scholarly journals Models of care in forensic psychiatry

2021 ◽  
pp. 1-14
Author(s):  
Harry G. Kennedy

SUMMARY Forensic psychiatry services have grown and become more complex in structures, processes and pathways. Legacy customs, practices and changing policy are now organised into formal models of care. These are written accounts of how a health service is delivered, outlining best practice and services for patients progressing through the stages of their condition and the care and treatment available. This article explores the four key elements of a model of care: goals; pathways and processes; treatment programmes; and systematic evaluation. It describes the most common model of care in forensic services, which builds on structures of stratified therapeutic security. It also considers variations on this basic or standard model matched to needs arising from the complex interrelationship with other parts of the mental health service for the population served and with criminal justice, primary care and physical health, housing and welfare agencies.

2000 ◽  
Vol 63 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Chris Lloyd ◽  
Jo Bassett ◽  
Pam Samra

Early psychosis is a relatively new area of practice in the field of mental health. Early intervention for people with psychosis is increasingly being recognised as a crucial component of quality care. Rehabilitation interventions in early psychosis assist in promoting recovery and involvement in community life, reduce the development of disability and facilitate the achievement of personal goals. The development of models of care and best practice in early psychosis intervention has been promoted by the Commonwealth of Australia. This paper describes a model of care and best practice in early psychosis intervention — the Early Psychosis Programme — which has been implemented in an integrated mental health service.


2001 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Christopher Dowrick

Following ground-breaking work by Shepherd et al (1966) and, more recently, Goldberg & Huxley (1992), primary care is now recognised as the arena in which most contact occurs between the National Health Service (NHS) and people with mental health problems. General practitioners (GPs) remain the first, and in many cases the only, health professionals involved in the management of a whole range of conditions, from common anxiety and depressive disorders to severe and enduring mental illnesses.


2000 ◽  
Vol 6 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Chris Simpson

The current National Health Service (NHS) approach to commissioning health services is in flux. The purchasing of care from providers by general practitioner fundholders (GPFHs) and health authorities has changed with the new White Papers. GPFHs no longer exist and the commissioning role is being handed over from health authorities to primary care groups (PCGs). An understanding of the reasons for change and current arrangements will aid the consultant psychiatrist in influencing this process.


2020 ◽  
Vol 10 (3) ◽  
pp. 598-605
Author(s):  
Andrea K Graham ◽  
Carolyn J Greene ◽  
Thomas Powell ◽  
Pauli Lieponis ◽  
Amanda Lunsford ◽  
...  

Abstract Implementing a digital mental health service in primary care requires integration into clinic workflow. However, without adequate attention to service design, including designing referral pathways to identify and engage patients, implementation will fail. This article reports results from our efforts designing referral pathways for a randomized clinical trial evaluating a digital service for depression and anxiety delivered through primary care clinics. We utilized three referral pathways: direct to consumer (e.g., digital and print media, registry emails), provider referral (i.e., electronic health record [EHR] order and provider recommendation), and other approaches (e.g., presentations, word of mouth). Over the 5-month enrollment, 313 individuals completed the screen and reported how they learned about the study. Penetration was 13%, and direct to consumer techniques, most commonly email, had the highest yield. Providers only referred 16 patients through the EHR, half of whom initiated the screen. There were no differences in referral pathway based on participants’ age, depression severity, or anxiety severity at screening. Ongoing discussions with providers revealed that the technologic implementation and workflow design may not have been optimal to fully affect the EHR-based referral process, which potentially limited patient access. Results highlight the importance of designing and evaluating referral pathways within service implementation, which is important for guiding the implementation of digital services into practice. Doing so can ensure that sustained implementation is not left to post-evaluation bridge-building. Future efforts should assess these and other referral pathways implemented in clinical practice outside of a research trial.


2020 ◽  
pp. archdischild-2020-320358
Author(s):  
C Ronny Cheung ◽  
Anna Finnemore ◽  
Jennifer Handforth ◽  
Richard Bohmer ◽  
Nanna Christiansen ◽  
...  

This article describes the rapid, system-wide reconfiguration of local and network services in response to the newly described paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (also known as multisystem inflammatory syndrome in children). Developing the model of care for this novel disease, whose natural history, characteristics and treatment options were still unclear, presented distinct challenges.We analyse this redesign through the lens of healthcare management science, and outline transferable principles which may be of specific and urgent relevance for paediatricians yet to experience the full impact of the COVID-19 pandemic; and more generally, for those developing a new clinical service or healthcare operating model to manage the sudden emergence of any unanticipated clinical entity. Health service leaders in areas where COVID-19 is, or will soon be, in the ascendancy, and who are anticipating the imminent influx of PIMS-TS, should use these principles and recommendations to plan an agile, responsive and system-wide model of care for these children.


2015 ◽  
Vol 24 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Parashar P Ramanuj ◽  
Carlos FA Carvalho ◽  
Robert Harland ◽  
Philippa A Garety ◽  
Tom KJ Craig ◽  
...  

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