scholarly journals Experiences of psychiatrists assessing under 18s on an “all age” rota. An evaluation of the current service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S315-S315
Author(s):  
Nicoleta Clarisa Turtoi ◽  
Martin Ansell ◽  
Trinisha Govender ◽  
Helen Bould

AimsGloucestershire Health Care Trust operates an “all age” out of hours on-call rota, staffed by Registrars and Consultants who cross-cover all psychiatric sub-specialities. Our aim was to understand the challenges faced by psychiatrists of different professional backgrounds when assessing under 18 year olds in a health-based Place of Safety (POS).MethodWe circulated a survey to all psychiatrists on the on-call rota, to gather quantitative and qualitative information on the challenges posed by assessments of under-18s in a POS and assess whether an under-18 specific policy was needed.ResultOut of the 50 psychiatrists invited, 27 completed this survey (during February 2021). 33.3% of respondents reported that they had completed a POS assessment of an under 18-year-old when a Consultant Child and Adolescent Psychiatrist/Registrar was not available to join. 33.3% of respondents had been asked to complete such an assessment as the sole psychiatrist joining the AMHP, with 24% of those respondents reporting feeling uncomfortable doing these assessments without a second doctor present, and an additional 24% feeling comfortable only sometimes. 48.1% of the doctors surveyed did not invite parents or carers to take part in the assessment, despite this being considered best practice, citing reasons such as: being unaware that this was a possibility, assessments conducted at unsociable hours, safeguarding concerns involving the parents, and social distancing in the context of COVID-19. 41% of respondents had assessed vulnerable young people (children looked after or with a diagnosis of an autism spectrum condition) in the POS and reported that these assessments posed significant challenges to safe discharge planning and identifying appropriate placements. 81.5% felt that a tailored policy for young people was needed. Qualitative findings suggest psychiatrists think such a policy should include clear procedures (flowcharts), potential outcome scenarios/options for safe discharge, referral criteria for CAMHS, contact details for key staff members, a handover protocol. Respondents felt a shared policy with all stakeholders (AMHP service, Mental Health Services, police) was required.ConclusionOur survey highlights the challenges for non-CAMHS specialists assessing under 18s in a health-based POS and the need for an under-18 policy to support safe practice. Major themes will be further explored in a focus group to guide policy development.

2002 ◽  
Vol 25 (4) ◽  
pp. 178 ◽  
Author(s):  
Stewart L Einfeld ◽  
John Beard ◽  
Margaret Tobin ◽  
Richard Buss ◽  
Michael Dudley ◽  
...  

In 1998-1999, two Area Health Services in NSW conducted a project to implement evidence-based service enhancements for the clinical management of young people who present with Deliberate Self Harm (DSH) behaviour. The present study examined what structures and procedures were required to implement and sustain evidence-based practice in different health care settings for patients with DSH behaviour. Service provision was assessed at three points during the initial project to assess the degree of change that occurred, and 9 months after the completion of the project to allow an assessment of sustainability of the service provision. We examined staff perceptions of the importance of education, management directives, policy and procedure changes, and cultural/ attitudinal changes, in implementing clinical best practice. Results indicated that support from both service management and clinical staff is necessary for successful implementation of service enhancements. High levels of staff education and policy development were also associated with high levels of service performance. The best sustained enhancements were those that were developed by the services themselves.


2014 ◽  
Vol 38 (1) ◽  
pp. 18 ◽  
Author(s):  
Jo Robinson ◽  
Jane Pirkis

Objective Suicide prevention, including among youth, has been a national priority in Australia for some time. Yet despite this, rates of suicide, and related behaviour, remain high. The aim of this study was to review all suicide-prevention research that had been conducted in Australia between January 2007 and December 2011, with a specific emphasis on studies relating to young people, in order to determine whether or not we are prioritising the sort of research that can adequately inform policy development and guide ‘best practice’. Methods Data were collected from two sources. First, several electronic databases were searched in October 2012 in order to identify published journal articles relating to suicide, written by Australian authors. Second, summary data obtained from the National Health and Medical Research Council, the Australian Rotary Health Research Fund and the Australian Research Council were examined in order to identify currently funded studies that relate to suicide. Studies were then classified according to whether or not they had a focus on youth, and according to research type, type of suicide-related behaviour under investigation and method of suicide. Results There were 224 articles published and 12 grants funded that specifically focussed on suicide-related behaviour over the period January 2007 to December 2011. Of these, 47 articles (21%) and five funded grants (42%) focussed on young people. Youth studies, in particular those reported in the published articles, tended to be epidemiological in nature and only six of the published articles (13%) and two of the funded grants related to intervention studies. Conclusions Although the focus on youth is welcome, the lack of intervention studies is disappointing. Given that rates of suicide and related behaviour remain high, there is a clear need for a stronger body of intervention research that can inform national policy, if we are to successfully develop effective approaches to reducing suicide risk. What is known about the topic? Although the prevention of youth suicide has been a national priority for some time, rates of suicide and suicide-related behaviour remain high among young Australians. Much is known about the epidemiology of suicide; however, relatively little is known about which interventions may be effective in reducing this risk. Previous research suggests that although youth receive a reasonable amount of research attention in Australia, the majority of studies focus on epidemiological as opposed to intervention research. What does this paper add? This paper reviews all suicide research that has been conducted in Australia between 2007 and 2011 in order to examine how much attention is currently given to studies relating to youth, and the relative priority given to intervention and epidemiological studies. Our findings support those reported previously, which suggest that although a significant proportion of suicide research focuses on youth, relatively little attention continues to be given to intervention studies. What are the implications for practitioners? This paper argues that further intervention research is needed if we are to build a sufficiently strong evidence base that can effectively inform policy development and guide best practice when it comes to preventing youth suicide in Australia.


2010 ◽  
Vol 5 (2) ◽  
Author(s):  
Andrew Speers ◽  
Allen Gale ◽  
Nancy Penney

This paper describes an international biosolids management initiative, known as the Australian and New Zealand Biosolids Partnership (ANZBP). The ANZBP - known formerly as the Australasian Biosolids Partnership – comprises 33 members dedicated to promoting the sustainable management of biosolids across the two nations. Two critical research projects are described, each of which contributes to the ANZBP goal of promoting the sustainable management of biosolids. The first is a review of community attitudes to biosolids management, the outcomes of which will be used to refine communication tools and methods of community consultation and which will provide input to policy development over time. The second is a review of regulations in place in Australia and New Zealand carried out to identify inconsistencies and improvements that could be made. An outcome of this initiative is potentially the development of a best practice manual. The relationship of the two projects to a sustainability framework adopted by the ANZBP is also described, as is the relationship of the two projects to each other.


2019 ◽  
Vol 58 (12) ◽  
pp. 1139-1141 ◽  
Author(s):  
Benjamin M. Isenberg ◽  
Amy M. Yule ◽  
James W. McKowen ◽  
Lisa A. Nowinski ◽  
Gina A. Forchelli ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lukasz Cybulski ◽  
Darren M. Ashcroft ◽  
Matthew J. Carr ◽  
Shruti Garg ◽  
Carolyn A. Chew-Graham ◽  
...  

Abstract Background There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. Methods Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1–20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1–5, 6–9, 10–12, 13–16, 17–19), depression, anxiety disorders (6–9, 10–12, 13–16, 17–19), eating disorders and self-harm (10–12, 13–16, 17–19) during 2003–2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. Results The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18–3.89), depression (2.37; 2.03–2.77), ASD (2.36; 1.72–3.26), ADHD (2.3; 1.73–3.25), and self-harm (2.25; 1.82–2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06–1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. Conclusion The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.


2021 ◽  
Vol 5 (3) ◽  
pp. 11
Author(s):  
Grazia Ragone ◽  
Judith Good ◽  
Kate Howland

Autism affects how people perceive and make sense of the world around them. Autism is a spectrum condition which impacts people in different ways. Also referred to as Autism Spectrum Disorder (ASD), it is characterized by challenges in the domains of social, cognitive and motor functioning, which differ in severity. Previous research suggests that music can have cognitive, psychosocial, behavioural, and motor benefits in this population. We systematically review the use of technology in Music-therapy and related sound-based activities to improve the motor and social skills of children. In May 2020 we conducted a systematic search on Music-therapy and musical activities for autistic children in research databases including Science Direct, APA PsycNet, Cochrane, IEE and Web of Science, to collect relevant studies. We initially collected 5179 papers of which only 27 studies were identified as suitable for the scope of this review. In the paper, we analyse and describe key characteristics of each project. We then highlight the commonalities, strengths and limitations of existing work, and identify implications for future interaction design.


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