Multidisciplinary review to identify patients who could be managed in primary care

2011 ◽  
Vol 28 (3) ◽  
pp. 138-140 ◽  
Author(s):  
Vincent IO Agyapong ◽  
Olorunfemi Ahmodu ◽  
Allys Guerandel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Health Service ◽  
Multidisciplinary Team ◽  
Psychiatric Clinic ◽  
Community Mental Health Service ◽  
Primary Care Teams ◽  
Specialist Services ◽  
Clinical Records

AbstractObjectives: Primary care teams have the potential to deliver much of the care currently provided by specialist services. The aim of this review was to determine from patients' clinical records and multidisciplinary team discussions, those that may be suitable for discharge back into primary care.Methods: A retrospective review of the clinical notes of all patients attending a psychiatric outpatient clinic was carried out by all members of the multidisciplinary team to determine the appropriateness of continuing to provide psychiatric services in a specialised psychiatric clinic rather than in a primary care setting, taking into account the patients demographic and clinical variables.Results: It was recommended that 60% of all the patients needed to continue attending the local mental health service, 35.2% could be discharged back into primary care for continuing management whilst the remaining 4.8% could be managed jointly between primary care and the community mental health service. The bulk of the patients recommended for discharge into primary care had a diagnosis of anxiety disorder or depression and all of them had been stable on their treatment for more than six months.Conclusion: Regular multidisciplinary team review has a potential to identify patients who could be discharged back into primary care.

Should all community mental health teams be sectorised?

2020 ◽  
Vol 37 (1) ◽  
pp. 48-54
Author(s):  
R. Vaughan ◽  
K. Antczak ◽  
L. Kowalewski ◽  
L. Feeney
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Community Mental Health ◽  
Health Service ◽  
Health Service Delivery ◽  
Community Mental Health Service ◽  
Service Users ◽  
Health Service Provision ◽  
Catchment Areas

ObjectivesSectorised catchment areas have characterised Irish mental health service delivery since the devolution of institutional care. Unlike other catchment areas, the Cluain Mhuire Community Mental Health Service (CMCMHS) never sectorised. With the development of Community Health Networks (CHNs) and Primary Care Centres, the CMCMHS has come under renewed pressure for structural change. We aimed to consider the implications of these proposed changes on staff and service users.MethodWe obtained demographic information comparing the CHNs with respect to attendee numbers, new referrals and admissions over a 1- year period. Secondly, we conducted an anonymous survey seeking opinions on the proposals to switch to a sector-based model and/or specialist inpatient care.ResultsReferral and admission rates differed across CHNs, broadly consistent with populations. About 36% of staff and 33% of service users supported changing to a sector-based system. In the event of a sector-based system of care being implemented, 66% of service users felt that existing service users should remain under the care of their current team. There was little support among any group for the development of specialist inpatient teams.ConclusionsWe discuss the benefits and drawbacks of sectorisation of mental health service provision. Most patients did not want to change teams either as current service users or as re-referrals (indicating it will take a significant time to transition to a sector-based system). Without clear pathways towards integration with primary care teams, the advantages of sectorisation may not outweigh the challenges associated with its implementation.

An analysis of 100 referrals for depression from primary care to an adult mental health service

2013 ◽  
Vol 30 (4) ◽  
pp. 237-244 ◽  
Author(s):  
C. Rogers ◽  
S. Heatherington ◽  
M. Carroll ◽  
M. Leonard ◽  
W. Cullen ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Antidepressant Treatment ◽  
Severe Illness ◽  
Moderate Depression ◽  
Clinical Records

ObjectivesImproving the interface between primary care and mental health services is a key target in current healthcare policy in Ireland. This study examines the content of referrals from primary care to a community mental health service for apparent depression.MethodWe retrospectively reviewed the clinical records of 100 patients with depression who consecutively attended a specialist mental health service in Ireland's midwest region. Records were reviewed for demographic and clinical information provided by the doctor at the time of referral, subsequent service engagement, diagnosis and treatment initiated.ResultsThere was considerable variation in the content and presentation of information contained in referral letters. Eleven per cent used structured HSE mental health referral forms. Seventy-six per cent of referrals contained clear information regarding name, address, symptoms and treatment previously initiated. Specifically, low mood, biological symptoms of depression and illness severity were documented in 43%, 34% and 27%, respectively. Suicide risk was documented in 20%. More detail was significantly associated with more severe illness. At initial specialist assessment, 71% had commenced antidepressant treatment, with 11% having received an adequate trial of a first antidepressant and 3% an adequate trial of two antidepressants. Two-thirds were diagnosed with mild/moderate depression. Initiation of antidepressant treatment was linked to subsequent diagnosis of depressive illness by mental health services (p < 0.001).ConclusionsOur findings indicate variable referral practices from general practice to mental health in our region. Most referrals were for mild to moderate depression. Poor access to psychological services locally may be a key factor in this phenomenon.

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

scholarly journals Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

2021 ◽  
Author(s):  
Kate Corrigan ◽  
Maeve Haran ◽  
Conor McCandliss ◽  
Roisin McManus ◽  
Shannon Cleary ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service User ◽  
Religious Beliefs ◽  
Age Groups ◽  
Total Sample ◽  
Psychiatric Clinic ◽  
User Attitudes ◽  
Mental Health Service User

Abstract Introduction Despite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes. Objectives To explore mental health service user attitudes to psychedelics and psilocybin therapy. Methods A questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users. Results Ninety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued. Conclusions The majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy.

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