The Influence of Consensus on the Assessment of Physical Disease in Chronic Community Psychiatric Patients

1989 ◽  
Vol 51 (3) ◽  
pp. 142-149
Author(s):  
A. Honig ◽  
E.S. Tan ◽  
P. Pop ◽  
H. Philipsen ◽  
R. de Wit ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Physical Disease ◽  
Community Psychiatric

The Practice of Community Psychiatric Nursing and Mental Health Social Work in Salford Some Implications for Community Care

1988 ◽  
Vol 152 (6) ◽  
pp. 783-792 ◽  
Author(s):  
K. Wooff ◽  
D. P. Goldberg ◽  
T. Fryers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Health Staff ◽  
Mental Health Staff ◽  
Term Care ◽  
Community Psychiatric ◽  
Wide Range

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

A Controlled Trial of Goal Setting for Long-Term Community Psychiatric Patients

1986 ◽  
Vol 49 (8) ◽  
pp. 264-268 ◽  
Author(s):  
Christine Howell
Keyword(s):  
Goal Setting ◽  
Work Performance ◽  
Goal Attainment ◽  
Psychiatric Patients ◽  
Controlled Trial ◽  
Control Group ◽  
Treatment Technique ◽  
Community Psychiatric ◽  
Experimental Group

Clinical goal setting is a widely advocated, yet poorly documented technique. This paper describes a controlled trial which was carried out with long-term community psychiatric patients. The experimental group received goal setting in the form of goal attainment scaling (GAS), whilst the control group received social reinforcement. The experimental group had a higher goal score and a significantly higher sessional involvement (p<0.05). The goal categories decided by the clinicians as relevant, differed from those wished by the subjects; the latter subsequently attained only low goal scores. There were no significant differences between the two groups on the work performance or social interaction outcome measures. These differences between the two groups were obtained despite the fact that the subjects of the research were the most intransigent to treatment. It is suggested that goal setting is an independent treatment technique which requires further substantiation, particularly amongst occupational therapists who are covertly or overtly employing the technique. Further research must address the question of identifying the characteristics of patients most likely to benefit from goal setting.

Long-stay forensic psychiatric inpatients in the Republic of Ireland: aggregated needs assessment

2003 ◽  
Vol 20 (4) ◽  
pp. 119-125 ◽  
Author(s):  
Conor O'Neill ◽  
Patrick Heffernan ◽  
Ray Goggins ◽  
Ciaran Corcoran ◽  
Sally Linehan ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Multidisciplinary Teams ◽  
Mentally Disordered Offenders ◽  
Dynamic Risk Factors ◽  
Republic Of Ireland ◽  
Lengths Of Stay ◽  
Community Psychiatric ◽  
Forensic Psychiatric ◽  
The Republic

AbstractObjectives:To profile the current cohort of forensic psychiatric inpatients in the Republic of Ireland, comparing psychiatric healthcare and placement needs of long-stay patients with those more recently admitted.Method:All forensic psychiatric inpatients in the Central Mental Hospital, Dundrum on a census date were included in the study. Patients and key worker were interviewed using a standardised schedule and validated research instruments. Static and dynamic risk factors for violence including demographic, diagnostic and legal characteristics were supplemented by detailed chart review. Standardised anonymised case vignettes were presented to panels of forensic and community psychiatric multidisciplinary teams who assessed current and future treatment and placement requirements for the cohort.Results:There were 88 forensic psychiatric inpatients on the census date. Forty-three had lengths of stay over two years (17 over 20 years). Both patient groups were predominantly males with severe mental illness and histories of violent offending. The majority of the long-stay group were receiving regular parole and this group had lower levels of positive symptoms and comorbid substance misuse disorders. Significant gaps in existing rehabilitation inputs were identified. Almost half the long-stay patients were inappropriately placed. Thirty per cent of long-stay patients could be safely transferred to lower levels of security within six months and 63% within three years.Conclusions:Holding patients in conditions of excessive security impedes rehabilitation and has considerable human rights implications. Almost half of long-stay forensic psychiatric patients in Ireland are inappropriately placed. Barriers to discharge include legislative inadequacies, lack of local low-secure facilities and under-resourcing of community psychiatric services. Such barriers lead to inappropriate utilisation of limited resources and limit access to secure facilities for higher-risk mentally disordered offenders. These findings are of particular relevance in the context of proposed new insanity legislation.

scholarly journals Development Of Community Psychiatric Crisis Management Indicators And Assessment Framework In Taiwan: A Focus Group Study

2016 ◽  
Vol 12 (12) ◽  
pp. 113
Author(s):  
Shu-Fang Su ◽  
Jiin-Ru Rong ◽  
Jin-Biau Li
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Focus Group ◽  
Crisis Management ◽  
Psychiatric Patients ◽  
Community Dwelling ◽  
Community Psychiatric ◽  
Psychiatric Crisis ◽  
Community Crisis ◽  
Cpcm Model

This study was to develop the Community Psychiatric Crisis Management (CPCM) Model for community-dwelling psychiatric patients of Taiwan. Purposes of this study were: 1. To develop psychiatric patients’ community crisis management indictors; 2. To develop the psychiatric patients’ community crisis management framework. Methods: Three focus group interviews involving a total of 42 experts, included psychiatrists, psychiatric nurses, social worker, and community mental health service providers were implemented. Interview data were analyzed with qualitative content analysis. Results: The model of CPCM concretized the objectives, crisis assessment indicators, and crisis intervention services for community psychiatric patients, and proved to be an important part of CPCM. The level of crisis severity and impact of patient can be assessed by the four indicators: medical care seeking behaviors, psychiatric symptom severity and impact, history of violence and substance abuse, and protective factors of family and social support system. In addition, the severity and impact of CPCM score could be implement to provide home visiting care and crisis management interventions. The recommended CPCM model enabled community mental health care professionals’ assessment and management the patient’s crisis problems in three stages, from crisis, acute and maintenance stage. Conclusions: The CPCM model was improved practically, and the contents of the intervention were constructed. It is important to integrate crisis management with the preventive intervention to the community psychiatric patient care.

scholarly journals Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng province, South Africa

2018 ◽  
Vol 24 ◽  
Author(s):  
Dumakazi Mapatwana ◽  
Andrew Tomita ◽  
Jonathan Burns ◽  
Lesley Robertson
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
South Africa ◽  
Social Relationships ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Community Dwelling ◽  
Gauteng Province ◽  
Community Psychiatric

Introduction: Few studies on quality of life (QoL) in the mentally ill population of South Africa have been conducted, but none in community-dwelling individuals. This study examined the QoL of psychiatric patients at community mental health clinics in Gauteng province of South Africa.Methods: A cross-sectional interview-based study was conducted on 121 adult patients attending community psychiatric clinics. To reduce the impact of acute psychiatric symptoms on subjective QoL, only clinically stable patients were included. Instruments used included the World Health Organization Quality of Life BREF domains (i.e. physical health, psychological health, social relationships and environment), the Brief Psychiatric Rating Scale (BPRS) for severity of illness and a socio-demographic and clinical questionnaire.Results: Just under half of the sample rated their overall QoL as good or very good. The strongest predictor of a poor QoL in all four domains was residual psychiatric symptomatology. The most severe BPRS scores were for the symptoms of depression, anxiety and somatic concern. Perceived social support significantly predicted a better QoL in the psychological, social relationships and environmental domains.Conclusion: This study highlights the negative impact of residual psychiatric symptoms on subjective QoL, and the importance of social support and enhancing QoL. If better QoL is the goal of care, then our findings highlight the importance of managing residual symptoms and promoting social support.

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