Emergency Department Psychiatry

2014 ◽  
Author(s):  
Amber Fossey
Keyword(s):  
Mental Illness ◽  
Emergency Services ◽  
Mental Health Problems ◽  
Acute Stress ◽  
Medically Unexplained Symptoms ◽  
Psychosocial Assessment ◽  
Acute Psychosis ◽  
Stress Reactions ◽  
Mind And Body ◽  
Self Harm

All doctors working in the ED will regularly meet patients with acute mental health problems. Five percent of total ED attendees are attrib­utable to mental disorder. With nationwide ED attendances averaging 400 000 per week during November to April 2013, the trend shows a growing pressure on emergency services. However, these figures repre­sent just the tip of the true burden of acute mental illness in our com­munities. Stigma, the healthcare funnel, and marginalization often mean that it is the sickest who finally present to the ED. It is also important to recognize the co-morbidity of mental illness and addictions in those seeking help for what initially appear to be physical complaints, as so often the mind and body are closely intertwined. Most common psychiatric presentations to the ED include DSH, alco­hol and substance misuse, delirium, acute psychosis, factitious disorders, medically unexplained symptoms (MUS), and acute stress reactions (such as to trauma). DSH is common but under-recognized. A quarter of people who die by suicide attended the ED in the preceding year. All patients in the ED presenting with self-harm should have a detailed psychosocial assessment. Alcohol is responsible for 0% of all ED attendances. It is also an independent variable, raising the risk of DSH. Substance users are also frequent attendees, with high levels of medical morbidity and mortality. Patients with a dual diagnosis of substance use plus mental illness fre­quently present with multiple psychosocial problems. Acute psychosis may be caused by a functional disorder, such as schizophrenia, but organic conditions must also be considered. Where a patient is extremely disturbed in the ED, restraint and sedation may be necessary to enable safe and adequate assessment. Security presence may also be required to minimize the risk of violence, where this has been identified. Implications for working in the ED are that all doctors should famil­iarize themselves with the management of common acute psychiatric presentations. Know how to access local Trust rapid tranquillization guidelines. Read NICE guidelines for management of self-harm. Seize opportunities to screen for mental illness and social problems.

The assessment of need in patients presenting to psychiatrists in the general hospital

2006 ◽  
Vol 23 (3) ◽  
pp. 92-95
Author(s):  
Larkin Feeney ◽  
Annette Kavanagh ◽  
Mary Mooney ◽  
Stephen Browne
Keyword(s):  
Mental Illness ◽  
General Hospital ◽  
Alcohol Problems ◽  
Psychosocial Assessment ◽  
Assessment Process ◽  
Psychotic Symptoms ◽  
Semi Group ◽  
Camberwell Assessment Of Need ◽  
Self Harm ◽  
Assessment Of Need

AbstractObjective: The evaluation of psychosocial need is an important part of the assessment of any patient who presents to a psychiatrist. The Camberwell Assessment of Need (CAN) instrument was developed for the systematic assessment of need in people with severe and enduring mental illness. Variations of the CAN have been developed for forensic, elderly and learning disability populations. Patients presenting to psychiatrists in the general hospital may also have different needs to those presenting to psychiatrists in other settings. We set out to examine whether the CAN would be useful in identifying needs in patients referred to psychiatrists in the general hospital with self-harm or alcohol problems.Method: Over a four-month period from September 2004 we prospectively assessed all patients with self-harm or alcohol problems referred to a liaison psychiatry service. We used the short version of the Camberwell Assessment of Need instrument (CANSAS) to assess psychosocial needs. Urgent referrals to a local psychiatric service of patients with severe enduring mental illness (SEMI) were assessed using identical methodology over the same time period and used as a comparison group.Results: Over the study period 53 patients with self-harm, 42 with alcohol problems and 45 with SEMI were assessed. Patients presenting with self-harm and alcohol problems had significantly fewer needs than those with SEMI (4.40 vs 3.98 vs 7.96, p < 0.001). Looking after the home, self-care, daytime activity, psychotic symptoms, safety to others and sexual expression needs were significantly greater in the SEMI group than in either the DSH or alcohol groups. Only safety to self-needs in the DSH group and alcohol needs in the alcohol group were significantly higher than in the SEMI group. The proportion of needs that were unmet was similar in each group.Conclusions: The CANSAS instrument identified some needs in deliberate self-harm and alcohol problem patients that might not have been identified during the course of a standard psychosocial assessment. It was easy to administer and as such was a useful addition to the assessment process. However the development of a more specific instrument for the assessment of need in these populations would be useful.

scholarly journals Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0245271
Author(s):  
Scott J. Fitzpatrick ◽  
Tonelle Handley ◽  
Nic Powell ◽  
Donna Read ◽  
Kerry J. Inder ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Information System ◽  
Retrospective Study ◽  
Mental Health Problems ◽  
Indigenous Australians ◽  
Service Utilisation ◽  
Health Seeking ◽  
Self Harm ◽  
Rural Australia

Background Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. Methods A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010–2015 from the National Coronial Information System. Results There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010–2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated. Conclusions Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.

Psychiatric Interventions for Prevention of Mental Disorders: A Psychosocial Perspective

1996 ◽  
Vol 12 (4) ◽  
pp. 604-617 ◽  
Author(s):  
Odd Steffen Dalgard ◽  
Tom Sørensen ◽  
Inger Sandanger ◽  
John Ivar Brevik
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Acute Stress ◽  
Health Problems ◽  
Social Disintegration ◽  
Preventive Work ◽  
Psychosocial Perspective

AbstractTechnology for psychiatric prevention is poorly developed, and knowledge about the causes of mental Illness is difficult to apply to practical preventive work. As it would take many years before the effects of primary preventive efforts would be visible, secondary and tertiary prevention are essential to reducing the prevalence of mental illness. Recent studies on reducing the negative health consequences of acute stress seem to justify some optimism that psychosocially-oriented prevention is possible. Experience with the preventive benefits of social support at times of crisis suggests that active social support can prevent social disintegration at the community level and mental health problems for individuals.

Stigmatisation of mental illness in the workplace: evidence and consequences

2013 ◽  
Vol 10 (02) ◽  
pp. 102-107 ◽  
Author(s):  
N. Bezborodovs ◽  
G. Thornicroft
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Everyday Life ◽  
Mental Health Problems ◽  
Self Esteem ◽  
Health Problems ◽  
Work Place ◽  
Stigma And Discrimination ◽  
Workplace Stigma

SummaryWork plays an important part in everyday life. For people experiencing mental health problems employment may both provide a source of income, improved self-esteem and stability, and influence the course and outcomes of the disorder. Yet in many countries the work-place consistently surfaces as the context where people with mental health problems feel stigmatised and discriminated the most. This paper will review the existing evidence of stigma and discrimination in the workplace, consider the consequences of workplace stigma on the lives of people experiencing mental health problems, and discuss implications for further action.

Socio Demographic and Clinical Profile of Indoor Female Patients of RINPAS

2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Relevant Information ◽  
Health Problems ◽  
High Rate ◽  
Physical And Mental Health ◽  
Cross Sectional

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient

scholarly journals Overview of CAPICE—Childhood and Adolescence Psychopathology: unravelling the complex etiology by a large Interdisciplinary Collaboration in Europe—an EU Marie Skłodowska-Curie International Training Network

2021 ◽  
Author(s):  
Hema Sekhar Reddy Rajula ◽  
Mirko Manchia ◽  
Kratika Agarwal ◽  
Wonuola A. Akingbuwa ◽  
Andrea G. Allegrini ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Interdisciplinary Collaboration ◽  
Adolescent Psychopathology ◽  
Childhood And Adolescence ◽  
Global Alliance ◽  
Dissemination Strategy ◽  
Health And Wellbeing ◽  
Hyperactivity Disorder

AbstractThe Roadmap for Mental Health and Wellbeing Research in Europe (ROAMER) identified child and adolescent mental illness as a priority area for research. CAPICE (Childhood and Adolescence Psychopathology: unravelling the complex etiology by a large Interdisciplinary Collaboration in Europe) is a European Union (EU) funded training network aimed at investigating the causes of individual differences in common childhood and adolescent psychopathology, especially depression, anxiety, and attention deficit hyperactivity disorder. CAPICE brings together eight birth and childhood cohorts as well as other cohorts from the EArly Genetics and Life course Epidemiology (EAGLE) consortium, including twin cohorts, with unique longitudinal data on environmental exposures and mental health problems, and genetic data on participants. Here we describe the objectives, summarize the methodological approaches and initial results, and present the dissemination strategy of the CAPICE network. Besides identifying genetic and epigenetic variants associated with these phenotypes, analyses have been performed to shed light on the role of genetic factors and the interplay with the environment in influencing the persistence of symptoms across the lifespan. Data harmonization and building an advanced data catalogue are also part of the work plan. Findings will be disseminated to non-academic parties, in close collaboration with the Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe).

Tobacco smoking and mental disorders in Australian adolescents

2021 ◽  
pp. 000486742110096
Author(s):  
David Lawrence ◽  
Sarah E Johnson ◽  
Francis Mitrou ◽  
Sharon Lawn ◽  
Michael Sawyer
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Tobacco Smoking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Major Depressive ◽  
Current Smoking ◽  
Self Harm ◽  
Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

scholarly journals Embitterment as a Specific Mental Health Reaction during the Coronavirus Pandemic

2021 ◽  
pp. 1-10
Author(s):  
Beate Muschalla ◽  
Clio Vollborn ◽  
Anke Sondhof
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Online Survey ◽  
Mental Health Problems ◽  
Affective State ◽  
Well Being ◽  
Health Problems ◽  
Social Consequences ◽  
High Rate ◽  
Perceived Injustice

<b><i>Introduction:</i></b> Embitterment can occur as a reaction to perceived injustice. During the pandemic and restrictions in daily living due to infection risk management, a range of many smaller or severe injustices have occurred. <b><i>Objective:</i></b> The aim of this study is to investigate what characterizes persons with high embitterment, mental illness, embitterment and mental illness, and those without embitterment or mental health problems. <b><i>Methods:</i></b> We conducted an online survey including persons from the general population in November 2020 and December 2020, the phase during which a second lockdown took place, with closed shops, restaurants, cultural and activity sites. 3,208 participants (mean age 47 years) gave self-ratings on their present well-being, burdens experienced during the pandemic, embitterment, wisdom, and resilience. <b><i>Results:</i></b> Embitterment occurred among 16% of the sample, which is a high rate in comparison with 4% during pre-pandemic times. Embitterment was weakly correlated with unspecific mental well-being. There were more persons with embitterment than those with embitterment and a mental health problem. Persons with embitterment reported less coronavirus-related anxiety than persons without embitterment. However, embittered persons reported more social and economic burdens and more frequent experiences of losses (job loss and canceling of medical treatments). Embittered persons perceive their own wisdom competencies on a similar level as persons with mental health problems or persons without mental health problems. <b><i>Conclusion:</i></b> Embitterment is a specific potentially alone-standing affective state, which is distinguishable from general mental health and coping capacities (here: wisdom). The economic and social consequences of pandemic management should be carefully recognized and prevented by policy.

Sign in / Sign up

Export Citation Format

Share Document