The successful impact of adapting CBT in IAPT for people with complex long-term physical health conditions

Abstract It is widely recognised that a diagnosis of a long-term physical health condition (LTC) is likely to have a significant impact on a person’s mental health. This is highlighted in the Five Year Forward View for Mental Health (NHS England, 2016) where significant numbers of patients projected to be seen through the expansion of Improving Access to Psychological Therapies (IAPT) services are to come from within the LTC community. IAPT services offer evidence-based therapeutic interventions for common mental health issues – anxiety disorders and depression. The South East Staffordshire IAPT services have developed an integrated pathway as a Wave 2 site for the delivery of cognitive behavioural therapy (CBT) adaptations for LTC. The main themes outlined in this paper focus on the innovations and service developments of IAPT-LTC including: the importance of engagement between mental health and medical healthcare professionals, identifying the key professionals in medical healthcare to enhance engagement, extended training for clinicians with in-house continued professional development, as an extension to the National IAPT-approved top-up training for LTC, and developments in clinical supervision structures and practice, along with future developments in the field of IAPT-LTC. These themes have direct relevance to CBT practitioners working within the LTC community in IAPT services. The four contrasting case studies demonstrate how the application of CBT can successfully be adapted to condition related beliefs and behaviours, despite the complexity of the medical condition. Findings show how integrated services and engaging with medical healthcare professionals had profound benefits for the patients, IAPT therapists and medical healthcare professionals. Key learning aims (1) The good practice points in the development of the IAPT-LTC pathway within South East Staffordshire IAPT services. (2) The successful design and implementation of the IAPT-LTC pathway within South East Staffordshire IAPT services. (3) The key considerations of the interaction for patients between their physical and mental health symptoms. (4) The application of CBT adaptations for people with complex LTCs can be effective in improving psychological wellbeing and physical condition management.

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An Assessment of Long-Term Physical and Emotional Quality of Life of Persons Injured on 9/11/2001

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16061054 ◽

2019 ◽

Vol 16 (6) ◽

pp. 1054 ◽

Cited By ~ 3

Author(s):

Robert Brackbill ◽

Howard Alper ◽

Patricia Frazier ◽

Lisa Gargano ◽

Melanie Jacobson ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Status ◽

Physical Health ◽

Injury Severity ◽

Mental Health Status ◽

Physical And Mental Health ◽

Component Score

Fifteen years after the disaster, the World Trade Center Health Registry (Registry) conducted The Health and Quality of Life Survey (HQoL) assessing physical and mental health status among those who reported sustaining an injury on 11 September 2001 compared with non-injured persons. Summary scores derived from the Short Form-12 served as study outcomes. United States (US) population estimates on the Physical Component Score (PCS-12) and Mental Component Score (MCS-12) were compared with scores from the HQoL and were stratified by Post-traumatic Stress Disorder (PTSD) and injury status. Linear regression models were used to estimate the association between both injury severity and PTSD and PCS-12 and MCS-12 scores. Level of injury severity and PTSD history significantly predicted poorer physical health (mean PCS-12). There was no significant difference between injury severity level and mental health (mean MCS-12). Controlling for other factors, having PTSD symptoms after 9/11 predicted a nearly 10-point difference in mean MCS-12 compared with never having PTSD. Injury severity and PTSD showed additive effects on physical and mental health status. Injury on 9/11 and a PTSD history were each associated with long-term decrements in physical health status. Injury did not predict long-term decrements in one’s mental health status. Although it is unknown whether physical wounds of the injury healed, our results suggest that traumatic injuries appear to have a lasting negative effect on perceived physical functioning.

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Progress After Placement

Outcomes of Open Adoption from Care ◽

10.1007/978-3-030-76429-6_7 ◽

2021 ◽

pp. 199-222

Author(s):

Harriet Ward ◽

Lynne Moggach ◽

Susan Tregeagle ◽

Helen Trivedi

Keyword(s):

Mental Health ◽

Physical Health ◽

Online Survey ◽

Poor Mental Health ◽

Adoptive Parents ◽

Developmentally Delayed ◽

Physical And Mental Health ◽

Adult Adoptees

AbstractThe chapter explores the progress made by the 93 adoptees in the core follow-up sample in terms of physical and mental health and education from the time they entered their adoptive homes until they were followed up, on average 18 years later. It draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort) completed at follow-up, and interviews focusing on 24 adult adoptees. On entering their placements, 40% of adoptees were developmentally delayed; 13% had poor physical health; 38% were in poor mental health. Emotional and behavioural problems affected their academic progress; 76% required specialist help. After placement, 74% improved in physical health, 66% in mental health and 68% in academic performance. The challenges faced by adoptive parents provide a powerful case for careful preparation and long-term post-adoption support.

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Exploring the mental health impact on private flat owners in residential buildings with external combustible cladding

BJPsych Open ◽

10.1192/bjo.2021.715 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S268-S269

Author(s):

William Martin

Keyword(s):

Mental Health ◽

Physical Health ◽

Residential Buildings ◽

Health Impact ◽

Direct Result ◽

Free Text ◽

List Type ◽

Physical And Mental Health ◽

Human Right ◽

The Uk

AimsTo explore the mental health of private flat owners in residential buildings with external combustible cladding, which require remediation following the 2017 Grenfell tower fire.The speed at which the fire at Grenfell spread, killing 72 people, is largely attributed to external combustible cladding. It is increasingly suspected that there are ongoing profound effects on the mental health of people living in flats with external combustible cladding like Grenfell both in the UK and abroad. The issue has left flat owners facing severe financial hardship, the threat of bankruptcy and concerns about safety in their own homes.MethodAn exploratory ‘Google Forms’ online mental health survey comprising multiple choice and free text questions over 47 sections was distributed to flat owners in affected buildings. The survey remained open for 6 weeks to allow response. 550 individual responses were studied.Result550 individuals completed the survey, from 143 buildings across 45 UK councils.As a direct result of external combustible cladding: 89.5% said their mental health had deteriorated,22.5% reported having suicidal feelings or a desire to self-harm,71.1% reported having difficulty sleeping,93.8% said they were suffering from worry and anxiety,59.6% used coping strategies to deal with their situation,35.1% said that existing physical and mental health conditions had been exacerbated,84.1% said they cannot move on with their lives and57.9% of people had concerns about seeking help or treatment for mental/physical health problems caused by their situation during the pandemic.In addition, free text responses reflected feelings of anxiety and low mood attributed to the constant fear of fire, and an inability to plan families and future homes. One person said, “I have been left utterly broken by this. My mental and physical health has worsened, I have severe anxiety, depression and PTSD. I struggle each day to keep myself alive.”ConclusionSafe housing is a basic human right. The results show the current situation is having a detrimental impact on flat owners’ mental health and makes a strong case for the provision of specific services offering support - particularly given it is 3.5 years since Grenfell and a viable solution for all is yet to be found.

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Role of Physiotherapy in Long Term Physical and Mental Health of People Recovered From COVID 19: A Systematic Review Protocol

10.21203/rs.3.rs-44727/v1 ◽

2020 ◽

Author(s):

Vyom Gyanpuri ◽

Neetu Dhiman ◽

Abhishek Pathak ◽

Om Prakash Singh

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Physical Health ◽

Depression Scale ◽

Functional Independence ◽

Biomedical Literature ◽

Current Evidence ◽

Hamilton Depression Scale ◽

Physical And Mental Health

Abstract Background: the objective of the study to design a protocol on the effectiveness of physiotherapy on long term physical and mental health of recovered patients from coronavirus disease 2019. Methods: The following electronic databases will be searched from inception to June 2020: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Databases, and other databases. We will include all published documents regarding this topic. Two separate individuals will analyse studies and select accordingly after removal of duplicate studies. Then, final screening, assessment of quality of the articles and data analysis will be done. Meta-analyses, subgroup analysis, and descriptive analysis will be performed based on the included data conditions. Results: Methodological heterogeneity analysis of current evidence will be provided from Physical health outcomes like Barthel Index or Functional Independence measure scale and questionnaires describing health status like Physical Health Questionnaire and Mental health outcomes like SRQ-20, Hamilton Depression scale or Hamilton Anxiety scale.Conclusion: This study will provide the evidence regarding the importance of physiotherapy in future physical and mental health of recovered COVID-19 patients, when performed during treatment of disease in acute hospital management.PROSPERO registration number: CRD42020190863

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Maternal health and health-related behaviours and their associations with child health: Evidence from an Australian birth cohort

PLoS ONE ◽

10.1371/journal.pone.0257188 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257188

Author(s):

Kabir Ahmad ◽

Enamul Kabir ◽

Syed Afroz Keramat ◽

Rasheda Khanam

Keyword(s):

Mental Health ◽

Chronic Illness ◽

Physical Health ◽

General Health ◽

Chronic Condition ◽

Medical Condition ◽

Physical And Mental Health ◽

Poor General Health ◽

Health Related ◽

Outcome Index

Objective This study investigates the associations between maternal health and health-related behaviours (nutrition, physical activity, alcohol consumption and smoking) both during pregnancy and up to 15 months from childbirth and children’s health outcomes during infancy and adolescence (general health, presence of a chronic illness, and physical health outcome index). Methods This study used Wave 1 (2004) and Wave 7 (2016) data from the Longitudinal Survey of Australian Children (LSAC). We measured mothers’ general health, presence of a medical condition during pregnancy and mental health during pregnancy or in the year after childbirth. We subsequently measured the children’s general health, presence of a medical condition, and physical health outcome index at ages 0–1 (infancy) and 12–13 (adolescence). Binary logistic and linear regression analyses were performed to examine the association between the mothers’ health-related variables and their children’s health. Results Our results showed that poor general health of the mother in the year after childbirth was associated with higher odds of poor health in infants and adolescents in all three dimensions: poor general health (OR: 3.13, 95% CI: 2.16–4.52 for infants; OR: 1.39, 95% CI: 0.95–2.04 for adolescents), presence of a chronic condition (OR: 1.47, 95% CI: 1.19–1.81 for adolescents) and lower physical health score (b = −0.94, p-value <0.05 for adolescents). Our study also revealed that the presence of a chronic condition in mothers during pregnancy significantly increased the likelihood of the presence of a chronic condition in their offspring during infancy (OR: 1.31, 95% CI: 1.12–1.54) and during adolescence (OR: 1.45, 95% CI: 1.20–1.75). The study found that stressful life events faced by mothers increase the odds of poor general health or any chronic illness during adolescence, while stress, anxiety or depression during pregnancy and psychological distress in the year after childbirth increase the odds of any chronic illness during infancy. Conclusions The present study found evidence that poor maternal physical and mental health during pregnancy or up to 15 months from childbirth has adverse health consequences for their offspring as measured by general health, presence of chronic health conditions, and physical health index scores. This suggests that initiatives to improve maternal physical and mental health would not only improve child health but would also reduce the national health burden.

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Implementing out of hours MDT safety huddles at the Ladywell Unit, Lewisham, South London and the Maudsley (SLAM) NHS Foundation Trust

BJPsych Open ◽

10.1192/bjo.2021.612 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S229-S230

Author(s):

Su Yeoh ◽

Natavan Babayeva ◽

Hugh Williams ◽

Emma Jones

Keyword(s):

Mental Health ◽

Physical Health ◽

Best Practice ◽

Management Plan ◽

Slight Reduction ◽

List Type ◽

Physical And Mental Health ◽

Out Of Hours ◽

Team Cohesiveness ◽

Mental And Physical Health

Aims•For 100% of patients admitted OOH (Friday 5pm – Sunday 9am) to have a multi-disciplinary review of their treatment•For 100% of patients with deteriorating physical and mental health to be discussed•To improve multi-disciplinary team (MDT) morale, working relationships and team cohesiveness OOHBackgroundIn most specialties, the standard of best practice is that patients admitted to the ward out of hours (OOH) receive a senior review over the weekend. However this does not usually take place in Psychiatry, and patients routinely wait until Monday to be seen by the ward team. This has been highlighted as problematic in cases where patients are agitated and not receiving any treatment for > 24 hours.We trialled a weekend teleconference safety huddle in Lewisham involving the on call consultant, registrar (SpR), core trainee (CT) and duty senior nurse (DSN).MethodThe weekend huddles were through a teleconference line, with participants dialling in at 9.45am.Issues discussed: 1)Management plan for newly admitted patients OOH.2)Plan for patients with deteriorating mental health or escalating level of aggression.3)Plan for patients with deteriorating physical health.Feedback was collected from CTs, SpRs and consultants focusing on whether the huddle made any difference to the speed of care, cohesiveness of the OOH team, and whether it was generally helpful or not.Result54% of CTs (n = 11) felt that patients admitted OOH had an MDT review, and 90% felt that patients with deteriorating mental and physical health were discussed and a plan put in place. 80% of CTs, 63% of SpRs (n = 8) and 67% of consultants (n = 6) agreed it improved team cohesiveness. 90% of DSNs felt safer and more supported in decision-making OOH.80% of CTs, 63% of SpRs and 83% of consultants found weekend huddles helpful.Data were also collected on violent incidents OOH, and there was a slight reduction in the number of violent incidents in the weeks following introduction of the huddle.ConclusionIntroducing safety huddles in Lewisham has facilitated the prompt discussion of the management of patients admitted OOH, and of those with deteriorating mental and physical health. It has also fostered a greater sense of cohesiveness in the MDT team.In light of this feedback, safety huddles have now been established as part of the weekend schedule in Lewisham, and are being rolled out to other boroughs within SLaM.

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ISSUE OF YOGA ON PHYSICAL AND MENTAL HEALTH

CBU International Conference Proceedings ◽

10.12955/cbup.v4.833 ◽

2016 ◽

Vol 4 ◽

pp. 689-692

Author(s):

Silvia Horváthová ◽

Iveta Petríková Rosinová

Keyword(s):

Mental Health ◽

Physical Health ◽

Human Health ◽

Sensory Input ◽

Inductive Reasoning ◽

Healthy Person ◽

Relaxation Techniques ◽

Physical And Mental Health ◽

Lifestyle Diseases

The effect of yoga on human health has long term interest. In this regard, we view the effect on physical health, not only mental, in terms of the sensory input. This paper attempts to present a position on whether yoga affects human health status and limits an increase in lifestyle diseases. In this work, we collect data and use inductive reasoning methods with the aim of generalizing conclusions. Our findings indicate the effect of yoga, not only on mental health, but also in terms of physical health, in particular in reducing obesity. It is concluded that to find a completely healthy person is rare, but with various relaxation techniques of yoga, one can eliminate a variety of ailments and benefit overall in health.

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Physiotherapy in Long Term Physical and Mental Health of People Recovered from COVID 19: A Systematic Review Protocol

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2021.196 ◽

2021 ◽

Vol 9 (6) ◽

pp. 4066-4070

Author(s):

Vyom Gyanpuri ◽

◽

C. Mohanty ◽

Neetu Rani Dhiman ◽

◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Physical Health ◽

Depression Scale ◽

Functional Independence ◽

Biomedical Literature ◽

Current Evidence ◽

Hamilton Depression Scale ◽

Physical And Mental Health

The objective of the study to design a protocol on the effectiveness of physiotherapy on long term physical and mental health of recovered patients from coronavirus disease 2019. Methods: The following electronic databases will be searched from inception to December 2021: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Databases, and other databases. We will include all published documents regarding this topic. Two separate individuals will analyse studies and select accordingly after removal of duplicate studies. Then, final screening, assessment of quality of the articles and data analysis will be done. Meta-analyses, subgroup analysis, and descriptive analysis will be performed based on the included data conditions. Results: Methodological heterogeneity analysis of current evidence will be provided from Physical health outcomes like Barthel Index or Functional Independence measure scale and questionnaires describing health status like Physical Health Questionnaire and Mental health outcomes like SRQ-20, Hamilton Depression scale or Hamilton Anxiety scale. Conclusion: This study will provide the evidence regarding the importance of physiotherapy in future physical and mental health of recovered COVID-19 patients, when performed during treatment of disease in acute hospital management. PROSPERO registration number: CRD42020190863 KEY WORDS: Coronavirus disease 2019, Protocol, Rehabilitation, Review.

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Queensland Family Cohort: a study protocol

BMJ Open ◽

10.1136/bmjopen-2020-044463 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044463

Author(s):

Danielle Borg ◽

Kym Rae ◽

Corrine Fiveash ◽

Johanna Schagen ◽

Janelle James-McAlpine ◽

...

Keyword(s):

Mental Health ◽

Family Environment ◽

Biological Samples ◽

Local Governments ◽

Financial Stability ◽

Federal State ◽

Physical And Mental Health ◽

Future Health ◽

The Impact

IntroductionThe perinatal–postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice.Methods and analysisThe Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease.Ethics and disseminationEthical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.

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Health of mothers of children with a life-limiting condition: a comparative cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320655 ◽

2021 ◽

pp. archdischild-2020-320655

Author(s):

Lorna K Fraser ◽

Fliss EM Murtagh ◽

Jan Aldridge ◽

Trevor Sheldon ◽

Simon Gilbody ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Secondary Care ◽

Incidence Rates ◽

Health Conditions ◽

Clinical Practice Research Datalink ◽

Physical And Mental Health ◽

Term Condition ◽

Limiting Condition

ObjectiveThis study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition.MethodsComparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal–child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk.ResultsA total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18).ConclusionThis study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.

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