scholarly journals An audit of admission clerking of patients in Heddfan, Adult Mental Health Unit in BCUHB - north Wales

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S75-S75
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Manjula Simiyon ◽  
Vinila Zachariah ◽  
Rajvinder Sambhi
Keyword(s):  
Mental Health ◽  
Physical Examination ◽  
Junior Doctors ◽  
Physical And Mental Health ◽  
Improvement Project ◽  
North Wales ◽  
History Of ◽  
Mental Health Unit ◽  
State Examination ◽  
Source Of Information

AimsTo ensure admission clerking includes salient features needed for the management of both physical and mental health of the patient and also to aid in administrative purposes.MethodThe audit included a team of doctors reviewing the admission clerking notes for 50 patients in the General Adult Psychiatric unit in-patient ward.We created a standard questionnaire-based on Intended learning outcome of core training in psychiatry CT1-CT3 from Royal College of Psychiatry and standard textbooks.Our aim is to achieve 100 % compliance in clerkingResultIt was noted that only 30% wrote their GMC number, 4% added route of admission of the patient and a mere 8% filled the Consultants name. Though almost everyone had written the presenting complaints, the other aspects such as history of presenting illness, medical and family history, Allergy status and substance misuse history were missing in many clerking notes. None of them had filled in details of personal history and very few did a risk assessment.Further lacuna was noted with Mental state examination. Physical examination was also noted to be incomplete. While more than 50% had completed the Blood investigations and ECG, half of them had not documented it and that meant searching in the entire file. A mere 20% filled the nursing observation level whilst none had completed the formulation in the notes.ConclusionAdmission clerking is a vital source of information that would be needed for the formulation of patients diagnosis and future management.Apart from this, it also is needed for further continuity of care.Hence this vital source of information will need to be shared with the junior doctors who will be clerking the patient and seeing them in the first instance.We, therefore, intend to create a complete clerking proforma along with physical health proforma to aid us in this respect.We will audit initially in the first round and then plan to introduce a proforma for Clerking and physical examination based on the findings.We will re-audit to see if the standards are achieved after using the proforma and will consider a Quality improvement project based on this topic

scholarly journals The application of mental health legislation in younger children

2015 ◽  
Vol 39 (6) ◽  
pp. 302-304 ◽  
Author(s):  
Victoria Thomas ◽  
Barry Chipchase ◽  
Lisa Rippon ◽  
Paul McArdle
Keyword(s):  
Mental Health ◽  
Young Child ◽  
Legal Issues ◽  
Legal Authority ◽  
Challenging Behaviour ◽  
Health Unit ◽  
Mental Health Legislation ◽  
History Of ◽  
Health Legislation ◽  
Mental Health Unit

SummaryWe review a case history of a young child who was admitted to an in-patient mental health unit due to extremely challenging behaviour and review the legal issues that had to be considered in ensuring that there was appropriate legal authority for the child's admission and treatment. In this particular case, the patient was detained for assessment under section 2 of the Mental Health Act 1983. This case demonstrates that all clinicians working in this area require a good understanding of the law in relation to treatment of children with mental disorder, which is extremely complex.

scholarly journals Resilience, well-being, depression symptoms and concussion levels in equestrian athletes

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Annika McGivern ◽  
Stephen Shannon ◽  
Gavin Breslin
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Well Being ◽  
Depression Symptoms ◽  
Physical And Mental Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Mental Health Support ◽  
History Of

Purpose This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being. Design/methodology/approach In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being. Findings In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores. Practical implications Findings highlight the need for mental health promotion and support in equestrian sport. Social implications Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being. Originality/value This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.

scholarly journals Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders

2018 ◽  
Vol 64 (3) ◽  
pp. 180-189
Author(s):  
Laura M. Heath ◽  
Jill Torrie ◽  
Kathryn J. Gill
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Psychological Distress ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Emotional Abuse ◽  
Substance Dependence ◽  
Physical And Mental Health ◽  
Parental History ◽  
History Of

Objective: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. Methods: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. Results: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. Conclusions: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

Pain during physical examination of a healing upper extremity fracture

2020 ◽  
pp. 175319342095201
Author(s):  
Amanda I. Gonzalez ◽  
Joost T. P. Kortlever ◽  
Tom J. Crijns ◽  
David Ring ◽  
Lee M. Reichel ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Examination ◽  
Upper Extremity ◽  
Adaptive Responses ◽  
Physical And Mental Health ◽  
Fracture Union ◽  
Level Of Evidence ◽  
Symptom Intensity ◽  
Extremity Fracture ◽  
Upper Extremity Fracture

The evidence that symptom intensity and magnitude of limitations correlate with thoughts and emotions means that subjective signs, such as pain with physical examination, reflect both physical and mental health. During a 1-month evaluation of a rapidly healing upper extremity fracture with no risk of nonunion, 117 people completed measures of adaptiveness to pain and pain during the physical examination. Greater pain during examination correlated with less adaptive responses to pain and older age. This finding raises questions about using tenderness to assess fracture union. Level of evidence: II

scholarly journals Flourishing Despite Migraines: A Nationally Representative Portrait of Resilience and Mental Health among Canadians

2021 ◽  
Author(s):  
Esme Fuller-Thomson
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Secondary Analysis ◽  
Well Being ◽  
Care Providers ◽  
Physical And Mental Health ◽  
History Of ◽  
Nationally Representative ◽  
The Relationship

Objective 1) To examine the relationship between migraine status and complete mental health (CMH) among a nationally representative sample of Canadians; 2) To identify significant correlates of CMH among those with migraine. Methods Secondary analysis of the nationally representative Canadian Community Health Survey – Mental Health (CCHS-MH) (N=21,108). Bivariate analyses and a series of logistic regression models were performed to identify the association between migraine status and CMH. Significant correlates of CMH were identified in the sample of those with migraine (N=2,186). Results Individuals without a history of migraine had 72% higher odds of being in CMH (OR=1.72; 95% CI=1.57, 1.89) when compared with those with a history of migraine. After accounting for physical health and mental health problems, the relationship between migraine status and CMH was reduced to non-significance, with both groups having an approximately equal likelihood of achieving CMH (OR=1.03; 05% CI=(0.92, 1.15). Among those with migraine, factors that were strongly associated with CMH were a lack of a history of depression, having a confidant, and having an income of $80,000 or more. Conclusion Clinicians and health care providers should also address co-occurring physical and mental health issues to support the overall well-being of migraineurs.

scholarly journals Multidisciplinary residential home intervention to improve outcomes for frail residents

2021 ◽  
Author(s):  
Anna Steel ◽  
Helen Hopwood ◽  
Elizabeth Goodwin ◽  
Elizabeth L Sampson
Keyword(s):  
Mental Health ◽  
Residential Home ◽  
Physical And Mental Health ◽  
Improvement Project ◽  
Cardio Pulmonary Resuscitation ◽  
Poor Access ◽  
Advance Care ◽  
Perceived Impact ◽  
Health Review

Abstract BackgroundResidential homes provide accommodation and assistance with personal care only and are not required to have registered nurses on site. However, their residents often have a combination of comorbidity, polypharmacy, frailty and mental-health conditions with poor access to healthcare to meet these needs. Integrated healthcare for older people is a key NHS priority in the Long-Term Plan and the Five-Year Forward View. We describe development and implementation of multi-disciplinary intervention to integrate healthcare and promote interprofessional education.MethodsA multi-disciplinary residential home quality improvement project in two cycles by a team comprising senior and trainee general practitioners, trainees in geriatrics, psychiatry, pharmacist and residential home senior staff. The intervention was underpinned by the framework for enhanced health in care homes including Comprehensive Geriatric Assessment (CGA) and mental-health review. Each intervention session included an educational presentation by a team member consideration of each resident in a pre-evaluation multi-disciplinary discussion followed by a structured clinical assessment and discussion of proposed management.ResultsThree residential homes participated with a total 34 residents receiving intervention. In one residential home, there was a 75% reduction in admissions for those reviewed and a reduction in overall admission costs. Polypharmacy was reduced by an average of 2 medications per resident across the three sites. There was a 63% increase in cardio-pulmonary resuscitation decisions and 76% increase in advance care planning discussions.ConclusionThis was an effective model for multi-disciplinary trainees working with a perceived impact on physical and mental health, and valuable opportunities for sharing learning.

scholarly journals Violence against Women: An Exploration of the Physical and Mental Health Trends among Immigrant and Refugee Women in Canada

2012 ◽  
Vol 2012 ◽  
pp. 1-15 ◽  
Author(s):  
Sepali Guruge ◽  
Brenda Roche ◽  
Cristina Catallo
Keyword(s):  
Mental Health ◽  
Violence Against Women ◽  
Psychological Abuse ◽  
Sri Lankan ◽  
Physical And Mental Health ◽  
Health Trends ◽  
Refugee Women ◽  
History Of ◽  
Sexually Degrading ◽  
Immigrant And Refugee

Violence against women is a serious health and social problem for women worldwide. Researchers have investigated the broad physical and mental health consequences of violence against women but few have focused on immigrant and refugee women. We assessed the history of violence and the impairment of physical and mental health among 60 women participants from the Iranian and Sri Lankan Tamil communities in Toronto, Canada. Our survey findings revealed that the participants had experienced various types of violence throughout their lifespan, with psychological abuse by a spouse/partner occurring most frequently in the past 12 months. Commonly reported types of abuse included insulting, criticizing, and intimidation by partner (psychological abuse); slapping, hitting, and shoving (physical abuse); and forced sexual intercourse and sexually degrading acts (sexual abuse) by a partner/spouse. We found that a substantial proportion of the participants also had experienced physical and mental health impairment, which could be a result of the various types of violence they had experienced throughout their lifespan. Research and practice implications are provided.

scholarly journals Do Junior Doctors feel confident using Emergency Detention Certificates?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S60-S61
Author(s):  
Sarah Wordie ◽  
Alice Troup ◽  
Giovana Klefti ◽  
Cinzia Giuntoli
Keyword(s):  
Mental Health ◽  
Legal Aspects ◽  
Junior Doctors ◽  
Educational Materials ◽  
Educational Tools ◽  
Electronic Survey ◽  
Self Confidence ◽  
Health Officer ◽  
Pro Forma ◽  
Source Of Information

AimsTo assess junior doctors understanding of the law surrounding the use of The Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA) with a focus on assessing confidence and knowledge of the use of the emergency detention certificate (EDC). A secondary aim was to use these findings to develop a variety of educational tools to subsequently improve junior doctors understanding in using the MHA.MethodWe created and distributed a comprehensive electronic survey to 152 Foundation Year Two Doctors working in NHS Lothian, Fife and Borders in December 2020. We subsequently interviewed 20 respondents to enquire about additional resources needed to improve knowledge of the MHA. Following on, we completed worked EDC exemplars, created an easily accessible guide with step-by-step instructions on implementing an EDC and devised a checklist pro-forma that can be accessed and inserted into a patient's electronic notes to ensure all necessary steps are completed for the EDC.Result51 doctors (34%) responded to our survey, of which 10 (19%) had previously worked in psychiatry and 16 (31%) had previously completed an EDC. 27 respondents (52%) reported a lack of self-confidence and knowledge and 26 (51%) reported a lack of understanding in the legal processes as barriers faced when putting an EDC in place. 23 (45%) respondents were unaware that a Mental Health Officer (MHO) must be contacted to grant an EDC. Respondents who had experience of working in psychiatry reported greater awareness of the MHA. From the focused interviews held, colleagues requested for worked EDC examples, an easily accessible checklist with relevant contact details and an electronic pro-forma for patients notes to assist with completing the relevant legal steps when implementing an EDC.ConclusionOur study identified a lack of confidence in understanding the MHA and completing an EDC. Our educational materials will provide an invaluable source of information for junior doctors, in particular those with little experience of the MHA. Importantly, our resources will ensure the legal aspects of implementing an EDC are both complied with and documented appropriately.

scholarly journals Audit of physical health monitoring on admission to Mill Lodge (CAMHS Inpatient Unit, York)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S352-S352
Author(s):  
Andreea Steiu ◽  
Emma Diggins ◽  
Nagulan Thevarajan
Keyword(s):  
Mental Health ◽  
Young People ◽  
Physical Examination ◽  
Physical Health ◽  
Health Assessment ◽  
Health Problems ◽  
Inpatient Unit ◽  
Junior Doctors ◽  
Blood Tests ◽  
Service Specification

AimsThis audit aimed to evaluate the standard of initial physical health assessment that young people receive on admission to Mill Lodge.Adherence to recommendation 2.6.3 of the service specification for Tier 4 CAMHS was assessed. Standard 2.6.3 of the service specification for Tier 4 child and adolescent mental health services states that “on admission all young people must have an initial assessment (including a risk assessment) and care-plan completed within 24 hours. Where admission is for day/in-patient care this will include a physical examination.” In line with this standard this audit will evaluate the use of physical examination, baseline blood tests and ECG carried out on young people.BackgroundMental health problems in children and young people are associated with both short- and long-term physical health problems. It is therefore important that they undergo full physical health assessment on admission to a Tier 4 inpatient unit.MethodElectronic records were reviewed for all patients admitted within a 6 months period, between 1st August 2018 and 1st February 2019. Data were collected in March 2019 and entered directly into an excel spread sheet designed for data collection. A total of 23 patients were identified for inclusion in this audit.Simple statistical analysis was carried out using excel.ResultOver 80% of patients who did not refuse had a completed physical examination (85%), blood results recorded (82%) and ECG (84%) within the first 24 hours of their admission. 100% of patients who did not refuse had bloods and ECG checked at some time during their admission, with 90% having a physical examination.For several patients (3 physical examination, 2 bloods, 3 ECG), no reason was documented as to why the procedure or examination did not take place. For 1 patient, blood tests were delayed due to having no blood tubes available.ConclusionTaken into account the result of this audit and bearing in mind the importance of physical examination as part of the admission process, it is important to try and support both regular Mill Lodge staff and on-call junior doctors to follow Standard 2.6.3's guidance around physical examination on admission to hospital. While good results were seen in many areas, the ward is not yet achieving the standard of 100%. A re-audit will take place in twelve months’ time to review recommendation and compliance.

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