scholarly journals Utilisation of mental health transfer checklist proforma from acute physical health hospitals (Liverpool University Hospitals NHS Foundation Trust) to mental health hospitals (Mersey Care NHS Foundation Trust)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S307-S307
Author(s):  
Dalal Al-Bazz ◽  
Fareeba Anwar ◽  
Qaiser Javed
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
University Hospitals ◽  
Political Issue ◽  
Patient Admissions ◽  
Hospital Policies ◽  
Medical Wards ◽  
The Uk ◽  
Health Hospital ◽  
Mental Health Hospitals

AimsTesting the compliance and completion rate of a transfer checklist (proforma) created in accordance with local hospital policies.BackgroundThe proforma was developed following serious incidents where medically unstable patients were inappropriately discharged to mental health hospitals, requiring readmission to acute medical hospitals. Frequently these events reported an inadequate handover from medical to mental health teams and patients were often prematurely deemed medically fit with evidence to the contrary.Although parity of esteem between mental and physical health has been a high profile political issue in the UK since 2011, evidence indicates that parity is far from being achieved. This first ever checklist was designed to improve safety of patient transfer from acute physical health hospitals to mental health hospitals by ensuring patients are medically fit and better communication between the two trusts.MethodData were collected retrospectively over a six-month period between August 2018 and January 2019 and retrieved from patient notes available at relevant trusts. Electronic notes were obtained from medical wards, accident and emergency and Mersey Care electronic systems. Notes were specifically scrutinised for presence of the proforma, quality of completion and, number and reasons for readmission from mental health hospitals to acute physical health hospitals following their medical optimization. Readmissions were considered as admissions to physical health hospitals up to one month following discharge with evidence of ongoing concerns.Result6597 referrals were made to liaison services from Liverpool University Hospitals, of which 5–6 % were admitted to inpatient mental health units. 31% of admissions from Liverpool University Hospitals were readmitted to a physical health hospital within one month of discharge indicating inappropriate and unsafe discharges. Of all those readmitted, 10% had ongoing acute medical concerns prior to admission to a mental health hospital. The proforma was filled in 13% of admissions from Liverpool University Hospitals. None of the forms were fully complete.Conclusion10% of patient admissions to mental health hospitals were identified as inappropriate due to ongoing acute medical concerns. The proforma served as structured guidance and evidence of medical fitness at time of transfer. However poor compliance was observed, which could be secondary to lack of awareness of the proforma and inadequate dissemination of the policy. Findings were shared and discussed with the appropriate teams both in acute physical health and mental health hospitals and steps will be taken to raise awareness of the proforma before completing a second audit.

scholarly journals The cost of mental and physical health disability in childhood and adolescence to families in the UK: findings from a repeated cross-sectional survey using propensity score matching

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018729 ◽  
Author(s):  
Francesca Solmi ◽  
Mariya Melnychuk ◽  
Stephen Morris
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Childhood And Adolescence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Family ◽  
Additional Costs ◽  
The Uk ◽  
The Cost ◽  
Mental And Physical Health

ObjectiveIn the UK, families of disabled children are entitled to receive disability benefits to help meet costs associated with caring for their child. Evidence of actual costs incurred is scant, especially for mental health disability. In this study, we aimed to quantify the cost of mental and physical health disability in childhood and adolescence to families in the UK using the concept of compensating variation (CV).DesignRepeated cross-sectional survey.SettingThe UK general populationParticipants85 212 children drawn from 8 waves of the Family Resources Survey.OutcomesUsing propensity score matching we matched families with a disabled child to similar families without a disabled child and calculated the extra income the former require to achieve the same living standards as the latter, that is, their CV. We calculated the additional costs specifically associated with several definitions of mental health and physical health disability.ResultsFamilies of a child with any mental health disability, regardless of the presence of physical health comorbidity, needed an additional £49.31 (95% CI: 21.95 to 76.67) and, for more severe disabilities, an additional £57.56 (95% CI: 17.69 to 97.44) per week to achieve the same living standards of families without a disabled child. This difference was greater for more deprived families, who needed between £59.28 (95% CI: 41.38 to 77.18) and £81.26 (95% CI: 53.35 to 109.38) more per week depending on the extent of mental health disability. Families of children with physical health disabilities, with or without mental health disabilities, required an additional £35.86 (95% CI: 13.77 to 57.96) per week, with economically deprived families requiring an extra £42.18 (95% CI: 26.38 to 57.97) per week.ConclusionsMental and physical health disabilities among children and adolescents were associated with high additional costs for the family, especially for those from deprived economic backgrounds. Means testing could help achieve a more equitable redistribution of disability benefit.

scholarly journals Attitudes About COVID-19 and Health: A Mixed-Methods Smartphone-App and Online Survey Study (Preprint)

2021 ◽  
Author(s):  
Anna M. Hood ◽  
Hanne Stotesbury ◽  
Jennifer Murphy ◽  
Melanie Kölbel ◽  
April Slee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Data Collection ◽  
Physical Health ◽  
Online Survey ◽  
Smartphone App ◽  
The Uk ◽  
The Impact ◽  
Monthly Survey

BACKGROUND Behavioral mitigation strategies to slow the spread of COVID-19 have resulted in sweeping lifestyle changes, with short and long-term psychological, well-being, and quality of life implications. The Attitudes About COVID-19 and Health (ATTACH) study focuses on understanding attitudes and beliefs whilst considering the impact on mental and physical health and the influence of broader demographic and geographic factors on attitudes, beliefs, and mental health burden. OBJECTIVE In this assessment of our first wave of data collection, we provide baseline cohort descriptives of ATTACH study participants in the United Kingdom (UK), United States of America (USA), and Mexico. Additionally, we assess responses to daily poll questions related to COVID-19 and conduct a cross-sectional analysis of baseline assessments collected in the UK between June 26 and October 31, 2020. METHODS The ATTACH study uses smartphone-app technology and online survey data collection. Participants completed poll questions twice daily related to COVID-19 and a monthly survey assessing mental health, social isolation, physical health, and quality of life. Poll question responses were graphed using 95% Clopper-Pearson (exact) tests with 95% confidence intervals. Pearson correlations, hierarchical linear regression analyses, and generalized linear models assessed relationships, predictors of self-reported outcomes, and group differences, respectively. RESULTS By October 31, 2020, 1405, 80, and 90 participants had consented to participate in the UK, USA, and Mexico, respectively. Descriptive data for the UK daily poll questions indicated that participants were generally following social distancing measures, but worry and negative impacts on families increased as the pandemic progressed. Although participants generally reported feeling that the reasons for current measures had been made clear, there was low trust that the government was doing everything in its power to meet public needs. In the UK, 1282 participants also completed a monthly survey (95% white, 72% female, 21% key or essential workers). Nineteen percent of UK participants reported a pre-existing mental health disorder, 31% reported a pre-existing chronic medical illness, and 35% were over 65. Fifty-seven percent of participants reported being more sedentary since the pandemic began, and 41% reported reduced access to medical care. Those with poorer mental health outcomes lived in more deprived neighborhoods, in larger households (ps < .05), had more pre-existing mental health disorders and medical conditions, and were younger than 65 years (all ps < .001). CONCLUSIONS Communities who have been exposed to additional harm during the COVID-19 pandemic were experiencing worse mental outcomes. Factors including having a medical condition, or living in a deprived neighborhood or larger household were associated with heightened risk. Future longitudinal studies should investigate the link between COVID-19 exposure, mental health, and sociodemographic and residential characteristics.

scholarly journals What challenges do UK adults face when adhering to COVID-19-related instructions? Cross-sectional survey in a representative sample

2020 ◽  
Author(s):  
Chris Keyworth ◽  
Tracy Epton ◽  
Lucie Byrne-Davis ◽  
Jessica Leather ◽  
Chris Armitage
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Representative Sample ◽  
Final Analysis ◽  
Analysis Data ◽  
Daily Routine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The People ◽  
The Uk

AimsAdherence to government COVID-19-related instructions is reported to be high, but the psychosocial impacts of measures such as self-isolation and physical distancing could undermine adherence in the longer term. The first step in designing interventions to mitigate the impacts of adhering to COVID-19 related instructions is to identify what are the most prevalent challenges and what characterises the people facing them.MethodA cross-sectional survey was administered to a representative sample of the UK population (N=2,252), of whom n=2,139 (94.9%) reported adhering to the UK government's COVID-19-related instructions, and were included in the final analysis. Data were analysed using descriptive statistics and binary logistic regression.ResultsOf the people who reported adhering to UK government's COVID-19-related instructions, 80.3% reported experiencing challenges. Adults aged 55 years or over (OR=1.939, 95%CI 1.331-2.825) and men (OR=0.489, 95%CI 0.393-0.608) were least likely to report challenges. Adjusting to changes in daily routine (reported by 48.7% of the sample), mental health (reported by 41.4% of the sample) and physical health (reported by 31.5% of the sample) were the most prevalent challenges. ConclusionsFor the first time, the present study quantifies the extent to which people experienced challenges in relation to adhering to government COVID-19-related instructions. Few people reported experiencing no challenges when adhering to COVID-19-related instructions. Interventions to address the effects of changes in daily routine, mental health challenges, and physical health challenges should be prioritised, with a focus on women and adults aged younger than 55 years.

scholarly journals Public mental health: An interdisciplinary subject?

2015 ◽  
Vol 207 (3) ◽  
pp. 192-194 ◽  
Author(s):  
Sarah L. Stewart-Brown
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Physical Health ◽  
Public Mental Health ◽  
Public Health Perspective ◽  
The Public ◽  
Health Circles ◽  
Important Landmark ◽  
The Uk

SummaryThe Chief Medical Officer's report for 2013 was the first of its kind to highlight the public's mental rather than physical health and thus represents a very important landmark for public health in the UK. Written primarily from the perspective of psychiatrists, the report has created confusion in public health circles by failing to adequately address the public health perspective. David Foreman's editorial in this issue, calling as it does for more training in public health for psychiatrists, is therefore very welcome and timely.

Exploring the health risks of help-seeking military veterans living in different parts of the UK

2017 ◽  
Vol 164 (1) ◽  
pp. 8-14 ◽  
Author(s):  
RL Ashwick ◽  
D Murphy
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Physical Health ◽  
Help Seeking ◽  
Alcohol Misuse ◽  
Military Veterans ◽  
Service Planning ◽  
Treatment Seeking ◽  
Health Differences ◽  
The Uk

BackgroundLittle is known about the mental and physical health differences of treatment-seeking military veterans across the different nations that make up the UK. The aim of this research was to explore potential health differences in order to support better service planning.MethodsA random cross-sectional sample of treatment-seeking veterans residing in England, Scotland, Wales and Northern Ireland was identified from a national mental health charity. 403 veterans completed a questionnaire highlighting their demographics, mental health and physical health difficulties. The data were analysed using a multinomial logistic regression with England as the baseline comparison.ResultsHelp-seeking veterans residing in Northern Ireland tended to be older, have experienced less childhood adversity, joined the military after the age of 18 and took longer to seek help. Additionally, veterans from Northern Ireland had higher levels of obesity, sensory, mobility and systemic problems and a greater number of physical health conditions. Scottish and Welsh veterans had a higher risk of smoking and alcohol misuse. No differences were found in mental health presentations.ConclusionThe findings from this paper suggest that a greater focus needs to be placed on treating physical problems in Northern Irish veterans. Alcohol misuse should be addressed in more detail in treatment programmes, particularly in Scotland and Wales. As few differences were found in the mental health presentations, this suggests that standardised services are adequate.

scholarly journals Exploring the mental health impact on private flat owners in residential buildings with external combustible cladding

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S268-S269
Author(s):  
William Martin
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Residential Buildings ◽  
Health Impact ◽  
Direct Result ◽  
Free Text ◽  
List Type ◽  
Physical And Mental Health ◽  
Human Right ◽  
The Uk

AimsTo explore the mental health of private flat owners in residential buildings with external combustible cladding, which require remediation following the 2017 Grenfell tower fire.The speed at which the fire at Grenfell spread, killing 72 people, is largely attributed to external combustible cladding. It is increasingly suspected that there are ongoing profound effects on the mental health of people living in flats with external combustible cladding like Grenfell both in the UK and abroad. The issue has left flat owners facing severe financial hardship, the threat of bankruptcy and concerns about safety in their own homes.MethodAn exploratory ‘Google Forms’ online mental health survey comprising multiple choice and free text questions over 47 sections was distributed to flat owners in affected buildings. The survey remained open for 6 weeks to allow response. 550 individual responses were studied.Result550 individuals completed the survey, from 143 buildings across 45 UK councils.As a direct result of external combustible cladding: 89.5% said their mental health had deteriorated,22.5% reported having suicidal feelings or a desire to self-harm,71.1% reported having difficulty sleeping,93.8% said they were suffering from worry and anxiety,59.6% used coping strategies to deal with their situation,35.1% said that existing physical and mental health conditions had been exacerbated,84.1% said they cannot move on with their lives and57.9% of people had concerns about seeking help or treatment for mental/physical health problems caused by their situation during the pandemic.In addition, free text responses reflected feelings of anxiety and low mood attributed to the constant fear of fire, and an inability to plan families and future homes. One person said, “I have been left utterly broken by this. My mental and physical health has worsened, I have severe anxiety, depression and PTSD. I struggle each day to keep myself alive.”ConclusionSafe housing is a basic human right. The results show the current situation is having a detrimental impact on flat owners’ mental health and makes a strong case for the provision of specific services offering support - particularly given it is 3.5 years since Grenfell and a viable solution for all is yet to be found.

scholarly journals Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

2021 ◽  
Author(s):  
George David Batty ◽  
Ian Deary ◽  
Drew Altschul
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Physical Health ◽  
General Health Questionnaire ◽  
Vaccine Hesitancy ◽  
Symptom Scale ◽  
Individual Level ◽  
Successful Testing ◽  
The Uk ◽  
Mental And Physical Health

Importance: Although several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health has not been well-examined, and the association with mental health is unknown. Objective: To examine the association of pre-pandemic mental health, physical health, and shielding with vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine. Design, Setting, and Participants: We used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, completed the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression), and indicated whether they or someone in their household was shielding. Main outcome measures: Self-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for indices of health and shielding adjusted for selected covariates. Results: In an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to take up a vaccine. Conclusions and relevance: People who have been prioritised for COVID-19 vaccination owing to a physical condition are more likely to take it up. These effects were not apparent for indices of mental health.

scholarly journals The effect of mental and physical health problems on sickness absence

2021 ◽  
Author(s):  
Mark L. Bryan ◽  
Andrew M. Bryce ◽  
Jennifer Roberts
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Common Mental Disorders ◽  
Labour Force ◽  
Chronic Health Condition ◽  
Health Conditions ◽  
Significant Heterogeneity ◽  
Physical And Mental Health ◽  
Chronic Health ◽  
The Uk

AbstractAbsenteeism is an important feature of the labour market, imposing significant costs on employers and the economy as a whole. This paper is the first to use a large labour force survey sample to investigate how different physical and mental health conditions affect absence rates among prime age workers in the UK. A pooled time series/cross-section analysis reveals that people with a chronic health condition are more likely to be absent from work, and mental health has a significantly larger effect than physical health. From a longitudinal perspective, we find that a change in mental health has an effect on absenteeism more than three times greater than a change in physical health. These findings imply that the prevention and alleviation of chronic health conditions, particularly common mental disorders such as depression and anxiety that are highly prevalent in prime age workers, will deliver significant benefits to the UK economy due to reduced absenteeism. Further, there is significant heterogeneity between different health conditions, with some having no effect at all on absenteeism having controlled for other factors.

scholarly journals The impact of the COVID-19 pandemic on mental health in the general population: a comparison between Germany and the UK

2020 ◽  
Author(s):  
Franziska Knolle ◽  
Lisa Ronan ◽  
Graham K Murray
Keyword(s):  
Mental Health ◽  
General Population ◽  
Physical Health ◽  
Mental Health Problems ◽  
Well Being ◽  
Work Place ◽  
Financial Situation ◽  
The Uk ◽  
The Impact ◽  
Mental And Physical Health

In March 2020 the SARS-CoV-2infection (COVID-19) was declared a pandemic. In response to its world-wide outbreak radical measures were taken by governments across the world including curfew, quarantine, travel bans, social distancing, work place and school closures, etc, to reduce the transmission of the virus. These measures led to dramatic social and economic changes for the general population, in addition to the fears and worries related to the disease and its contraction. First studies report the impact of the pandemic on mental well-being of the general population showing increased levels of anxiety, stress and depression. In this study, we compare the impact of the pandemic on two European countries: the UK and Germany, which reported their first cases within a week. 241 residents of the UK and 541 residents of Germany filled in an online survey, including questions on COVID-19 exposure, impact on financial situation and work, substance and media consumption, self-reported mental and physical health, as well as including two clinical questionnaires, the general mental health Symptom Check List-27 (SCL-27) and the Schizotypal Personality Questionnaire. Data collection was completed between 27/04/20-31/05/20. We found distinct differences between the two countries. UK responders reported a stronger direct impact on their health, financial situation and their families. UK responders had higher clinical scores on the SCL-27, with a higher percentage being above cut-off. Interestingly, however, we found that German responders were less hopeful for an end of the pandemic and more concerned about their life-stability. Generally, we found that a younger age, being female, lower education, poorer mental and physical health before the pandemic, as well as more social media and substance consumption was associated with a higher clinical risk. This research shows strong differences between two economically and culturally similar countries, but as 25% of both German and UK responders reported a subjective worsening of the general psychological symptoms and 20-50% of German and UK responders reached the clinical cut-off for depressive, dysthymic and anxieties, it specifically shows the need for health emergency tailored intervention systems to assist not only people vulnerable for mental health problems, but also large proportions of the general public.

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