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 Mental health service activity during COVID-19 lockdown among individuals with Personality Disorders: South London and Maudsley data on services and mortality from January to May 2020

2020 ◽  
Author(s):  
Eleanor Nuzum ◽  
Evangelia Martin ◽  
Matthew Broadbent ◽  
Robert Stewart
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Personality Disorder ◽  
Health Service ◽  
Personality Disorders ◽  
Mental Healthcare ◽  
Health Service Provider ◽  
Data Resource ◽  
Face To Face ◽  
Early Intervention In Psychosis

The lockdown and social distancing policy imposed due to the COVID-19 pandemic is likely to have a widespread impact on mental healthcare for both services themselves and the people accessing those services. 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 first wave. However, there is a need to understand this further for specific groups, including those diagnosed with a personality disorder who might have particular vulnerabilities. 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 personality disorders across community, specialist, crisis and inpatient services. The report focussed on the period 1st January to 31st May 2020. We also report on daily accepted and discharged trust referrals, total trust caseloads and daily inpatient admissions and discharges for individuals with personality disorders. In addition, daily deaths are described for all current and previous SLaM service users with personality disorder 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. Liaison and Older Adult teams showed the largest drop in caseloads, whereas Early Intervention in Psychosis service caseloads remained the same. Reduced accepted referrals and inpatient admissions were observed and there was a 28% increase in average daily deaths in the period after 16th March, compared to the period 1st January to 15th March.

scholarly journals Using past and current data to estimate potential crisis service use in mental healthcare after the COVID-19 lockdown: South London and Maudsley data

2020 ◽  
Author(s):  
Robert Stewart ◽  
Matthew Broadbent
Keyword(s):  
Inpatient Care ◽  
Service Use ◽  
Mental Healthcare ◽  
Current Data ◽  
Treatment Team ◽  
Health Service Provider ◽  
Data Resource ◽  
Face To Face ◽  
Crisis Care ◽  
The Uk

AbstractThe lockdown policy response to the COVID-19 pandemic in the UK has a potentially important impact on provision of mental healthcare with uncertain consequences over the 12 months ahead. Past activity may provide a means to predict future demand. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource at the South London and Maudsley NHS Trust (SLaM; a large mental health service provider for 1.2m residents in south London), we carried out a range of descriptive analyses to inform the Trust on patient groups who might be most likely to require inpatient and home treatment team (HTT) crisis care. We considered the 12 months following UK COVID-19 lockdown policy on 16th March, drawing on comparable findings from previous years, and quantified levels of change in service delivery to those most likely to receive crisis care. For 12-month crisis days from 16th March in 2015-19, we found that most (over 80%) were accounted for by inpatient care (rather than HTT), most (around 75%) were used by patients who were current or recent Trust patients at the commencement of follow-up, and highest numbers were used by patients with a previously recorded schizophreniform disorder diagnosis. For current/recent patients on 16th March there had been substantial reductions in use of inpatient care in the following 31 days in 2020, more than previous years; changes in total non-inpatient contact numbers did not differ in 2020 compared to previous years, although there had been a marked switch from face-to-face to virtual contacts.

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 Impact of the first COVID-19 outbreak on mental health service utilisation at a Dutch mental health centre: retrospective observational study

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Man Wei Chow ◽  
Eric O. Noorthoorn ◽  
André I. Wierdsma ◽  
Marte van der Horst ◽  
Nini de Boer ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Psychotic Disorders ◽  
Health Centre ◽  
Diagnostic Category ◽  
Mental Healthcare ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Face To Face

Background Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking. Aims We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak. Method This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category. Results We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10−3) as the number of face-to-face out-patient contacts significantly decreased (B = −0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders. Conclusions Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.

Clinical risk assessment rating and all-cause mortality in secondary mental healthcare: the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) Case Register

2011 ◽  
Vol 42 (8) ◽  
pp. 1581-1590 ◽  
Author(s):  
C.-Y. Wu ◽  
C.-K. Chang ◽  
R. D. Hayes ◽  
M. Broadbent ◽  
M. Hotopf ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Healthcare ◽  
Research Centre ◽  
Case Register ◽  
All Cause Mortality ◽  
Unit Increase ◽  
Clinical Risk Assessment

BackgroundMental disorders are widely recognized to be associated with increased risk of all-cause mortality. However, the extent to which highest-risk groups for mortality overlap with those viewed with highest concern by mental health services is less clear. The aim of the study was to investigate clinical risk assessment ratings for suicide, violence and self-neglect in relation to all-cause mortality among people receiving secondary mental healthcare.MethodA total of 9234 subjects over the age of 15 years were identified from the South London and Maudsley Biomedical Research Centre Case Register who had received a second tier structured risk assessment in the course of their clinical care. A cohort analysis was carried out. Total scores for three risk assessment clusters (suicide, violence and self-neglect) were calculated and Cox regression models used to assess survival from first assessment.ResultsA total of 234 deaths had occurred over an average 9.4-month follow-up period. Mortality was relatively high for the cohort overall in relation to national norms [standardized mortality ratio 3.23, 95% confidence interval (CI) 2.83–3.67] but not in relation to other mental health service users with similar diagnoses. Only the score for the self-neglect cluster predicted mortality [hazard ratio (HR) per unit increase 1.14, 95% CI 1.04–1.24] with null findings for assessed risk of suicide or violence (HRs per unit increase 1.00 and 1.06 respectively).ConclusionsLevel of clinician-appraised risk of self-neglect, but not of suicide or violence, predicted all-cause mortality among people receiving specific assessment of risk in a secondary mental health service.

The Classification and Statistical Manual of Mental Health Concerns: A Proposed Practical Scientific Alternative to the DSM and ICD

2017 ◽  
Vol 58 (1) ◽  
pp. 93-114 ◽  
Author(s):  
Jeffrey Rubin
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Disorders ◽  
Health Service ◽  
Health Services ◽  
Service Provider ◽  
Health Service Provider ◽  
Statistical Manual ◽  
Health Concerns ◽  
Mental Health Concerns

The Classification and Statistical Manual of Mental Health Concerns ( CSM) is a proposed alternative to the Diagnostic and Statistical Manual of Mental Disorders ( DSM) and International Classification of Diseases ( ICD). In contrast to the DSM/ ICD overarching concept of “mental disorders,” the CSM’s overarching concept is “mental health concerns.” A mental health concern occurs when a person seeking mental health services expresses to a mental health service provider a concern about any of these topics: behavior, emotion, mood, meaning of life, death, dying, managing chronic pain, addiction, work, relationships, education, eating, cognition, sleep, and challenging life situations. The CSM begins from the perspective of the person seeking services and that is what would be classified in its manual. In addition to classifying mental health concerns, the CSM would describe a collaborative approach between the person expressing the concern and the mental health service provider for creating a psychological formulation narrative that eschews the DSM/ ICD pathologizing jargon. Compared with the DSM/ ICD approach, the use of the CSM potentially would be less stigmatizing, as well as more practical. Moreover, it would be more consistent with principles of science, eliminate the monopoly of the DSM/ ICD mental disorder approach for accessing mental health services, provide a new choice to both mental health service users and providers, challenge old ideas, stimulate fresh perspectives, and open new avenues of research.

Occupational health in mental health services: a qualitative study

2019 ◽  
Vol 13 (1) ◽  
pp. 32-44
Author(s):  
Jennifer Oates ◽  
Rasiha Hassan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Occupational Health ◽  
Lived Experience ◽  
Mental Healthcare ◽  
Working Environment ◽  
Small Scale ◽  
Structured Interviews ◽  
Content Type

Purpose The purpose of this paper is to explore occupational health (OH) clinicians’ perspectives on employee mental health in the mental health workplace in the English National Health Service. Design/methodology/approach Thematic analysis of data from seven semi-structured interviews is performed in this paper. Findings Three themes emerged under the core theme of “Situating OH services”: “the Uniqueness of the mental health service setting”, “the Limitations of OH services” and “the Meaning of mental health at work”. An important finding came from the first theme that management referrals in mental health may be due to disputes about workers’ fitness to face violence and aggression, a common feature of their working environment. Research limitations/implications This was a small scale study of a previously unresearched population. Practical implications These findings should be used to refine and standardise OH provision for mental healthcare workers, with a particular focus on exposure to violence and workers’ potential “lived experience” of mental illness as features of the mental health care workplace. Originality/value This is the first study to explore OH clinicians’ perspectives on the mental health service working environment.

scholarly journals The crucible of co-production: Case study interviews with Recovery College practitioner trainers

2019 ◽  
Vol 78 (8) ◽  
pp. 977-987
Author(s):  
Mark Dalgarno ◽  
Jennifer Oates
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Single Site ◽  
Future Research ◽  
Service Users ◽  
Structured Interviews

Objectives: This study explored healthcare professionals’ accounts of being practitioner trainers in a mental health Recovery College, where they worked with peer trainers, who were people with lived experience of mental illness, to co-produce workshops for mental health service users and staff. The aim of this study was to understand the process of co-production in the Recovery College from the perspective of practitioner trainers. Design: Single-site case study. Setting: A Recovery College in the South of England, open to staff and service users from one mental health care provider organisation. Methods: Semi-structured interviews with eight mental healthcare professionals. Transcripts were thematically analysed. Results: A central image of ‘the workshop as crucible’ emerged from the three themes derived from the analysis. Co-facilitating the workshop was a ‘structured’ encounter, within which health professionals experienced ‘dynamism’ and change. For them, this involved experiences of ‘challenge and discomfort’. Conclusion: Findings from this study contribute to the evidence base for the evaluation of Recovery Colleges by focusing on the training impact on staff. Findings suggest that taking on a trainer role in Recovery College co-production is beneficial for healthcare professionals as well as mental health service users, especially if healthcare professionals are open to the dynamism and possible discomfort of these workshop encounters. Future research, however, should expand beyond single-site case studies to test the extent to which this metaphor and themes are appropriate to describing the ‘transformative’ element of co-production.

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