scholarly journals The ecopsychosocial provision for psychiatric environments

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Chrysikou
Keyword(s):  
Evaluation System ◽  
Psychiatric Patients ◽  
Social Activity ◽  
Space Syntax ◽  
Mental Healthcare ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Therapeutic Environment ◽  
Social Logic ◽  
The Uk

Abstract Environment affects quality of care. Yet there are very few evaluation methods to address such issues. The SCP model is a user-inclusive, multi-paramentric method for the planning, design and evaluation of psychiatric facilities. Its application to psychiatric wards indicated hiatus between top-down (designers, building commissioning authorities) vs bottom up (patients and staff) understanding of what constitutes a therapeutic environment. That generated the need to investigate the socio-spatial context of psychiatric wards. This research aimed to promote our understanding of psychiatric space in relation to social interaction. Two acute wards in the UK provided the locus. Each was evaluated using the SCP model institutional vs domestic checklist, open-ended interviews with 10 staff and 12 patients and auditing of the spaces. Then, a Space Syntax analysis using depthmap was employed to model social activity inside the wards. The SCP model analysis indicated that the wards, one of them new and purpose built and the other part of an old psychiatric campus soon to be replaced, demonstrated strong institutional features, even compared to previous samples using the same tools. The juxtaposition with space syntax demonstrated that areas mapped as integrated, i.e., socio-friendly, were areas where antisocial behaviours were observed. This could be interpreted by Goffman's theory on total institutions, as institutional spaces might be the context of reverse socio-spatial norms according to Hillier's social logic of space. Thus, institutional spaces could still house mental health provision. Integrated approaches for evaluating healthcare facilities for fit for purpose and social integration need to become part of a healthcare evaluation system. Healthcare provision should be evaluated for ecopsychosocially supportive environments. Key messages The project raised the question of the appropriateness of mental healthcare environments. The spaces for the treatment and care of psychiatric patients might not be fit for their social re-integration.

scholarly journals It's time to talk: rekindling the relationship with primary care

2008 ◽  
Vol 14 (2) ◽  
pp. 84-85 ◽  
Author(s):  
Roger Banks ◽  
Linda Gask
Keyword(s):  
Mental Health Problems ◽  
Mental Healthcare ◽  
Strategy Training ◽  
Specialist Care ◽  
Healthcare Provision ◽  
Policy And Strategy ◽  
Working Together ◽  
Strategic Policy ◽  
The Uk ◽  
The Relationship

Healthcare provision in the UK is in a process of continual change. The structures and processes by which people with mental health problems and people with learning disabilities receive support from statutory services have been, and continue to be, subject to many and varied strategic, policy and professional influences. Integrated and collaborative ways of working between generalist (‘primary’) and specialist (‘secondary’) care have become eroded over time and yet they may be needed more than ever. In this editorial we encourage a collaborative approach between practitioners in generalist and specialist care in studying and developing three strands of work: policy and strategy; training; and professional behaviour. Above all, we advocate strongly for a renewed and dynamic dialogue between psychiatrists and general practitioners in working together to provide high-quality mental healthcare.

Attitudes Towards Psychiatry Among Physiotherapy Students in Poland – pilot Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S616-S616
Author(s):  
A.R. Szczegielniak ◽  
J. Szczegielniak
Keyword(s):  
Pilot Study ◽  
Physical Therapy ◽  
Media Coverage ◽  
Physical Therapists ◽  
Psychiatric Patients ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Healthcare Facilities ◽  
Competing Interest ◽  
Physiotherapy Students

Poor knowledge regarding mental health in general population in Poland, along with media coverage limited to repetition of harmful stereotypes towards patients treated at psychiatric wards and reinforcement of discriminative attitudes, results in an unfair evaluation and stigmatization of mental healthcare services. As a consequence, psychiatry, in comparison to many other medical fields, is unpopular among physiotherapy students, even though there is a compulsory subject in the university curriculum that covers, in theory, all the important knowledge that healthcare worker should possess in this regards. Young physical therapists are not taught about specific needs of the psychiatric patients. After graduation, they are lacking all basic skills on how to communicate with the patient. Being devoid of a direct contact with people suffering from mental disorders, physical therapists do not feel comfortable placed in the mental healthcare facilities. The aim of the study was to assess the extent of a basic psychiatric knowledge and general attitudes towards mentally ill of the physiotherapy students. The group consisted of 147 students. The pilot study has been limited to those studying physical therapy within borders of the Opole voivodship. Authors’ questionnaire has been developed in order to reach the aim and answers were gathered between January and June 2016. The results will be used to develop questionnaire suitable to share with physiotherapy students within the whole country and, consequently, formulate recommendations on necessary changes that must be introduced to the physical therapy curriculum in Poland by Polish Society of Physiotherapy (Psychiatry Section).Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals In-patient services for people with intellectual disability and mental health or behavioural difficulties

2015 ◽  
Vol 21 (2) ◽  
pp. 116-123 ◽  
Author(s):  
John Devapriam ◽  
Alan Rosenbach ◽  
Regi Alexander
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
General Population ◽  
Patient Care ◽  
Mental Healthcare ◽  
Healthcare Provision ◽  
The Past ◽  
Behavioural Difficulties ◽  
Quality And Outcomes ◽  
The Uk

SummaryOver the past few decades, care for people with intellectual disability in the UK has moved from long-stay hospitals to the community. As in the general population, a number of these people have mental health and behavioural difficulties for which they may require in-patient services. Consequently, psychiatrists need to be aware of the in-patient mental healthcare provision for these individuals. This article describes the different categories of in-patient bed for patients with intellectual disability and ways to monitor the quality and outcomes of in-patient care.

scholarly journals No wrong door: addressing injustices and achieving better mental healthcare provision for under-18s in acute physical healthcare settings

2021 ◽  
pp. 1-7
Author(s):  
Virginia Davies
Keyword(s):  
Young People ◽  
Mental Healthcare ◽  
Hospital Service ◽  
Healthcare Provision ◽  
Children And Young People ◽  
Healthcare Settings ◽  
Adequate Knowledge ◽  
Service Models ◽  
The Uk ◽  
Acute Trust

Summary The distressing reality that mental healthcare for children and young people in acute trust settings in the UK is woefully underprovided is not news. But with acute trust debts being written off, hospital trusts and commissioners of services have a timely opportunity to address this age- and condition-based discrimination. Delivering a just service for under-18s depends on attitude, resources and adequate knowledge of the tasks involved. This article aims to describe the current landscape, summarise the arguments for better integrating mental healthcare into physical healthcare settings, articulate the tasks involved and the challenges for commissioning and providing, and finally share examples of current service models across the country. Ultimately, commissioning and provider choices will be constrained by resource pressures, but this article aims to underscore why commissioning and providing a portmanteau ‘no wrong door’ hospital service for children, young people and families is worth the headache of thinking outside old commissioning and provider boxes.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

scholarly journals Exploring patterns in psychiatric outpatients’ preferences for involvement in decision-making: a latent class analysis approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ingunn Mundal ◽  
Mariela Loreto Lara-Cabrera ◽  
Moisés Betancort ◽  
Carlos De las Cuevas
Keyword(s):  
Decision Making ◽  
Depressive Disorder ◽  
Latent Class ◽  
Psychiatric Patients ◽  
Mental Healthcare ◽  
Psychological Reactance ◽  
Psychiatric Outpatients ◽  
Public And Private ◽  
Level Of Education ◽  
Healthcare Settings

Abstract Background Shared decision-making (SDM), a collaborative approach that includes and respects patients’ preferences for involvement in decision-making about their treatment, is increasingly advocated. However, in the practice of clinical psychiatry, implementing SDM seems difficult to accomplish. Although the number of studies related to psychiatric patients’ preferences for involvement is increasing, studies have largely focused on understanding patients in public mental healthcare settings. Thus, investigating patient preferences for involvement in both public and private settings is of particular importance in psychiatric research. The objectives of this study were to identify different latent class typologies of patient preferences for involvement in the decision-making process, and to investigate how patient characteristics predict these typologies in mental healthcare settings. Methods We conducted latent class analysis (LCA) to identify groups of psychiatric outpatients with similar preferences for involvement in decision-making to estimate the probability that each patient belonged to a certain class based on sociodemographic, clinical and health belief variables. Results The LCA included 224 consecutive psychiatric outpatients’ preferences for involvement in treatment decisions in public and private psychiatric settings. The LCA identified three distinct preference typologies, two collaborative and one passive, accounting for 78% of the variance. Class 1 (26%) included collaborative men aged 34–44 years with an average level of education who were treated by public services for a depressive disorder, had high psychological reactance, believed they controlled their disease and had a pharmacophobic attitude. Class 2 (29%) included collaborative women younger than 33 years with an average level of education, who were treated by public services for an anxiety disorder, had low psychological reactance or health control belief and had an unconcerned attitude toward medication. Class 3 (45%) included passive women older than 55 years with lower education levels who had a depressive disorder, had low psychological reactance, attributed the control of their disease to their psychiatrists and had a pharmacophilic attitude. Conclusions Our findings highlight how psychiatric patients vary in pattern of preferences for treatment involvement regarding demographic variables and health status, providing insight into understanding the pattern of preferences and comprising a significant advance in mental healthcare research.

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

scholarly journals Registration of Blood Exposure Accidents in the Netherlands by a Nationally Operating Call Center

2012 ◽  
Vol 33 (10) ◽  
pp. 1017-1023
Author(s):  
Peter M. Schneeberger ◽  
Annemarie E. Meiberg ◽  
Janet Warmelts ◽  
Sander C. A. P. Leenders ◽  
Paul T. L. van Wijk
Keyword(s):  
The Netherlands ◽  
Call Center ◽  
Preventive Measures ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Incidence Rates ◽  
Hepatitis B Vaccination ◽  
Occupational Health Services ◽  
Healthcare Facilities ◽  
Call Center Employees

Objective.Healthcare providers and other employees, especially those who do not work in a hospital, may not easily find help after the occurrence of a blood exposure accident. In 2006, a national call center was established in the Netherlands to fill this gap.Methods.All occupational blood exposure accidents reported to the 24-hours-per-day, 7-days-per-week call center from 2007, 2008, and 2009 were analyzed retrospectively for incidence rates, risk assessment, handling, and preventive measures taken.Results.A total of 2,927 accidents were reported. The highest incidence rates were reported for private clinics and hospitals (68.5 and 54.3 accidents per 1,000 person-years, respectively). Dental practices started reporting incidents frequently after the arrangement of a collective financial agreement with the call center. Employees of ambulance services, midwife practices, and private clinics reported mostly high-risk accidents, whereas penitentiaries frequently reported low-risk accidents. Employees in mental healthcare facilities, private clinics, and midwife practices reported accidents relatively late. The extent of hepatitis B vaccination in mental healthcare facilities, penitentiaries, occupational health services, and cleaning services was low (<70%).Conclusions.The national call center successfully organized the national registration and handling of blood exposure accidents. The risk of blood exposure accidents could be estimated on the basis of this information for several occupational branches. Targeted preventive measures for healthcare providers and other employees at risk can next be developed.Infect Control Hosp Epidemiol 2012;33(10):1017-1023

scholarly journals Opinion of mental healthcare providers on the impact of electronic games on psychiatric patients in Saudi Arabia

2021 ◽  
pp. 100647
Author(s):  
Sarah Al-zahrani ◽  
Arwa Althumairi ◽  
Afnan Aljaffary ◽  
Asma Alfayez ◽  
Demah Alsalman ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Psychiatric Patients ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Electronic Games ◽  
The Impact

“There is still a perception that homelessness is a housing problem”: devolution, homelessness and health in the UK

2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson
Keyword(s):  
Qualitative Interviews ◽  
Homeless People ◽  
Small Sample ◽  
Issue Salience ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Policy And Practice ◽  
Content Type ◽  
The Uk ◽  
Comparative Policy

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.

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