irish Travellers committed to prison.Method: Irish Travellers admitted to the National Forensic Psychiatry service were identified from a case register over three years 1997-1999. New prison committals were sampled and interviewed as part of the routine committal screening to identify ethnicity.Results: Irish Travellers accounted for 3.4% of forensic psychiatric admissions compared to 0.38% of the adult population. Travellers transferred from prison to psychiatric hospital had more learning disability and less severe mental illness than other groups, while black and other ethnic minorities had a higher proportion of severe mental illness. Travellers accounted for 6% (95% CI 3-11) of 154 male committals and 4% (95% CI 2-12) of 70 female committals. The estimated annualised prison committal rate was 2.8% (95% CI 2.4-3.3) of all adult male Travellers in Ireland and 1% for female Travellers (95% CI 0.8-1.3). Male Travellers had a relative risk of imprisonment compared to the settled community of 17.4 (95% CI 2.3-131.4), the relative risk for female Travellers was 12.9 (95% CI 1.7-96.7). Imprisoned Travellers had greater rates of drugs and alcohol problems than other prisoners (Relative risk 1.46, 95% C11.11-1.90).Conclusion: There is gross over-representation of Travellers in forensic psychiatric admissions. This reflects the excess of Travellers amongst prison committals.

scholarly journals Attitudes of patients with severe mental illness towards COVID-19 vaccinations: A preliminary report from a public psychiatric hospital

2021 ◽  
Vol 143 ◽  
pp. 16-20
Author(s):  
Renana Danenberg ◽  
Sharon Shemesh ◽  
Dana Tzur Bitan ◽  
Hagai Maoz ◽  
Talia Saker ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Preliminary Report

scholarly journals Supported Housing as a recovery option for long-stay patients with severe mental illness in a psychiatric hospital in South India: Learning from an innovative de-hospitalization process

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0230074
Author(s):  
Archana Padmakar ◽  
Emma Emily de Wit ◽  
Sagaya Mary ◽  
Eline Regeer ◽  
Joske Bunders-Aelen ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
South India ◽  
Supported Housing

scholarly journals Examining equity in the utilisation of psychiatric inpatient care among patients with severe mental illness (SMI) in Ontario, Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Claire de Oliveira ◽  
Joyce Mason ◽  
Rowena Jacobs
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Ordinary Least Squares ◽  
Sensitivity Analyses ◽  
Psychiatric Admissions ◽  
Economic Equity ◽  
Over Time ◽  
Deprived Areas

Abstract Background Severe mental illness (SMI) comprises a range of chronic and disabling conditions, such as schizophrenia, bipolar disorder and other psychoses. Despite affecting a small percentage of the population, these disorders are associated with poor outcomes, further compounded by disparities in access, utilisation, and quality of care. Previous research indicates there is pro-poor inequality in the utilisation of SMI-related psychiatric inpatient care in England (in other words, individuals in more deprived areas have higher utilisation of inpatient care than those in less deprived areas). Our objective was to determine whether there is pro-poor inequality in SMI-related psychiatric admissions in Ontario, and understand whether these inequalities have changed over time. Methods We selected all adult psychiatric admissions from April 2006 to March 2011. We identified changes in socio-economic equity over time across deprivation groups and geographic units by modeling, through ordinary least squares, annual need-expected standardised utilisation as a function of material deprivation and other relevant variables. We also tested for changes in socio-economic equity of utilisation over years, where the number of SMI-related psychiatric admissions for each geographic unit was modeled using a negative binomial model. Results We found pro-poor inequality in SMI-related psychiatric admissions in Ontario. For every one unit increase in deprivation, psychiatric admissions increased by about 8.1%. Pro-poor inequality was particularly present in very urban areas, where many patients with SMI reside, and very rural areas, where access to care is problematic. Our main findings did not change with our sensitivity analyses. Furthermore, this inequality did not change over time. Conclusions Individuals with SMI living in more deprived areas of Ontario had higher psychiatric admissions than those living in less deprived areas. Moreover, our findings suggest this inequality has remained unchanged over time. Despite the debate around whether to make more or less use of inpatient versus other care, policy makers should seek to address suboptimal supply of primary, community or social care for SMI patients. This may potentially be achieved through the elimination of barriers to access psychiatrist care and the implementation of universal coverage of psychotherapy.

Reducing hospitalisation among people living with severe mental illness

2016 ◽  
Vol 40 (2) ◽  
pp. 124 ◽  
Author(s):  
Shannon McDermott ◽  
Jasmine Bruce ◽  
Kristy Muir ◽  
Ioana Ramia ◽  
Karen R. Fisher ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Small Sample ◽  
Supported Housing ◽  
Health Records ◽  
Individual Level ◽  
Over Time

Objective People with severe mental illness have high rates of hospitalisation. The present study examined the role that permanent housing and recovery-oriented support can play in reducing the number and length of psychiatric hospital admissions for people with severe mental illness. Methods The study examined de-identified, individual-level health records of 197 people involved in the New South Wales Mental Health Housing and Accommodation Support Initiative (HASI) to compare changes in hospitalisation over a continuous 4-year period. Results On average, HASI consumers experienced significant reductions in the number of psychiatric hospital admissions and length of stay after entering the HASI program, and these reductions were sustained over the first 2 years in HASI. Male consumers and consumers under 45 years of age experienced the largest reductions in the number and length of hospital admissions. Conclusions The findings of the present study add support to the hypothesis that supported housing and recovery-oriented support can be effective approaches to reducing hospital admissions for people with chronic mental illness, and that these changes can be sustained over time. What is known about this topic? People living with severe mental illness are heavy users of health and hospitalisation services. Research into the effects of partnership programs on preventing unnecessary admissions is limited because of short periods of comparison and small sample sizes. What does this paper add? The present study extends previous research by analysing de-identified individual-level health records over a continuous 4-year period and showing that reductions in hospitalisation among people with severe mental illness can be sustained over time. What are the implications for practitioners? These findings provide further evidence that community-based recovery-oriented supported housing programs can assist consumers to manage their mental health and avoid hospital admissions. Although the provision of recovery-oriented community services requires an investment in community mental health, the reduction in consumers’ use of hospital services makes this investment worthwhile.

scholarly journals Revascularisation and mortality rates following acute coronary syndromes in people with severe mental illness: comparative meta-analysis

2011 ◽  
Vol 198 (6) ◽  
pp. 434-441 ◽  
Author(s):  
Alex J. Mitchell ◽  
David Lawrence
Keyword(s):  
Mental Illness ◽  
Relative Risk ◽  
Severe Mental Illness ◽  
Acute Coronary Syndromes ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Coronary Procedures

BackgroundHigh levels of comorbid physical illness and excess mortality rates have been previously documented in people with severe mental illness, but outcomes following myocardial infarction and other acute coronary syndromes are less clear.AimsTo examine inequalities in the provision of invasive coronary procedures (revascularisation, angiography, angioplasty and bypass grafting) and subsequent mortality in people with mental illness and in those with schizophrenia, compared with those without mental ill health.MethodSystematic search and random effects meta-analysis were used according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies of mental health and cardiovascular procedures following cardiac events were eligible but we required a minimum of three independent studies to warrant pooling by procedure type. We searched Medline/PubMed and EMBASE abstract databases and ScienceDirect, Ingenta Select, SpringerLink and Online Wiley Library full text databases.ResultsWe identified 22 analyses of possible inequalities in coronary procedures in those with defined mental disorder, of which 10 also reported results in schizophrenia or related psychosis. All studies following acute coronary syndrome originated in the USA. The total sample size was 825 754 individuals. Those with mental disorders received 0.86 (relative risk, RR: 95% CI 0.80–0.92,P<0.0001) of comparable procedures with significantly lower receipt of coronary artery bypass graft (CABG; RR = 0.85, 95% CI 0.72–1.00), cardiac catheterisation (RR = 0.85, 95% CI 0.76–0.95) and percutaneous transluminal coronary angioplasty or percutaneous coronary intervention (PTCA/PCI; RR = 0.87, 95% CI 0.72–1.05). People with a diagnosis of schizophrenia received only 0.53 (95% CI 0.44–0.64,P<0.0001) of the usual procedure rate with significantly lower receipt of CABG (RR = 0.69, 95% CI 0.55–0.85) and PTCA/PCI (RR = 0.50, 95% CI 0.34–0.75). We identified 6 related studies examining mortality following cardiac events: for those with mental illness there was a 1.11 relative risk of mortality up to 1 year (95% CI 1.00–1.24,P= 0.05) but there was insufficient evidence to examine mortality rates in schizophrenia alone.ConclusionsFollowing cardiac events, individuals with mental illness experience a 14% lower rate of invasive coronary interventions (47% in the case of schizophrenia) and they have an 11% increased mortality rate. Further work is required to explore whether these factors are causally linked and whether improvements in medical care might improve survival in those with mental ill health.

scholarly journals Providers’ competencies positively affect personal recovery of involuntarily admitted patients with severe mental illness: A prospective observational study

2017 ◽  
Vol 64 (2) ◽  
pp. 145-155 ◽  
Author(s):  
Ellen Jas ◽  
Martijn Wieling
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Patients ◽  
Linear Regression Analysis ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Alcohol Problems ◽  
Treatment Motivation ◽  
Personal Recovery ◽  
Inpatient Settings

Objective: There is limited research on the patient–provider relationship in inpatient settings. The purpose of this study was to measure the effect of mental healthcare providers’ recovery-promoting competencies on personal recovery in involuntarily admitted psychiatric patients with severe mental illness. Methods: In all, 127 Dutch patients suffering from a severe mental illness residing in a high-secure psychiatric hospital reported the degree of their personal recovery (translated Questionnaire about Processes of Recovery questionnaire (QPR)) and the degree of mental healthcare providers’ recovery-promoting competence (Recovery Promoting Relationship Scale (RPRS)) at two measurement points, 6 months apart. Analyses: (Mixed-effects) linear regression analysis was used to test the effect of providers’ recovery-promoting competence on personal recovery, while controlling for the following confounding variables: age, gender drug/alcohol problems, social relationships, activities of daily living, treatment motivation and medication adherence. Results: Analyses revealed a significant positive effect of providers’ recovery-promoting competencies on the degree of personal recovery ( t = 8.4, p < .001) and on the degree of change in personal recovery over time ( ts > 4, p < .001). Conclusion: This study shows that recovery-promoting competencies of mental healthcare providers are positively associated with (a change in) personal recovery of involuntarily admitted patients. Further research is necessary on how to organize recovery-oriented care in inpatient settings and how to enhance providers’ competencies in a sustainable way.

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