scholarly journals Side-effect monitoring of continuing LAI antipsychotic medication in UK adult mental health services

2021 ◽  
Vol 11 ◽  
pp. 204512532199127
Author(s):  
Carol Paton ◽  
Tom K. J. Craig ◽  
Brittany McConnell ◽  
Thomas R. E. Barnes
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Mental Health Services ◽  
Health Services ◽  
Adverse Effects ◽  
Antipsychotic Medication ◽  
Side Effect ◽  
Antipsychotic Medications ◽  
Adult Mental Health ◽  
Effect Monitoring

Background: Long-acting injectable (LAI) antipsychotic medications are used to optimise treatment outcomes in schizophrenia. Guaranteed medication delivery increases the responsibility of prescribers to monitor and manage adverse effects. Methods: In the context of a quality improvement programme conducted by the Prescribing Observatory for Mental Health, a clinical audit addressed documented side-effect monitoring in patients prescribed continuing LAI antipsychotic medication under the care of United Kingdom adult mental health services. Results: A total of 62 mental health services submitted data on 5169 patients prescribed LAI antipsychotic medication for more than a year. An assessment of side effects had been documented in the past year in 2304 (45%) cases. Post hoc analysis showed that extrapyramidal side effects were more likely to have been assessed and found to be present in those patients prescribed LAI haloperidol, flupentixol or zuclopenthixol. There was little other targeting of assessments to the known side effects profiles of individual LAI antipsychotic medications, but when dysphoria had been assessed it was most commonly found with LAI haloperidol treatment and when weight gain, sexual and prolactin-related side effects had been assessed, they were more often identified with LAI paliperidone. Conclusion: The data suggest a relatively low frequency of side-effect assessments, largely untargeted. This is likely to result in many adverse effects going unrecognised and unmanaged, thus failing to tackle their potential to confound mental state assessment and adversely affect physical health and adherence. Patients receiving LAI antipsychotic medication have regular contact with a healthcare professional who administers the medication, which provides an opportunity to potentially remedy this situation.

scholarly journals Audit on antipsychotic prescribing in children and young people with a learning disability under the care of mental health services in Surrey

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S71-S71
Author(s):  
Timothy Cherian James ◽  
Asifa Zainab ◽  
Salvatore Mura ◽  
Aaron Vallance ◽  
Dola Okusi
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Side Effects ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Antipsychotic Medication ◽  
The Other ◽  
Nice Guidelines ◽  
Medication Reviews

AimsTo check the extent to which National Institute of Clinical Excellence (NICE) guidelines were being followed in clinical practice with regards to prescribing antipsychotic medication to Child and Adolescent Mental Health Services (CAMHS) patients with a diagnosed learning disability (LD).MethodA data collection tool (based on a similar Royal College of Psychiatrists [RCPsych] audit) was filled out with retrospective data from patients’ clinical records, then analysed using Microsoft Excel and Microsoft Powerpoint.The agreed standards were the NICE guidelines.There were no ethical issues as the data were retrospective and anonymised.Sample size was 13, comprising 7 males and 6 females.All service users were less than 18 years of age.Result7 out of the 13 patients who were prescribed antipsychotics had a Severe/Profound LD.Among the 5 patients who had been prescribed antipsychotic medication, 4 were on Risperidone and 2 were on Aripiprazole. The reasons for starting antipsychotic medication were clearly documented for all 5, the most common reasons being overt aggressive behaviour and general agitation/anxiety.Only 1 patient had antipsychotic medication initiated in the previous 12 months. NICE guidelines had been generally followed for the management of this case, with good documented evidence.For the other 4 patients, in whom antipsychotic medication was initiated more than 12 months ago, there was a lack of documentation of the subsequent assessment of side effects, extra-pyramidal side effects, body weight, blood pressure, glycaemic control and lipid profile. 1 of these patients did not have a documented review of antipsychotic medication in the previous 6 months. For the other 3 patients, their medication reviews did not consider whether to reduce the dose or stop antipsychotic medication.1 patient had been transferred to primary care, with a clear transfer of prescribing responsibility and documented evidence that written guidance was provided to primary care which addressed all the necessary management details.ConclusionAlthough there was clear documentation of reasons for initiating antipsychotics, there appeared to be a lack of awareness of NICE guidelines for antipsychotic medication reviews, side effect and metabolic markers assessment, and their documentation. This is an area for potential change in practice to conform better to national guidelines and improve patient care.

scholarly journals Concerns about the children of psychiatric in-patients – what the parents say

1997 ◽  
Vol 21 (8) ◽  
pp. 495-497 ◽  
Author(s):  
Fiona Stormont ◽  
Tom Craig ◽  
Zerrin Atakan ◽  
Peter Loader ◽  
Cindy Williams
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Research Literature ◽  
Parental Mental Illness ◽  
Adult Mental Health

There is an increasing body of research literature investigating the effects of parental mental illness on children. This study investigates the views of psychiatric in-patients on consequences of their admission to hospital and their mental illness for their children. The results suggest that the parents do not readily acknowledge that their children have problems, and that interventional approaches require good liaison between adult mental health services and child-focused agencies.

scholarly journals The divide between child and adult mental health services: points for debate

2013 ◽  
Vol 202 (s54) ◽  
pp. s41-s44 ◽  
Author(s):  
Clare Lamb ◽  
Margaret Murphy
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Discussion Paper ◽  
Adult Mental Health ◽  
The Uk

SummaryThis discussion paper outlines our personal views for debate on some of the complexities inherent in the crucial task of improving mental health services for young people in the UK.

Novel research on transition from child to adult mental health services in Europe: The MILESTONE project

2016 ◽  
Vol 33 (S1) ◽  
pp. S58-S59 ◽  
Author(s):  
H. Tuomainen ◽  
S.P. Singh ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Care Pathway ◽  
Controlled Trial ◽  
Ethical Challenges ◽  
Adult Mental Health ◽  
Related Service ◽  
Competing Interest

IntroductionCurrent service configuration of distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS) is considered the weakest link where the care pathway should be most robust. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge for the EU.ObjectivesThe overall objective of the MILESTONE project is to improve transition from CAMHS to AMHS in diverse healthcare settings in Europe.AimsTo improve the understanding of current transition-related service characteristics, and processes, outcomes and experiences of transition from CAMHS to AMHS using a bespoke suite of measures; to explore the ethical challenges of providing appropriate care to young people as they move to adulthood; to test a model of managed transition in a cluster randomized controlled trial (cRCT) for improving health, social outcomes and transition to adult roles; and to develop training modules for clinicians and policy guidelines.MethodsData will be collected via systematic literature reviews; bespoke surveys to CAMHS professionals, experts and other stakeholders; focus groups with service providers and users and members of youth and mental health advocacy groups; and a longitudinal cohort study with a nested cRCT in eight EU countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS service users, their parents/carers, and clinicians, with assessments at baseline, 9, 18 and 27 months.ResultsFirst results are expected in 2016 with further major findings following in 2019.ConclusionsThe MILESTONE project will provide unprecedented information on the nature and magnitude of problems at the CAMHS-AMHS interface, and potential solutions to overcome these.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

2018 ◽  
pp. 1-7
Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Autistic Spectrum Disorder ◽  
Mental Health Problems ◽  
Health Problems ◽  
Spectrum Disorder ◽  
Intellectual Impairment ◽  
Autistic Spectrum ◽  
Adult Mental Health

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

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