scholarly journals Continuing Care for Mentally Stable Psychiatric Patients in Primary Care: Patients' Preferences and Views

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Vincent I. O. Agyapong
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Health Centre ◽  
Psychiatric Services ◽  
Community Mental Health Centre

Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.

The discharge of patients with enduring mental health problems into primary care: Patients’ preferences and views

2011 ◽  
Vol 26 (S2) ◽  
pp. 1696-1696
Author(s):  
V.I.O. Agyapong ◽  
T.B. Thekiso ◽  
A. Guerandel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Health Centre ◽  
Community Mental Health Centre ◽  
Service Setting ◽  
Primary Care Patients

ObjectivesTo investigate the preferences of psychiatric patients regarding attendance for their continued mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting.Methods150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semi-structures questionnaire designed to assess the objectives of the study.Results145 patients completed the questionnaire giving a response rate of 97%. The majority of patients had a general practitioner (GP, 132, 94.3%) and most attended their GP every 3 months (68, 48.6%). Ninety-eight patients (70.0%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason was fear of substandard quality of psychiatric care from their GPs (68.4%), followed by inability to afford a GP appointment (23, 23.5%) and not having a GP (9, 9.2%). Thirty two patients (22.9%) preferred to attend their GP. Reasons for this included confidence in GPs providing same level of care as psychiatrist for mental illness (18, 56.3%), the advantage of managing both mental and physical health by GPs (13, 40.6%) and less stigma (28.1%).ConclusionAlthough most patients attended their GP more frequently than the psychiatry clinic, they preferred attending specialized psychiatric services once mentally stable than primary care with most reasons revolving around fears of inadequate psychiatric care from GPs.

Access to mental health care in an inner-city health district. I: Pathways into and within specialist psychiatric services

1997 ◽  
Vol 170 (4) ◽  
pp. 312-316 ◽  
Author(s):  
M. J. Commander ◽  
S. P. Sashi Dharan ◽  
S. M. Odell ◽  
P. G. Surtees
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Inner City ◽  
Mental Health Problems ◽  
Psychiatric Morbidity ◽  
Psychiatric Services ◽  
Specialist Services ◽  
Epidemiological Surveys

BackgroundNeeds for mental health care are likely to be high in urban areas. Purchasers must assess the extent to which these are being met. The pathways to care model provides a framework for this purpose.MethodEpidemiological surveys of adults living in deprived multi-ethnic innercity catchment area were undertaken in psychiatric services, primary care and community settings. Estimated prevalence rates were calculated and the association between clinical and demographic factors and the use of psychiatric services examined.ResultsAround a third of people with mental health problems did not consult a GP. and half failed to have their problems recognised by their doctor. Access to psychiatric services and especially to inpatient care was highly restricted. Diagnosis and ethnicity had a marked influence on the use of specialist services.ConclusionsMany people with psychiatric morbidity are not receiving treatment either from primary care or specialist services. High levels of severe morbidity and compulsory admissions highlight the pressures placed on inner-city psychiatric services.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Identification and Management of Depression in Australian Primary Care and Access to Specialist Mental Health Care

2012 ◽  
Vol 63 (12) ◽  
pp. 1247-1251 ◽  
Author(s):  
Nicholas Glozier ◽  
Tracey Davenport ◽  
Ian B. Hickie
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care

scholarly journals Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Focus Groups ◽  
Care Delivery ◽  
Virtual Care ◽  
Primary Care Teams ◽  
The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

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