scholarly journals Psychiatric Services in Saskatchewan under Medicare*

1970 ◽  
Vol 15 (1) ◽  
pp. 63-72 ◽  
Author(s):  
Wilfred A. Cassell ◽  
Colin M. Smith ◽  
Maggie Grandy Rankin
Keyword(s):  
Private Practice ◽  
Urban Areas ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Treatment Session ◽  
Psychiatric Services ◽  
Treatment Services ◽  
Hospital Visits ◽  
To Receive

This study has examined the nature and extent of services provided to psychiatric patients under ‘Medicare’. An analysis of the records of 864,128 residents of Saskatchewan revealed that in 1965, 13,950 males and 27,009 females received a psychiatric diagnosis from physicians in private practice. Psychoneurotic conditions were frequent. General practitioners provided the majority of treatment services for this group. Physicians practising in urban areas were found to complete more psychiatric treatment than their rural counterparts. Female patients were found to receive relatively more psychiatric care than males. The latter obtained more consultations, hospital visits and somatic investigations. Lastly, the rate of service was infrequent, averaging less than one treatment session per patient.

scholarly journals Organization of Community Psychiatric Services in Finland

10.17816/cp64 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 55-64
Author(s):  
Jyrki Korkeila
Keyword(s):  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Economic Recession ◽  
Psychiatric Services ◽  
Severe Mental Disorders ◽  
Community Based ◽  
Institutional Settings ◽  
Primary Organization ◽  
Methods Of Treatment ◽  
Rapid Transformation

Background. The Finnish psychiatric treatment system has undergone a rapid transformation from operating in institutional settings to a adopting a community-based approach, through implementation of national plans; this process was carried out quickly, due to a severe economic recession in the early 1990s. Methods. This paper is a narrative review, based on relevant documents by national authorities, academic dissertations and published scientific literature, between 1984 and 2018, as well as the interviews of key experts in 2019. Results. The municipality is currently the primary organization, responsible for all health services. Municipalities may also work together in organizing the services, either through unions of municipalities or hospital districts. Services are to a great extent outpatient-oriented. The number of beds is one fifth of the previous number, around four decades ago, despite the increase in population. In 2017, 191,895 patients in total (4% of Finns) had used outpatient psychiatric services, and the number of visits totalled 2.25 million. Psychotherapy is mainly carried out in the private sector by licensed psychotherapists. Homelessness in relation to discharged psychiatric patients has not been in evidence in Finland and deinstitutionalization has not caused an increase in the mortality rate among individuals with severe mental disorders. Conclusion. Psychiatric patients have, in general, benefitted greatly from the shift from institutions to the community. This does not preclude the fact that there are also shortcomings. The development of community care has, to date, focused too heavily on resource allocation, at the expense of strategic planning, and too little on methods of treatment.

Psychiatric treatment-associated stigmatization as viewed through eyes of rural health clinic patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S740-S741
Author(s):  
D. Sendler ◽  
A. Markiewicz
Keyword(s):  
Trend Analysis ◽  
Rural Health ◽  
Rural Community ◽  
Psychiatric Treatment ◽  
Mental Disease ◽  
Psychiatric Patients ◽  
Qualitative Interviews ◽  
Health Clinic ◽  
Competing Interest ◽  
To Receive

IntroductionHaving a mental disease is frequently a stigmatizing experience for patients. We know little about urban inhabitants who travel to rural health clinics to receive mental treatment.ObjectivesRecruit and interview urban-based psychiatric patients who, to avoid stigmatization; travel to rural community clinics with the intention of receiving treatment.MethodsStudy included participants (n = 32) who exchanged treatment in government subsidized city clinics for rural community centers. Qualitative interviews lasting thirty minutes were recorded and transcribed for content analysis. MAXQDA, version 12, was used to annotate transcripts with topic specific nodes, followed by cluster theme and trend analysis.ResultsTrend analysis yielded three areas of concern for subsidized urban psychiatry: cost/insurance, lack of staff professionalism, and family-driven ostracism. Seven respondents cited cost as the main factor, influencing the choice of rural-based care over city clinic. Patients with stable income, but without insurance (n = 14), felt unwelcome in city clinics as their ability to pay was frequently questioned by supporting staff. Lack of trained social workers caused additional distress, as participants could not receive access to additional resources. Only four patients said that their psychiatrists acknowledged poor clinic environment and encouraged remaining in treatment. For 18 respondents, family demanded that they receive treatment in rural clinic so that no one finds out about their mental disease.ConclusionIn large urban clinics, stigma in psychiatry comes in many flavors, especially projected by unprofessional clinic staff and ashamed family. Lack of support forces patients to travel to rural premises to receive unbiased, stress-free care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

Attitudes of general practitioners to the psychiatric services

1994 ◽  
Vol 11 (1) ◽  
pp. 44-46 ◽  
Author(s):  
Liam Watters ◽  
Miriam Gannon ◽  
Denis Murphy
Keyword(s):  
General Practitioners ◽  
Catchment Area ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Psychiatric Morbidity ◽  
Psychiatric Hospitals ◽  
Psychiatric Services ◽  
Community Psychiatric ◽  
High Level

Structural AbstractObjective: General practitioners play a crucial role in the delivery of psychiatric treatment to patients who have many similarities to those attending the general psychiatric services. The purpose of this study was to elicit attitudes of general practitioners to an existing local service. Methods: We used an anonymous questionaire hand delivered to 54 general practitioners with practices in the catchment area of one of Dublin's psychiatric hospitals. Results: We received responses from 40 of the GP's indicating a high level of psychiatric morbidity in the primary care setting, a moderate level of satisfaction with psychiatric service, a low level of knowledge of the catchment area system, limited interest in taking on an increased role in the care of psychiatric patients and a high popularity rating for the community psychiatric nurse. Conclusions: This study confirms previous estimates of psychiatric morbidity in general practice, a need for improved communication between psychiatrists and general practitioners to identify more realistic expectations on both sides of the equation, and a huge potential for the expanding community psychiatric services to improve liaison between general practitioners and psychiatrists and yield considerable patient and doctor gains.

Incidence of Psychiatric Treatment of Adolescents

1979 ◽  
Vol 24 (6) ◽  
pp. 521-531 ◽  
Author(s):  
Hamish Nichol
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Psychiatric Facility ◽  
Presenting Problems ◽  
Vulnerable Group ◽  
First Time ◽  
The City

The characteristics of adolescents aged 15–19 years who received psychiatric treatment for the first time in British Columbia in 1966 are considered. Females predominated substantially over males, as did those living in urban areas over those in rural ones. Somatic, psychological, behavioural and suicidal presenting problems were commoner in females, with delinquent and academic ones being more frequent in males. Depression, psycho-neurosis and personality disorders were commoner in females. Medication was used in conjunction with psychotherapy more frequently in females. Long-term psychotherapy (more than 16 visits to a psychiatric facility) was employed in only 3 percent of females and 2 percent of males. Psychiatrists provided the greatest amount of care given. The hypothesis that females from rural areas living in the city constitute a vulnerable group of individuals more likely than their adolescent peers to seek psychiatric care requires evaluation in a further study.

Adult Needs and Strengths Assessment–Abbreviated Referral Version to Specify Psychiatric Care Needed for Incoming Patients: Exploratory Analysis

2008 ◽  
Vol 102 (1) ◽  
pp. 131-143 ◽  
Author(s):  
Charles Nelson ◽  
Megan Johnston
Keyword(s):  
Psychiatric Care ◽  
Rating Scale ◽  
Psychiatric Treatment ◽  
Function Analysis ◽  
Psychiatric Patients ◽  
Level Of Care ◽  
Placement Decisions ◽  
Cutoff Scores ◽  
Mean Differences ◽  
Strengths Assessment

The present study examined the Adult Needs and Strengths Assessment-Abbreviated Referral Version ratings for a group of 272 incoming psychiatric patients over a 2-yr. period to assess whether the rating scale was useful in predicting clinical placement for psychiatric treatment. Participants were patients (125 women) admitted to Regional Mental Health Care, St. Thomas, Canada between April 2004 and June 2006. Most participants were Euro-Canadian and ranged in age from 16 to 87 years. Clinical cutoff scores were established using observed mean differences in the patients' total scores and are expected to help guide psychiatric triage and longer term rehabilitation placement decisions. A canonical discriminant function analysis showed 85.9% of original level of care placements were correctly classified. The rating scale is a valid and reliable tool to specify level of psychiatric care needed for adults with mental disorders.

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

Pathways through psychiatric care: the experience of psychiatric patients

2007 ◽  
Vol 3 (6) ◽  
pp. 343-352 ◽  
Author(s):  
Paul Spicker ◽  
Irene Anderson ◽  
Richard Freeman ◽  
Robin McGilp
Keyword(s):  
Psychiatric Care ◽  
Psychiatric Patients

Utilization of Emergency Departments for Psychiatric Treatment

1978 ◽  
Vol 23 (3) ◽  
pp. 143-148 ◽  
Author(s):  
G.D. Watson
Keyword(s):  
Emergency Department ◽  
Emergency Services ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Relevant Literature ◽  
Emergency Department Utilization ◽  
Annual Number ◽  
Personal Distress ◽  
Clinical Records

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.

Mortality among Psychiatric Patients

1970 ◽  
Vol 15 (4) ◽  
pp. 143-148 ◽  
Author(s):  
G. Innes ◽  
W. M. Millar
Keyword(s):  
Causes Of Death ◽  
Psychiatric Patients ◽  
Psychiatric Services ◽  
Social Classes ◽  
First Year ◽  
Organic Psychosis ◽  
Physical Symptomatology ◽  
Regional Board ◽  
Excessive Number

A 5-year follow-up study was carried out of all referrals to the psychiatric services in a Regional Board area. The death registers of the Registrar General for Scotland were searched for all patients who were not known to be alive at the end of the study. Of the 2103 patients included in the original study, 343 were found to have died. This represents 15.9 per cent of males and 16.7 per cent of females referred. Most of the deaths (41%) occurred in the first year of follow-up, 20 per cent in the first 3 months. The overall death rate was approximately twice the expectation based on death rates in the general population of the area. The excess was greatest in those aged under 55 years. All areas of residence, occupations and social classes had increased mortality. Those patients diagnosed as organic psychosis had highest mortality (70%) but all diagnoses had an excessive number of deaths when standardised for age. Of the initial referrals, 1.4 per cent committed suicide during the follow-up period. Apart from neoplasms where deaths were close to expectation, all other broad categories of causes of death were equally involved in the increase. This survey of a total psychiatric referral group (in-patients, out-patients and domiciliary visits and private patients) supports previously reported studies, mainly of in-patients, in their finding of an association between high mortality rates and psychiatric illness. It is possible that this association may result from selective referral to the psychiatric services of those psychiatrically ill patients who exhibit physical symptomatology.

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