The Nottingham Acute Bed Study: Alternatives to acute psychiatric care

1997 ◽  
Vol 170 (3) ◽  
pp. 247-252 ◽  
Author(s):  
A. Beck ◽  
T. J. Croudace ◽  
S. Singh ◽  
G. Harrison
Keyword(s):  
Resource Use ◽  
Psychiatric Care ◽  
Community Support ◽  
Decision Makers ◽  
Psychiatric Services ◽  
Community Based ◽  
Residential Community ◽  
Acute Psychiatric Wards ◽  
Population Ratio ◽  
Acute Psychiatric Care

BackgroundAlthough modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing reed for acute care.MethodWe surveyed key decision makers in a community-oriented district service with a low acute psychiatric bed to population ratio, in order to examine alternatives to hospitalisation in a cohort of consecutive admissions over a six-month period.ResultsAlternatives to acute ward hospitalisation were identified for 29% of admissions, and for 42% of those with an admission duration of more than 60 days. Residential options were chosen more often than intensive community support. Simulated bed day savings were considerable.ConclusionsIn a community-oriented service, key decision-makers could identify further alternatives to acute ward hospitalisation, although relatively few non-residential, community support options were chosen. Although this methodology has limitations, data based upon keyworker judgements probably have greater local ‘ownership’, and the option appraisal process itself may challenge stereotyped patterns of resource use.

scholarly journals Some Die Young

2021 ◽  
Vol 12 (3) ◽  
pp. 485-505
Author(s):  
Kim Silow Kallenberg
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Drug Use ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
Community Support ◽  
Psychiatric Services ◽  
Auditory Hallucinations ◽  
Acting Out

This is an ethnographic and an autoethnographic study based on qualitative interviews as well as memories and experiences of the author. It focuses on two men that were childhood friends of the author and who both died prematurely. Marcus died in November 2013 while he was under psychiatric care due to auditory hallucinations and anxiety. Noel died little over a year later, in January 2015, from an overdose of heroin. The aim of the article is to analyse the narratives of women and is concerned with understanding the loss of a son, a brother, or a former boyfriend or friend due to substance abuse or mental health problems. The empirical cases analysed in this text are women’s understandings of the deaths of Marcus and Noel – two young men who were close to them in different ways. Their narratives about the men, their memories, and their rationalisations for what happened to them are analysed.   The analysis shows that when the women talk about, and try to explain, the male lives that led up to the death, a limited number of narratives are available. Narratives about absent and/or abusive fathers, narratives about mothers who fail in providing the expected care, and narratives about shortcomings in psychiatric services and community support are dominant in the analysed material. In relation to these available narratives, the story follows the making of a protest masculinity in which elements such as rock star dreams, violence, drug use, and talk of legalising drugs have a place. Together they form an overarching narrative about protest masculinity; i.e. ways to act in reaction to a perceived alienation or subordination by acting out in ways associated with masculinity.

scholarly journals Effects of Recovery-Orientation on the Use of Forced Medication and Maximum Daily Drug Dose: The “Weddinger Modell”

2021 ◽  
Vol 12 ◽  
Author(s):  
Klara Czernin ◽  
Felix Bermpohl ◽  
Alexandre Wullschleger ◽  
Lieselotte Mahler
Keyword(s):  
Psychotropic Drugs ◽  
Psychiatric Care ◽  
Intervention Group ◽  
Drug Dose ◽  
Control Group ◽  
Retrospective Case ◽  
Recovery Orientation ◽  
Acute Psychiatric Wards ◽  
Drug Doses ◽  
Acute Psychiatric Care

Objective: The aim of the present study was to analyze the effects of the implementation of the Recovery-orientated psychiatric care concept “Weddinger Modell” on the incidence of forced medication, the total number of forced medication incidents per affected case, the maximum dose of a singular forced medication and the maximum voluntary daily drug dose of different psychotropic drugs administered during an inpatient stay.Methods: This retrospective case-control study included 234 patients. A pre/post-comparison of patients on two acute psychiatric wards before (control group, n = 112) and after (intervention group, n = 122) the implementation of the Weddinger Modell in 2010 was performed. Patient data was selected at two reporting periods before and at two reporting periods after 2010.Results: No significant differences were found in the incidence of forced medication and the total number of forced medications. A significant reduction of the maximum forced medication dose of haloperidol in the intervention group was seen. Furthermore, the analysis of the intervention group showed a significant reduction of the maximum voluntary daily drug doses of clozapine, haloperidol and risperidone.Discussion: The results indicate that the implementation of the Weddinger Modell had no effect on the incidence of forced medication, but it can help to improve the approach to psychotropic drugs. Despite the reduction of mechanical coercive measures by the model, as shown in a previous study, there is no increase in forced medications or administered drug doses. Focus on Recovery helps in reducing coercion in acute psychiatric care.

scholarly journals Satisfaction with psychiatric services in the emergency department

2004 ◽  
Vol 1 (5) ◽  
pp. 3-4
Author(s):  
Brenda Happell ◽  
Monica Summers
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Emergency Departments ◽  
Psychiatric Care ◽  
Psychiatric Services ◽  
Clinical Tool ◽  
Timely Manner ◽  
Lower Priority ◽  
Acute Psychiatric Care ◽  
Psychiatric Issues

The move to provide psychiatric services within the general health care system has resulted in emergency departments becoming the means of access to acute psychiatric care in Australia (Gillette & Bucknell, 1996). Triage within the emergency departments ensures that patients are reviewed and treated in a timely manner, in accordance with the urgency of the presenting problem. The National Triage Scale was developed as a clinical tool for this purpose for use in Australia and New Zealand (Australasian College for Emergency Medicine, 1994). However, this scale tends to attach lower priority to psychiatric issues (Smart et al, 1998).

Psychological Problems in Adolescent Residential Community Based Treatment

2007 ◽  
Author(s):  
Paul Turner ◽  
Connor Barry ◽  
Alicia Barry ◽  
Lisa C. Turner
Keyword(s):  
Psychological Problems ◽  
Community Based ◽  
Residential Community

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

scholarly journals Psychiatric Services in Saskatchewan under Medicare*

1970 ◽  
Vol 15 (1) ◽  
pp. 63-72 ◽  
Author(s):  
Wilfred A. Cassell ◽  
Colin M. Smith ◽  
Maggie Grandy Rankin
Keyword(s):  
Private Practice ◽  
Urban Areas ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Treatment Session ◽  
Psychiatric Services ◽  
Treatment Services ◽  
Hospital Visits ◽  
To Receive

This study has examined the nature and extent of services provided to psychiatric patients under ‘Medicare’. An analysis of the records of 864,128 residents of Saskatchewan revealed that in 1965, 13,950 males and 27,009 females received a psychiatric diagnosis from physicians in private practice. Psychoneurotic conditions were frequent. General practitioners provided the majority of treatment services for this group. Physicians practising in urban areas were found to complete more psychiatric treatment than their rural counterparts. Female patients were found to receive relatively more psychiatric care than males. The latter obtained more consultations, hospital visits and somatic investigations. Lastly, the rate of service was infrequent, averaging less than one treatment session per patient.

scholarly journals Providing a primary care service for psychiatric in-patients

2004 ◽  
Vol 28 (5) ◽  
pp. 167-170 ◽  
Author(s):  
Enone Welthagen ◽  
Sarah Talbot ◽  
Oliver Harrison ◽  
Michael Phelan
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Psychiatric Care ◽  
Care Service ◽  
Primary Care Service ◽  
Clinical Implications ◽  
Model Of Care ◽  
Wide Range ◽  
Set Up ◽  
Acute Psychiatric Care

Aims and MethodA prospective descriptive study was set up to evaluate the feasibility, acceptability and activity of an innovative weekly primary care service for patients admitted for acute psychiatric care.ResultsDuring 10 months, 36 clinics were held and 123 appointments were attended. Presenting complaints included a wide range of acute and chronic conditions, affecting all body systems. As well as treating specific complaints, the doctor providing this service undertook considerable health promotion work and gave advice about patient management to junior psychiatrists.Clinical ImplicationsIt appears that there is considerable need for primary care expertise within an acute psychiatric unit, and that a weekly clinic is a feasible model of care.

scholarly journals Architectural design and acute psychiatric care

1994 ◽  
Vol 18 (5) ◽  
pp. 279-281 ◽  
Author(s):  
Rizwan Taj ◽  
John Sheehan
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Architectural Design ◽  
Psychiatric Care ◽  
Observation Station ◽  
Initial Stage ◽  
Psychiatric Units ◽  
Acute Psychiatric Care ◽  
Roof Garden

All staff based in a newly built acute psychiatric unit for more than six months were asked about the difficulties they encountered in the implementation of their duties and what changes they recommended. The problem areas identified included poor design and location of nursing observation station, lack of proper seclusion facilities, insufficient ventilation, unsafe position of the roof garden, exposed beams and supports, proximity to the lake and inadequate interview facilities for all staff. The urgent recommendations included alteration in the design and positioning of observation station, improving ventilation, making the roof garden safe, and covering all exposed beams and supports. The desirable changes included extra interviewing facilities and a spacious observable television room. Consultation by mental health professionals during the initial stage of designing of psychiatric units is essential.

Sign in / Sign up

Export Citation Format

Share Document