Correctional Mental Health Your Connection to Quality Care, July 11-12, 2010, Boston, MA [Program]

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

Download Full-text

Widespread emergency department access block: a human rights issue in Australia?

Australasian Psychiatry ◽

10.1177/1039856218810156 ◽

2018 ◽

Vol 27 (1) ◽

pp. 10-13 ◽

Cited By ~ 3

Author(s):

Stephen Allison ◽

Tarun Bastiampillai ◽

Richard O’Reilly ◽

Steven S Sharfstein ◽

David Castle

Keyword(s):

Mental Health ◽

Human Rights ◽

Quality Care ◽

Physical Restraint ◽

Community Services ◽

Optimal Care ◽

Inpatient Psychiatric Care ◽

Lengths Of Stay ◽

Health Rights ◽

Rights Issue

Objective: There are increasing demands on emergency psychiatrists with higher numbers of mental health presentations, and longer stays in emergency departments (EDs). Australia, like other English speaking countries, funds considerably lower numbers of psychiatric beds than average for Organisation for Economic Co-operation and Development (OECD) countries. Consequently, acute bed occupancy is high, and a bed is frequently unavailable when a person needs admission. Patients with serious mental illness can wait days in busy and overstimulating EDs, become agitated and assaultive, and then require chemical and physical restraint. All patients have a right to safe high quality care, but the paucity of beds deprives patients of this right. The Australasian College of Emergency Medicine recommends reporting ED access block to health ministers, and human rights and/or health rights commissioners, and recommends increased funding for inpatient psychiatric care, emergency mental health and after-hours community services, together with more alcohol and other drug programs. Conclusions: It is challenging for emergency physicians and psychiatrists to provide optimal care for acutely unwell patients who stay extended periods in the ED. Increasing the availability of inpatient care must be considered as part of a comprehensive solution for minimising ED lengths of stay in Australia.

Download Full-text

Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains (Preprint)

10.2196/preprints.19198 ◽

2020 ◽

Author(s):

Eva Serhal ◽

Anne Kirvan ◽

Marcos Sanches ◽

Allison Crawford

Keyword(s):

Mental Health ◽

Patient Satisfaction ◽

Quality Of Care ◽

Quality Care ◽

Clinical Intervention ◽

Strongly Correlated ◽

Clinical Quality ◽

Survey Tool ◽

Development And Validation

BACKGROUND Telepsychiatry is an increasingly used model of mental health care that connects patients with psychiatrists at a distance via videoconference. Telepsychiatry is an effective clinical intervention that improves access to quality care in regions with limited resources or in clinical situations where in-person care is unavailable. OBJECTIVE This study aims to develop a validated survey tool to measure patient experience and satisfaction with telepsychiatry based on the quality of care domains. This study also seeks to understand which health service outcomes were most strongly correlated with overall satisfaction in the context of telepsychiatry. METHODS The survey created in this study was developed and validated with a panel of subject matter and process experts and was piloted with 274 patients who received clinical consultations through the TeleMental Health Program at the Centre for Addiction and Mental Health. Factor analysis was used to determine correlations between questions and quality of care domains and was also used to assess model fit. RESULTS The study provides a validated survey to measure patient satisfaction and experience with telepsychiatry across 4 domains: access and timeliness, appropriateness, effectiveness, and safety. Both safety and access and timeliness were found to be statistically significant predictors of satisfaction in our sample. CONCLUSIONS By situating patient satisfaction and experience within this framework, the survey facilitates patient data collection and interpretation through a clinical quality lens.

Download Full-text

Handbook of Correctional Mental Health

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v67n0822b ◽

2006 ◽

Vol 67 (08) ◽

pp. 1312-1313

Author(s):

William Bernet

Keyword(s):

Mental Health ◽

Correctional Mental Health

Download Full-text