Heterogeneity of reasons for attendance in frequent attenders of emergency departments and its relationship to future attendance

2021 ◽  
pp. emermed-2020-210412
Author(s):  
Richard Hotham ◽  
Colin O'Keeffe ◽  
Tony Stone ◽  
Suzanne M Mason ◽  
Christopher Burton
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Emergency Care ◽  
Health Problem ◽  
Patient Characteristics ◽  
Health Needs ◽  
Data Set ◽  
Frequent Attenders ◽  
History Of ◽  
Ed Visits

BackgroundEDs globally are under increasing pressure through rising demand. Frequent attenders are known to have complex health needs and use a disproportionate amount of resources. We hypothesised that heterogeneity of patients’ reason for attendance would be associated with multimorbidity and increasing age, and predict future attendance.MethodWe analysed an anonymised dataset of all ED visits over the course of 2014 in Yorkshire, UK. We identified 15 986 patients who had five or more ED encounters at any ED in the calendar year. Presenting complaint was categorised into one of 14 categories based on the Emergency Care Data Set (ECDS). We calculated measures of heterogeneity (count of ECDs categories and entropy of categories) and examined their relationship to total number of ED visits and to patient characteristics. We examined the predictive value of these and other features on future attendance.ResultsMost frequent attenders had more than one presenting complaint type. Heterogeneity increased with number of attendances, but heterogeneity adjusted for number of attendances did not vary substantially with age or sex. Heterogeneity was associated with the presence of one or more contacts for a mental health problem. For a given number of attendances, prior mental health contact but not heterogeneity was associated with further attendance.ConclusionsHeterogeneity of presenting complaint can be quantified and analysed for ED use: it is increased where there is a history of mental disorder but not with age. This suggests it reflects more than the number of medical conditions.

scholarly journals Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California’s Child Welfare Systems

2017 ◽  
Vol 18 (1) ◽  
pp. 335-348 ◽  
Author(s):  
Brent R. Crandal ◽  
Andrea L. Hazen ◽  
Jennifer Rolls Reutz
Keyword(s):  
Mental Health ◽  
Child Welfare ◽  
Health Needs ◽  
Screening Tools ◽  
Mental Health Needs ◽  
Screening Process ◽  
Trauma Informed Care ◽  
History Of ◽  
Trauma Informed ◽  
State Of The Science

A central aspect of trauma-informed care in child welfare (CW) systems is the use of a trauma-informed screening process. This includes the use of a broadly administered measurement approach to assist professionals in identifying current trauma-related symptomology or a history of potentially traumatizing events. With a high prevalence of unmet mental health needs among CW-involved children, screening can be a crucial step as systems strive to identify children impacted by trauma. This paper offers a summary of CW screening approaches in county-administered CW systems across California. Through a web-administered survey, 46 county administrators reported on their screening practices and perceptions. Information about ages of children screened and screening tools used, perceptions of screening implementation priorities, degree of implementation and satisfaction with screening processes is provided. Several implementation considerations for future trauma-informed care efforts are offered including maintaining a focus on childhood trauma, closing the science-practice gap, and evaluating the state of the science.

Non-governmental organizations and mental health

2018 ◽  
pp. 487-498
Author(s):  
Marguerite Regan ◽  
Jenny Edwards ◽  
Iris Elliott
Keyword(s):  
Mental Health ◽  
Health Needs ◽  
Current Policy ◽  
Health It ◽  
International Networks ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Policy Frameworks ◽  
History Of ◽  
The Uk

This chapter examines to contribution of non-governmental organizations (NGOs) to meeting the mental health needs of individuals, families, and communities. After providing an overview of the history of mental health NGOs, and the current policy frameworks within which they work, it then examines the scope of mental health NGOs, and maps the main international networks and within the UK context. It examines the contribution of NGOs, the key challenges they face working within mental health, and concludes with the steps NGOs can take when striving for parity for mental health. It includes examples of international mental health NGOs throughout.

scholarly journals Attitudinal and demographic factors associated with seeking help and receiving antidepressant medication for symptoms of common mental disorder

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Elena A. Manescu ◽  
Emily J. Robinson ◽  
Claire Henderson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
Mental Health Problem ◽  
Health Problem ◽  
Help Seeking ◽  
Common Mental Disorder ◽  
General Health Questionnaire ◽  
Seeking Help ◽  
Positive Effect

Abstract Background Despite the increased attention given to improvement of mental health-related knowledge and attitudes, rates of help-seeking for mental illness remain low even in countries with well-developed mental health services. This study examines the relationships between attitudes to mental illness, symptoms of common mental disorder and seeking-help and receiving medication for a mental health problem. Methods We used data from the nationally representative Health Survey for England 2014 to design three logistic regression models to test for the effects of attitudes to mental illness (measured by a shortened version of the Community Attitudes toward the Mentally Ill, CAMI scale) on: recent contact with a doctor for a mental health problem; use of any type of mental health service in the last 12 months; and having antidepressants currently prescribed, while controlling for symptoms of common mental disorder (measured by the General Health Questionnaire, GHQ). We also tested for an interaction between attitudes to mental illness and symptoms of common mental disorder on the outcomes. Results A significant but very small effect of CAMI score was found on ‘antidepressants currently prescribed’ model (OR = 1.01(1.00, 1.02) but not on the two indicators of help-seeking. We also found a significant but very small interaction between CAMI and GHQ scores on recent contact with a doctor (OR = 0.99, 95% CI (0.990, 0.998); adjusted Wald test P = 0.01)). Knowing someone with a mental illness had a significant positive effect on help-seeking indicated by: (a) recent contact with a doctor (2.65 (1.01, 6.98)) and (b) currently prescribed antidepressant (2.67 (1.9, 3.75)) after controlling for attitudes to mental illness. Conclusions Our results suggest that knowing someone with a mental health problem seems to have a further positive effect on help-seeking, beyond improving attitudes to mental illness. Furthermore, multiple different types and aspects of stigma may contribute to help-seeking behaviours, consequently multi-faceted approaches are likely to be most efficient.

Madness

2017 ◽  
Author(s):  
Alfonso Troisi
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
History Of Psychiatry ◽  
Evolutionary Analysis ◽  
Behavioral Diversity ◽  
The Core ◽  
Biological Adaptation ◽  
History Of ◽  
Evolutionary View ◽  
Functional Capacities

Medicalization of human behavioral diversity is a recurring theme in the history of psychiatry, and the problem of defining what is a genuine mental disorder remains an unresolved question since the origins of clinical psychopathology. This chapter presents an evolutionary view of mental health, placing functional capacities and biological adaptation at the core of attempts to define mental disorder instead of other criteria of morbidity that are commonly used . This theoretical shift depends on the fact that the evolutionary concept of mental disorder is consequence oriented: what makes a condition pathological are its consequences, not its causes or correlates. The chapter then provides, an evolutionary analysis, which reveals that the degree of efficiency of functional capacities is dependent on features of the environment. Optimal functional capacities are sets of coevolved traits that are best suited to increasing adaptation in specific environments. The same trait can be highly adaptive in one environment and minimally adaptive in another.

scholarly journals Women And Hysteria In The History Of Mental Health

2012 ◽  
Vol 8 (1) ◽  
pp. 110-119 ◽  
Author(s):  
Cecilia Tasca ◽  
Mariangela Rapetti ◽  
Mauro Giovanni Carta ◽  
Bianca Fadda
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Mental Disorder ◽  
Sexual Abstinence ◽  
Western Countries ◽  
Scientific Innovation ◽  
Innovative Therapies ◽  
History Of ◽  
A Priority

Hysteria is undoubtedly the first mental disorder attributable to women, accurately described in the second millennium BC, and until Freud considered an exclusively female disease. Over 4000 years of history, this disease was considered from two perspectives: scientific and demonological. It was cured with herbs, sex or sexual abstinence, punished and purified with fire for its association with sorcery and finally, clinically studied as a disease and treated with innovative therapies. However, even at the end of 19th century, scientific innovation had still not reached some places, where the only known therapies were those proposed by Galen. During the 20th century several studies postulated the decline of hysteria amongst occidental patients (both women and men) and the escalating of this disorder in non-Western countries. The concept of hysterical neurosis is deleted with the 1980 DSM-III. The evolution of these diseases seems to be a factor linked with social “westernization”, and examining under what conditions the symptoms first became common in different societies became a priority for recent studies over risk factor.

scholarly journals DESIGNING THE MINIMUM DATA SET OF PSYCHIATRIC EMERGENCY RECORD

2017 ◽  
Vol 1 (4) ◽  
pp. 117-118
Author(s):  
Zahra Ebnehoseini ◽  
Marziyhe Meraji ◽  
Farzad Akbarzadeh ◽  
Malihe Irajzade
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Literature Review ◽  
Work Experience ◽  
Psychiatric Emergency ◽  
Clinical Psychologist ◽  
Emergency Psychiatry ◽  
Data Element ◽  
Data Set ◽  
History Of

Introduction: Psychiatric emergencies are acute mental health disturbances, behavior and social relationship that require immediate intervention. The major role of psychiatric emergency services is to provide mental health care services for patients with acute mental health problems. Design emergency psychiatry core dataset has improved the coordination and integration of services and improved the outcomes for the patient with severe and persistent mental illness with complex needs. So the aim of this study was to design data elements (DEs) in emergency psychiatry for Iran.   Methods: This is an applied study. Emergency psychiatry (DEs) collected via literature review and then psychologist and psychiatrist (16 experts) assign the score from 0 to 5 to them according to the value of each data element. (DEs)  selected as core Emergency psychiatry (DEs) that were achieved 4 or 5 scores from 75% specialist.   Results: According to the literature review, 110 (DEs) included studying. 13 experts (8 psychologists, 8 Clinical Psychologist) evaluated psychiatric emergency (DEs) set. The average work experience of psychiatrists and psychologists was 16 years and their work experience ranged from 2 to 25 years (table 1). according to the experts opinion, 54 (DEs) with at least 75% of the agreement were identified as the psychiatric emergency (DEs). Emergency psychiatric (DEs) and average agreement of each of them were: demographic characteristics (6 DEs with an agreement average of 82.5%), history of mental illness (9 DEs with an agreement average of 79%), family history of psychology (3 DEs with an average agreement of 77.08%), medical history (1 DEs with an average agreement of 81.25 %) Assessment of mental status ( 20 DEs with an average agreement of 82%), assessment of the self harm risk or harm risk for others ( 13 DEs with an average agreement of 93.6%) and diagnosis and treatment (3 DEs with an average agreement of 81.25%). Conclusion: Given the importance of psychiatric disorder and lack of the national system for gathering psychiatric information, perform the same study abut psychiatric data element is very important. The results of this study can be used for design psychiatric emergency forms and gather accurate and complete patient information.

scholarly journals Attitudinal and demographic factors associated with seeking help and receiving antidepressant medication for symptoms of common mental disorder

2020 ◽  
Author(s):  
Elena Andreea Manescu ◽  
Emily J. Robinson ◽  
Claire Henderson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
Mental Health Problem ◽  
Health Problem ◽  
Help Seeking ◽  
Common Mental Disorder ◽  
General Health Questionnaire ◽  
Seeking Help ◽  
Positive Effect

Abstract Background: Despite the increased attention given to improvement of mental health-related knowledge and attitudes, rates of help-seeking for mental illness remain low even in countries with well-developed mental health services. This study examines the relationships between attitudes to mental illness, symptoms of common mental disorder and seeking-help and receiving medication for a mental health problem. Methods: We used data from the nationally representative Health Survey for England 2014 to design three logistic regression models to test for the effects of attitudes to mental illness (measured by a shortened version of the Community Attitudes toward the Mentally Ill, CAMI scale) on: recent contact with a doctor for a mental health problem; use of any type of mental health service in the last 12 months; and having antidepressants currently prescribed, while controlling for symptoms of common mental disorder (measured by the General Health Questionnaire, GHQ). We also tested for an interaction between attitudes to mental illness and symptoms of common mental disorder on the outcomes. Results: A significant but very small effect of CAMI score was found on ‘antidepressants currently prescribed’ model (OR=1.01(1.00, 1.02) but not on the two indicators of help-seeking. We also found a significant but very small interaction between CAMI and GHQ scores on recent contact with a doctor (OR= 0.99, 95% CI (0.990, 0.998); adjusted Wald test P=0.01)). Knowing someone with a mental illness had a significant positive effect on help-seeking indicated by: (a) recent contact with a doctor (2.65 (1.01, 6.98)) and (b) currently prescribed antidepressant (2.67 (1.9, 3.75)) after controlling for attitudes to mental illness. Conclusions: Our results suggest that knowing someone with a mental health problem seems to have a further positive effect on help-seeking, beyond improving attitudes to mental illness. Furthermore, multiple different types and aspects of stigma may contribute to help-seeking behaviours, consequently multi-faceted approaches are likely to be most efficient.

scholarly journals Is there a social gradient in how youth with mental disorder perform academically? Findings from a Swedish longitudinal register-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Evelina Landstedt ◽  
Cristian Bortes ◽  
Mattias Strandh
Keyword(s):  
Mental Health ◽  
Academic Achievement ◽  
Mental Disorder ◽  
Family Income ◽  
Social Gradient ◽  
Socioeconomic Background ◽  
Parental History ◽  
History Of ◽  
Prospective Association ◽  
Parental Level

Abstract Background It is well established that academic achievement and other school-related outcomes are associated with mental health status in children and youths. However, few studies have examined the influence of socioeconomic background on the relationship between poor childhood/adolescent mental health and school performance. From an equity perspective, it is important to explore how school-related outcomes are affected for young people with mental disorder and if these outcomes differ depending on gender and socioeconomic background. This study aimed to investigate social gradients in the prospective association between childhood/adolescent mental disorder and academic achievement. Methods This register based study used data from the Umeå SIMSAM Lab of linked Swedish registers on all children born between 1990 and 1994 and their parents (N = 642 558). The outcome was school grades achieved upon compulsory school graduation (age 15/16). Mental disorder was indicated by number of hospitalisations due to ICD classified mental disorders and prescription of psychoanaleptic drugs. Indicators of socioeconomic position were parental level of education and family income in four categories respectively. Parental history of mental disorder was controlled for. Linear regressions, including interaction analyses, were performed. Results Mental disorder in childhood/adolescence was related to lower grades, particularly in boys. The drop in academic achievement among youth with mental disorder was more pronounced among girls in mid SEP categories than among their less and more advantaged peers. A less clear interaction pattern was identified in boys. Conclusions Based on theory and existing research we expected a typical social gradient in the strength of the association between mental disorder and academic achievement. However, we identified a U-shaped social gradient among girls. Analyses of the links between mental health and academic outcomes need to take both gender and social position into account. More research is needed to investigate these patterns further.

EX TURPI CAUSA and mental disorder

1998 ◽  
Vol 57 (3) ◽  
pp. 429-471
Author(s):  
C.A. Hopkins
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Health Authority ◽  
Health Assessment ◽  
Local Health Authority ◽  
Local Health ◽  
Trial Judge ◽  
Care Services ◽  
After Care ◽  
History Of

IN September 1992 Christopher Clunis, who had a long history of mental disorder, was discharged from a hospital where he had been detained under section 3 of the Mental Health Act 1983. Under section 117 of that Act, it was the duty of his local Health Authority to arrange to provide after-care services for him until it was satisfied that he no longer needed them. After an interval of twelve weeks, during which he failed to attend three out-patient appointments and a mental health assessment arranged for him, Clunis launched an unprovoked and fatal knife attack on a total stranger, Jonathan Zito, at Finsbury Park tube station. Clunis was charged with murder, but a plea of guilty to manslaughter on the grounds of diminished responsibility was accepted, and the trial judge ordered his detention in a secure mental hospital. Clunis claimed damages for his incarceration from the Health Authority, arguing that it was in breach of a common law duty to treat him with professional care and skill, and that if it had acted more expeditiously he would either have been detained or consented to become a patient before the date of the attack and therefore would not have been able to commit it–in other words, that a timely brief period of hospitalisation would have saved him from an indeterminate but doubtless much longer period. The first instance judge refused to strike out the action, but a unanimous Court of Appeal allowed the Health Authority's appeal: Clunis v. Camden and Islington Health Authority [1998] 2 W.L.R. 902.

Sign in / Sign up

Export Citation Format

Share Document