Assessment and management of vulnerable patients

2019 ◽  
pp. 141-148
Author(s):  
Sophie Behrman ◽  
Dorcas Dan-Cooke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Inpatient Care ◽  
Discharge Planning ◽  
Management Strategies ◽  
Holistic Treatment ◽  
Complex Patients ◽  
Vulnerable Patients ◽  
The Uk

Staff working on mental health wards are well accustomed to assessing and managing vulnerable patients. With the current organization of mental health care in the UK, where only 5.7% of patients in contact with mental health services received inpatient care in a year, only the most unwell and/or complex patients are seen on mental health wards. These patients may well have numerous vulnerabilities, which require assessment and management as part of the holistic treatment of the patient during their admission and for discharge planning. This chapter discusses who these particularly vulnerable patients are, examines what sort of vulnerabilities patients might experience, and suggests possible management strategies.

Mental health care in London

2005 ◽  
Vol 20 (S2) ◽  
pp. s274-s278 ◽  
Author(s):  
P. De Ponte ◽  
G. Hughes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
National Policy ◽  
Health Staff ◽  
Mental Health Staff ◽  
The Uk ◽  
Occupancy Rates

AbstractAimTo describe principles and characteristics of mental health care in London.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsLondon experiences high levels of need and use of mental health services compared to England as a whole. Inpatient andcompulsory admissions are considerably higher than the national average. Despite having more psychiatric beds and mental health staff, London has higher bed occupancy rates and staffing shortages. At the same time there is a trend away from institutionalised care to care in the community.ConclusionMental health services in the UK are undergoing considerable reform. These changes will not remove the greater need formental health services in the capital, but national policy and funding lends support to cross-agency and pan-London work to tackle some of the problems characteristic of mental health in London. Whilst various issues of mental health care in London overlap with those in other European capitals, there also are some specific problems and features.

scholarly journals Editorial: Models of Care

2009 ◽  
Vol 33 (1) ◽  
pp. 11 ◽  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Health Services ◽  
Discharge Planning ◽  
Demand Management ◽  
Management Strategies ◽  
Community Mental Health Services ◽  
Models Of Care ◽  
Measurement Tool ◽  
Health Model

THIS MODELS OF CARE section features two articles that address issues of quality and cost efficiency. Models of substitution and effective tools for demand management strategies are discussed. The first is an article entitled ?Substitution across professions within the home care sector: an investigation of nursing and allied health services? by Stevens and Vecchio (page 19). The article explores two different health professional groups within the home sector. The article by Prowse and Coombs entitled ?The use of the Health of the Nation Outcome Scales (HoNOS) to inform discharge and transfer decisions in community mental health services? (page 13) focuses on a community mental health model which has put in place a measurement tool to assist in discharge planning.

The context of inpatient mental health care in England

2019 ◽  
pp. 41-46
Author(s):  
Rob Chaplin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Inpatient Care ◽  
Psychiatric Care ◽  
Inpatient Psychiatric Care ◽  
Recent Trends ◽  
Uk National Health Service ◽  
The Uk

This chapter reviews the practice of inpatient care in relation to the provision of overall psychiatric care in England. The structure of mental health care in the UK National Health Service (NHS) is outlined and in particular the various subspecialties of inpatient care. Recent trends in the provision of inpatient psychiatric care in the UK are considered in comparison to those in Europe and North America. There follows a review of the role of public sector care under the NHS and a debate about the effectiveness of inpatient care and whether it should be a separate psychiatric subspecialty. Finally, local service developments are discussed as a type of case study to illustrate how services are currently undergoing rapid changes.

Technologies for the Delivery of Mental Health Care

1996 ◽  
Vol 12 (4) ◽  
pp. 673-687 ◽  
Author(s):  
David Mechanic
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Case Management ◽  
Mental Health Care ◽  
Inpatient Care ◽  
Cost Effective ◽  
Cost Constraints ◽  
Alternative Community ◽  
Efficacious Drug

AbstractMental health services depend both on efficacious drug and interpersonal interventions and strategies for financing, organizing, and delivering these services. In recent years, much attention has been devoted to approaches that seek to coordinate needed care and to provide it in the most cost-effective ways. Cost constraints encourage the substitution of alternative community treatments for expensive inpatient care and the identification of appropriate ways to link effectively the varying care components. The mechanism most commonly advocated is case management, but the concept is applied in diverse ways and has little agreed upon meaning and disparate outcomes. This paper discusses and evaluates concepts of case management and a variety of other systems interventions designed to reduce fragmentation. It also reviews approaches to managed care, including mental health capitation and utilization management. New organizational technologies are likely to change dramatically professional practices and standards and the future provision of mental health care.

scholarly journals Service innovations

2003 ◽  
Vol 27 (09) ◽  
pp. 346-348
Author(s):  
Chris Simpson ◽  
Prasanna De Silva
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
High Quality ◽  
The Uk ◽  
Multi Disciplinary Team

The increase in older people in the UK will increase the need for mental health services to run efficient, high-quality services. Multi-disciplinary team assessments, although not new, provide a method of increasing the capacity to see referrals. Two similar systems of multi-disciplinary team assessments from North Yorkshire are reported with evidence of improvement in quality.

Recovery Star: validating user recovery

2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Internal Consistency ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Health Recovery ◽  
Addictive Behaviour ◽  
Health Service Providers ◽  
The Uk

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.

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