scholarly journals A comparison of clinical outcomes, service satisfaction and well-being in people using acute day units and crisis resolution teams: cohort study in England

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Danielle Lamb ◽  
Thomas Steare ◽  
Louise Marston ◽  
Alastair Canaway ◽  
Sonia Johnson ◽  
...  
Keyword(s):  
Cohort Study ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Client Satisfaction ◽  
Well Being ◽  
Crisis Resolution ◽  
Health Crisis ◽  
Satisfaction Questionnaire ◽  
Crisis Resolution Teams

Background For people in mental health crisis, acute day units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to crisis resolution teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly compared with those receiving CRT care alone. Aims We aimed to investigate readmission rates, satisfaction and well-being outcomes for people using ADUs and CRTs. Method We conducted a cohort study comparing readmission to acute mental healthcare during a 6-month period for ADU and CRT participants. Secondary outcomes included satisfaction (Client Satisfaction Questionnaire), well-being (Short Warwick–Edinburgh Mental Well-being Scale) and depression (Center for Epidemiologic Studies Depression Scale). Results We recruited 744 participants (ADU: n = 431, 58%; CRT: n = 312, 42%) across four National Health Service trusts/health regions. There was no statistically significant overall difference in readmissions: 21% of ADU participants and 23% of CRT participants were readmitted over 6 months (adjusted hazard ratio 0.78, 95% CI 0.54–1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire scores (2.5, 95% CI 1.4–3.5, P < 0.001) and well-being scores (1.3, 95% CI 0.4–2.1, P = 0.004), and lower depression scores (−1.7, 95% CI −2.7 to −0.8, P < 0.001), than CRT participants. Conclusions Patients who accessed ADUs demonstrated better outcomes for satisfaction, well-being and depression, and no significant differences in risk of readmission, compared with those who only used CRTs. Given the positive outcomes for patients, and the fact that ADUs are inconsistently provided in the National Health Service, their value and place in the acute care pathway needs further consideration and research.

scholarly journals A comparison of clinical outcomes, service satisfaction, and well-being in people using Acute Day Units and Crisis Resolution Teams: a cohort study in England

2020 ◽  
Author(s):  
Danielle Lamb ◽  
Thomas Steare ◽  
Louise Marston ◽  
Alastair Canaway ◽  
Sonia Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Care Pathway ◽  
Well Being ◽  
Service Users ◽  
Mental Health Crisis ◽  
Crisis Resolution ◽  
Readmission Rates ◽  
Health Crisis ◽  
Crisis Resolution Teams

AbstractBackgroundFor people in mental health crisis, Acute Day Units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to Crisis Resolution Teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly in comparison to those receiving CRT care alone.AimsTo investigate readmission rates, satisfaction, and wellbeing outcomes for ADU and CRT service users.MethodsA cohort study comparing readmission to acute mental health care during a six-month period for ADU and CRT participants. Secondary outcomes included satisfaction (CSQ), wellbeing (SWEMWBS), and depression (CES-D).ResultsWe recruited 744 participants (ADU: 431, 58%; CRT 312, 42%) across 4 NHS Trusts/health regions. There was no statistically significant overall difference in readmissions; 21% of ADU participants (versus 23% CRT) were readmitted over 6 months (adjusted HR 0.78, 95%CI 0.54, 1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire (CSQ) scores (2.5, 95% CI 1.4 to 3.5, p<0.001) and wellbeing scores (1.3, 95%CI 0.4 to 2.1, p=0.004), and lower depression scores (−1.7, 95%CI −2.7 to −0.8, p<0.001) than CRT participants.ConclusionsService users who accessed ADUs demonstrated better outcomes for satisfaction, wellbeing, and depression, and no significant differences in risk of readmission compared to those who only used CRTs. Given the positive outcomes for service users, and the fact that ADUs are inconsistently provided across the country, their value and place in the acute care pathway needs further consideration and research.

Looking forward to the next 70 years: from a National Ill-Health Service to a National Health System

2018 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
David J. Hunter
Keyword(s):  
National Health Service ◽  
Local Government ◽  
Health Service ◽  
Health System ◽  
21St Century ◽  
National Health ◽  
National Health System ◽  
Well Being ◽  
Tipping Point ◽  
Health And Well Being

AbstractAmidst the NHS’s (National Health Service) success lies its major weakness, although one that Klein overlooks in his reflections on the NHS as it approaches 70. The focus on, and investment in, curing ill-health has been at the expense of attending to the public’s overall health and well-being. This preoccupation poses a greater threat to the NHS’s future than privatisation. Despite the weakness having been diagnosed decades ago, redressing the imbalance has proved stubbornly hard to achieve. Rhetoric has not been translated into reality. Yet, we may be on the cusp of a tipping point where in order to ensure a sustainable NHS, and one that is capable of meeting the 21st century challenges facing it, there is a renewed and overdue interest in promoting health and well-being in communities. But for this to succeed, the NHS will need to embrace its bete noire, local government.

scholarly journals Gaining approvals for mental health research in the NHS

2016 ◽  
Vol 22 (1) ◽  
pp. 64-72
Author(s):  
Miriam Cooper ◽  
Olga Eyre ◽  
Joanne Doherty ◽  
Rhys Bevan Jones
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Well Being ◽  
Mental Health Research ◽  
Ethical Aspects ◽  
Future Developments ◽  
Conducting Research

SummaryWhen embarking on mental health research it is often necessary to apply for approvals from one or more review bodies to ensure that the research is ethical and that the safety and well-being of participants are safeguarded. This can be complicated and time consuming, particularly to those unfamiliar with the process. In this article we describe the approvals commonly required for National Health Service-based research involving patients and endeavour to clearly explain what is involved at each stage. We then highlight some of the main considerations, including ethical aspects, which are particularly pertinent to conducting research in the field of mental health, and finish with general advice and considerations for future developments in the area.

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