The 2016 RANZCP Guidelines for the Management of Schizophrenia and Related Disorders – what’s next?

2017 ◽  
Vol 25 (6) ◽  
pp. 600-602 ◽  
Author(s):  
Assen Jablensky ◽  
David J Castle ◽  
Frances Dark ◽  
Verity Humberstone ◽  
Eoin Killackey ◽  
...  
Keyword(s):  
Mental Health ◽  
Scientific Evidence ◽  
Standard Of Care ◽  
Mental Health Research ◽  
Response To Treatment ◽  
Clinical Expertise ◽  
The Public ◽  
Measuring Outcomes ◽  
Treatment Plans ◽  
Personalised Treatment

Objectives: The recently published RANZCP guidelines for schizophrenia and related disorders reviewed recent scientific evidence, and, where lacking, referred to clinical expertise to supply a template for raising the standard of care. This paper builds on the guidelines and recommends how they might be used to improve outcomes. Methods: The guidelines call for evidence-based mental health policies, inclusive of mobilising affected families, communities and the public in support of policies that ensure better care and protect the wellbeing of people with severe mental disorders. The process of preparing the guidelines highlighted the limits of our scientific understanding of schizophrenia and shortcomings in the care currently provided. Results: Writing the guidelines evinced the need for a culture of measuring outcomes and response to treatment, and harnessing such data to monitoring and optimising patient care. Conclusions: We recommend creation of a national case cohort for mental health research involving a collaborative network of clinical research centres, using the guidelines and generating scientific evidence for translation into clinical practice protocols that enable personalised treatment plans for patients and criteria for the performance of clinical services.

More than just characters in a story: effective and meaningful involvement of young people in mental health research

2019 ◽  
Vol 18 (1) ◽  
pp. 14-16 ◽  
Author(s):  
Niamh MacSweeney ◽  
Sarah Bowman ◽  
Clare Kelly
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Research ◽  
Youth Mental Health ◽  
Mental Health Research ◽  
Content Type ◽  
The Public ◽  
Advisory Groups ◽  
Meaningful Involvement ◽  
Youth Involvement

Purpose The story of youth mental health remains poorly understood. To truly progress our understanding of youth mental health, we must shift our focus from one in which young people are the subjects, or “characters”, of research efforts to one in which they are active agents, or “authors”. This change in dynamic falls under the banner of public and patient involvement (PPI), a growing movement that emphasises the meaningful involvement of the public in health research. The paper aims to discuss these issues. Design/methodology/approach Here, the authors aim to stimulate this shift in focus by describing emerging practices of youth involvement in paediatric research and outlining how such practices can be extended to the domain of youth mental health. In particular, the authors highlight Young Persons’ Advisory Groups (YPAG), through which young people can be involved in an active, meaningful and mutually beneficial manner, at each step in the research life cycle. Findings A YPAG comprises young people who act as research partners, providing guidance on a range of activities. In the health domain, YPAGs have provided fresh perspectives, generated valuable knowledge and changed attitudes about youth involvement in research. Moreover, they provide young people with genuine opportunities to shape research so that it addresses issues they encounter in their everyday lives. Originality/value The establishment of youth mental health YPAGs will enhance the authors’ research questions, design, delivery and impact. The authors outline how researchers can embrace PPI and work together with young people to tell a different story of youth mental health.

scholarly journals Boredom among psychiatric in-patients: does it matter?

2013 ◽  
Vol 19 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Rachel Steele ◽  
Paul Henderson ◽  
Frances Lennon ◽  
Donna Swinden
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Scientific Evidence ◽  
Mental Health Research ◽  
Biological Psychiatry ◽  
Dopamine Antagonist ◽  
Sense Of Control ◽  
Meaningful Relationships ◽  
Internal Experience ◽  
Therapeutic Activities

SummaryMany psychiatric in-patients report boredom. Such complaints may appear trivial, but this literature review by a clinical librarian suggests that boredom is more complex than may initially appear and relates to wider areas of importance for in-patient psychiatric teams. Boredom may relate to the internal experience of meaning, which itself encompasses meaningful relationships and roles and a sense of control. Although meaningful therapeutic activities are vital, mental health professionals should focus on the internal as well as the external dimensions of boredom. Medications, particularly dopamine antagonist antipsychotics, may be a contributing factor. This article highlights the benefits of the clinical librarian role in synthesising research in mental health. Research can illuminate psychiatric practice in a more holistic way than purely by applying 'scientific' evidence in the practice of ‘biological’ psychiatry.

AAC Clinical Education: Measuring Outcomes With Single Subject Designs

2016 ◽  
Vol 1 (12) ◽  
pp. 48-58 ◽  
Author(s):  
Jolene Hyppa-Martin
Keyword(s):  
Clinical Education ◽  
Augmentative And Alternative Communication ◽  
Scientific Evidence ◽  
Experimental Designs ◽  
Single Subject ◽  
Clinical Expertise ◽  
Alternative Communication ◽  
Clinical Tool ◽  
Speech Language Pathologists ◽  
Measuring Outcomes

Single subject experimental designs are a clinical tool that enable speech-language pathologists to make low-inference, data-driven intervention decisions and can be particularly useful when treating heterogeneous clinical populations for which there is limited directly applicable extant scientific evidence. Single-subject experimental designs are also useful in supporting the development of clinical expertise for speech-language pathologists and graduate students. This article provides a basic overview of the role of single-subject experimental designs in augmentative and alternative communication clinical education and the potential contributions that the application of these designs can make to the field of augmentative and alternative communication.

scholarly journals Invited commentary on … Rethinking funding priorities in mental health research

2016 ◽  
Vol 208 (6) ◽  
pp. 510-511 ◽  
Author(s):  
Kamaldeep Bhui
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Health Research ◽  
Service Provision ◽  
Research Priorities ◽  
Mental Health Research ◽  
Policy Makers ◽  
The Public ◽  
Research Findings ◽  
Economic Perspectives

SummaryThis commentary takes up the notion proposed by Lewis-Fernández and colleagues that we need more balance in research priorities. Specifically, our reliance on neurobiology may be misplaced and likely to be unrewarding unless we ensure that: (a) research with better return for patients and the public is also pursued; (b) research findings are put into practice; and (c) we retain a focus on proportionate investment in service provision. Patient, public and economic perspectives should drive the decision making for better investment, and behaviour change might be better targeted at commissioners and policy makers rather than patients and providers.

scholarly journals Psychiatric research platform within SAIL - Linkage of prospectively ascertained phenotypically rich and genetic data to routinely collected anonymised records.

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Joanna McGregor ◽  
Ann John ◽  
Keith Lloyd
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Large Population ◽  
Genetic Data ◽  
Population Based ◽  
Mental Health Research ◽  
Response To Treatment ◽  
Psychiatric Research ◽  
Illness Onset ◽  
Polygenic Scores

ABSTRACT ObjectivesWe have conducted a feasibility study linking clinically rich survey data to routine data to create a platform for psychosis research in Wales: K Lloyd et al (2015), A national population-based e-cohort of people with psychosis (PsyCymru) linking prospectively ascertained phenotypically rich and genetic data to routinely collected records: overview, recruitment and linkage, Schizophrenia Research. Now we expand upon this through the linkage of large clinically rich cohorts with a range of mental health diagnoses along with genetic data to conduct validation exercises, develop novel methodologies, assess genetic and environment interactions and outcomes and address hypothesis-driven research questions. ApproachThrough collaborations between the Farr Institute, Cardiff University based MRC centre for Neuropsychiatric Genetics and Genomics and the National Centre for Mental Health (NCMH) clinically rich data and genetic (CNVs, SNPs & polygenic scores) data from around 6000+ participants recruited from a variety of mental health research studies including ‘PsyCymru’, ‘Genetic susceptibility to cognitive deficits study and NCMH amongst others will be loaded and linked to the datasets within SAIL. The analysis plan would firstly include validation exercises to compare the data between sources. Methodologies would be developed using this data to determine illness onset, relapse, chronicity, severity and response to treatment applied to large population-based mental health e-cohorts. ResultsBy pooling together health service data, genetic variants, environmental and lifestyle factors, phenotypic and endo-phenotypic (cognitive scores) along with the ability to ascertain temporal relationships afforded by the longitudinal perspective available in SAIL we may be able to evaluate potential risk factors, assess the complex GxE interactions that lead to disease progression, and assess outcomes such as prognosis, remission, relapse and premature mortality. The on-going routine updates provide us with the opportunity to follow-up these individuals across multiple health care settings in a cost effective and in-obtrusive manner and to carry out health services utilization/benefit and treatment surveillance in a naturalistic setting. This resource will continue to expand over the coming years in size, breadth and depth of data, with continued recruitment and additional measures planned. ConclusionTo advance mental health research by developing our understanding of the causes, course and outcomes of mental illness that may lead to the development of better diagnostic classification, predictive, preventative strategies and therapeutic approaches.

scholarly journals Public Policy Responses to Address the Mental Health Consequences of the COVID-19 Pandemic: Evidence From Chile

2021 ◽  
Vol 9 ◽  
Author(s):  
Matias Irarrazaval ◽  
Pablo Norambuena ◽  
Cristian Montenegro ◽  
Olga Toro-Devia ◽  
Belen Vargas ◽  
...  
Keyword(s):  
Mental Health ◽  
Public Policy ◽  
Action Plan ◽  
Scientific Evidence ◽  
Well Being ◽  
Mental Health Crisis ◽  
Health Consequences ◽  
Health Crisis ◽  
The Public ◽  
Policy Responses

Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.

AAC Clinical Education: Measuring Outcomes With Single Subject Designs

2016 ◽  
Vol 1 (12) ◽  
pp. 45-55
Author(s):  
Jolene Hyppa-Martin
Keyword(s):  
Clinical Education ◽  
Augmentative And Alternative Communication ◽  
Scientific Evidence ◽  
Experimental Designs ◽  
Single Subject ◽  
Clinical Expertise ◽  
Alternative Communication ◽  
Clinical Tool ◽  
Speech Language Pathologists ◽  
Measuring Outcomes

Single subject experimental designs are a clinical tool that enable speech-language pathologists to make low-inference, data-driven intervention decisions and can be particularly useful when treating heterogeneous clinical populations for which there is limited directly applicable extant scientific evidence. Single-subject experimental designs are also useful in supporting the development of clinical expertise for speech-language pathologists and graduate students. This article provides a basic overview of the role of single-subject experimental designs in augmentative and alternative communication clinical education and the potential contributions that the application of these designs can make to the field of augmentative and alternative communication.

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