Factors associated with homelessness referrals for an acute young adult psychiatric unit

2020 ◽  
pp. 002076402097023
Author(s):  
Alexander Dymond ◽  
Grace Branjerdporn
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young Adult ◽  
Length Of Stay ◽  
Bipolar Affective Disorder ◽  
Psychiatric Ward ◽  
Chart Audit ◽  
Post Discharge ◽  
Acute Presentation ◽  
Clinical Risk

Background: Homelessness is correlated with significant mental illness. Homelessness is a key psychosocial issue leading to significant use of hospital resources outside medical intervention. Aim: This study examines the characteristics, post-discharge pathway and length of stay of individuals presenting with homelessness in an acute young adult psychiatric ward. Method: Prospective chart audit was conducted to assess the demographic information, acute presentation, clinical risk and length of stay for homelessness referrals to Social Work. Participants ( N = 88) were aged 18 to 25 years old and admitted to a tertiary level psychiatric ward specifically for this age group. Acute risk presentations of all psychiatric conditions, such as Schizophrenia, Emotionally Unstable Personality Disorder, Bipolar Affective Disorder, Drug Induced Psychosis and Anorexia Nervosa, may be admitted to the unit. Descriptive statistics, one sample t-tests and Pearson’s correlations were completed. Results: No homeless patient was accommodated by local area services due to lack of availability. Change in homelessness status tended to worsen during hospitalisation, with 24% having worse accommodation upon discharge compared to 13% who improved. Length of stay was significantly longer for homeless patients compared to non-homeless patients, but not when excluding the length of time spent attempting to address homeless risk. Homeless patients presenting with an eating disorder acute presentation spent longer time in hospital, and those with psychotic acute presentations had more dynamic risk factors. Length of stay and static risk factors were positively correlated with government mental health community follow-up. Conclusion: Hospitalisation is not an effective intervention for homelessness and the Gold Coast Mental Health units are not resourced or linked to provide accommodation outcomes in a positive or economic manner. Future consideration should be given to health and community resources around homelessness, including health-specific housing interventions and community mental health teams incorporating homelessness risk vulnerability into their ongoing clinical risk mitigation.

scholarly journals Factors Associated With Older Adults’ In-Hospital Mobility: A Comparison Between Israel and Denmark

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 26-26
Author(s):  
Mette Merete Pedersen ◽  
Janne Petersen ◽  
Ove Andersen ◽  
Efrat Shadmi ◽  
Ksenya Shulyaev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Length Of Stay ◽  
Bed Rest ◽  
Analysis Of Covariance ◽  
Admission Diagnosis ◽  
Mobility Limitations ◽  
Post Discharge ◽  
Mobility Performance ◽  
Similar Risk

Abstract Low levels of in-hospital mobility and excessive bed rest are widely described across the globe as a major risk factor for hospital associated disabilities. Different predictors of in-hospital and post-discharge mobility limitations have been proposed across studies, including age, admission diagnosis, physical performance, cognitive impairment, performance of activities of daily living, and length of stay. However, it is unknown whether similar risk factors across countries are associated with in-hospital mobility given different mobility measurement methods, variations in measurement of predictors and differences in populations studied. In the current study, we investigated the relationship between in-hospital mobility and a set of similar risk factors in functionally independent older adults (65+) hospitalized in acute care settings in Israel (N=206) and Denmark (N=113). In Israel, mobility was measured via ActiGraph and in Denmark by ActivPal for up to seven hospital days. Parallel analysis of covariance (ANCOVA) in each sample showed that community-mobility before hospitalization, mobility performance at admission and length of stay were associated with in-hospital mobility in both countries, whereas age and self-reported health status were associated with mobility only in Denmark. This comparison indicates that despite slightly different measurement approaches, similar risks are attributed to older adults’ low in-hospital mobility and emphasizes the contribution of commonly used pre-hospitalization mobility measures as strong and consistent risk factors. This knowledge can support a better understanding of the need of both standard risk assessments and country-based tailored approaches.

scholarly journals A qualitative comparison of experiences of specialist mother and baby units versus general psychiatric wards

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica Griffiths ◽  
Billie Lever Taylor ◽  
Nicola Morant ◽  
Debra Bick ◽  
Louise M. Howard ◽  
...  
Keyword(s):  
Mental Health ◽  
Best Practice ◽  
Mental Health Problems ◽  
Perinatal Period ◽  
Psychiatric Ward ◽  
Structured Interviews ◽  
Post Discharge ◽  
Qualitative Comparison ◽  
Inpatient Settings ◽  
Perinatal Services

Abstract Background Mother and baby units (MBUs) are an inpatient mental health service where women experiencing acute severe postpartum psychiatric difficulties can be admitted with their babies. They are currently viewed as best practice in the UK and elsewhere. However, as service provision is fragmented, some women residing in areas without MBUs are admitted to acute general psychiatric wards without their infants. This study aimed to compare qualitatively experiences of these two service types from the perspectives of women and clinicians. Methods Semi-structured interviews were conducted with fifteen women who received treatment for perinatal mental health problems on a general psychiatric ward and/or MBU in England. Two focus groups were also conducted, one with MBU staff (n = 11) and one with acute ward staff (n = 6). Data were analysed thematically. Results Women generally preferred being co-admitted with their baby to an MBU over lone admission to a general psychiatric ward. Women and clinicians felt that MBUs provided more perinatally-focused, family-centred care, and were better-equipped to meet women’s needs. General wards were reported by women and staff to lack the necessary facilities and expertise to support perinatal women adequately, while separation of mothers and babies was often experienced by women as traumatic and detrimental to recovery. However, some areas for improvement were also identified across both service types, particularly relating to difficulties transitioning home post-discharge, inadequate support for family members, staffing issues and access problems (with MBUs). Conclusions Findings suggest that specialist perinatal inpatient care is considered preferable to generic care in the perinatal period from both service user and staff perspectives. Increased collaboration between perinatal and non-perinatal services could help improve perinatal expertise on general psychiatric wards, while further expansion of perinatal services (e.g. to cater for women currently considered too high risk for MBUs and for those discharged from inpatient settings) could tackle other shortfalls in care.

scholarly journals Risk Factors for Revolving Door in Children and Adolescents with Psychiatric Disorders

2021 ◽  
Vol 10 (21) ◽  
pp. 5004
Author(s):  
Barbara D’Aiello ◽  
Deny Menghini ◽  
Roberto Averna ◽  
Milena Labonia ◽  
Stefano Vicari
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Psychiatric Hospitalization ◽  
Psychiatric Patients ◽  
Severity Of Illness ◽  
Revolving Door ◽  
Psychiatric Ward ◽  
Emotional Symptoms ◽  
Post Discharge ◽  
Clinical Conditions

Revolving Door (RD) is a frequent phenomenon afflicting children and adolescents with psychiatric diagnoses. Nevertheless, risk factors for RD are still a matter of debate. To better understand RD phenomenon, we conducted a retrospective study on 224 children and adolescents (165 females and 59 males, aged 6–16 years) with a psychiatric hospitalization, taking the multiple risk factors together. At this aim, 108 patients with multiple hospitalizations and 116 patients with only one hospitalization were compared on demographic characteristics, clinical conditions, psychiatric ward stay, and post-discharge management factors. More than half of psychiatric patients were readmitted within three months of discharge. RD patients presented greater severity of illness, needed longer stays, and were more frequently placed in residential facilities than non-RD patients. Non-suicidal self-injurious and adoption were the main predictors of RD. Clinical instruments that detected behavioural and emotional symptoms, suicidal ideation severity, and level of impairment of the person’s functioning were useful to identify patients at high risk for RD. In conclusion, our findings pointed out that several risk factors have to be considered to better understand and, in the future, prevent RD phenomenon.

scholarly journals Compliance With a Protocol for Intrapartum Antibiotic Prophylaxis Against Neonatal Group B Streptococcal Sepsis in Women With Clinical Risk Factors

2002 ◽  
Vol 10 (4) ◽  
pp. 223-229 ◽  
Author(s):  
Toni R. Sanders ◽  
Christine L. Roberts ◽  
Gwendolyn L. Gilbert
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Clinical Risk Factors ◽  
Chart Audit ◽  
Clinical Risk ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Related Risk ◽  
Neonatal Group ◽  
Intrapartum Antibiotic ◽  
Group B

Objective:The aim of this study was to determine the prevalence of clinical risk factors (CRF) for neonatal sepsis in laboring women and to evaluate clinician compliance with a CRF-based protocol for intrapartum antibiotic prophylaxis (IAP).Methods:A retrospective chart audit was undertaken at a district hospital (A) and a tertiary obstetric hospital (B) in Sydney, Australia between 1996 and 1998, to determine compliance with IAP in women with defined CRF.Results:Eighty-five (12%) women at Hospital A and 117 (19%) at Hospital B had one or more CRF. Overall compliance rates with the IAP protocols were 65 and 50%at Hospitals A and B respectively, but varied according to maternal, obstetric and sepsis-related risk factors. We postulate that differences between the hospitals were related to protocol implementation.Conclusions: Compliance with a CRF-based protocol was lower than previously reported. Improvements in protocol development, implementation and maintenance are required to enhance compliance with IAP based on CRF.

The management of bipolar disorder in the perinatal period and risk factors for postpartum relapse

2011 ◽  
Vol 27 (8) ◽  
pp. 563-569 ◽  
Author(s):  
K. Doyle ◽  
J. Heron ◽  
G. Berrisford ◽  
J. Whitmore ◽  
L. Jones ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Lower Risk ◽  
Unplanned Pregnancy ◽  
Bipolar Affective Disorder ◽  
Perinatal Period ◽  
Care Plans ◽  
History Of ◽  
Risk Of Relapse ◽  
In Pregnancy

AbstractAimsThe perinatal period is a time of high risk of relapse for women with a history of bipolar affective disorder (BPAD). We describe the pregnancy management of women with BPAD and identify risk factors for postpartum relapse.MethodsThe case records of 78 women with BPAD referred to perinatal mental health services before conception, during pregnancy or the postpartum period, between 1998 and 2009 in Birmingham UK, were screened. In women who were managed during pregnancy, those who relapsed in the postpartum were compared with those who remained well.ResultsForty-seven percent of women with BPAD referred in pregnancy suffered postpartum relapse. Women who were unwell at referral, younger, with unplanned pregnancy, previous perinatal episodes or a family history of BPAD were more likely to suffer postpartum illness.ConclusionIdentifying risk factors for postpartum relapse enables us to individualise the estimation of a woman's risk and modify care plans accordingly. Duration of wellness prior to pregnancy is not associated with a lower risk of postpartum illness and so it is imperative that all women with BPAD receive referral in pregnancy.

scholarly journals History for some or lesson for all? A systematic review and meta-analysis on the immediate and long-term mental health impact of the 2002–2003 Severe Acute Respiratory Syndrome (SARS) outbreak

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steven W. H. Chau ◽  
Oscar W. H. Wong ◽  
Rema Ramakrishnan ◽  
Sandra S. M. Chan ◽  
Evelyn K. Y. Wong ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Outcomes ◽  
General Public ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Health Impact ◽  
Mental Health Outcomes ◽  
Post Discharge

Abstract Background The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. Methods We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. Results The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. Conclusions The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.

scholarly journals Risk factors for severity of COVID-19 in hospital patients age 18–29 years

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255544
Author(s):  
Micaela Sandoval ◽  
Duc T. Nguyen ◽  
Farhaan S. Vahidy ◽  
Edward A. Graviss
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Young Adult ◽  
Severe Disease ◽  
Significant Risk ◽  
Clinical Risk Factors ◽  
Marginalized Communities ◽  
Clinical Risk ◽  
Social Settings ◽  
Hospital Patients

Background Since February 2020, over 2.5 million Texans have been diagnosed with COVID-19, and 20% are young adults at risk for SARS-CoV-2 exposure at work, academic, and social settings. This study investigated demographic and clinical risk factors for severe disease and readmission among young adults 18–29 years old, who were diagnosed at a hospital encounter in Houston, Texas, USA. Methods and findings A retrospective registry-based chart review was conducted investigating demographic and clinical risk factors for severe COVID-19 among patients aged 18–29 with positive SARS-CoV-2 tests within a large metropolitan healthcare system in Houston, Texas, USA. In the cohort of 1,853 young adult patients diagnosed with COVID-19 infection at a hospital encounter, including 226 pregnant women, 1,438 (78%) scored 0 on the Charlson Comorbidity Index, and 833 (45%) were obese (≥30 kg/m2). Within 30 days of their diagnostic encounter, 316 (17%) patients were diagnosed with pneumonia, 148 (8%) received other severe disease diagnoses, and 268 (14%) returned to the hospital after being discharged home. In multivariable logistic regression analyses, increasing age (adjusted odds ratio [aOR] 1.1, 95% confidence interval [CI] 1.1–1.2, p<0.001), male gender (aOR 1.8, 95% CI 1.2–2.7, p = 0.002), Hispanic ethnicity (aOR 1.9, 95% CI 1.2–3.1, p = 0.01), obesity (3.1, 95% CI 1.9–5.1, p<0.001), asthma history (aOR 2.3, 95% CI 1.3–4.0, p = 0.003), congestive heart failure (aOR 6.0, 95% CI 1.5–25.1, p = 0.01), cerebrovascular disease (aOR 4.9, 95% CI 1.7–14.7, p = 0.004), and diabetes (aOR 3.4, 95% CI 1.9–6.2, p<0.001) were predictive of severe disease diagnoses within 30 days. Non-Hispanic Black race (aOR 1.6, 95% CI 1.0–2.4, p = 0.04), obesity (aOR 1.7, 95% CI 1.0–2.9, p = 0.046), asthma history (aOR 1.7, 95% CI 1.0–2.7, p = 0.03), myocardial infarction history (aOR 6.2, 95% CI 1.7–23.3, p = 0.01), and household exposure (aOR 1.5, 95% CI 1.1–2.2, p = 0.02) were predictive of 30-day readmission. Conclusions This investigation demonstrated the significant risk of severe disease and readmission among young adult populations, especially marginalized communities and people with comorbidities, including obesity, asthma, cardiovascular disease, and diabetes. Health authorities must emphasize COVID-19 awareness and prevention in young adults and continue investigating risk factors for severe disease, readmission and long-term sequalae.

Post-migratory risk factors and asylum seekers’ mental health

2018 ◽  
Vol 11 (4) ◽  
pp. 257-269
Author(s):  
Thomas Korup Kjærgaard ◽  
Natasja Koitzsch Jensen
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Length Of Stay ◽  
Asylum Seekers ◽  
Design Methodology ◽  
Search Strategy ◽  
Poor Mental Health ◽  
Content Type ◽  
Asylum Procedure ◽  
Practical Implications

Purpose The purpose of this paper is to examine if the post-migrational risk factors, namely length of stay and number of relocations, are associated with asylum seekers’ mental health. Design/methodology/approach The review includes seven main studies published later than 2006 examining the effect of the asylum procedure on the mental health of asylum seekers. The articles were identified through the search databases PubMed, Embase and PsycINFO. A systematic search strategy based on the concepts of Patient, Intervention, Comparison, and Outcome has laid the groundwork for the findings of relevant articles. Findings Two out of three articles investigating the association between number of relocations and mental health among asylum seekers observed an effect on mental health. Three out of six studies found associations between length of stay in asylum centres and poor mental health. The overall assessment of the studies indicates an effect of the post-migrational risk factors. Research limitations/implications The included studies vary in study populations, outcome measures and methodical soundness. Practical implications The review suggests that length of stay in asylum centres and the number of relocations should be considered as risk factors for poor mental health of asylum seekers and, hence, considered in the organisational procedures in the asylum process. Originality/value To the best of the authors’ knowledge, this is the first review to specifically examine the literature on the association between the post-migratory risk factors, number of relocations and length of stay, in asylum centres and mental health among non-detained asylum seekers in Europe.

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