Involuntary admissions to a district mental health service – implications for a new mental treatment act

1993 ◽  
Vol 10 (3) ◽  
pp. 139-144 ◽  
Author(s):  
Teresa G Carey ◽  
John M Owens
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Mental Health Service ◽  
Civil Rights ◽  
Psychiatric Service ◽  
Case Note ◽  
Compulsory Admission ◽  
Access To Treatment ◽  
Mental Treatment ◽  
One Year

AbstractObjective: The aim of this study was to examine the working of the 1945 Irish Mental Treatment Act in relation to compulsory admission and detention and to establish issues that will need to be addressed in imminent new legislation. Method: A 3 year retrospective study was carried out on all compulsory admissions to the Cavan/Monaghan Psychiatric Service using case note material. The circumstances surrounding application for compulsory admission in one year of the study period were further investigated by delivery of a schedule to Relative-Applicants. Results: The study revealed rates of compulsory admission equivalent to other Irish regions but much higher than neighbouring jurisdictions. There was no evidence of deliberate abuse of the act. Indications emerged of excessive and inappropriate recourse to certification by some relatives and General Practitioners. Excessive length of detained stay and lack of specific procedures for informing patients of their rights were evident. Conclusions: A new Mental Treatment Act will need to place much greater emphasis on patients' civil rights while facilitating access to treatment.

Monitoring the physical health of individuals with serious mental illness

2008 ◽  
Vol 25 (3) ◽  
pp. 108-115
Author(s):  
Majella Cahill ◽  
Anne Jackson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Monitoring ◽  
Service Providers ◽  
Psychiatric Service ◽  
Service Users ◽  
Effective Models

AbstractDeveloping effective models of identifying and managing physical ill health amongst mental health service users has become an increasing concern for psychiatric service providers. This article sets out the general professional and Irish statutory obligations to provide physical health monitoring services for individuals with serious mental illness. Review and summary statements are provided in relation to the currently available guidelines on physical health monitoring.

Doctors' Holding Power in Practice: Section 5(2) of the Mental Health Act 1983

1995 ◽  
Vol 35 (3) ◽  
pp. 231-236 ◽  
Author(s):  
A D Hall ◽  
B K Puri ◽  
T Stewart ◽  
P S Grahame
Keyword(s):  
Mental Health ◽  
Psychotic Disorder ◽  
Psychiatric Service ◽  
Patient Admission ◽  
Case Note ◽  
Short Term ◽  
Affective Psychosis ◽  
Mental Health Act ◽  
Holding Power ◽  
Large Catchment

Section 5(2) of the Mental Health Act 1983 (England and Wales) is a commonly used short term power of detention often implemented by junior medical staff, which has no statutory right of appeal. There is little published analysis of its use in clinical practice. A detailed case note study of its use in a psychiatric service with a large catchment area is presented. Fifty-seven per cent of the patients detained under s.5(2) were female. Affective psychosis was over-represented in detained females, while schizophrenia and paranoid states were over-represented in males. Eight per cent of s.5(2) detentions were initiated via the nurses' holding power, s.5(4). None of these patients were subsequently regraded to s.2 or 3, which may be accounted for by the finding that personality disorder and alcohol dependence were more commonly diagnosed in this subgroup. Of s.5(2) detainees, none of those with a non-psychotic disorder were regraded to s.2 or 3. Three patients had not accepted in-patient admission prior to implementation of s.5(2). Moreover, 38 per cent of all s.5(2) detentions took place within 24 hours of admission. Patients with a psychotic disorder were more likely to be detained within 24 hours of admission. Doubts regarding the validity of consent to voluntary admission in these patients are raised.

Quality of mental health services: a self audit in the South Verona mental health service

2006 ◽  
Vol 15 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Liliana Allevi ◽  
Giovanni Salvi ◽  
Mirella Ruggeri
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Service ◽  
Health Services ◽  
Community Mental Health Services ◽  
Community Mental Health Service ◽  
Continuous Quality ◽  
One Year

SUMMARYAims – To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. Methods – The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. Results – There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. Conclusions – A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.

scholarly journals Clinical activity within a specialist mental health service for deaf people: comparison with a general psychiatric service

2003 ◽  
Vol 27 (10) ◽  
pp. 375-377 ◽  
Author(s):  
Jim Appleford
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Psychiatric Service ◽  
Bipolar Affective Disorder ◽  
Community Services ◽  
Patient Treatment ◽  
Clinical Activity ◽  
Deaf People ◽  
Specialist Mental Health Service

Aims and Method This paper compares the case mix and clinical activity in a specialist mental health service for deaf people within a general psychiatric population, using ICD–10 diagnostic criteria. Results Out-patient and in-patient caseloads differ between the two services: 27% of the deaf out-patient caseload have schizophrenia, schizotypal and delusional disorders (compared with 19% of hearing patients) and 19% have neurotic, stress-related and somatoform disorders (compared with 8% of hearing patients). The general psychiatric service out-patient case-load had rates of 8% and 43% for bipolar affective disorder and unipolar depression, respectively, compared with 3% and 17% in the deaf group. Deaf patients have a mean length of stay of 59 days, compared with 30 days for the hearing group. In-patient treatment accounts for 89% of the annual treatment cost for the deaf patient population. Clinical Implications Expansion of community services for deaf people as recommended by a recent Health Advisory Service report could reduce admission rates for deaf patients, delivering treatment benefits and cost savings.

scholarly journals Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape

2016 ◽  
Vol 22 (1) ◽  
pp. 5 ◽  
Author(s):  
Kiran Sukeri ◽  
Orlando A. Betancourt ◽  
Robin Emsley ◽  
Mohammed Nagdee ◽  
Helmut Erlacher
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Provision ◽  
Average Length ◽  
Psychiatric Service ◽  
Situational Analysis ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Forensic Psychiatric

<strong>Objectives:</strong> No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. <strong></strong><p><strong>Methodology:</strong> This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. <strong></strong></p><p><strong>Results:</strong> During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. <strong></strong></p><p><strong>Conclusions:</strong> Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic psychiatric service. This should be driven by the provincial Department of Health.</p>

scholarly journals Access to a child mental health service

2002 ◽  
Vol 26 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Graeme Lamb ◽  
Anita Anfield ◽  
Anne Sheeran
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Child Mental Health ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Consultation Service ◽  
Child Mental Health Service ◽  
Initial Appointment

Aims and MethodThis was a retrospective case note analysis of all referrals to an inner-London child and family consultation service aiming to examine any changes in patterns of referral and attendance of Bangladeshi and indigenous families over the previous 10-year period.ResultsBangladeshi referrals increased over the period but remained under-represented compared to indigenous families. They were less likely to attend an initial appointment, but once engaged with the service dropout rates were unaffected by ethnicity.Clinical ImplicationsImproved communication between the department, families and referrers may help to increase understanding of the function of the department and lead to more equitable uptake of services in the future.

Controlled assessment of alcoholics admitted involuntarily to a general psychiatric hospital

1996 ◽  
Vol 13 (4) ◽  
pp. 140-143
Author(s):  
Fionnula O'Loughlin ◽  
Marcus Webb
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Alcohol Dependence ◽  
Psychiatric Hospital ◽  
Involuntary Admission ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Mental Treatment

AbstractObjective:As the provision for the involuntary admission to hospital of alcoholics is likely to be discarded in a new Irish Mental Health Act, the characteristics of patients committed under the 1945 Irish Mental Treatment Act were explored and compared with those alcoholics admitted voluntarily.Method:All alcoholics admitted compulsorily from 1989-1992 to a general psychiatrichospital in Dublin were compared retrospectively with voluntarily admitted alcoholics. Data was taken from case notes.Results:Results showed that patients admitted compulsorily were older (t = 3.74, df = 62, p < 0.001) and had more physical complications (X2= 8.4, df = 1, p < 0.004) than those admitted voluntarily. Although results did not reach a statistically significant level, there were proportionately more females in the compulsorily admitted group compared with the voluntary group. The outcome of admission overall was better in those admitted voluntarily, although this was influenced both by length of stay and previous admissions for treatment of alcohol dependence. One particularly interesting finding, regardless of admission category, was that duration of admission was statistically significantly longer for women when compared with men.Conclusions:Compulsory admission of alcoholics to a psychiatric hospital for very brief periods was not shown to be strikingly helpful, but this study cannot decide whether or not longer periods of compulsory admission would be valuable.

Validation of a web-radio station (“Radio Tab”) run by users of the Reggio Emilia mental health service: A pilot study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1715-1715
Author(s):  
E. Mazzoni ◽  
S. Ferrari ◽  
L. Pingani ◽  
G. Zanni ◽  
M. Rigatelli
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Reggio Emilia ◽  
Radio Station ◽  
List Type ◽  
People With Mental Illness ◽  
Preparatory Course ◽  
Mental Health Service System ◽  
One Year

IntroductionA recovery-oriented mental health service system should focus on empowering people with mental illness.Aim of the studyTo analyse the feasibility of setting up a web-radio run by 13 subjects suffering from mental disorders.Materials and methodsThe patients involved in the project attended a one-year preparatory course promoted by the Province of Reggio Emilia, before the factual setting up of “Radio TAB”. After six months, each patient was asked to fill in a qualitative questionnaire addressing motivation and personal competences; opinions on the preparatory course; the identity of the radio, objectives and values shared by participants, the satisfaction they obtained from the activities and their vision of the radio then and for the future.Results•great motivation for joining the project and holding on to it•the preparatory course was judged to be effective to acquire technical, communication and interpersonal skills;•expectations and objectives of participants were consistent with the values underpinning the radio and the outcomes of the project, suggesting good internal cohesion;•a well-defined vision of the radio as a result of the work emerged, which will hopefully lead to setting up an actual workplace in future.ConclusionThe experience of “Radio TAB” could be a good example of empowerment strategies, encouraging individuals to autonomy, reintegration and sense of active citizenship.

Changes in service delivery following HIV/AIDS education of medical and mental health service providers: Results of a one-year follow-up.

2006 ◽  
Vol 29 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Judith A. Cook ◽  
Lisa A. Razzano ◽  
Nathan Linsk ◽  
Barbara L. Dancy ◽  
Dennis D. Grey ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Delivery ◽  
Service Providers ◽  
Aids Education ◽  
Health Service Providers ◽  
One Year ◽  
Hiv Aids

scholarly journals Results on sociological survey of healthcare specialists and consumers about their opinion on reforms of psychiatric service in Moscow, conducted in 2010–2017

2019 ◽  
pp. 49-58
Author(s):  
Anton Valerevich Masyakin
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Outpatient Care ◽  
Psychiatric Care ◽  
Psychiatric Service ◽  
Psychosocial Rehabilitation ◽  
Service Needs ◽  
Outpatient Unit ◽  
Day Hospitals

Relevance. Since 2010, in Moscow a plan for the reorganization of the psychiatric service is carried out. In accordance with the WHO plans, reforms is including the reduction of inpatient types of care and expansion of the outpatient unit. Aim. The analysis of the specialists and users opinions of mental health service on its reform. Materials and methods. Specialists and users of mental health services opinions survey regarding the ongoing changes was conducted (900 respondents). Results. Most respondents gave a positive assessment of the reforms. Interviewees believe that reform was necessary, optimization of the number of psychiatric beds and expansion of community-based care were justified, the formation of territorial associations was appropriate, and that the quality of psychiatric care, the work of clinics and day hospitals, the amount of care provided by dispensaries, the territorial availability of outpatient psychiatric care, the availability of outpatient facilities, and the number of places in day hospitals increased. According to the survey, reorganization of the psychiatric service first of all should include the development of psychosocial rehabilitation and psychotherapy, a decrease in the level of hospitalizations, the development of inpatient technologies and continuity in the provision of care. According to respondents, the mental health service needed to improve funding and develop outpatient care. Conclusion: Respondents positively assess the mental health service reforms in Moscow. The psychiatric service reorganization should include the development of psychosocial rehabilitation and psychotherapy, reduction hospitalizations level, inpatient technologies and continuity care provision development. According to respondents, the mental health service needs to improve the funding and development of outpatient care.

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