An Expert Delphi study to derive a tool for mental health triage in emergency departments

2019 ◽  
pp. emermed-2018-208388 ◽  
Author(s):  
Anna J Mackway-Jones ◽  
Kevin C Mackway-Jones
Keyword(s):  
Mental Health ◽  
Delphi Study ◽  
Mental Health Problems ◽  
Delphi Panel ◽  
Mental Health Crisis ◽  
Physical And Mental Health ◽  
Health Crisis ◽  
Consensus Statements ◽  
Self Harm ◽  
Harm To Others

ObjectiveThis study aimed to investigate and collate the opinions of experts regarding the triage of patients in mental health crisis presenting to EDs.DesignA three-round e-Delphi study was conducted between November 2017 and April 2018. The panel of 28 representative experts were drawn from six stakeholder groups. 23 of the panel were clinicians working in England, while 5 were international triage experts.ResultsExperts generated 173 statements in six topic areas in the first round. 32 of these statements reached consensus in round 2. A further 20 statements reached consensus in round 3, leaving 121 statements that did not reach consensus. The consensus statements were used to develop a structured five-level triage tool where the highest level of priority was assigned to patients exhibiting extreme aggression or agitation, those requiring restraint, those at immediate risk of leaving before assessment and those who presented a high risk of self-harm or harm to others. At lower triage priorities, other factors, such as items of psychiatric history, collateral history, observations and judgements, have been identified.ConclusionsA broadly based, multispecialty, multiprofessional expert Delphi panel has reached consensus on 52 statements concerning the triage of patients presenting in mental health crisis to EDs. The triage tool derived from this work can be used to inform the design of triage instruments employed to prioritise patients with physical and mental health problems equitably.

scholarly journals The profundity of mental health during the COVID-19 pandemic

2021 ◽  
Vol 10 (2) ◽  
pp. 104-105
Author(s):  
Avilasha Singh
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
The Future ◽  
Physical Health Problems

Mental health has always been stigmatised and overlooked. Since, anxiety and stress are natural responses while facing a threat of new diseases. Hence, this pandemic has shown us the importance of mental health. During this time there have been many triggers that have caused repercussions in people’s mental health. Mental health crisis is on the rise. So, it is important to be able to tackle mental health problems as effectively as physical health problems, not only now but in the future as well, once and for all.

scholarly journals COVID-19: Emergence of Mental Health Upheaval and Transition in Human Future Perspectives: A Qualitative Study

2020 ◽  
Vol 2 (6) ◽  
pp. 94-100
Author(s):  
Saba Khurshid ◽  
Sidra Mumtaz ◽  
Hafsa Khalil Toor ◽  
Rubina Hanif
Keyword(s):  
Mental Health ◽  
General Population ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Psychological Services ◽  
Mental Health Crisis ◽  
Future Perspectives ◽  
Health Crisis ◽  
Major Transition

The outbreak of COVID-19 pandemic is constantly posing warning and creating mental health crisis among people without any discrimination. Therefore, the current study purpose is to explore mental health upheaval and transition in future perspectives due to COVID-19. Using exploratory study design, semi structure interviews were conducted. Interviews were recorded, transcribed and analyzed by using Thematic Content Analysis. The major themes which were identified showed that COVID-19 is constantly eliciting panic and mental health issues such as anxiety, stress, and depression, fears of death, xenophobia, OCD and uncertainty about future among general population. Results also indicated the major transition in public future perspectives and perception. Concern related to adjustability in life after pandemic is major emerging future concern among Pakistani People. During pandemic outbreak, people are becoming vulnerable to different mental health problems. To overcome these issues successfully, role of mental health professionals cannot be denied. There is strong need to devise activities and strategies which help people to increase resilience and build strong relationships during the period of social distancing. This paper gives a deep insight into mental health problems among general population due to COVID-19 and it also implicates need of psychological services to overcome these issues.

scholarly journals Care-pathways for patients presenting to emergency ambulance services with self-harm: national survey

2020 ◽  
pp. emermed-2019-208967
Author(s):  
Mohammed Gaber Zayed ◽  
Victoria Williams ◽  
Alexander Charles Glendenning ◽  
Jenna Katherine Bulger ◽  
Tom Hewes ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Admissions ◽  
Psychosocial Assessment ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Alternative Pathways ◽  
Mental Health Patients ◽  
Emergency Ambulance ◽  
Self Harm ◽  
The Uk

BackgroundSelf-harm is among the top five causes of acute hospital admissions and ambulance clinicians are often the first point of contact. However, the Emergency Department (ED) may not be the most appropriate place of care and little is known about the existence or nature of alternative pathways available to UK ambulance services. This survey describes the current management pathways used by ambulance services for patients who have self-harmed.MethodsA structured questionnaire was sent to all UK ambulance services by email and followed up by telephone in 2018. Three independent researchers (two clinical) coded responses which were analysed thematically.ResultsAll 13 UK ambulance services responded to the survey: nine by email and four by telephone interview. Two services reported a service-wide protocol for managing people presenting with self-harm, with referral to mental health crisis team available as an alternative to conveyance to ED, following on-scene psychosocial assessment. Four services reported local pathways for managing mental health patients which included care of patients who had self-harmed. Four services reported being in the process of developing pathways for managing mental health patients. Six services reported no service-wide nor local pathways for managing self-harm patients. No robust evaluation of new care models was reported.ConclusionPractice in ambulance services in the UK is variable, with a minority having a specific clinical pathway for managing self-harm, with an option to avoid ED. New pathways for patients who have self-harmed must be evaluated in terms of safety, clinical and cost-effectiveness.

What Twitter Can Tell Us About User Experiences of Crisis Text Lines: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Alanna Coady ◽  
Keeley Lainchbury ◽  
Rebecca Godard ◽  
Susan Holtzman
Keyword(s):  
Mental Health ◽  
Text Messaging ◽  
Mental Health Problems ◽  
Health Problems ◽  
Research Literature ◽  
Mental Health Crisis ◽  
User Experiences ◽  
Health Crisis ◽  
Crisis Services ◽  
Communication Modalities

BACKGROUND Mental health problems are the leading cause of disability worldwide. Despite the prevalence and cost of mental illness, there are insufficient health services to meet this demand. Crisis hotlines have a number of advantages for addressing mental health challenges and reducing barriers to support. Further, mental health crisis services have recently expanded beyond telephone hotlines to include other communication modalities such as crisis chat and text messaging services, largely in response to the increased use of mobile phones and text messaging for social communication. OBJECTIVE Despite the high uptake of crisis text line services (CTLs) and rising mental health problems worldwide, CTLs remain understudied. Thus the current study aimed to address an urgent need to evaluate user experiences with text-based crisis services. METHODS The current study explored user experiences of CTLs by accessing users’ publicly available Twitter posts that describe personal use and experience with CTLs. Data were qualitatively analysed using inductive thematic analysis. RESULTS Six main themes were identified from 776 tweets: (1) approval of CTLs, (2) helpful counselling, (3) invalidating or unhelpful counselling, (4) problems with how the service is delivered, (5) features of the service that facilitate accessibility, and (6) indication that the service suits multiple needs. CONCLUSIONS Overall, there was strong evidence to support the value of text-based crisis support, as many users reported positive experiences of effective counselling that provided helpful coping skills, de-escalation, and reduction of harm. Results also identified areas in need of improvement, particularly ensuring more timely service delivery and effective communication of empathy and support. Text-based services may require targeted training to apply methods that effectively convey empathy in this medium. Moving forward, CTL services will require systematic attention in the clinical research literature to ensure their continued success and popularity among users.

scholarly journals Mental Health Crisis and Stress Coping among Healthcare College Students Momentarily Displaced from Their Campus Community Because of COVID-19 Restrictions in Japan

2021 ◽  
Vol 18 (14) ◽  
pp. 7245
Author(s):  
Masatoshi Tahara ◽  
Yuki Mashizume ◽  
Kayoko Takahashi
Keyword(s):  
Mental Health ◽  
College Students ◽  
Health Status ◽  
Mental Health Problems ◽  
General Health Questionnaire ◽  
Health Problems ◽  
Poor Mental Health ◽  
Stress Coping ◽  
Mental Health Crisis ◽  
Health Crisis

College students are one of the most affected groups by self-quarantine due to COVID-19, as they may live in loneliness and anxiety, increasing their risk of mental health crisis. This study aimed to identify risk factors for poor mental health and stress coping strategies among healthcare college students during the COVID-19 pandemic in Japan. A cross-sectional survey was conducted over 7 consecutive days starting on 28 April 2020 using a web-based questionnaire. The survey assessed socioeconomic characteristics and the General Health Questionnaire-12 score, self-reported health status, anxiety, and satisfaction with daily life, work, leisure, and new activities. Approximately 70% of 223 respondents had poor mental health. Less communication with friends was the main risk factor for mental health problems. Good health status and satisfaction with leisure and new activities were associated with reduced risk of mental health problems. Students with poor mental health tended to seek social support as a stress coping strategy. This study showed that the mental health of students declined during self-quarantine, and loneliness could be the major reason. There is a need for a new form of communication and learning that deals with the isolation and loneliness of students, especially for students living alone.

scholarly journals A Multicenter Study of Short-Term Changes in Mental Health Emergency Services Use During Lockdown in Kitchener-Waterloo, Ontario During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Christopher Dainton ◽  
Simon Donato-Woodger ◽  
Charlene Chu
Keyword(s):  
Mental Health ◽  
Emergency Services ◽  
Suicide Attempts ◽  
Mental Health Crisis ◽  
Short Term ◽  
Health Crisis ◽  
Waterloo Region ◽  
Self Harm ◽  
Ed Visits ◽  
Services Use

Abstract Background The COVID-19 pandemic and subsequent lockdown measures have led to increasing mental health concerns in the general population. We aimed to assess the short-term impact of the pandemic lockdown on mental health emergency services use in the Kitchener-Waterloo region of Ontario, Canada. Methods We conducted an observational study during the 6-month period between March 5 and September 5, 2020 using National Ambulatory Care Reporting System metadata from mental health visits to three regional Emergency Departments (ED); mental health and substance related police calls; and calls to a regional mental health crisis telephone line, comparing volumes during the pandemic lockdown with the same period in 2019. Poisson regressions were used to determine significant differences between numbers of each visit or call type during the lockdown period versus the previous year. Results Involuntary admissions, substance related visits, mood related visits, situational crisis visits, and self-harm related mental health visits to the EDs were significantly reduced during the lockdown period compared to the year before. Psychosis-related and alcohol-related visits were not significantly reduced. Among police calls, suicide attempts were significantly decreased during the period of lockdown, but intoxication, assault, and domestic disputes were not significantly different. Mental health crisis telephone calls were significantly decreased during the lockdown period. Conclusions Contrary to our hypothesis, the decrease in most types of mental health ED visits, mental health and substance-related police calls, and mental health crisis calls largely mirrored the overall decline in emergency services usage during the lockdown period. This finding is unexpected in the context of increased attention to acutely deteriorating mental health during the COVID-19 pandemic.

scholarly journals Drayton Park, an alternative to hospital admission for women in acute mental health crisis

2000 ◽  
Vol 24 (3) ◽  
pp. 101-104 ◽  
Author(s):  
Helen Killaspy ◽  
Joy Dalton ◽  
Shirley McNicholas ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Hospital Admission ◽  
Mental Health Problems ◽  
Clinical Implications ◽  
Mental Health Crisis ◽  
Safe Alternative ◽  
Health Crisis ◽  
Case Files ◽  
The Uk ◽  
Depressive Episodes

Aims and MethodTo describe Drayton Park, the first women-only residential mental health crisis facility in the UK and to investigate whether it is succeeding in its remit of providing a viable alternative to hospital admission. We randomly selected case files from 100 women admitted to Drayton Park since its opening and examined variables including demographic details, the reasons for referral, diagnosis and the source of referral.ResultsOur findings show that the service is able to respond quickly to referrals and appears to be functioning safely. The women admitted have a relatively short length of stay, half suffer from depressive episodes and one-third have a relapse of schizophrenia or bipolar disorder.Clinical ImplicationsThis project appears to be succeeding in providing a safe alternative to hospital admission for women with severe and enduring mental health problems.

The Mental Health Acute Assessment Team: a collaborative approach to treating mental health patients in the community

2017 ◽  
Vol 25 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Steven C Faddy ◽  
Kevin J McLaughlin ◽  
Peta T Cox ◽  
Senthil S Muthuswamy
Keyword(s):  
Mental Health ◽  
Primary Outcome ◽  
Proof Of Concept ◽  
Mental Health Crisis ◽  
Physical And Mental Health ◽  
Model Of Care ◽  
Community Based ◽  
Health Crisis ◽  
Appropriate Care ◽  
Mental Health Patients

Objective: Many models of community-based mental health crisis teams have been reported. We present our experience of an outreach team made up of a paramedic and mental health nurse. Methods: A proof-of-concept was conducted in Western Sydney. The primary outcome was the proportion of patients where the team were able to facilitate the most appropriate care. Results: Nearly 70% of patients were able to be treated outside the Emergency Department, with about two-thirds being transported directly to a mental health facility. Conclusion: We have demonstrated that our model of care is successful in enabling appropriate physical and mental health care for patients suffering an acute mental health crisis.

The Immediate Physical and Mental Health Crisis in Residents Proximal to the Evacuation Zone After Japan's Nuclear Disaster: An Observational Pilot Study

2014 ◽  
Vol 8 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Masaharu Tsubokura ◽  
Kazuo Hara ◽  
Tomoko Matsumura ◽  
Amina Sugimoto ◽  
Shuhei Nomura ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Power Plant ◽  
Nuclear Power Plant ◽  
Nuclear Power ◽  
Clinical Parameters ◽  
Mental Health Crisis ◽  
Physical And Mental Health ◽  
Health Crisis ◽  
Nuclear Disaster

AbstractObjectiveThe 2011 earthquake and Fukushima nuclear disaster in Japan have had devastating effects on residents near the damaged nuclear power plant, but quantifying its effect on their health has been difficult.MethodsAmong the 564 residents of Iitate Village and Soma City who enrolled in this study, we evaluated the changes of clinical parameters in 155 participants who underwent annual health evaluations in the previous year and after the earthquake. Psychological distress was also measured by using patient health questionnaire 9 (PHQ-9).ResultsParticipants (median age, 64 years) showed significant post-disaster increases in body weight, body mass index, systolic and diastolic blood pressure, blood glucose levels, and triglyceride levels. PHQ-9 scores of 10 or greater were found in 12% of the subjects, indicating that a substantial number had major depression.ConclusionsThe findings in this study showed substantial deterioration in clinical parameters related to lifestyle diseases and the presence of general psychological distress among residents living near the damaged nuclear power plant after the Fukushima Daiichi disaster. In addition to controlling the levels of radiation exposure, aggressive management of immediate physical and mental health crisis for residents may be necessary in future nuclear accidents. (Disaster Med Public Health Preparedness. 2014;0:1–7)

Leveraging Convergence Science to Address Global Mental Health Challenges

2021 ◽  
pp. 7-28
Author(s):  
Erin Smith ◽  
Helen Lavretsky ◽  
Charles F Reynolds III ◽  
Michael Berk ◽  
Harris A Eyre
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Early Stage ◽  
Global Mental Health ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
New Era ◽  
Improved Outcomes ◽  
The World ◽  
Medical Educators

The world is in the throes of a global mental health crisis with severe physical, societal, and economic ramifications. This has only exacerbated by the COVID-19 pandemic. Modern mental health problems are characterized by their complexity, multisystemic nature, and broad societal impact, making them poorly suited to siloed approaches of thinking and innovation. To solve the unprecedented complexities and challenges associated with the current global mental health crisis, a paradigm shift is needed. Convergence science integrates knowledge, tools, and thought strategies from various fields and is the point where novel insights arise. In the context of mental health, convergence involves integration of scientists, clinicians, bioinformaticists, global health experts, engineers, technology entrepreneurs, medical educators, caregivers, and patients; synergy between government, academia, and industry is also vital. A convergence mental health approach will lead to improved outcomes for patients and healthcare systems. Predicate examples of convergence science in adjacent fields to mental health provide a model for the path forward. Further, within the field of mental health, there are examples of convergence science currently in action that include early-stage companies, neuroscience initiatives, public health projects, and unconventional funding mechanisms. The world has a historic opportunity to leverage convergence science to lead to a new era of innovation and progress in global mental health.

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