Care of Chronic Neurotic Out-patients by Community Psychiatric Nurses

1991 ◽  
Vol 158 (5) ◽  
pp. 685-690 ◽  
Author(s):  
Tom Burns ◽  
E. S. Paykel ◽  
A. Ezekiel ◽  
S. Lemon
Keyword(s):  
Psychiatric Care ◽  
Controlled Trial ◽  
Psychiatric Service ◽  
Treatment Patterns ◽  
Original Study ◽  
Psychiatric Nurses ◽  
Social Disability ◽  
Community Psychiatric ◽  
Care Patterns

Ninety-nine neurotic patients from a controlled trial of CPN v. psychiatric out-patient aftercare were followed up seven years later. Of the 92 survivors, 76 were successfully interviewed. Few differences were found between the groups. Chronic mild symptoms and moderate social disability persisted, and tended to worsen a little. Treatment patterns persisted for one to two years beyond the original study; the CPN group had more CPN contacts, fewer psychiatric out-patient contacts and less psychiatric care. Thereafter, more out-patients were discharged from psychiatric care and care patterns for the two groups became similar. Out-patients attended more non-psychiatric out-patient clinics than the CPN group, but it is possible that this reflected pre-existing differences. About a third of patients remained in contact with the psychiatric service during follow-up.

Community Psychiatric Nursing for Neurotic Patients: A Controlled Trial

1982 ◽  
Vol 140 (6) ◽  
pp. 573-581 ◽  
Author(s):  
E. S. Paykel ◽  
S. P. Mangen ◽  
J. H. Griffith ◽  
T. P. Burns
Keyword(s):  
Social Adjustment ◽  
Marked Reduction ◽  
Home Visiting ◽  
Controlled Trial ◽  
Psychiatric Nursing ◽  
Psychiatric Nurses ◽  
Alternative Mode ◽  
Community Psychiatric ◽  
Satisfaction With Treatment

SummarySeventy-one neurotic patients requiring follow-up were randomly assigned to routine psychiatric out-patient care or to supportive home visiting from community psychiatric nurses as their main treatment agents and were assessed every six months for 18 months. No differences were found between effectiveness of the two modes of service on symptoms, social adjustment or family burden. Patients seeing community psychiatric nurses reported greater satisfaction with treatment. Community psychiatric nursing resulted in a marked reduction in out-patient contacts with psychiatrists and other staff, more discharges, and a small increase in general practitioner contact for prescribing. Care of such patients by community psychiatric nurses is a valuable alternative mode of deployment within the psychiatric team.

A three-year follow-up of psychiatric morbidity in urban and rural primary care

1991 ◽  
Vol 21 (2) ◽  
pp. 495-503 ◽  
Author(s):  
Helen Seivewright ◽  
Peter Tyrer ◽  
Patricia Casey ◽  
Nicholas Seivewright
Keyword(s):  
Personality Assessment ◽  
Psychiatric Service ◽  
Psychiatric Morbidity ◽  
Structured Interview ◽  
Medical Illness ◽  
Rural Primary Care ◽  
Urban Group ◽  
Community Psychiatric ◽  
General Practices

SYNOPSISFollow-up by examination of medical and psychiatric records was carried out on 357 patients with conspicuous psychiatric morbidity in two general practices three years after clinical and personality assessment using structured interview schedules. One practice was an inner-city urban one and the other was rural. Full follow-up data over the 3-year period was available for 301 patients (84 3%). After three years patients with personality disorder and those in the urban practice had greater morbidity, more contacts with all levels of the psychiatric service and more psychotropic drugs, particularly benzodiazepines. Despite this increased morbidity, the number of consultations with the general practitioner for psychiatric illness was no higher in the urban group and those for medical illness were significantly higher in the rural one. The implications of the findings are discussed with particular reference to developments in community psychiatric care.

scholarly journals Linking abuse and recovery through advocacy: an observational study

2013 ◽  
Vol 23 (1) ◽  
pp. 99-113 ◽  
Author(s):  
K. Trevillion ◽  
S. Byford ◽  
M. Cary ◽  
D. Rose ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Community Mental Health ◽  
Unmet Needs ◽  
Controlled Trial ◽  
Psychiatric Service ◽  
Community Mental Health Services ◽  
Service Users ◽  
Quasi Experimental

Aims.High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial.Methods.Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' (n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' (n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected.Results.Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up (p < 0.05). Service users receiving the intervention reported significant reductions in violence (p < 0.001) and unmet needs at follow-up (p < 0.05).Conclusions.Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.

scholarly journals Comparison of the assessment by doctors and nurses of deliberate self-harm

2003 ◽  
Vol 27 (02) ◽  
pp. 57-60
Author(s):  
Sian Nerys Weston
Keyword(s):  
Mental Illness ◽  
Psychiatric Nurses ◽  
Deliberate Self Harm ◽  
Use Of Resources ◽  
Community Psychiatric ◽  
Significant Difference ◽  
Referral Practices ◽  
Self Harm ◽  
Doctors And Nurses

Aims and Method To compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment. Results There was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)). Clinical Implications Further research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.

scholarly journals The future of community psychiatric nursing: some research findings

1990 ◽  
Vol 14 (9) ◽  
pp. 550-551 ◽  
Author(s):  
Peter Tyrer ◽  
Michael Gelder
Keyword(s):  
General Practitioner ◽  
Daily Living ◽  
Psychiatric Care ◽  
Psychiatric Nursing ◽  
Psychiatric Nurses ◽  
Research Committee ◽  
Community Psychiatric ◽  
Recent Developments ◽  
Research Findings ◽  
Working Practices

A workshop organised by the Research Committee of the College took place on 20 November 1989, in which 14 invited delegates from nursing, psychiatry and general practice presented and discussed the implications of recent research developments in community psychiatric nursing. Papers were given by Helen Hally, Chairman of the Community Psychiatric Nurses Association, on recent developments in the workload of community psychiatric nurses. Dr Joseph Connolly presented the preliminary findings of the ‘Daily Living Project’ at the Maudsley Hospital in which comprehensive community care is given primarily by community psychiatric nurses. Professor Brandon outlined some of the difficulties in obtaining data on the working practices of community psychiatric nurses arising from a study in Leicester and this was followed by an account by Dr Alastair Wright, a general practitioner in Glenrothes, Fife, of the typical psychiatric workload of a general practitioner and the ways in which community psychiatric nurses may be of value in treating this without the necessity of referral to psychiatric care.

The Effects that Patients Have on their Families in a Community Care and a Control Psychiatric Service—A Two Year Follow-up

1968 ◽  
Vol 114 (508) ◽  
pp. 265-278 ◽  
Author(s):  
Jacqueline Grad ◽  
Peter Sainsbury
Keyword(s):  
Mentally Ill ◽  
Community Care ◽  
Care Service ◽  
Psychiatric Service ◽  
Research Unit ◽  
Admission Rates ◽  
Community Psychiatric ◽  
Community Psychiatric Service ◽  
Made In

The effects that mentally ill people have on their families have been more commented upon than studied. The currently favoured practice of community care has increased the need for a systematic attempt to evaluate the families' problems, and an opportunity to do this occurred when a community psychiatric service was introduced in Chichester in 1958, while the neighbouring Salisbury district continued with a conventional hospital-based service. The Medical Research Council's Clinical Psychiatry Research Unit has been evaluating the new service to find out how it affects referral and admission rates; how it influences social and clinical outcome, and the effect it has on the community itself. As the patient's family is the sector of the community most closely concerned in any extension of the extra-mural care of patients, we began by assessing the effects on them. The present paper therefore describes the assessments we made of the burden the patients' families carried in the Chichester Community Care Service and compares their burden with that experienced by families in Salisbury, where admission to hospital was more commonly practised. The comparison is made in terms of the relief that was afforded the two groups of families over a period of two years.

Community Psychiatric Nurses in Primary Health Care

1994 ◽  
Vol 165 (2) ◽  
pp. 231-238 ◽  
Author(s):  
Kevin Gournay ◽  
Julia Brooking
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Nursing Intervention ◽  
Drop Out ◽  
Psychiatric Nurses ◽  
Primary Health ◽  
Community Psychiatric ◽  
Gp Care

Background.Community psychiatric nurses (CPNs) are increasingly working in primary health care with non-psychotic patients. This study was designed to test the efficacy of this work.Method.The study was carried out in six health centres in north London with a total of 36 participating general practitioners (GPs) and 11 CPNs. Using a randomised controlled trial, 177 patients were referred by their GP and randomly allocated to continuing GP care, immediate community psychiatric nursing intervention, or placed on a 12-week waiting-list, after which time the patient was offered CPN intervention. A range of measures of symptoms and social function were used, and ratings were carried out at assessment and at 24 weeks.Results.Patients improved on all measures over time (P < 0.001 for all measures). However, there was no difference between the group of patients receiving GP care and patients seen by the CPN. Improvements seemed to be independent of the amount of contact. Drop-out rates from CPN intervention were high (50%). CPN drop-outs were more disabled to start with, but did as well as CPN treatment completers. Patients were more likely to drop out with trained than untrained CPNs. There was no evidence that referral to a CPN saved GP time.Conclusions.The results add weight to the argument that CPNs should refocus their activity on people with serious mental health problems, and indicate that CPN education should focus on skill acquisition and interventions of proven effectiveness.

The Clinical Evaluation of a New Community Psychiatric Service Based on General Practice Psychiatric Clinics

1992 ◽  
Vol 160 (4) ◽  
pp. 493-497 ◽  
Author(s):  
Brian Ferguson ◽  
Sylvia Cooper ◽  
Judith Brothwell ◽  
Aristos Markantonakis ◽  
Peter Tyrer
Keyword(s):  
General Practice ◽  
Psychiatric Service ◽  
Multidisciplinary Care ◽  
Chronically Ill ◽  
Community Psychiatric ◽  
City Population ◽  
New Community ◽  
Community Psychiatric Service ◽  
Chronically Ill Patients

A new community psychiatric service in Nottingham based on general practice clinics was compared with a conventional hospital-orientated model. Despite providing treatment for an inner-city population of significantly greater social disadvantage, the community service was associated with similar levels of symptom morbidity as assessed by the CPRS and the SFS. It also involved greater use of day-hospital facilities, more extensive multidisciplinary care, and a commitment to longer-term follow-up of chronically ill patients. Such a model is offered as a basis for future developments of urban community psychiatric services.

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