scholarly journals Quality of prescribing of antipsychotic medication for people with intellectual disability under the care of UK mental health services: a cross-sectional audit of clinical practice

BMJ Open ◽  
2016 ◽  
Vol 6 (12) ◽  
pp. e013116 ◽  
Author(s):  
Carol Paton ◽  
Sumera Bhatti ◽  
Kiran Purandare ◽  
Ashok Roy ◽  
TRE Barnes
Author(s):  
Tella Lantta ◽  
Minna Anttila ◽  
Maritta Välimäki

Abstract Background This article aims to review the quality of mental health services and the rights of the people receiving treatment in inpatient hospital care in Finland using the World Health Organization’s QualityRights Tool Kit as a part of a randomized controlled trial VIOLIN. So far, reports on the QualityRights Tool Kit have mainly been from low- and middle-income countries or countries lacking resources for health services. Reports from countries with well-resourced health care systems, such as the Nordic countries, are still quite few. Methods A cross-sectional observational survey was conducted on 13 closed inpatient psychiatric wards (acute, rehabilitation, forensic psychiatric) at eight hospitals in Finland. The data for the survey were gathered through a document review, observations, and group interviews among staff members, service users and family members. The STROBE checklist for cross-sectional studies was followed in the reporting. Results Finnish mental health services are partially or fully achieving the standards set by the WHO QualityRights Tool Kit (final scores: 2.5–2.9 out of 3). The highest final score out of the five themes (2.9/3) was achieved under Freedom from torture or cruel, inhuman or degrading treatment or punishment and from exploitation, violence and abuse. The lowest final score out of the five themes (2.5/3) was achieved under the right to exercise legal capacity and the right to personal liberty and the security of person. Conclusions According to the findings, Finnish mental health services appear to be of high quality. However, we have identified some gaps in quality, which we have addressed in a national randomized controlled trial VIOLIN. Improvements can be realized through shared decision making and relaying information to service users.


2021 ◽  
Vol LII (3) ◽  
pp. 30-34
Author(s):  
Anna L. Bitova ◽  
Anna A. Portnova ◽  
Yury P. Sivolap ◽  
Oksana A. Kolomina ◽  
Artem Yu. Novikov ◽  
...  

Aim. The aim of this study was to analyze the main problems of provision of mental health services in orphanages for children with neurodevelopmental disabilities in Russia. Methods. A cohort cross-sectional study was conducted in 23 orphanages, in which 2853 pupils live. Results. There was determined a structure of psychotic disorders among children of psycho-neurological orphanages. Prevalence of mental disorders among this group was: mild intellectual disability 56 (1.96%) people, moderate intellectual disability 967 (33.89%), severe intellectual disability 1079 (37.82%), profound intellectual disability 429 (15.04%). Clinical and psychopathological examination of 1730 pupils was carried out. The most prominent problems of psychiatric care in in orphanages for children with neurodevelopmental disabilities were identified as: inconsistency of the psychiatric diagnosis and the actual condition of the child 289 (16.71%), a mismatch between the prescribed psychopharmacotherapy and the clinical picture 378 (21.85%), polypharmacy 344 (19.88%, or 35.61% of all receiving psychopharmacotherapy). Conclusion. The necessity of developing non-pharmacological approaches in tackling the problems associated with the provision of mental health services in orphanages was shown.


2012 ◽  
Vol 201 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
Sube Banerjee ◽  
Noel Collins ◽  
Adrian Treloar ◽  
Samantha M. McIntyre ◽  
...  

BackgroundUp to a quarter of people in the UK with a diagnosis of dementia are prescribed an antipsychotic in any year. The potential risks of such treatment are becoming clearer, but the benefits remain uncertain. Concern about the frequency and quality of such prescribing was expressed in the National Dementia Strategy for England in 2009.AimsTo provide an estimate of the prevalence of antipsychotic use for dementia in secondary mental health services in the UK and to collect data relevant to quality improvement initiatives for such prescribing practice.MethodIn the context of a UK quality improvement programme, relevant clinical audit data were collected for patients with dementia under the care of specialist older people's mental health services.ResultsFifty-four mental health National Health Service (NHS) trusts submitted data on 10 199 patients. Of those patients without comorbid psychotic illness, 1620 (16%) were prescribed an antipsychotic; the common clinical indications for such medication were agitation, psychotic symptoms, aggression and distress. Multivariable regression found younger age, care home or in-patient setting, vascular or Parkinson's disease dementia and greater severity of dementia to be all significantly associated with being prescribed antipsychotic medication. Of the 1001 (62%) patients prescribed treatment for more than 6 months, only three-quarters had a documented review of therapeutic response in the previous 6 months.ConclusionsThe data reveal areas of relatively good current practice, including consideration of alternatives to antipsychotic medication and clear documentation of target symptoms. They also suggest areas for improvement, such as the frequency and quality of review of long-term medication. Strategies to reduce antipsychotic use should take account of the demographic and clinical variables predicting increased likelihood of antipsychotic prescription.


2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.


2021 ◽  
Author(s):  
Nurun Layla Chowdhury

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.


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