scholarly journals Bridging the service divide

2004 ◽  
Vol 10 (4) ◽  
pp. 257-259 ◽  
Author(s):  
Philip P. Asherson
Keyword(s):  
Mental Health ◽  
Adult Adhd ◽  
Mental Health Problems ◽  
Stimulant Medication ◽  
Adult Life ◽  
Specific Treatment ◽  
Good Deal ◽  
Clinical Activity ◽  
Need For Treatment ◽  
Adult Psychiatry

Most child and adolescent mental health services recognise the existence of, and need for treatment in, attention-deficit hyperactivity disorder (ADHD). Many specialist multidisciplinary ADHD clinics have been developed in recent years, and many paediatricians have included the treatment of ADHD as an important part of their clinical activity. A good deal of the justification for this increase in therapeutic activity has been the demonstration that ADHD is indeed a predictor of adult mental health problems. General adult psychiatry, however, has not followed suit in identifying and treating substantial numbers of affected people. It is likely none the less that an increasing load in adult psychiatry will develop. A rising number of young people will enter adult life still receiving stimulant medication or other treatment for ADHD, and adult psychiatrists are likely to be consulted. Furthermore, an increasing number of adults are likely to recognise themselves as having been disabled by ADHD and therefore to seek assistance. In many cases, individuals with adult ADHD who require specific treatment for the condition will have been treated unsuccessfully for disorders with overlapping symptom profiles such as anxiety, depression, bipolar disorder and antisocial personality disorder.

scholarly journals Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Gellert ◽  
Sonia Lech ◽  
Eva-Marie Kessler ◽  
Wolfram Herrmann ◽  
Susanne Döpfmer ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Problems ◽  
Health Problems ◽  
General Health Status ◽  
Outpatient Psychotherapy ◽  
Need For Treatment ◽  
Perceived Need ◽  
Rural Residency ◽  
Perceived Need For Treatment

Abstract Beackground Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrant further investigation. Methods We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18–25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55–64 OR 1.02, 65–74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.

scholarly journals Neurodevelopment disorders in adolescence and transition into adulthood

2017 ◽  
Vol 41 (S1) ◽  
pp. 914-914
Author(s):  
A. Moscoso
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Strong Predictor ◽  
Psychiatric Morbidity ◽  
Later Life ◽  
Transitional Period ◽  
Adult Psychiatry ◽  
Competing Interest ◽  
Therapeutic Tools ◽  
Time Specific

The transitional period from adolescence into adulthood is an important developmental stage, known to be a risk factor for mental health problems. Neuropsychiatric disorders are the main cause of disability for young people aged 10–24 years and they seem to precede mental health disorders in adults. Since persistence of an adolescent episode is a strong predictor of outcome, giving proper care during critical stages might prevent later life psychiatric morbidity arising from adolescent-onset disorders. Mental health services for adolescents have evolved from non-specific secondary treatment to more extensive treatment goals, where prevention and early diagnosis take place; at the same time, specific therapeutic tools for adolescents are increasing and put into practice. In Europe, both child and adolescent psychiatrists (CAP) and adult psychiatrists treat adolescents, and for a few countries, the specialty of adolescent psychiatry exists. In this symposium, we propose to address new strategies to treat adolescents with defying pathologies that often pose problems; we will do it through the scope of CAP and adult psychiatry.Disclosure of interestThe author has not supplied his declaration of competing interest.

Could it be Adult ADHD?

2017 ◽  
Author(s):  
Jan Willer
Keyword(s):  
Mental Health ◽  
Behavioral Treatment ◽  
Adult Adhd ◽  
Adaptive Functioning ◽  
Mental Health Problems ◽  
Emotional Dysregulation ◽  
Full Description ◽  
Health Practitioner ◽  
Cognitive Behavioral Treatment ◽  
Adhd Treatment

One out of every 10 adult psychotherapy clients—or more—probably has attention deficit/hyperactivity disorder (ADHD). When psychotherapists miss the ADHD, treatment is frustrating and less effective. This book is for the general mental health professional who wishes to learn how to recognize, assess, and treat adult ADHD. Adults with ADHD are very different, developmentally and symptomatically, from children. ADHD affects adults of all races, gender identities, and backgrounds, and obvious hyperactivity is rarely part of the adult clinical picture. This book provides a full description of adult ADHD symptoms, based on the most current research, including executive functioning problems, emotional dysregulation, atypical reward sensitivity, and problems with time perception. Complete guidance to recognizing adult ADHD is provided, including behavior displayed during psychotherapy, developmental issues, educational challenges, and adaptive functioning problems. Depression, anxiety, self-image issues, and substance abuse are addressed, since these mental health problems are commonly associated with adult ADHD. Guidance is provided to help the mental health practitioner provide psychoeducation about cognitive differences in ADHD, which is essential for client self-acceptance and adaptive functioning. Common psychotherapy problems with ADHD clients are addressed, including chronic lateness to sessions, missed appointments, motivation problems, difficulties with homework, and tangentiality. The principles of cognitive-behavioral treatment of ADHD are provided, along with case examples to illustrate the implementation of these techniques. An overview of medications for ADHD is provided, including their benefits, contraindications, and side effects. Nontraditional treatments are reviewed for their effectiveness.

scholarly journals Notes on Occupational Maladjustment and Managerial response in 36 large South African enterprizes

1982 ◽  
Author(s):  
A. Vlok
Keyword(s):  
Mental Health ◽  
South African ◽  
Ad Hoc ◽  
Mental Health Problems ◽  
General Pattern ◽  
Good Deal ◽  
Work Organizations ◽  
Concerted Effort ◽  
Positive Attitudes ◽  
Maar Daar

A survey was undertaken to assess the scope of certain mental health problems in work organizations and ways these are being dealt with by management. The general pattern emerging from the data reflects a growing awareness of and concern for problems of this nature, particularly in the area of alcoholism. This is closely followed by emotional problems but a good deal of uncertainty in the area of drug abuse is apparent. Concerted effort on the part of industry and community is required to mould positive attitudes and ad hoc co-ordinated policies and programs.Opsomming'n Opname is onderneem om die voorkoms van sekere geestesgesondheids-probleme in werksorganisasies en wyses waarop dit van bestuursweë gehanteer word, te ondersoek. Die gegewens weerspieël 'n algemene patroon wat dui op 'n toenemende besef van en bemoeienis met probleme van hierdie aard, veral ten opsigte van alkoholisme. Dit word gevolg deur emosionele probleme, maar daar is blykbaar heelwat onsekerheid oor die misbruik van dwelmmiddels. Gesamentlike pogings deur die nywerheid en gemeenskap word vereis om positiewe houdinge en ad hoc hulp in gekoördineerde programme en beleid te omskep.

Using Perceptual Control Theory and the Method of Levels to work with people who experience psychosis

2009 ◽  
Vol 2 (3) ◽  
pp. 227-242 ◽  
Author(s):  
Sara J. Tai
Keyword(s):  
Mental Health ◽  
Control Theory ◽  
Psychotic Disorders ◽  
Mental Health Problems ◽  
Specific Treatment ◽  
Health Problems ◽  
Therapeutic Application ◽  
Perceptual Control Theory ◽  
Perceptual Control ◽  
Potential Benefits

AbstractThis paper provides an overview of perceptual control theory (PCT) in relation to understanding severe and enduring mental health problems. The core principles of control and conflict are reviewed in relation to understanding the experiences associated with psychotic disorders. The therapeutic application of PCT known as the Method of Levels (MOL) is described and an overview of how this might be a useful approach to use with people experiencing psychosis is provided. The benefits and difficulties of using MOL to work with people experiencing psychosis are described including case illustrations of preliminary work based on the application of MOL in clinical practice. It is concluded that PCT is a useful framework for understanding severe and enduring mental health problems and there are potential benefits in using MOL as a therapeutic intervention. Further research examining the effectiveness and feasibility of MOL as a specific treatment for psychosis is recommended.

A longitudinal analysis of a work inclusion model for psychiatric patients in the Mental Health Departments of the city of Milan

2021 ◽  
pp. 002076402110429
Author(s):  
Luca Ferrara ◽  
Alberto Varinelli ◽  
Valentina Caricasole ◽  
Chiara Dragoni ◽  
Sonia Mazzardis ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Mental Health Problems ◽  
Psychiatric Patients ◽  
Specific Treatment ◽  
Fundamental Aspect ◽  
Age Group ◽  
Treatment Plans ◽  
Age Range ◽  
The City

Background: Work functioning impairment is a key diagnostic and transnosographic criterion for psychiatric disorders in both DSM-5 and ICD-11. Occupational inclusion is a fundamental aspect of the care path for patients attending the territorial services provided by the Italian Mental Health and Addiction Departments (DSMDs). Since 2009, the Regional Innovative Programme (PIR) TR106, promoted by the Fatebenefratelli-Sacco hospital of Milan, Italy, in collaboration with six other metropolitan DSMDs, was created to promote integration for people suffering from mental health problems in the city of Milan. Method: Here we present the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients, conducted between 2012 and 2019. Results: Most of the interventions were conducted with people with psychotic disorders (39%), followed by personality disorders (25.2%) and affective disorders (22.2%). The age range of 25 to 54 years represented 91.5% of the whole sample, mainly in the 35 to 44 years range (36.4%). Significant age group-related changes in interventions were observed in the observation period, with a reduction in the interventions provided to subjects of the 35 to 44 age group, and an increase in the 25 to 34 age group. Conclusions: PIR TR106 provided the most accurate assessment and data collection so far for the city of Milan. Our data characterised psychiatric groups in order to develop specific treatment plans and work inclusion interventions.

Key differences in treatment-seeking stimulant users attending a specialised treatment service: a means of early intervention?

2017 ◽  
Vol 25 (3) ◽  
pp. 246-249 ◽  
Author(s):  
Shalini Arunogiri ◽  
Margret Petrie ◽  
Michelle Sharkey ◽  
Dan I Lubman
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Suicide Attempts ◽  
Mental Health Problems ◽  
Previous History ◽  
Specific Treatment ◽  
High Rate ◽  
Full Time ◽  
Treatment Service ◽  
Retrospective Audit

Objectives: Few people who use stimulants seek clinical treatment. This study sought to describe a cohort of stimulant users who attended a stimulant-specific treatment service, Access Point, in Melbourne, Australia between 2008 and 2014. Methods: A retrospective audit of the records of adults ( n = 175) who sought treatment for stimulant use at a stimulant-specific outpatient treatment service was conducted. Results: Service users had a median age of 32 (range = 19–54). Most stimulant users were in part- or full-time employment (53.6%) and had stable accommodation (85%). There was a high rate of mental health comorbidity, with over half (52%) reporting a previous history of mental health problems, while one-third (33%) reported previous suicide attempts. There was a high rate (48%) of previous methamphetamine-associated psychosis, which was significantly correlated with frequency of use ( x2 = 13.698, p = 0.008). Conclusions: This study supports the potential of a targeted and specialised treatment service as a means of early intervention for stimulant users. The high prevalence of methamphetamine-associated psychosis history in this group suggests that frequent use of stimulants increases the risk of psychosis, even among high-functioning individuals.

scholarly journals Association of illicit drug use in adolescence with socioeconomic and criminal justice outcomes in adulthood: prospective findings from a UK national birth cohort

2020 ◽  
pp. jech-2019-213282
Author(s):  
James White ◽  
Steven Bell ◽  
G David Batty
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Drug Use ◽  
Birth Cohort ◽  
Illicit Drug ◽  
Mental Health Problems ◽  
Adult Life ◽  
Illicit Drug Use ◽  
Birth Cohort Study ◽  
The Past

BackgroundIllicit drug use in adolescence has been linked to drug use and poor mental health in adult life, but few studies have examined the relation between adult economic and criminal justice outcomes.MethodsWe analysed data from 14 082 participants (6999 women) in the 1970 British Birth Cohort Study. Illicit drug use over study members’ lifetime and in the past year were self-reported at 16 years of age. Thirteen outcomes were self-reported at 30 years of age, including illicit drug use, smoking, problems with alcohol, mental and physical health, experience of socioeconomic disadvantage and experiences with the criminal justice system.ResultsAt 16 years of age, 20.3% of the participants had ever tried an illicit drug and 7.2% had used in the past year. After adjustment for childhood socioeconomic status and mental health problems, and following correction for multiple testing, there was a dose–response association between illicit drug use at 16 years with illicit drug use in adult life in the past year (OR; 95% CI – 1.83, 1.51 to 3.12), experiencing homelessness (1.74, 1.16 to 2.62), being arrested (1.57, 1.29 to 1.92) and cautioned (1.97, 1.50 to 2.57) by the police, and being found guilty at court (1.73, 1.34 to 2.23).ConclusionsAdolescent drug use was associated with an array of social and criminal outcomes in later life.

scholarly journals Improving physical health form completion on a general inpatient adult ward

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S227-S228
Author(s):  
Brandon Wong ◽  
Anjna Vekaria
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Mental Health Problems ◽  
Electronic Record ◽  
Psychiatric Ward ◽  
Excel Spreadsheet ◽  
Record Keeping ◽  
Blood Tests ◽  
Cholesterol Levels ◽  
Adult Psychiatry

AimsThe government's Five Year Forward View Plan for Mental Health has set a target for 280,000 people with severe mental health problems to be offered screening and appropriate intervention based on physical health risk stratification, including obesity, diabetes and heart disease. As such, physical health review for patients on a general inpatient adult psychiatry ward includes routine blood tests for cholesterol levels and HbA1c. They are recorded together in a Physical Health (PH) Form in the patient's electronic record and used to stratify cardiovascular risk factors and risk of diabetes. If a patient declines these blood tests it should be recorded on the PH form.This study aims to improve the completion of Physical Health forms to ≥95% by within a 4-month period on a general adult inpatient psychiatric ward.MethodPH form completion was measured using Tableau Software for a 4-week period as a baseline then fortnightly during the study. PH form completion required HbA1c and cholesterol levels to be inputted, or to be marked as declined where the patient had declined these tests. Potential interventions were discussed by clinicians and implemented using PDSA cycles with iterative changes tested and analysed. PH form completion was re-audited monthly for a 6-month period.ResultBaseline data showed 61.54% of patients had physical health forms completed (n = 26; 61.54% with HbA1c, 76.92% with cholesterol completed). Iterative changes and improvements included; (i) paper list to track PH form completion, (ii) table on Microsoft Word, (iii) Excel spreadsheet, and (iv) a conditionally formatted Excel spreadsheet. The conditionally formatted Excel spreadsheet was colour-coded to show completed elements as green and incomplete elements as red.Paper lists increased PH completion to 84.85% (n = 33). Word table increased PH completion to 96.43% (n = 28). Excel spreadsheet had PH completion of 96.67% (n = 30). Colour coded excel spreadsheet increased PH completion to 100% (n = 28). This was used as standard practice with sustained 100% completion in November (n = 34) and December (n = 39). The improvement was sustained to January 2021, although there was a decrease to 97.7% (n = 30).ConclusionIt was hypothesised an intervention to track completion of PH forms would improve completion rate. The use of a colour-coded conditionally formatted Excel spreadsheet improved PH form completion to 100% within an 8-week period and a sustained increase of >95% 6 months after the study began. This study recommends the use of such an electronic record keeping system to assist with PH form completion.

Childhood Sexual Abuse and Mental Health in Adult Life

1993 ◽  
Vol 163 (6) ◽  
pp. 721-732 ◽  
Author(s):  
Paul E. Mullen ◽  
Judy L. Martin ◽  
Jessie C. Anderson ◽  
Sarah E. Romans ◽  
G. Peter Herbison
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Mental Health Problems ◽  
Community Sample ◽  
Adult Life ◽  
Increased Risk ◽  
The Matrix ◽  
Effects Of Sexual Abuse ◽  
Adult Psychopathology

The relationship between childhood sexual abuse and mental health in adult life was investigated in a random community sample of women. There was a positive correlation between reporting abuse and greater levels of psychopathology on a range of measures. Substance abuse and suicidal behaviour were also more commonly reported by the abused group. Childhood sexual abuse was more frequent in women from disrupted homes as well as in those who had been exposed to inadequate parenting or physical abuse. While elements in the individual's childhood which increased the risks of sexual abuse were also directly associated to higher rates of adult psychopathology, abuse emerged from logistic regression as a direct contributor to adult psychopathology. Severity of abuse reported was related to the degree of adult psychopathology. The overlap between the possible effects of sexual abuse and the effects of the matrix of disadvantage from which it so often emerges were, however, so considerable as to raise doubts about how often, in practice, it operates as an independent causal element. Further, many of those reporting childhood sexual abuse did not show a measurable long-term impairment of their mental health. Abuse correlated with an increased risk for a range of mental health problems, but in most cases its effects could only be understood in relationship to the context from which it emerged.

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