User perspective on needs and satisfaction with mental health services

1998 ◽  
Vol 173 (5) ◽  
pp. 409-415 ◽  
Author(s):  
Morven Leese ◽  
Sonia Johnson ◽  
Mike Slade ◽  
Sue Parkman ◽  
Frank Kelly ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Unmet Needs ◽  
Community Mental Health Services ◽  
Living Situation ◽  
User Perspective ◽  
Met Needs ◽  
The Impact ◽  
Satisfaction With Services

BackgroundMeasurement of the impact of different types of service provision on the views of service users is important in planning mental health services.MethodNeeds (met and unmet) and satisfaction with services, were assessed. People with psychosis (n=131) were interviewed before (Time 1) and after (Time 2) the introduction of two community mental health services in south London. One was intensive, with two specialist teams, the other standard. Outcomes were compared at Time 2, controlling for the Time 1 values.ResultsOverall, 70% of needs were met and mean satisfaction was between ‘mixed’ and ‘mainly satisfied’. There was evidence for higher met needs in the intensive sector, but no evidence for lower unmet needs in the intensive sector or for differences in satisfaction. The additional needs met by the intensive service were associated with aspects of basic living situation. Satisfaction was negatively correlated with both unmet and met needs.ConclusionsBoth services were reasonably successful, with little difference from the user perspective. The intensive service provided benefits in terms of met needs, but this has to be balanced against a possible increase in unmet needs.

The impact of economic stress on community mental health services

1982 ◽  
Vol 10 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Brian J. Hagan ◽  
Bruce D. Forman ◽  
Michael J. Gorodezky
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Community Mental Health Services ◽  
Economic Stress ◽  
The Impact

scholarly journals Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge

2010 ◽  
Vol 197 (S53) ◽  
pp. s20-s25 ◽  
Author(s):  
Sarah Byford ◽  
Jessica Sharac ◽  
Brynmor Lloyd-Evans ◽  
Helen Gilburt ◽  
David P. J. Osborn ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Service Use ◽  
Community Mental Health Services ◽  
Index Admission ◽  
Lengths Of Stay ◽  
Clinical Records ◽  
The Impact

BackgroundResidential alternatives to standard psychiatric admissions are associated with shorter lengths of stay, but little is known about the impact on readmissions.AimsTo explore readmissions, use of community mental health services and costs after discharge from alternative and standard services.MethodData on use of hospital and community mental health services were collected from clinical records for participants in six alternative and six standard services for 12 months from the date of index admission.ResultsAfter discharge, the mean number and length of readmissions, use of community mental health services and costs did not differ significantly between standard and alternative services. Cost of index admission and total 12-month cost per participant were significantly higher for standard services.ConclusionsShorter lengths of stay in residential alternatives are not associated with greater frequency or length of readmissions or greater use of community mental health services after discharge.

Reducing the revolving door phenomenon

2010 ◽  
Vol 27 (1) ◽  
pp. 27-34
Author(s):  
Antoinette Daly ◽  
Donna Tedstone Doherty ◽  
Dermot Walsh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Current Model ◽  
Community Mental Health Services ◽  
Community Services ◽  
Revolving Door ◽  
Community Based ◽  
Policy Document ◽  
The Impact

AbstractObjectives: De-institutionalisation and the expansion of community services have resulted in a reduction in the number of inpatient admissions in Ireland having fallen by 31% between 1986 and 2006. However, despite this, readmissions continue to account for over 70% of all admissions. The policy document A Vision for Change identified many shortcomings in the current model of provision of mental health services, making recommendations for the future development of community-based services with emphasis on outreach components such as homecare, crisis intervention and assertive outreach approaches. These recommendations are reviewed in relation to readmissions and the impact they may have on reducing the revolving door phenomenon.Method: Three main intervention programmes essential to the delivery of an effective community-based service outlined and recommended by A Vision for Change, along with other pertinent factors, are discussed in relation to how they might reduce readmissions in Ireland. A series of Pearson correlations between Irish inpatient admissions rates and rates of outpatient attendances and provision of community mental health services are carried out and examined to explain possible relationships between increasing/decreasing admission rates and provision/attendances at community services. International literature is reviewed to determine the effectiveness of these intervention programmes in reducing admissions and readmissions and their relevance to the Irish situation is discussed.Conclusions: Whilst A Vision for Change goes a long way towards advocating a more person-centred, recovery oriented and integrated model of service delivery, it is apparent from the consistently high proportion of readmissions in Ireland that there are still many shortcomings in service provision. The availability of specialised community-based programmes of care is as yet relatively uncommon in Ireland and uneven in geographical distribution. A considerable improvement in their provision, quantitatively and qualitatively, is required to impact on the revolving door phenomenon. In addition a re-configuration of existing catchment populations is required if they are to be successfully introduced and expanded.

scholarly journals Service users’ perspective of their admission: a report of study findings

2016 ◽  
Vol 34 (4) ◽  
pp. 251-260 ◽  
Author(s):  
B. O’Donoghue ◽  
E. Roche ◽  
J. Lyne ◽  
K. Madigan ◽  
L. Feeney
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Procedural Justice ◽  
Community Mental Health Services ◽  
Service Users ◽  
Perceived Coercion ◽  
Mental Health Legislation ◽  
Health Legislation ◽  
Satisfaction With Services

ObjectivesThe ‘Service Users’ Perspective of their Admission’ study examined voluntarily and involuntarily admitted services users’ perception of coercion during the admission process and whether this was associated with factors such as the therapeutic alliance, satisfaction with services, functioning and quality of life. This report aims to collate the findings of the study.MethodsThe study was undertaken across three community mental health services in Ireland. Participants were interviewed before discharge and at 1 year using the MacArthur Admission Experience. Caregivers of participants were interviewed about their perception of coercion during the admission.ResultsA total of 161 service users were interviewed and of those admitted involuntarily, 42% experienced at least one form of physical coercion. Service users admitted involuntarily reported higher levels of perceived coercion and less procedural justice than those admitted voluntarily. A total of 22% of voluntarily admitted service users reported levels of perceived coercion comparable with involuntarily admitted service users and this was associated with treatment in a secure ward or being brought to hospital initially under mental health legislation. In comparison with the service user, caregivers tended to underestimate the level of perceived coercion. The level of procedural justice was moderately associated with the therapeutic relationship and satisfaction with services. After 1 year, 70% experienced an improvement in functioning and this was not associated with the accumulated level of coercive events, when controlled for confounders.ConclusionsThis study has provided valuable insights into the perceptions of coercion and can help inform future interventional studies aimed at reducing coercion in mental health services.

Evidence-Based Prevention Strategies of Suicide Behavior in the World: Implications for Slovenia

Crisis ◽  
2002 ◽  
Vol 23 (3) ◽  
pp. 121-126
Author(s):  
Claire Henderson ◽  
Paola Dazzan ◽  
Mojca Dernovsek ◽  
Rok Tavcar ◽  
Marija Brecelj
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Community Mental Health Services ◽  
Population Level ◽  
Risk Groups ◽  
High Rate ◽  
The Baltic ◽  
The Impact

Abstract: In this review we consider how Slovenia could consider tackling its high rate of suicide (overall 29 per 100,000, 46 in males, 13 in females). First, we consider the evidence for risk factors that may contribute to Slovenia's high rate of suicide. Second, we describe the interventions to try to reduce the impact of these factors and the evidence for such interventions. We categorize interventions in terms of their operation at either the population level or that of high-risk groups. However, it should be borne in mind that settings often assumed to provide access to population groups, such as general practice and schools, do not reach some people who are likely to be at high risk; for example those who have dropped out of school or who have been excluded from a GP's list. We focus particularly on those for high-risk groups, as a number of East-European countries with high suicide rates such as Slovenia, Hungary, and the Baltic republics are currently considering a shift toward more community-based mental health services. The provision of community mental health services in Slovenia would provide an opportunity to study their impact on the suicide rate. However, we conclude that their development should be accompanied by other initiatives operating at population levels. This multilevel approach acknowledges the complexity of the etiology of suicide, the impossibility of reaching all those at risk through services and the lack of strong evidence for any one intervention.

From efficacy to effectiveness in community mental health services

1998 ◽  
Vol 173 (5) ◽  
pp. 423-427 ◽  
Author(s):  
Graham Thornicroft ◽  
Til Wykes ◽  
Frank Holloway ◽  
Sonia Johnson ◽  
George Szmuckler
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Experimental Studies ◽  
Community Mental Health Services ◽  
Clinical Effectiveness ◽  
Community Health Services ◽  
Community Services ◽  
Met Needs

BackgroundThe PRiSM Psychosis Study investigated the outcomes of community mental health services for epidemiologically representative cases of psychosis in London.MethodThe results presented in the preceding nine papers are interpreted.Results(a) The health and social gains reported in experimental studies of community health services are replicable in ordinary clinical settings, and are more effective than hospital-oriented services which they replace, (b) Dilution does occur - these gains are less pronounced than in experimental (efficacy) studies, (c) Both models of community services produced a range of improved outcomes, (d) Some limited extra advantages (in terms of met needs, improved quality of life, and social networks) were found in the intensive sector, (e) There is no consistent evidence that community-oriented services (which include in-patient beds) fail service users, their families or the wider public. On balance the results weigh slightly in favour of the two-team model (for acute and continuing care) in terms of clinical effectiveness, but the general model is almost as effective and is less expensive.ConclusionsThe evidence supports a community-oriented rather than a hospital-oriented approach and there is little difference between the community mental health team models.

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