Acute Crisis Care for Patients with Mental Health Crises: Initial Assessment of an Innovative Prehospital Alternative Destination Program in North Carolina

2018 ◽  
Vol 22 (5) ◽  
pp. 555-564 ◽  
Author(s):  
Jamie O. Creed ◽  
Julianne M. Cyr ◽  
Hillary Owino ◽  
Shannen E. Box ◽  
Mia Ives-Rublee ◽  
...  
Keyword(s):  
Mental Health ◽  
North Carolina ◽  
Initial Assessment ◽  
Crisis Care ◽  
Acute Crisis

scholarly journals Mental health crisis resolution teams and crisis care systems in England: a national survey

2018 ◽  
Vol 42 (4) ◽  
pp. 146-151 ◽  
Author(s):  
Brynmor Lloyd-Evans ◽  
Danielle Lamb ◽  
Joseph Barnby ◽  
Michelle Eskinazi ◽  
Amelia Turner ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
National Survey ◽  
Online Survey ◽  
Service Improvement ◽  
Mental Health Crisis ◽  
Crisis Resolution ◽  
Health Crisis ◽  
Crisis Resolution Teams ◽  
Crisis Care

Aims and methodA national survey investigated the implementation of mental health crisis resolution teams (CRTs) in England. CRTs were mapped and team managers completed an online survey.ResultsNinety-five per cent of mapped CRTs (n = 233) completed the survey. Few CRTs adhered fully to national policy guidelines. CRT implementation and local acute care system contexts varied substantially. Access to CRTs for working-age adults appears to have improved, compared with a similar survey in 2012, despite no evidence of higher staffing levels. Specialist CRTs for children and for older adults with dementia have been implemented in some areas but are uncommon.Clinical implicationsA national mandate and policy guidelines have been insufficient to implement CRTs fully as planned. Programmes to support adherence to the CRT model and CRT service improvement are required. Clearer policy guidance is needed on requirements for crisis care for young people and older adults.Declaration of interestNone.

scholarly journals Women’s demand for late-term abortion: A social or psychiatric issue?

2014 ◽  
Vol 71 (7) ◽  
pp. 660-666
Author(s):  
Gordana Nikolic ◽  
Ljiljana Samardzic ◽  
Miroslav Krstic
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Educational Level ◽  
Unwanted Pregnancy ◽  
Initial Assessment ◽  
Psychiatric Evaluation ◽  
Lower Socioeconomic ◽  
Significant Difference ◽  
Psychiatric Issue ◽  
Gestational Week

Introduction/Aim. Induced termination of unwanted pregnancy after 12th gestational week (late-term abortion) is legally restricted in Serbia as well as in many other countries. On the other hand, unwanted pregnancy very often brings women into the state of personal crisis. Psychiatric indications for legally approved late-term abortion on women?s demand include only severe psychiatric disorders. The aim of this paper was to compare sociodemographic, psychological characteristics and claimed reasons for abortion in the two groups of women with late-term demand for abortion - the group of women satisfying legally prescribed mental health indications, and the group of women not satisfying these indications. The aim of the study was also to determine predictive validity of the abovementioned parameters for late-term abortion as the outcome of unwanted pregnancy. Methods. A total of 62 pregnant women with demand for late-term abortion were divided into two groups according to the criteria of satisfying or not satisfying legally proposed psychiatric indications for late-term abortion after psychiatric evaluation. For the assessment of sociodemographic and psychological parameters sociodemographic questionnaire and symptom checklist - 90 revised (SCL-90?) scale were used, respectively. The outcome of unwanted pregnancy was followed 6 months after the initial assessment. Results. The obtained results showed a statistically significant difference between the groups in educational level, satisfaction with financial situation, elevated anxiety and distress reactions. Unfavorable social circumstances were the main reason for an abortion in both groups and were predictive for an abortion. A 6-month follow-up showed that women had abortion despite legal restrictions. Conclusion. Pregnant women with psychiatric indication for late-term abortion belong to lower socioeconomic and educational level group compared to women without this indication who have more frequently elevated anxiety and distress reactions to unwanted pregnancy. It is necessary to have more accurate guidelines for mental health indications for legally approved late-term abortion, respecting social circumstances. Preventive measures are of great importance in order to lower the risk of illegally performed late-term abortions.

The use of HoNOSCA in a child and adolescent mental health service

2003 ◽  
Vol 20 (2) ◽  
pp. 52-55 ◽  
Author(s):  
Julie Manderson ◽  
Noel McCune
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Peer Relationships ◽  
Aggressive Behaviour ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Initial Assessment ◽  
Adolescent Mental Health Service ◽  
The Impact

AbstractObjectives: To assess the health and social functioning of patients attending a Child and Adolescent Mental Health Service (CAMHS) and to measure the impact of attendance using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA).Method: HoNOSCA was completed on 73 consecutive patients attending for initial assessment with a review assessment being completed after six months or at discharge from the clinic if this occurred sooner on 53 of these. The impact of attendance at the clinics was determined by comparing initial and review mean HoNOSCA Scores.Results: Of the 53, 66% were male and 34% female. Boys were more highly rated with regard to aggressive behaviour, performance in peer relationships and family life relationships whilst girls were rated as having more nonorganic and emotional symptoms. Older children showed the highest rates of poor school attendance, non accidental (self) injury and emotional problems while younger children showed the greatest aggressive behaviour and language skill problems. An improvement in the total HoNOSCA score from initial assessment to review was seen in 92%. There was an improvement in the HoNOSCA mean score from initial assessment to review.Conclusions: Age, sex and symptom profiles of patients attending the service were similar to other CAMHS. Attendance at CAMHS produces improvements in patient outcomes over a six month period as measured using HoNOSCA, which proved to be a useful if somewhat time consuming tool.

scholarly journals @Home eTherapy Service for People with Common Mental Health Problems: an Evaluation

2017 ◽  
Vol 46 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Judith Gellatly ◽  
Leanne Chisnall ◽  
Nic Seccombe ◽  
Kathryn Ragan ◽  
Nicola Lidbetter ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Treatment Options ◽  
Third Sector ◽  
Health Problems ◽  
Initial Assessment ◽  
Successful Implementation ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Common Mental Health Problems

Background: Ensuring rapid access to psychological interventions is a priority of mental health services. The involvement of peer workers to support the delivery of more accessible treatment options such as computerized cognitive behaviour therapy (CCBT) is recognized. Aims: To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience. Method: Supported CCBT packages with telephone support were delivered over a 30-month period. Self-complete measures identifying levels of depression, anxiety and functioning were administered at each treatment appointment. Results: Over 2000 people were referred to the @Home eTherapy service; two-thirds attended an initial assessment and 53.4% of referrals assigned to CCBT completed treatment. Statistically significant improvements in anxiety, depression and functioning were found, with 61.6% of treated clients meeting recovery criteria. Conclusions: The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT. Evidence for the successful implementation of such a service by a third sector organization is provided.

Multidisciplinary working, evidence, treatment, and decision-making in medicine

2019 ◽  
pp. 70-88
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Treatment Effectiveness ◽  
Medical Model ◽  
Mechanisms Of Action ◽  
Initial Assessment ◽  
Controlled Trials ◽  
Emergency Situations ◽  
Quantitative And Qualitative Research ◽  
Multidisciplinary Working

Patients have many needs and not all can be met using the medical model, hence the necessity of multiple therapeutic models and multidisciplinary working. Doctors’ sapiental role relies on evidence from research which can vary in quality. Quantitative and qualitative research are both useful. Randomized controlled trials with blinded assessments are the best method of assessing treatment effectiveness. Objectives of treatment should be jointly decided between doctor and patient and are often not simply about cure. Mechanisms of action of intervention do not always reverse disease progress but may involve other processes such as indirect compensation. Medication has many complex effects, both therapeutic and adverse. The medical model allows doctors to see many patients and work in emergency situations including providing overnight cover. This is because after the initial assessment, further assessments can be brief and if medication is used it is usually taken outside consultations. This ability to see many patients at all hours means mental health services will often include doctors using the medical model.

Initial assessment, ward rounds, the discharge process

2019 ◽  
pp. 83-90
Author(s):  
Alvaro Barrera
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Hospital Admission ◽  
Initial Assessment ◽  
Discharge Process ◽  
Chronological Order ◽  
Psychiatric Unit ◽  
Ward Rounds ◽  
Inpatient Units

Hospital admission to an acute psychiatric unit can be a challenging and at times distressing experience for patients, relatives, and friends. This chapter outlines the main multidisciplinary clinical tasks that must be carried out from admission to discharge, with a view to provide care that promotes dignity, autonomy, as well as a sense of hope for patients and all those involved. Taking as context the frameworks and standards provided by a several bodies, the chapter follows a chronological order starting and ending with a close look at the community mental health teams with which inpatient units must closely work for the benefit of patients and their families and friends.

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