Liaison old age psychiatry

2013 ◽  
Author(s):  
John Holmes
Keyword(s):  
Mental Health ◽  
Older People ◽  
General Hospital ◽  
Health Assessment ◽  
Cost Savings ◽  
Liaison Psychiatry ◽  
People With Dementia ◽  
Wide Range ◽  
Part Time ◽  
Set Up

About one-third of general hospital beds are occupied by older people with dementia, delirium or depression. All these conditions bring poorer outcomes for individuals and organisations alike. In response to this, liaison psychiatry services for older people have evolved in order to provide timely mental health assessment, ongoing treatment and signposting to other mental health services. They also provide teaching and training for general hospital colleagues from a wide range of disciplines. There is wide variation in liaison service configurations and activity, from a part-time nurse to a large multidisciplinary team but the best evidence for effectiveness is for the latter. Liaison services can be difficult to set up, requiring agreement from all stakeholders, but once established they can bring improvements in quality as well as cost savings. This chapter explains the case of need for these services, considers different service models, examines service activities and support needs and helps the reader understand how local services can be evaluated.

scholarly journals Higher training in liaison psychiatry for older adults: experiences of two specialist training posts

2007 ◽  
Vol 31 (9) ◽  
pp. 354-356
Author(s):  
Maura Young ◽  
Siobhan Morris
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
General Hospital ◽  
Old Age ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Liaison Psychiatry ◽  
The Past

Over the past decade, old age liaison psychiatry services have been developing across the UK. The driving force behind this has been the recognition of the inequity in service provision for people over the age of 65 with mental health problems in a general hospital setting. A postal survey of consultants in old age psychiatry in April 2002 showed that most respondents (71%) considered that the service they provided to older people in general hospitals was poor and needed to be improved (Holmes et al, 2002). Much work has been done to highlight this issue, and liaison psychiatry for older adults is gaining prominence. The national conference on liaison psychiatry for older people, which has been held in Leeds for the past 4 years, attracts large numbers of enthusiastic participants. The Department of Health (2006) document A New Ambition for Old Age specifically mentions the current poor standard of care that older people with mental health problems receive in a general hospital setting. The Royal College of Psychiatrists (2005) has produced guidelines for the development of liaison mental health services for older people.

A Mental Health Unit for the Deaf. The Spanish Experience

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Muñoz ◽  
A. Garcia ◽  
F. Ferre
Keyword(s):  
Mental Health ◽  
General Hospital ◽  
Social Worker ◽  
List Type ◽  
Type Number ◽  
Health Unit ◽  
Short Term ◽  
Part Time ◽  
Set Up ◽  
Mental Health Unit

In 2002 the first spanish mental health unit for the Deaf was set up at the Gregorio Marañón Hospital in Madrid.From this moment that unit has seen more than 400 profoundly deaf patients which means more than 6500 consultations.Only 3 professionals works in the unit. a psychologist, a social worker and a part time psychiatrist.We have 3 principal goals in our presentation:1.First: Present the results of the unit. Number and kind of patients, disorders and treatments.2.Second: Explain how difficult is to set up this kind of spcialized units in a big general hospital.3.Third: Prsent our plans to improve our unit in the short term.

scholarly journals Use of routinely collected data on psychiatric in-patient care

2003 ◽  
Vol 9 (4) ◽  
pp. 300-307 ◽  
Author(s):  
Gyles Glover
Keyword(s):  
Mental Health ◽  
Set Covering ◽  
Services Research ◽  
Data Set ◽  
Research Issues ◽  
Wide Range ◽  
Policy Work ◽  
Data Source ◽  
Set Up ◽  
Service Data

Since the start of the National Health Service, data have been collected on admissions to psychiatric in-patient units, first as the Mental Health Enquiry, then as part of Hospital Episode Statistics. Some details have changed but many have stayed remarkably consistent. Published literature on the wide range of research and policy work undertaken using this data source is reviewed. Early work was central to the government's deinstitutionalisation policy in the early 1960s. Subsequent studies cover a wide range of epidemiological and health services research issues. A new statistical base, the Mental Health Minimum Data Set, covering individuals receiving all types of health care is currently being set up. This will supplement (but not replace) admission statistics.

scholarly journals Trends in referrals to liaison psychiatry teams from UK emergency departments for patients over 65

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S311-S312
Author(s):  
Sarah Bradbury ◽  
George Crowther ◽  
Manimegalai Chinnasamy ◽  
Laura Shaw ◽  
Sara Ormerod ◽  
...  
Keyword(s):  
Mental Health ◽  
Older People ◽  
Emergency Departments ◽  
Community Mental Health Services ◽  
Service Evaluation ◽  
Liaison Psychiatry ◽  
Convenience Sample ◽  
National Priority ◽  
Health Related ◽  
The Uk

AimsThe number of people over the age of 65 attending Emergency Departments (ED) in the United Kingdom (UK) is increasing. Those who attend with a mental health related problem may be referred to liaison psychiatry for assessment. Improving responsiveness and integration of liaison psychiatry in general hospital settings is a national priority. To do this psychiatry teams must be adequately resourced and organised. However, it is unknown how trends in the number of referrals of older people to liaison psychiatry teams by EDs are changing, making this difficult.MethodWe performed a national multi-centre retrospective service evaluation, analysing existing psychiatry referral data from EDs of people over 65. Sites were selected from a convenience sample of older peoples liaison psychiatry departments. Departments from all regions of the UK were invited to participate via the RCPsych liaison and older peoples faculty email distribution lists. From departments who returned data, we combined the date and described trends in the number and rate of referrals over a 7 year period.ResultReferral data from up to 28 EDs across England and Scotland over a 7 year period were analysed (n = 18828 referrals). There is a general trend towards increasing numbers of older people referred to liaison psychiatry year on year. Rates rose year on year from 1.4 referrals per 1000 ED attenders (>65 years) in 2011 to 4.5 in 2019 . There is inter and intra site variability in referral numbers per 1000 ED attendances between different departments, ranging from 0.1 - 24.3.ConclusionTo plan an effective healthcare system we need to understand the population it serves, and have appropriate structures and processes within it. The overarching message of this study is clear; older peoples mental health emergencies presenting in ED are common and appear to be increasingly so. Without appropriate investment either in EDs or community mental health services, this is unlikely to improve.The data also suggest very variable inter-departmental referral rates. It is not possible to establish why rates from one department to another are so different, or whether outcomes for the population they serve are better or worse. The data does however highlight the importance of asking further questions about why the departments are different, and what impact that has on the patients they serve.

Principles of service provision in old age psychiatry

2020 ◽  
pp. 281-306
Author(s):  
Tom Dening ◽  
Kuruvilla George
Keyword(s):  
Mental Health ◽  
Older People ◽  
Old Age ◽  
Religion And Spirituality ◽  
Liaison Psychiatry ◽  
Memory Assessment ◽  
Challenges And Opportunities ◽  
Recent Developments ◽  
Old Age Psychiatry ◽  
Consultation Liaison Psychiatry

Globally increasing numbers of older people bring both challenges and opportunities for old age psychiatry services. This chapter outlines the history, underlying principles, and policy context for contemporary mental health services for older people. It discusses components of services, including community health teams, memory assessment services, consultation-liaison psychiatry, and in-patient mental health care, as well as newer types of service, such as crisis teams and outreach to care homes. Other recent developments include various models of case management and emphasis on post-diagnostic support. Equally important are issues of equality and access, and the chapter covers several key areas, such as age, gender, sexual orientation, religion and spirituality, and rurality. Major challenges to old age psychiatry come from limited resources and non-recognition of the distinct needs of older adults, as well as the demands of the growing older population, advances in science and technology, and the need to attract talented psychiatrists into this field.

College of Aboriginal Education

1975 ◽  
Vol 3 (2) ◽  
pp. 3-10
Author(s):  
J.G. Ingram
Keyword(s):  
Aboriginal People ◽  
Aboriginal Education ◽  
Advanced Education ◽  
Tribal People ◽  
Positive Attitudes ◽  
Wide Range ◽  
Part Time ◽  
Set Up

The College of Aboriginal Education was set up in March 1973 within the Torrens College of Advanced Education, Adelaide, to provide an opportunity for adult Aboriginal people to continue their education in areas meaningful to them. It offers a highly individualized twelve month course which emphasizes the development of positive self concepts, an understanding of society and the development of positive attitudes to it, and the finding of satisfying employment.The students come from a wide range of backgrounds and include both tribal and non-tribal people. At present 45 students are enrolled. The staff includes both Aboriginals and Euro-Australians. The College makes use of a large number of part-time teachers, many of whom are Aboriginal, while other people, including both Aboriginals and non-Aboriginals expert in their own field, are brought in from time to time.

scholarly journals M111. QUANTITATIVE ASSESSMENT OF MANIA AND PSYCHOSIS DURING HOSPITALIZATION USING AUTOMATED ANALYSIS OF FACE, VOICE, AND LANGUAGE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S177-S177
Author(s):  
Can Kilciksiz ◽  
Katrina Brown ◽  
Alexandria Vail ◽  
Tadas Baltrusaitis ◽  
Luciana Pennant ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Assessment ◽  
Automated Analysis ◽  
Psychotic Symptoms ◽  
Quantitative Metrics ◽  
Wide Range ◽  
Access And Quality ◽  
Speech Transcription ◽  
Mood And Cognition ◽  
Clinical Measures

Abstract Background A major challenge for reliable and effective mental health care is the lack of objective markers of illness. Computational approaches to measuring naturalistic behavior in clinical settings could therefore provide an objective backstop for mental health assessment and disease monitoring. This study aimed to train machine-learning (ML) classifiers to estimate conventional clinical measures of severe mental illness using quantitative metrics derived from computational analysis of facial and vocal behaviors. Methods Individuals hospitalized for any active psychotic condition were recruited to participate in up to ten recorded study visits, comprised of three segments. Each visit was captured using two synchronized HD webcams and cardioid microphones, to obtain high quality audiovisual (AV) data from both patient and interviewer. We performed automated facial action coding, vocal analysis, and speech transcription using publicly available software (e.g., openFace, openSmile, TranscribeMe). Results A total of 34 participants, participated in 66 sessions between 2015 and 2018, resulting in over 40 hours of AV recordings. In our visual and vocal analysis, we found that several features derived from face, voice, and use of language (i.e. eyebrow furrowing, eye widening, smile variability, characteristics of vowels) were both robustly measured using our approach, and allowed us to accurately estimate multiple symptom domains (i.e. mania, depression, psychosis) with (R= >0.7, p = <0.05). In our linguistic analysis, we found that abundance of power words (i.e. superiority, important) and lack of contextual language (i.e. yesterday, nearby) are highly indicative of positive psychotic symptoms with (R= +0.417, p = 0.002) and (R= -0.302, p = 0.028) respectively. Discussion Automated analysis of face, voice, and speech provides a number of robust behavioral markers sensitive enough to detect changes in psychopathology within individuals over time. Therefore, naturalistic, quantitative assessments can yield objective markers of mood and cognition that can be used to optimize both access and quality of treatments for a wide range of psychiatric conditions.

scholarly journals 0553 Hallucinogen Use Among College and University Students: Associations with Insufficient Sleep and Insomnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A211-A212
Author(s):  
C Holbert ◽  
C Bastien ◽  
S c ◽  
W D Killgore ◽  
C C Wills ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Assessment ◽  
Poor Sleep ◽  
Insufficient Sleep ◽  
College And University ◽  
Falling Asleep ◽  
Wide Range ◽  
The Us ◽  
National College Health Assessment ◽  
College Health Assessment

Abstract Introduction Previous studies have shown that poor sleep is associated with alcohol use, smoking, and other substance use, especially among young adults. Yet, very little is known about hallucinogen use. Methods Data from the 2011-2014 National College Health Assessment were used (N=113,749), representing a wide range of students across the US. Hallucinogen use was reported as “never,” “past,” and “present” (reflecting use in the past 30 days). Students also self-reported nights/week they did not get enough sleep to feel rested (insufficient sleep), as well as nights/week they had difficulty falling asleep (initial insomnia). Responses for both were categorized as 0, 1-2, 3-4, 5-6, or 7 nights/week. Multinomial logistic regressions examined hallucinogen use as outcome (past or present vs never) and sleep as predictor, with adjustment for covariates (age, sex, race/ethnicity, and survey year) and mental health (past 30 days depression/anxiety). Results Hallucinogen use was infrequently reported, with 4.8% (N=5,493) reporting past use and 0.98% (N=1,119) reporting present use. In adjusted analyses, increase likelihood of past use was associated with insufficient sleep on 1-2 (RRR=1.28, p=0.001), 3-4 (RRR=1.37, p<0.0005), 5-6 (RRR=1.30, p<0.0005), and 7 (RRR=1.34, p<0.0005) nights per week, as well as 1-2 (RRR=1.30, p<0.0005), 3-4 (RRR=1.52, p<0.0005), 5-6 (RRR=1.58, p<0.0005), and 7 (RRR=1.49, p<0.0005) nights per week of initial insomnia. Present use was associated with 1-2 (RRR=1.44, p<0.0005), 3-4 (RRR=1.76, p<0.0005), 5-6 (RRR=2.05, p<0.0005), and 7 (RRR=1.83, p<0.0005) nights per week of initial insomnia. When mental health was entered into the model, results were maintained. Conclusion Past use of hallucinogens was associated with insufficient sleep as well as insomnia. Present use was also associated with insomnia. When mental health was included in models, all results were maintained. It is not clear whether hallucinogen use leads to, or is predicted by, sleep difficulties. Support Dr. Grandner is supported by R01MD011600

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