scholarly journals Mental health services, suicide and 7-day working

2016 ◽  
Vol 209 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Nav Kapur ◽  
Saied Ibrahim ◽  
Isabelle M. Hunt ◽  
Pauline Turnbull ◽  
Jenny Shaw ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Risk ◽  
Weekend Effect ◽  
Post Discharge ◽  
Risk Of Death ◽  
Increased Risk ◽  
Mental Health Patients

BackgroundPatients admitted to hospital at the weekend appear to be at increased risk of death compared with those admitted at other times. However, a ‘weekend effect’ has rarely been explored in mental health and there may also be other times of year when patients are vulnerable.AimsTo investigate the timing of suicide in high-risk mental health patients.MethodWe compared the incidence of suicide at the weekend v. during the week, and also in August (the month of junior doctor changeover) v. other months in in-patients, patients within 3 months of discharge and patients under the care of crisis resolution home treatment (CRHT) teams (2001–2013).ResultsThe incidence of suicide was lower at the weekends for each group (incidence rate ratio (IRR) = 0.88 (95% CI 0.79–0.99) for in-patients, IRR = 0.85 (95% CI 0.78–0.92) for post-discharge patients, IRR = 0.87 (95% CI 0.78–0.97) for CRHT patients). Patients who died by suicide were also less likely to have been admitted at weekends than during the week (IRR = 0.52 (95% CI 0.45–0.60)). The incidence of suicide in August was not significantly different from other months.ConclusionsWe found evidence of a weekend effect for suicide risk among high-risk mental health patients, but with a 12–15% lower incidence at weekends. Our study does not support the claim that safety is compromised at weekends, at least in mental health services.

scholarly journals “Who needs secure services for personality disorder?” Results of an expert Delphi study with professional staff

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zoe Foyston ◽  
Celia Taylor ◽  
Mark Freestone
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Delphi Study ◽  
Professional Staff ◽  
Free Text ◽  
Forensic Mental Health ◽  
Increased Risk

Abstract Background Personality Disorder (PD) is an enduring, multi-faceted mental disorder, associated with adverse health effects, difficulties with interpersonal relationships and in some cases increased risk to others. A limited number of dedicated forensic mental health services are available for serious offenders with severe personality disorder. The recent Offender Personality Disorder (OPD) strategy aims to ensure that most such offenders are treated in prison rather than secure psychiatric services, except in highly complex cases where this is not possible. While the strategy sets out very broad criteria relating to this, greater clarity is needed to support decisions about appropriate transfer and hence enhance public protection. This study explored which characteristics professional experts associate with appropriate transfer from prison to forensic mental health services for high-risk offenders with PD. Method A modified Delphi survey distributed through an online survey system was conducted in two-rounds with a group of professional experts recruited from forensic mental healthcare; criminal justice and specialist commissioning. Results Fifty-one (56%) respondents completed stage one of the Delphi and 34 (61%) of these completed stage two. Consensus was reached for a total of 22 items indicating complexity, including co-morbid mental illness, high level of risk, lack of progress in prison and high motivation for treatment. A preliminary checklist for these factors was developed. Panel members consistently emphasised the importance of the individual’s presenting need, the overall clinical picture and formulation in their free text responses. Conclusions Professionals face a complex picture when making decisions regarding suitability for hospital admission for high-risk male offenders with PD, with varied opinions amongst professional experts as to priorities for intervention and a focus on individual needs through formulation. It was, nevertheless, possible to condense these views into a set of consistent variables that can be used to highlight the need for transfer into hospital-based treatment services.

scholarly journals Setting the scene: controversies on trends in mental health among adolescents in the Nordic countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Eriksson ◽  
A M Arnasson ◽  
N Lyyra ◽  
K R Madsen ◽  
T Torsheim ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Nordic Countries ◽  
Daily Hassles ◽  
Data Availability ◽  
Increased Risk ◽  
Advanced Analysis

Abstract At present there are different positions regarding trends in adolescent mental health. Can we trust trend data on the mental health among adolescents in the Nordic countries? Some question the trustworthiness of adolescent self-reports, which describe ordinary daily hassles as health complaints, which cannot be interpreted as signs of mental disorders. In addition, today there is a more open climate for talking about mental issues, which can lead to an overestimation of the prevalence of mental disorders. Statistics on mental health services statistics report increased psychopharmaceutic prescriptions as well as consumption of professional care. Such data argues for increased governmental investment in adolescent mental health services. Is this pattern due to increased availability of mental health services and/or increased prevalence of mental health problems in the adolescent population? A concern is that data availability influences policymaking and allocation of resources. If there is an emphasis on self-reported data from adolescents that may an increased risk of medicalization of young people's dealing with their daily lives. If on the other hand the reported problems among young people is disregarded, this would be against the UN Child Convention. The survey data has important qualities especially if the data is analysed and reported properly. The validation of survey measure has been done both regarding psychometric quality and content validity. Advanced analysis of the data can draw a more nuanced picture. Moreover, some screening instruments have been developed as a first step towards making diagnosis. Instead the HBSC surveys ask boys and girls about their health and well-being, social environment and health behaviours. HBSC uses findings at national and international levels to gain new insights into young people's health and wellbeing, understand the social determinants of health, and inform policy and practice to improve young people's lives.

scholarly journals Structured Professional Judgment to Assist the Evaluation and Safety Planning of Suicide Risk: The Risk of Suicide Protocol (RoSP)

2021 ◽  
Vol 12 ◽  
Author(s):  
Nicola S. Gray ◽  
Ann John ◽  
Aimee McKinnon ◽  
Stephanie Raybould ◽  
James Knowles ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Evaluation ◽  
Suicide Risk ◽  
Professional Judgment ◽  
Health Board ◽  
Safety Planning ◽  
Nice Guidelines ◽  
Structured Professional Judgment

Background: The Risk of Suicide Protocol (RoSP) is a structured professional judgment (SPJ) scheme designed in line with NICE guidelines to improve clinicians' ability to evaluate and manage suicide risk.Aims: This study aimed to evaluate the efficacy of RoSP in two settings: (1) unexpected deaths of people in the community who were known to mental health services; and (2) an inpatient hospital specializing in the assessment and treatment of patients with personality disorder.Method: In Study 1, information from a database of unexpected deaths (N = 68) within an NHS health board was used to complete a RoSP assessment (blind to cause of death) and information from the Coroner's Court was used to assign people to suicide vs. natural causes/accidental death. In Study 2, patients (N = 62) were assessed on the RoSP upon admission to hospital and their self-injurious behaviors were recorded over the first 3 months of admission.Results: (1) Evaluations using RoSP were highly reliable in both samples (ICCs 0.93–0.98); (2) professional judgment based on the RoSP was predictive of completed suicide in the community sample (AUC = 0.83) and; (3) was predictive of both suicide attempts (AUC = 0.81) and all self-injurious behaviors (AUC = 0.80) for the inpatient sample.Conclusion: RoSP is a reliable and valid instrument for the structured clinical evaluation of suicide risk for use in inpatient psychiatric services and in community mental health services. RoSP's efficacy is comparable to well-established structured professional judgment instruments designed to predict other risk behavior (e.g., HCR-20 and the prediction of violence). The use of RoSP for the clinical evaluation of suicide risk and safety-planning provides a structure for meeting NICE guidelines for suicide prevention and is now evidence-based.

scholarly journals Demystifying the pathway of assessment and treatment for bipolar disorder – utilising co-production and algorithms to personalise the approach

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S150-S150
Author(s):  
Jessica Nicholls-Mindlin ◽  
Digby Quested ◽  
Matthew Taylor ◽  
Lauren Fuzi ◽  
David Gee
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Public Involvement ◽  
Psychological Intervention ◽  
Patient And Public Involvement ◽  
Service Development ◽  
Post Discharge ◽  
Nice Guideline

AimsTo develop an evidence based, patient centred treatment pathway for people experiencing symptoms of bipolar disorder (BD), modifiable to include local resources.MethodThis project was developed in line with current approaches to service development such as coproduction, with patient and public involvement (PPI) and enhancing personalisation of treatment in medicine. As part of a local initiative, a multi-disciplinary team was brought together to understand and analyse the current local pathway for those affected by BD. It was found that the approach to assessment and management was not consistent between locality teams. Two experts by experience who have a diagnosis of BD were invited to become involved with the development of the pathway. Meetings were set up to enable coproduction and elicit information from those with the diagnosis. The responses provided insight into the effectiveness of different approaches used nationally to inform the methods and resources that are most helpful and appropriate to comprehensively support those with the illness.NICE guideline evidence was used to create two algorithms to streamline the care of those with BD in both primary and secondary care. These algorithms include pharmacological, psychological and social approaches. It also considers the junctions at which referrals should be made and the criteria on which decisions are based.ResultOne algorithm was designed for use in primary care and will be distributed to local GPs to clarify the initial steps for assessment and management of BD and the criteria for referral. A second decision tree will be made available to all doctors working in mental health services with detailed medication options, when they are appropriate and whether additional psychological intervention should be considered e.g. post-discharge groups. Other specialist options such as Early Intervention for Psychosis and Perinatal Mental Health Services were also included. An information pack was created to be offered to all those with a diagnosis or possible diagnosis of BD. This contains useful resources such as skills and exercises that patients may find of benefit, external resources and websites regarding additional support and further information on BD, its nature and management.ConclusionThe approach and resources collated here will help to streamline the management of those with bipolar disorder whilst also ensuring a more consistent approach. The involvement of experts by experience and the incorporation of NICE guidelines ensures a well-rounded and comprehensive set of documents that will be helpful to both clinicians and patients.

Developing methods that really do value the ‘Q’ in the QALY

2008 ◽  
Vol 3 (1) ◽  
pp. 69-77 ◽  
Author(s):  
PAUL DOLAN
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
General Public ◽  
Full Health ◽  
Risk Of Death ◽  
Ration Health Care ◽  
Good Guide

AbstractMost health economists recommend that improvements in health be valued by asking members of the general public to imagine themselves in different states of health and then to think about how many years of life they would give up or what risk of death they would be willing to accept in order to be in full health. In this paper, I argue that preferences are not a very good guide to future experiences and a more suitable way to value health is to ask people in different states of health how they think and feel about their lives. Valuing health in this way may result in greater priority being given to mental health services. Whatever the precise implications, it is my contention that it is much better to ration health care according to real experiences rather than according to hypothetical preferences.

scholarly journals (A66) Integration of Psycho-Social Social Support and Mental Health Services in to National Disaster Management Guidelines

2011 ◽  
Vol 26 (S1) ◽  
pp. s18-s18
Author(s):  
J.K. Christy
Keyword(s):  
Mental Health ◽  
Social Support ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Disaster Management ◽  
Disaster Response ◽  
Social Care ◽  
Management Guidelines ◽  
National Disaster

Integration of Psycho-social Social Support and Mental Health Services in to National Disaster Management Guidelines India is vulnerable, in varying degrees, to a large number of natural as well as man-made disasters and also a high risk country for disasters due to expanding population, urbanization and industrialisation, development within high-risk zones, environmental degradation and climate changes. The creation of National Disaster Management Authority (NDMA) in 2005, as the apex body for disaster management, has brought out a paradigm shift in the area of disaster management. One of the important mandate of NDMA is to issue National Disaster Management Guidelines (NDMG) to the ministries/ departments to assist them to formulate their respective Disaster Management (DM) plans. In this direction NDMA has issued number of NDMG on different themes to provide basis of preparation of DM plans at different levels. There are policies & guidelines on Psycho-social Support and Mental Health Services (PSSMHS) in disasters at the international level in the form of Inter Agency Standing Committee guidelines (IASC) which advocates PSSMHS in disasters. In India there was no such policy which streamlines the Psycho-social Support and Mental Health Services in Disasters. During preparation of various National Disaster Management Guidelines, one remarkable factor noticed was the need for psycho-social care, subsequently preparation of NDMG on Medical Preparedness and Mass Causality Management brought out an overwhelming consensus to formulate a separate NDMG for PSSMHS. In order to translate the critical need for psycho-social care and support into guidelines, NDMA adopted a mission-mode approach for integrating PSSMHS in disaster response by involving participatory and multi step methodology to formulate NDMG on Psycho-social Support and Mental Health Services in Disasters.

scholarly journals Advances in the Basicneeds Mental Health Services and Development Model of Mental Illness in Rural China

2016 ◽  
Vol 5 (1) ◽  
pp. 8 ◽  
Author(s):  
Shao Chen ◽  
Yunshu Zhang ◽  
Jinghua Cao ◽  
Keqing Li
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Rural Areas ◽  
Rural China ◽  
Development Model ◽  
Ability To Work ◽  
Charitable Organization ◽  
Mental Health Patients

Basicneeds Foundation as an international charitable organization，after years of efforts，it explores a suitable for the development of mental health services and the development model and developed countries.It makes the majority of mental health patients recover their health, social function and the ability to work has been restored.Since 2012, carried out in China, also made a lot of results.This article starts from Basicneeds’s five modules, which were summarized in China Baoding Shunping rural areas, for mental illness research progress.At the same time, the Basicneeds group also hopes to improve its model, making it more suitable for the situation in China, and in more places be promoted.

scholarly journals Parent-Perceived Barriers to Accessing Services for Their Child’s Mental Health Problems

2020 ◽  
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjærsdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Children And Adolescents ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Perceived Barriers ◽  
Symptom Duration ◽  
Increased Risk

Abstract Background: Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method: In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results: The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion: Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.

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