scholarly journals Understanding liaison psychiatry commissioning: an observational study

2020 ◽  
Vol 25 (4) ◽  
pp. 301-316
Author(s):  
Matt Fossey ◽  
Lauren Godier-McBard ◽  
Elspeth A. Guthrie ◽  
Jenny Hewison ◽  
Peter Trigwell ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Clinical Information ◽  
Design Development ◽  
Liaison Psychiatry ◽  
Content Type ◽  
Care Systems ◽  
Survey Responses

Purpose The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals. Design/methodology/approach Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98). Findings Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern. Research limitations/implications There were a small number of survey respondents (n = 98). The sampling used an opportunistic framework that targeted commissioner and clinician forums. Using an opportunistic framework, the sample may not be representative. Additionally, multiple pairwise comparisons were conducted during the analysis of the survey responses, increasing the risk that significant results were found by chance. Practical implications A number of steps were identified that could be applied in practice. These mainly related to the importance of collecting and communicating data and co-production with commissioners in the design, development and monitoring of liaison psychiatry services. Originality/value This is the first study that has specifically considered the challenges associated with the commissioning of liaison psychiatry services.

scholarly journals COVID-19, psychosocial issues, politics, and public mental health care

2021 ◽  
Vol 51 (2) ◽  
pp. 293-303
Author(s):  
Anthony L Pillay ◽  
Anne L Kramers-Olen
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Systems ◽  
Mental Health Policy ◽  
Public Mental Health ◽  
The Public ◽  
Care Systems ◽  
Public Mental Health Care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

Attitudes of British Psychiatrists to the Diagnosis of Somatisation Disorder

1993 ◽  
Vol 162 (4) ◽  
pp. 463-466 ◽  
Author(s):  
Julian Stern ◽  
Michael Murphy ◽  
Christopher Bass
Keyword(s):  
Health Care ◽  
North American ◽  
Health Care Systems ◽  
Postal Questionnaire ◽  
Liaison Psychiatry ◽  
Diagnostic Practices ◽  
Somatisation Disorder ◽  
Icd 10 ◽  
Care Systems ◽  
The Difference

A postal questionnaire was sent to 195 senior British psychiatrists who were asked about their attitudes towards the DSM-III-R diagnosis of somatisation disorder (SD) and the ICD-10 diagnosis of multiple somatisation disorder. Of the 148 respondents, 98 (66%) had experience of liaison psychiatry, and these psychiatrists used the diagnosis significantly more often than those without liaison sessions. More than half the respondents perceived SD as both a personality disorder and a mental state disorder, although 27% thought that patients with SD had an undiagnosed physical disease. The marked discrepancy between British and North American psychiatrists in diagnostic practices was perceived to be a consequence of both the difference in health care systems and the interest shown in the disorder by North American psychiatrists, rather than a reflection of genuine differences in prevalence.

scholarly journals Long-term hospital attendance of children and adults who have undergone removal of normal or inflamed appendices

2002 ◽  
Vol 181 (6) ◽  
pp. 526-530 ◽  
Author(s):  
Nicola J. Dummett ◽  
Nicola J. Maughan ◽  
Anne Worrall-Davies
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Attendance Rates ◽  
Liaison Psychiatry ◽  
Abdominal Symptoms ◽  
Secondary Health Care ◽  
Care Systems ◽  
Self Harm ◽  
Males And Females

BackgroundEarly studies suggested that presentations with unexplained acute abdominal pain were associated with increased long-term rates of hospital attendance and self-harm, especially in women, but few studies were large enough for definitive findings.AimsTo test the hypothesis that such presentations are followed by higher long-term utilisation rates of secondary health care even excluding further abdominal symptoms, and particularly for self-harm, than presentations with acute appendicitis.MethodNew hospital attendance rates, liaison psychiatry attendances and self-harm attendances of patients with normal appendices at emergency appendicectomy were compared with those of appendicitis patients.ResultsAttendance rates of all kinds were significantly higher for normal appendix patients than for appendicitis patients, with equal strengths of finding for males and females.ConclusionsPeople with normal appendices at emergency appendicectomy show higher long-term rates of hospital attendance. This has implications for how these patients are best managed by health care systems.

scholarly journals Patient Rounds With Video-Consulted Relatives: Qualitative Study on Possibilities and Barriers From the Perspective of Healthcare Providers (Preprint)

2018 ◽  
Author(s):  
Christina Østervang ◽  
Lene Vedel Vestergaard ◽  
Karin Brochstedt Dieperink ◽  
Dorthe Boe Danbjørg
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
New Technology ◽  
Work And Family ◽  
Focus Group Interviews ◽  
Work Routines ◽  
Care Systems ◽  
Group Interviews

BACKGROUND In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. OBJECTIVE This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. METHODS The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. RESULTS Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. CONCLUSIONS This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.

scholarly journals Forum: equity in access to health care. Introduction

2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
Care Access ◽  
Unethical Practices ◽  
Access To Health ◽  
Care Systems ◽  
Equity In Access

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.

Separate or integrated services?

2021 ◽  
pp. 439-448
Author(s):  
Sofie Bäärnhielm ◽  
Mike Mösko ◽  
Aina Basilier Vaage
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Systems ◽  
Integrated Services ◽  
Explanatory Models ◽  
Post Traumatic Stress ◽  
Immigrants And Refugees ◽  
Care Systems ◽  
Health Promoting

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.

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