An evaluation of the practice of electroconvulsive therapy (ECT) in a Victorian health service before and after the Mental Health Act 2014

2020 ◽  
Vol 28 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Jia L Lee ◽  
Kuruvilla George ◽  
Leah Price ◽  
Jeremy Couper
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Electroconvulsive Therapy ◽  
Eastern Health ◽  
Mental Health Act ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
Clinical File

Objective: The aim of the project was to identify changes in the practice of electroconvulsive therapy (ECT) in a metropolitan mental health service before and after the Mental Health Act 2014 (2014 Act) in Victoria. Method: Retrospective clinical file audit of ECT administration across all three sites at Eastern Health (EH) two years before and two years after introduction of the 2014 Act. Results: There was a statistically significant decrease in the number of compulsory ECT treatments and in the number of patients who had compulsory ECT across the three hospitals at EH in the two years following the 2014 Act compared to the two years prior to the 2014 Act. There was no significant difference in the number of voluntary ECT treatments and in the number of patients who had voluntary ECT. Conclusion: The review showed that there has been a significant decrease in the number of compulsory ECT treatments and in the number of patients who had compulsory ECT after the introduction of the 2014 Act. Potential reasons for the changes are discussed.

scholarly journals Trends in the administration of electroconvulsive therapy in England

2009 ◽  
Vol 33 (2) ◽  
pp. 61-63 ◽  
Author(s):  
David Bickerton ◽  
Adrian Worrall ◽  
Robert Chaplin
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Number Of Patients

Aims and MethodWe measured the use of electroconvulsive therapy (ECT) over 3 months in England in 2006 and compared that with studies from 1999 and 2002. Questionnaires were completed by hospital ECT staff and returned by post with data collected prospectively on ECT use from National Health Service organisations.ResultsTwo-thirds (56 of 76) of the trusts providing ECT at 109 clinics responded. the number of clinics providing ECT and the number of patients receiving ECT has declined. There has been an increase in the proportion of people receiving ECT when detained under the Mental Health Act 1983.Clinical ImplicationsThe number of ECT clinics is likely to continue to decrease and psychiatrists may have decreasing experience of treating patients with ECT.

scholarly journals New ways of working: COVID-19 as a catalyst for change in acute mental health services

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000366
Author(s):  
Kezanne Tong ◽  
Genevieve Crudden ◽  
Wen Xi Tang ◽  
David McGuinness ◽  
Margaret O'Grady ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Response Times ◽  
New Ways Of Working ◽  
Number Of Patients ◽  
Service Staff ◽  
Alternative Settings ◽  
Quality Response ◽  
Spread Of Infection

BackgroundA need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric consultations to reduce footfall during COVID-19. We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service and its effect on service quality: response time and number of patients leaving before the review. We evaluated the satisfaction of patients, general practitioners (GPs) and mental health service staff with the pathway.MethodsAll patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ2 and independent sample t-test were used to compare the variables.ResultsOver 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.ConclusionThe pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.

scholarly journals Generic clozapine: outcomes after switching formulations

2006 ◽  
Vol 189 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Carol Paton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Clinical Outcomes ◽  
Clinical Global Impression ◽  
Severity Of Illness ◽  
Clinical Deterioration ◽  
Change Scores ◽  
Before And After ◽  
The Uk

SummaryTwo generic preparations of clozapine have been licensed in the UK. The bioequivalence of these products compared with Clozaril® has not been unequivocally demonstrated. Clinical equivalence has also been questioned. The objective of this study was to determine clinical outcomes for all patients switched from Clozaril® to a generic formulation in one mental health service. We examined dosage data and Clinical Global Impression (CGI) of Severity of Illness scores for 337 patients before and after the switch and CGI change scores after the switch. There was no evidence of clinical deterioration or need to use higher dosages. Generic clozapine is not inferior to Clozaril®.

scholarly journals Comparison of mental health service activity before and shortly after UK social distancing responses to the COVID-19 pandemic: February-March 2020

2020 ◽  
Author(s):  
Robert Stewart ◽  
Evangelia Martin ◽  
Ioannis Bakolis ◽  
Matthew Broadbent ◽  
Nicola Byrne ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Community Services ◽  
Home Treatment ◽  
Social Distancing ◽  
Face To Face ◽  
National Implementation ◽  
Before And After ◽  
Service Activity

This study sought to provide an early description of mental health service activity before and after national implementation of social distancing for COVID-19. A time series analysis was carried out of daily service-level activity on data from a large mental healthcare provider in southeast London, from 01.02.2020 to 31.03.2020, comparing activity before and after 16.03.2020: i) inpatient admissions, discharges and numbers, ii) contact numbers and daily caseloads (Liaison, Home Treatment Teams, Community Mental Health Teams); iii) numbers of deaths for past and present patients. Daily face-to-face contact numbers fell for liaison, home treatment and community services with incomplete compensatory rises in non-face-to-face contacts. Daily caseloads fell for all services, apart from working age and child/adolescent community teams. Inpatient numbers fell 13.6% after 16th March, and daily numbers of deaths increased by 61.8%.

The Effect of a New Integrated Mental Health Service on Hospitalisation

1997 ◽  
Vol 31 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Graham W. Mellsop ◽  
George W. Blair-West ◽  
Vasanthi Duraiappah
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Length Of Stay ◽  
Health Service ◽  
Average Length ◽  
Average Length Of Stay ◽  
Lengths Of Stay ◽  
Before And After ◽  
Cumulative Length ◽  
Integrated Mental Health

Objective: The purpose of the present study was to partially evaluate a new integrated mental health service by monitoring inpatient lengths of stay. We hypothesised that the median cumulated length of stay for inpatients would decrease, and that the frequency of readmissions would not increase. Method: Data was collected for two 6-month periods before and after the introduction of an integrated mental health service (IMHS). Two functionally identical wards (G and E) were studied. Ward G was then integrated with the regional community psychiatry service, while Ward E remained non-integrated. Results: Following integration, the median cumulative length of stay in the IMHS's Ward G was more than halved in comparison with both its own baseline and with the non-integrated ward. The average length of stay of overdose patients at the regional general hospital that was serviced by the IMHS was also reduced from 2.6 days to 1.5 days. The non-IMHS ward had a non-significant increase in admissions and no change in cumulative length of stay. Conclusion: The hypotheses of this study were supported by the results. Twelve beds were subsequently closed as a result of the efficiencies generated by integration. These findings support the model of true integration trialled here.

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