scholarly journals Comparison of mental health service activity before and shortly after UK social distancing responses to the COVID-19 pandemic: February-March 2020

2020 ◽  
Author(s):  
Robert Stewart ◽  
Evangelia Martin ◽  
Ioannis Bakolis ◽  
Matthew Broadbent ◽  
Nicola Byrne ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Community Services ◽  
Home Treatment ◽  
Social Distancing ◽  
Face To Face ◽  
National Implementation ◽  
Before And After ◽  
Service Activity

This study sought to provide an early description of mental health service activity before and after national implementation of social distancing for COVID-19. A time series analysis was carried out of daily service-level activity on data from a large mental healthcare provider in southeast London, from 01.02.2020 to 31.03.2020, comparing activity before and after 16.03.2020: i) inpatient admissions, discharges and numbers, ii) contact numbers and daily caseloads (Liaison, Home Treatment Teams, Community Mental Health Teams); iii) numbers of deaths for past and present patients. Daily face-to-face contact numbers fell for liaison, home treatment and community services with incomplete compensatory rises in non-face-to-face contacts. Daily caseloads fell for all services, apart from working age and child/adolescent community teams. Inpatient numbers fell 13.6% after 16th March, and daily numbers of deaths increased by 61.8%.

scholarly journals Mental health service activity during COVID-19 lockdown among individuals with potential neurodevelopmental disorders: South London and Maudsley data on services and mortality from January to July 2020

2020 ◽  
Author(s):  
Evangelia Martin ◽  
Eleanor Nuzum ◽  
Matthew Broadbent ◽  
Robert Stewart
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Neurodevelopmental Disorders ◽  
Mental Healthcare ◽  
Home Treatment ◽  
Treatment Team ◽  
Health Service Provider ◽  
Data Resource ◽  
Face To Face

AbstractThe lockdown and social distancing policy imposed due to the COVID-19 pandemic is likely to have had a widespread impact on mental healthcare service provision and use. Previous reports from the South London and Maudsley NHS Trust (SLaM; a large mental health service provider for 1.2m residents in South London) highlighted a shift to virtual contacts among those accessing community mental health and home treatment teams and an increase in deaths over the pandemic’s first wave. However, there is a need to quantify this for individuals with particular vulnerabilities, including those with learning disabilities and other neurodevelopmental disorders. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource with 24-hourly updates of electronic mental health records data, this paper describes daily caseloads and contact numbers (face-to-face and virtual) for individuals with potential neurodevelopmental disorders across community, specialist, crisis and inpatient services. The report focussed on the period 1st January to 31st July 2020. We also report on daily accepted and discharged trust referrals, total trust caseloads and daily inpatient admissions and discharges for individuals with potential neurodevelopmental disorders. In addition, daily deaths are described for all current and previous SLaM service users with potential neurodevelopmental disorders over this period. In summary, comparing periods before and after 16th March 2020 there was a shift from face-to-face contacts to virtual contacts across all teams. The largest declines in caseloads and total contacts were seen in Home Treatment Team, Liaison/A&E and Older Adult teams. Reduced accepted referrals and inpatient admissions were observed and there was an 103% increase in average daily deaths in the period after 16th March, compared to the period 1st January to 15th March (or a 282% increase if the 2-month period from 16th March to 15th May was considered alone).

scholarly journals Mental health service activity during COVID-19 lockdown: South London and Maudsley data on working age community and home treatment team services and mortality from February to mid-May 2020

2020 ◽  
Author(s):  
Robert Stewart ◽  
Evangelia Martin ◽  
Matthew Broadbent
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Healthcare ◽  
Home Treatment ◽  
Treatment Team ◽  
Health Service Provider ◽  
Data Resource ◽  
Face To Face ◽  
Working Age

AbstractThe lockdown and social distancing policy response to the COVID-19 pandemic in the UK has a potentially important impact on provision of mental healthcare; however, there has been relatively little quantification of this. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource with 24-hourly updates of electronic mental health records data, this paper describes daily caseloads and contact numbers (face-to-face and virtual) for home treatment teams (HTTs) and working age adult community mental health teams (CMHTs) from 1st February to 15th May 2020 at the South London and Maudsley NHS Trust (SLaM), a large mental health service provider for 1.2m residents in south London. In addition daily deaths are described for all current and previous SLaM service users over this period and the same dates in 2019. In summary, comparing periods before and after 16th March 2020 the CMHT sector showed relatively stable caseloads and total contact numbers, but a substantial shift from face-to-face to virtual contacts, while HTTs showed the same changeover but reductions in caseloads and total contacts (although potentially an activity rise again during May). Number of deaths for the two months between 16th March and 15th May were 2.4-fold higher in 2020 than 2019, with 958 excess deaths.

scholarly journals Generic clozapine: outcomes after switching formulations

2006 ◽  
Vol 189 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Carol Paton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Clinical Outcomes ◽  
Clinical Global Impression ◽  
Severity Of Illness ◽  
Clinical Deterioration ◽  
Change Scores ◽  
Before And After ◽  
The Uk

SummaryTwo generic preparations of clozapine have been licensed in the UK. The bioequivalence of these products compared with Clozaril® has not been unequivocally demonstrated. Clinical equivalence has also been questioned. The objective of this study was to determine clinical outcomes for all patients switched from Clozaril® to a generic formulation in one mental health service. We examined dosage data and Clinical Global Impression (CGI) of Severity of Illness scores for 337 patients before and after the switch and CGI change scores after the switch. There was no evidence of clinical deterioration or need to use higher dosages. Generic clozapine is not inferior to Clozaril®.

scholarly journals Clinical activity within a specialist mental health service for deaf people: comparison with a general psychiatric service

2003 ◽  
Vol 27 (10) ◽  
pp. 375-377 ◽  
Author(s):  
Jim Appleford
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Psychiatric Service ◽  
Bipolar Affective Disorder ◽  
Community Services ◽  
Patient Treatment ◽  
Clinical Activity ◽  
Deaf People ◽  
Specialist Mental Health Service

Aims and Method This paper compares the case mix and clinical activity in a specialist mental health service for deaf people within a general psychiatric population, using ICD–10 diagnostic criteria. Results Out-patient and in-patient caseloads differ between the two services: 27% of the deaf out-patient caseload have schizophrenia, schizotypal and delusional disorders (compared with 19% of hearing patients) and 19% have neurotic, stress-related and somatoform disorders (compared with 8% of hearing patients). The general psychiatric service out-patient case-load had rates of 8% and 43% for bipolar affective disorder and unipolar depression, respectively, compared with 3% and 17% in the deaf group. Deaf patients have a mean length of stay of 59 days, compared with 30 days for the hearing group. In-patient treatment accounts for 89% of the annual treatment cost for the deaf patient population. Clinical Implications Expansion of community services for deaf people as recommended by a recent Health Advisory Service report could reduce admission rates for deaf patients, delivering treatment benefits and cost savings.

scholarly journals Three months in the life of a community mental health team

1994 ◽  
Vol 18 (10) ◽  
pp. 615-617 ◽  
Author(s):  
Jan Scott ◽  
Sara McCluskey ◽  
Lesley Smith
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Psychotic Disorders ◽  
Community Services ◽  
Community Mental Health Team ◽  
Community Based ◽  
Mental Health Team ◽  
Referral Patterns ◽  
Health Team

An audit was undertaken to assess the efficacy and efficiency of a community-based mental health service which attempts to prioritise the care of those with severe and enduring disorders. Referral patterns over a three month period and change in case-load over the subsequent 12 months were recorded. Seventy-five per cent of new referrals met the priority group criteria, allaying anxieties that community services unceasingly get drawn to the care of those with less severe disorders. Furthermore, at 12 months the service had maintained contact with all patients previously admitted to hospital and all those presenting with psychotic disorders (27% referrals). Some changes in service structure are also suggested as a result of this evaluation.

The Effect of a New Integrated Mental Health Service on Hospitalisation

1997 ◽  
Vol 31 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Graham W. Mellsop ◽  
George W. Blair-West ◽  
Vasanthi Duraiappah
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Length Of Stay ◽  
Health Service ◽  
Average Length ◽  
Average Length Of Stay ◽  
Lengths Of Stay ◽  
Before And After ◽  
Cumulative Length ◽  
Integrated Mental Health

Objective: The purpose of the present study was to partially evaluate a new integrated mental health service by monitoring inpatient lengths of stay. We hypothesised that the median cumulated length of stay for inpatients would decrease, and that the frequency of readmissions would not increase. Method: Data was collected for two 6-month periods before and after the introduction of an integrated mental health service (IMHS). Two functionally identical wards (G and E) were studied. Ward G was then integrated with the regional community psychiatry service, while Ward E remained non-integrated. Results: Following integration, the median cumulative length of stay in the IMHS's Ward G was more than halved in comparison with both its own baseline and with the non-integrated ward. The average length of stay of overdose patients at the regional general hospital that was serviced by the IMHS was also reduced from 2.6 days to 1.5 days. The non-IMHS ward had a non-significant increase in admissions and no change in cumulative length of stay. Conclusion: The hypotheses of this study were supported by the results. Twelve beds were subsequently closed as a result of the efficiencies generated by integration. These findings support the model of true integration trialled here.

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