scholarly journals Acute mental health presentations before and during the COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Naaheed Mukadam ◽  
Andrew Sommerlad ◽  
Jessica Wright ◽  
Abigail Smith ◽  
Aleksandra Szczap ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Symptoms ◽  
Interrupted Time Series ◽  
Psychiatric Services ◽  
Psychotic Symptoms ◽  
Duration Of Symptoms ◽  
Mental Capacity Act

Background A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. Aims We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. Method We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. Results There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. Conclusions UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

Psychiatry and Covid-19: Acute mental health presentations before and during the pandemic

2020 ◽  
Author(s):  
Naaheed Mukadam ◽  
Andrew Sommerlad ◽  
Jessica Wright ◽  
Abigail Smith ◽  
Aleksandra Szczap ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Inpatient ◽  
Interrupted Time Series ◽  
Psychiatric Services ◽  
Psychotic Symptoms ◽  
Duration Of Symptoms ◽  
Mental Health Act ◽  
Before And After

BackgroundWe aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the Covid-19 pandemic. MethodsWe analysed electronic data between January and April 2020 for 2,534 patients referred to acute psychiatric services. We used interrupted time series analyses to compare trends in A&amp;E and psychiatric presentations before and after lockdown, and tested for differences in patients’ demographics, symptom severity, and use of the Mental Health Act, before and after lockdown.ResultsThere were 11% fewer psychiatric presentations the first week and 64% fewer A&amp;E presentations the first month after lockdown initiated. A higher proportion of patients were detained under the Mental Health Act (22.2% vs 16.1%) and Mental Capacity Act (2.2 vs 1.1%)(χ2(2)=16.3, p&lt;0.0001) and they experienced a longer duration of symptoms before seeking help from mental health services (χ 2(3)= 18.6, p&lt;0.0001). A higher proportion of patients presented with psychotic symptoms (23.3% v 17.0%) or delirium (7.0 v 3.6%) and fewer had parasuicidal behaviour (43.8% v 52.0, χ2 (7)= 28.7, p&lt;0.0001). A higher proportion were admitted to psychiatric inpatient units (22.2% vs 18.3%) (χ 2(6)= 42.8, p&lt;0.0001) after lockdownConclusions UK lockdown resulted in fewer psychiatric presentations but those who presented were more likely to have severe symptoms, be detained under the Mental Health Act and admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

Examining Models of Mental Health Service Delivery in the Emergency Department

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

The Impact of Mental Health Services in a Pediatric Emergency Department

2017 ◽  
Vol 33 (5) ◽  
pp. 311-314 ◽  
Author(s):  
Sharon M. Holder ◽  
Kenneth Rogers ◽  
Eunice Peterson ◽  
Robbie Shoenleben ◽  
Dawn Blackhurst
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Services ◽  
Health Services ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
The Impact

scholarly journals From taking to using medication: recovery-focused prescribing and medicines management

2013 ◽  
Vol 19 (1) ◽  
pp. 2-10 ◽  
Author(s):  
Elina Baker ◽  
Jason Fee ◽  
Louise Bovingdon ◽  
Tina Campbell ◽  
Elaine Hewis ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Well Being ◽  
Psychiatric Services ◽  
Psychiatric Practice ◽  
Medicines Management ◽  
The Relationship ◽  
Recovery Tools

SummaryMental health services are increasingly supporting recovery-oriented practice as a basis for service delivery. There is considerable overlap between the values and approaches associated with recovery-based practice and those already endorsed as good psychiatric practice. However, these agreed principles may not be consistently applied and further steps may be needed if the reorientation of the relationship between psychiatrists and people using psychiatric services is to fully reflect recovery principles. This article describes ways in which psychiatric practice could develop, including conceptualising medication as one of many possible recovery tools that a person can actively use to support their well-being, and a range of practices available to professionals to support people in taking up an active stance in relation to medication. It also identifies recovery-supportive practices for when someone is unable to fully participate in decision-making, owing to crisis, loss of capacity or concerns about safety.

Identification of Prodromal Signs and Symptoms and Early Intervention in Manic Depressive Psychosis Patients: A Case Example

1995 ◽  
Vol 23 (4) ◽  
pp. 399-409 ◽  
Author(s):  
Alison Perry ◽  
Nicholas Tarrier ◽  
Richard Morriss
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Signs And Symptoms ◽  
Pharmacological Intervention ◽  
Psychotic Symptoms ◽  
Prodromal Phase ◽  
Manic Depressive Psychosis ◽  
Manic Depressive

Recent research has revealed that relapse in manic depressive psychosis and schizophrenia is preceded by specific prodromal signs and symptoms that include dysphoria, other non-psychotic symptoms and features unique to individual patients. Treatment studies in schizophrenia have shown that early pharmacological intervention during a prodromal phase of psychotic relapse may be effective in the prevention of hospitalization. This paper describes the procedure of prodromal signs identification in manic depressive psychosis and the negotiation of an appropriate plan of action with the mental health services in order to abort the relapse or reduce its severity through early pharmacological intervention. A case example is presented to demonstrate this approach.

scholarly journals An overview of mental health legislation in Singapore

2015 ◽  
Vol 12 (2) ◽  
pp. 42-44 ◽  
Author(s):  
Roger C. Ho ◽  
Cyrus S. Ho ◽  
Nusrat Khan ◽  
Ee Heok Kua
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Capacity ◽  
Mental Health Legislation ◽  
Mental Capacity Act ◽  
Health Legislation ◽  
The Relationship

This article summarises the development of mental health legislation in Singapore in three distinctive periods: pre-1965; 1965–2007 and 2007 onwards. It highlights the origin of mental health legislation and the relationship between mental health services and legislation in Singapore. The Mental Health (Care and Treatment) Act 2008 and Mental Capacity Act 2008 are described in detail.

Preferences of dress and address: views of attendees and mental health professionals of the psychiatric services

2012 ◽  
Vol 29 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Christina Sim ◽  
Brian Hallahan ◽  
Colm McDonald
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Service User ◽  
Psychiatric Services ◽  
Health Staff ◽  
Mental Health Staff ◽  
Medical Terms

AbstractObjectives: The aim of this study was to determine the views of both individuals attending the mental health services (attendees) and mental health professionals in relation to how attendees and staff should be addressed, how attendees should be described, and how staff should be attired.Methods: We surveyed 132 attendees of the West Galway Mental Health Services and 97 mental health professionals in relation to how they prefer to be addressed (first name/ title and surname/ no preference) the description of attendees (patient / client / service user / no preference) and the attire of mental health staff (casual / smart / no preference). We also ascertained how mental health professionals believed attendees would view these issues.Results: Attendees preferred to be described as patients rather than clients or service users by all mental health professionals, with 46-54% of attendees preferring this term “patient” compared to 14-17% preferring the term “client”, 11-13% preferring the term “service user” and 20-25% having no preference (p < 0.001). They preferred to address doctors by their title and surname (61%) but other mental health professionals by their first names (60-69%) (p < 0.001). Attendees had a strong preference for being addressed by their first names by all the mental health professionals (86-91%) (p < 0.001). Doctors preferred to be attired formally (88%), compared to nurses (50%) or other mental health professionals (42%) (p = 0.002). Attendees had no preference in relation to the attire of doctors but preferred other mental health professionals to be attired informally.Conclusions: The study demonstrates that despite the increased use of several non-medical terms to describe attendees of mental health services; the preferred term of attendees of the psychiatric services in both in-patient and out-patient settings remains ‘patient’. However, this is not universally the case, and the ascertainment of the preference of the attendee at the first encounter with the health professional should be ascertained. We also demonstrated that attendees preferences in relation to both “dress and address” of doctors is significantly different to their preference for nurses or other allied mental health professionals; which may reflect a wish for a less familiar and more formal interaction with doctors.

Mental Health Services for Youth

1973 ◽  
Vol 7 (3) ◽  
pp. 309-312
Author(s):  
W. Warren
Keyword(s):  
Mental Health ◽  
United Kingdom ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Psychiatry ◽  
Mental Health Problems ◽  
Psychiatric Services ◽  
Narrow Scope ◽  
The United Kingdom ◽  
Set Up

This paper discusses some of the mental health problems that occur among Youth, and some of the services that have been set up to deal with them in the United Kingdom. While fairly widespread, they are limited through their rather narrow scope. Some of the difficulties encountered are pointed out, including shortages of trained man-power. Suggestions are made on what further could be done to widen these services. It is realised, however, that what is applicable to one country is not necessarily so to another. Psychiatric services especially for adolescents are nevertheless spreading. Can Adolescent Psychiatry yet qualify as another sub-specialty in psychiatry?

Managing offenders with psychiatric disorders in general psychiatric services

2012 ◽  
pp. 2009-2014
Author(s):  
James R. P. Ogloff
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Psychiatric Services ◽  
Mentally Ill Offenders ◽  
General Mental Health ◽  
General Community

It has been shown that the prevalence of mental illness among those in the criminal justice system is significantly greater than that found in the general community. As presented in Chapter 11.4, for example, the per capita rate of psychotic illness in prisons is approximately 10 times greater than that found in the general community. Tragically, relatively few services exist that provide continuity of mental health care between gaols and the community. This produces a situation where individuals whose mental illness may have been identified and treated in gaol find themselves without services in the community. Typically, only when in crisis do they find their way into general psychiatric services either in community settings or in hospital. This situation has produced considerable stress on already taxed mental health services. Given the prevalence of offence histories among psychiatric patients, it is important for mental health professionals to be aware of the unique issues—and myths—that accompany patients with offence histories. At the outset it is important to emphasize that the duty of mental health services is to address mental health issues. That ought to be the focus of mental health services. As this chapter makes clear, though, for some patients, there is a relationship between the mental illness and offending and by addressing the mental illness, the risk of re-offending might well be reduced. Moreover, many of the ancillary issues that lead to relapse and destability in psychiatric patients also may lead to offending. Addressing these issues will both help provide long-term stability for patients and will help reduce their risk of offending. As a result, there is a need for general mental health services to acquire expertize to identify and manage patients with offending histories. This chapter will provide information about the relative risk of offending among psychiatric patients and the relationship (or lack thereof) of inpatient aggression and community-based violence and offending. A framework will be provided for assessing and treating patients with offending histories and issues using a typology of mentally ill offenders. The role of forensic mental health services in bolstering general psychiatric services, and in sometimes providing primary care for mentally ill offenders, will also be discussed.

Sign in / Sign up

Export Citation Format

Share Document