Predisposing, enabling and need factors associated with increased use and ongoing increased use of inpatient mental health care: A population-based longitudinal study

2020 ◽  
pp. 000486742097684
Author(s):  
Bianca Suesse ◽  
Luise Lago ◽  
Victoria Westley-Wise ◽  
Jose Cuenca ◽  
Nagesh Pai
Keyword(s):  
Mental Health ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Service Use ◽  
Population Based ◽  
Mental Health Service Use ◽  
History Of ◽  
Self Harm ◽  
History Of Depression ◽  
Hospital Use

Objective: The study investigated factors associated with frequent (admissions), high (total length of stay) or heavy (frequent and high) hospital use, and with ongoing increased hospital use, for mental health conditions in a regional health district. Methods: A retrospective population-based study using longitudinal hospital, emergency department and community service use data for people admitted with a mental health condition between 1 January 2012 and 31 December 2016. Multivariate logistic regression models assessed the association of predisposing, enabling and need factors with increased, and ongoing increased, hospital use. Results: A total of 5,631 people had at least one mental health admission. Frequent admission was associated with not being married (odds ratio = 2.3, 95% confidence interval = [1.5, 3.3]), no private hospital insurance (odds ratio = 2.2, 95% confidence interval = [1.2, 3.8]), previous mental health service use (community, emergency department, lengthy admissions) and a history of a substance use disorder, childhood trauma, self-harm or chronic obstructive pulmonary disease. High and heavy hospital use was associated with marital status, hospital insurance, admission for schizophrenia, previous mental health service use and a history of self-harm. Ongoing frequent use was less likely among those aged 65 and older (odds ratio = 0.2, 95% confidence interval = [0.1, 1.0]) but more likely among those with a history of depression (odds ratio = 2.2, 95% confidence interval = [1.1, 4.4]). Ongoing high use was also associated with admissions for schizophrenia and a history of self-harm. Conclusion: Interventions targeted at younger people hospitalised with schizophrenia, a history of depression or self-harm, particularly with evidence of social and or health disadvantage, should be considered to improve long-term consumer and health system outcomes. These data can support policymakers to better understand the context and need for improvements in stepped or staged care for people frequently using inpatient mental health care.

Self-harm hospitalised morbidity and mortality risk using a matched population-based cohort design

2017 ◽  
Vol 52 (3) ◽  
pp. 262-270 ◽  
Author(s):  
Rebecca J Mitchell ◽  
Cate M Cameron
Keyword(s):  
At Risk ◽  
Confidence Interval ◽  
Mortality Risk ◽  
Service Use ◽  
Population Based ◽  
Mortality Data ◽  
Post Discharge ◽  
Self Harm ◽  
Rate Ratios ◽  
Hospital Use

Objective: Prior and repeated self-harm hospitalisations are common risk factors for suicide. However, few studies have accounted for pre-existing comorbidities and prior hospital use when quantifying the burden of self-harm. The aim is to quantify hospitalisation in the 12 months preceding and re-hospitalisation and mortality risk in the 12 months post a self-harm hospitalisation. Method: A population-based matched cohort using linked hospital and mortality data for individuals ⩾18 years from four Australian jurisdictions. A non-injured comparison cohort was matched on age, gender and residential postcode. Twelve-month pre- and post-index self-harm hospitalisations and mortality were examined. Results: The 11,597 individuals who were hospitalised following self-harm in 2009 experienced 21% higher health service use in the 12 months pre and post the index admission and a higher mortality rate (2.9% vs 0.3%) than their matched counterparts. There were 133 (39.0%) deaths within 2 weeks of hospital discharge and 342 deaths within 12 months of the index hospitalisation in the self-harm cohort. Adjusted rate ratios for hospital readmission were highest for females (2.86; 95% confidence interval: [2.33, 2.52]) and individuals aged 55–64 years (3.96; 95% confidence interval: [2.79, 5.64]). Conclusion: Improved quantification of the burden of self-harm-related hospital use can inform resource allocation for intervention and after-care services for individuals at risk of repeated self-harm. Better assessment of at-risk self-harm behaviour, appropriate referrals and improved post-discharge care, focusing on care continuity, are needed.

scholarly journals Mental Health Service Use Among Children and Youth in Ontario: Population-Based Trends Over Time

2016 ◽  
Vol 61 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Sima Gandhi ◽  
Maria Chiu ◽  
Kelvin Lam ◽  
John C. Cairney ◽  
Astrid Guttmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Population Based ◽  
Children And Youth ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Trends Over Time ◽  
Over Time

scholarly journals Self-harm following release from prison: A prospective data linkage study

2016 ◽  
Vol 51 (3) ◽  
pp. 250-259 ◽  
Author(s):  
Rohan Borschmann ◽  
Emma Thomas ◽  
Paul Moran ◽  
Megan Carroll ◽  
Ed Heffernan ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Confidence Interval ◽  
Mental Disorder ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
History Of ◽  
Self Harm ◽  
Release From Prison

Objective: Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison. Method: Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations. Results: During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In all, 83 (6.4%) participants presented due to self-harm, accounting for 165 (4.4%) presentations. The crude incidence rates of self-harm for males and females were 49.2 (95% confidence interval: [41.2, 58.7]) and 60.5 (95% confidence interval: [44.9, 81.6]) per 1000 person-years, respectively. Presenting due to self-harm was associated with being Indigenous (incidence rate ratio: 2.01; 95% confidence interval: [1.11, 3.62]), having a lifetime history of a mental disorder (incidence rate ratio: 2.13; 95% confidence interval: [1.19, 3.82]), having previously been hospitalised for psychiatric treatment (incidence rate ratio: 2.68; 95% confidence interval: [1.40, 5.14]) and having previously presented due to self-harm (incidence rate ratio: 3.91; 95% confidence interval: [1.85, 8.30]). Conclusion: Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release. Demographic and mental health variables help to identify at-risk groups, and such presentations could provide opportunities for suicide prevention in this population. Transition from prison to the community is challenging, particularly for those with a history of mental disorder; mental health support during and after release may reduce the risk of adverse outcomes, including self-harm.

Mental health service use and help-seeking among women firefighters with a career history of suicidality.

2018 ◽  
Vol 15 (3) ◽  
pp. 316-324 ◽  
Author(s):  
Melanie A. Hom ◽  
Ian H. Stanley ◽  
Sally Spencer-Thomas ◽  
Thomas E. Joiner
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Help Seeking ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Women Firefighters ◽  
History Of

scholarly journals Child Abuse Experiences and Perceived Need for Care and Mental Health Service Use among Members of the Canadian Armed Forces

2017 ◽  
Vol 62 (6) ◽  
pp. 413-421 ◽  
Author(s):  
Sarah Turner ◽  
Tamara Taillieu ◽  
Kristene Cheung ◽  
Mark Zamorski ◽  
David Boulos ◽  
...  
Keyword(s):  
Mental Health ◽  
Child Abuse ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Mental Health Service Use ◽  
Perceived Need ◽  
Regular Force ◽  
History Of ◽  
Canadian Military

Objective: Child abuse is associated with poor mental health outcomes in adulthood. However, little is known about how a history of child abuse may be related to perceived need for care (PNC) and mental health service use (MHSU) among Canadian military personnel. The objectives of this study were to determine 1) the relationship between child abuse history and PNC and 2) the relationship between child abuse history and MHSU in the Canadian military. Method: Data were drawn from the 2013 Canadian Forces Mental Health Survey ( n = 6692 Regular Force personnel between the ages of 18 and 60 years). Logistic regression was used to examine the relationships between individual child abuse types and PNC and MHSU while adjusting for sociodemographic variables, the presence of mental disorders, deployment-related variables, and other types of child abuse. Population attributable fractions (PAFs) were calculated to estimate the proportion of PNC and MHSU that may be attributable to child abuse. Results: Each individual child abuse type was associated with increased odds of PNC and MHSU after adjusting for all covariates (adjusted odds ratio ranging from 1.26 to 1.80). PAFs showed that if any child abuse did not occur, PNC and MHSU among Regular Force personnel may be reduced by approximately 14.3% and 11.3%, respectively. Conclusions: This study highlights that preenlistment factors, such as a history of child abuse, have an independent association with PNC and MHSU and hence need to be considered when assessing the mental health service needs of the Canadian Regular Force personnel.

scholarly journals Psychiatric symptoms and risk of victimisation: a population-based study from Southeast London

2018 ◽  
Vol 28 (2) ◽  
pp. 168-178 ◽  
Author(s):  
V. Bhavsar ◽  
K. Dean ◽  
S. L. Hatch ◽  
J. H. MacCabe ◽  
M. Hotopf
Keyword(s):  
Mental Health ◽  
Violence Exposure ◽  
Service Use ◽  
Psychiatric Symptoms ◽  
Public Health Problem ◽  
Sensitivity Analyses ◽  
Mental Health Service Use ◽  
Violence Perpetration ◽  
History Of ◽  
The Impact

AbstractAimsAlthough violence is a vital public health problem, no prospective studies have tested for subsequent vulnerability to violence, as a victim or witness, in members of the general population with a range of psychiatric symptoms, or evaluated the importance of higher symptom burden on this vulnerability.MethodsWe used successive waves of a household survey of Southeast London, taken 2 years apart, to test if association exists between psychiatric symptoms (symptoms of psychosis, common mental disorders, post-traumatic stress disorder and personality disorder) and later victimisation, in the form of either witnessing violence or being physically victimised, in weighted logistic regression models. Statistical adjustment was made for prior violence exposure, sociodemographic confounders, substance/alcohol use and violence perpetration. Sensitivity analyses were stratified by violence perpetration, sex and history of mental health service use.ResultsAfter adjustments, psychiatric symptoms were prospectively associated with reporting any subsequent victimisation (odds ratio (OR) 1.88, 95% confidence interval (CI) 1.25–2.83), a two times greater odds of reporting witnessed violence (OR 2.24, 95% CI 1.33–3.76) and reporting physical victimisation (OR 1.76, 95% CI 1.01–3.06). One more symptom endorsed was accompanied by 47% greater odds of subsequent victimisation (OR 1.47, 95% CI 1.16–1.86). In stratified analyses, statistical associations remained evident in non-perpetrators, and among those without a history of using mental health services, and were similar in magnitude in both men and women.ConclusionsPsychiatric symptoms increase liability to victimisation compared with those without psychiatric symptoms, independently of a prior history of violence exposure and irrespective of whether they themselves are perpetrators of violence. Clinicians should be mindful of the impact of psychiatric symptoms on vulnerability to victimisation, including among those with common psychiatric symptoms and among those who are not considered at risk of perpetrating violence.

History of Forensic Mental Health Service Use Among Homeless Adults with Mental Illness

2017 ◽  
Vol 16 (1) ◽  
pp. 69-82 ◽  
Author(s):  
Alicia Nijdam-Jones ◽  
Tonia L. Nicholls ◽  
Anne G. Crocker ◽  
Laurence Roy ◽  
Julian M. Somers
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Forensic Mental Health ◽  
Homeless Adults ◽  
History Of
Sign in / Sign up

Export Citation Format

Share Document