scholarly journals Executives have taken over the asylum: the fate of 71 psychiatric hospitals

2003 ◽  
Vol 27 (6) ◽  
pp. 227-229 ◽  
Author(s):  
Robert Chaplin ◽  
Steve Peters
Keyword(s):  
Psychiatric Hospitals ◽  
Descriptive Data ◽  
Mental Hospitals ◽  
The Uk

This article gives an account of a 2-year project to establish the fate of the mental hospitals in three areas of the UK. There were two aims: to determine the proportion of mental hospitals that are currently open and to provide descriptive data on the fate of those that had closed.

scholarly journals Executives have taken over the asylum: the fate of 71 psychiatric hospitals

2003 ◽  
Vol 27 (06) ◽  
pp. 227-229 ◽  
Author(s):  
Robert Chaplin ◽  
Steve Peters
Keyword(s):  
Psychiatric Hospitals ◽  
Descriptive Data ◽  
Mental Hospitals ◽  
The Uk

This article gives an account of a 2-year project to establish the fate of the mental hospitals in three areas of the UK. There were two aims: to determine the proportion of mental hospitals that are currently open and to provide descriptive data on the fate of those that had closed.

scholarly journals Staff attitudes to a psychiatric hospital closure

1997 ◽  
Vol 21 (3) ◽  
pp. 139-141
Author(s):  
Nick Ardagh-Walter ◽  
Prakash Naik ◽  
David Tombs
Keyword(s):  
Psychiatric Hospital ◽  
Psychiatric Hospitals ◽  
Staff Attitudes ◽  
Staff Morale ◽  
Hospital Closures ◽  
Factors Influencing ◽  
Hospital Closure ◽  
Future Hospital ◽  
The Uk ◽  
Enoch Powell

Many psychiatric hospitals in the UK have closed. Factors influencing staff morale around the time of a hospital closure will affect the functioning of that institution. This study surveyed staff anxieties, attitudes and expectations in a major psychiatric hospital three weeks prior to its closure. We found evidence of widespread denial despite energetic dissemination of information. There were also significant differences between staff groups. Our findings will have implications for the management of future hospital closures.“We have to get it into our heads that a hospital is like a shell, a framework to contain certain processes, and when the processes are superseded, the shell must, most probably, be scrapped and the framework dismantled” (Enoch Powell, 1961).

scholarly journals Early Intervention Services for First Episode of Psychosis in South London and the Maudsley (SLaM): 20 Years of Care and Research for Young People

2020 ◽  
Vol 11 ◽  
Author(s):  
Paolo Fusar-Poli ◽  
Serena Lai ◽  
Marta Di Forti ◽  
Eduardo Iacoponi ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Early Intervention ◽  
Clinical Research ◽  
Psychiatric Hospitals ◽  
First Episode ◽  
Scientific Publications ◽  
Early Intervention Services ◽  
White Ethnicity ◽  
Service Characteristics ◽  
Accident And Emergency ◽  
The Uk

Introduction: Early Intervention for a first episode of Psychosis (EI) is essential to improve outcomes. There is limited research describing real-world implementation of EI services.Method: Analysis of service characteristics, outcomes (described through a retrospective 2007–2017 Electronic Health Record (EHR) cohort study) and clinical research relating to the first 20 years of implementation of EI services in South London and Maudsley (SLaM) Trust.Results: SLaM EI are standalone services serving 443,050 young individuals in South-London, where (2017) incidence of psychosis (58.3–71.9 cases per 100,000 person-years) is greater than the national average. From 2007–2017 (when the EHR was established), 1,200 individuals (62.67% male, mean age 24.38 years, 88.17% single; two-thirds of non-white ethnicity) received NICE-compliant EI care. Pathways to EI services came mainly (75.26%) through inpatient (39.83%) or community (19.33%) mental health services or Accident and Emergency departments (A&E) (16%). At 6 year follow-up 34.92% of patients were still being prescribed antipsychotics. The 3 month and 6 year cumulative proportions of those receiving clozapine were 0.75 and 7.33%; those compulsorily admitted to psychiatric hospitals 26.92 and 57.25%; those admitted to physical health hospitals 6.83 and 31.17%, respectively. Average 3 months and 6 year days spent in hospital were 0.82 and 1.85, respectively; mean 6 year attendance at A&E was 3.01. SLaM EI clinical research attracted £58 million grant income and numerous high-impact scientific publications.Conclusions: SLaM EI services represent one of the largest, most established services of its kind, and are a leading model for development of similar services in the UK and worldwide.

Changes in the Administrative Incidence of Schizophrenia

1991 ◽  
Vol 159 (6) ◽  
pp. 811-816 ◽  
Author(s):  
Glynn Harrison ◽  
J. E. Cooper ◽  
Richard Gancarczyk
Keyword(s):  
At Risk ◽  
Psychiatric Hospitals ◽  
Case Register ◽  
Admission Rates ◽  
First Onset ◽  
Administrative Incidence ◽  
Substantial Decline ◽  
The Uk ◽  
Different Parts ◽  
First Admission

First-admission rates to psychiatric hospitals, and data from certain psychiatric case registers suggest that there may have been a substantial decline in the administrative incidence of schizophrenia in recent years. However, data from the Nottingham case register show that rates for first-onset schizophrenia remained stable between 1975 and 1987. It is suggested that variations in trends between different parts of the UK may be partly explained by differences in the proportion of migrants and their children in the population at risk.

scholarly journals ‘Heading up a blind alley’? Scottish psychiatric hospitals in the era of deinstitutionalization

2016 ◽  
Vol 28 (1) ◽  
pp. 115-128 ◽  
Author(s):  
Vicky Long
Keyword(s):  
Institutional Care ◽  
Psychiatric Hospitals ◽  
Blind Alley ◽  
Department Of Health ◽  
Institutional Services ◽  
1960S And 1970S ◽  
Post War ◽  
The 1960S ◽  
The Uk ◽  
The City

This article examines Scottish provision of psychiatric care in the 1960s and 1970s. It demonstrates that institutional services did not rapidly disappear across the UK following the Ministry of Health’s decision to shut down psychiatric hospitals in 1961, and highlights Scotland’s distinctive trajectory. Furthermore, it contends that psychiatric hospitals developed new approaches to assist patients in this era, thereby contributing towards the transformation of post-war psychiatric practice. Connecting a discussion of policy with an analysis of provision, it examines the Department of Health for Scotland’s cautious response to the Ministry’s embrace of deinstitutionalization, before analysing Glasgow’s psychiatric provision in the 1970s. At this point the city boasted virtually no community-based services, and relied heavily on its under-resourced and overburdened hospitals. Closer analysis dispels any impression of stagnation, revealing how ideologies of deinstitutionalization transformed institutional care.

scholarly journals The effect of COVID-19 lockdown on psychiatric admissions: role of gender

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Monica Davies ◽  
Luke Hogarth
Keyword(s):  
Mental Health ◽  
Seasonal Variation ◽  
Legal Status ◽  
Social Care ◽  
Psychiatric Service ◽  
Psychiatric Hospitals ◽  
Psychological Effects ◽  
Psychiatric Admissions ◽  
The Uk

Background The UK went into nationwide lockdown on 24 March 2020, in response to COVID-19. The direct psychiatric effects of this are relatively unknown. Aims We examined whether the first UK lockdown changed the demographics of patients admitted to psychiatric hospitals (to include gender, legality, route of admission and diagnoses), independent of seasonal variation.. Method We conducted an anonymous review of psychiatric admissions aged ≥18 years in the 6-month period after the announcement of the first UK lockdown (March to August 2020), and in the previous year (March to August 2019), in Kent and Medway NHS and Social Care Partnership Trust in-patient facilities. The number of admissions were compared, along with factors that may help to explain the psychological effects of national lockdown. Results There was no significant increase in total number of admissions or the gender percentage. However, there was a 11.8% increase in formal sectioning under the Mental Health Act 1983. This increase was sustained and statistically significant across all 6 months. A sustained decrease in admissions via the crisis team was also observed as being statistically significant. Separate diagnoses saw changes in percentage of admissions between March and May. The most statistically significant was schizophrenia admissions for men in April (18.7%), and women in March (18.4%). Conclusions Our findings highlight the effect of COVID-19 on the legal status of psychiatric admissions, and emphasise the importance of having a robust, adaptable and open psychiatric service that caters to the ongoing needs of patients, regardless of government restrictions.

Use of risk assessment tools for people with intellectual disability: The latest evidence

2016 ◽  
Vol 33 (S1) ◽  
pp. S38-S38 ◽  
Author(s):  
C. Morrissey
Keyword(s):  
Risk Assessment ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Outcome Measurement ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Assessment Tools ◽  
High Rate ◽  
Lower Intelligence ◽  
The Uk

A relatively high proportion of people detained in forensic psychiatric hospitals have intellectual disabilities (up to 3000 people in the UK; Royal College of Psychiatrists, 2013), and people with intellectual disability are significantly over-represented among those psychiatric patients with long lengths of hospital stay (CQC, 2013; Vollm, 2015). People with mild to borderline intellectual disabilities are also prevalent in the UK prison system.Although the relationship between intelligence and offending is complex, lower intelligence is a known actuarial risk factor for offending behaviour. Studies, which have investigated the prediction of re-offending risk in populations with intellectual disability, have nevertheless found lower rates of recorded re-offending compared to those in mainstream forensic populations (e.g. Gray et al., 2010). The relatively high rate of ‘offending-like’ behaviour, which is not processed through the criminal justice system in people with intellectual disability makes risk prediction a more complex exercise with this group of people. It also makes outcomes measurement more difficult.This paper will give an overview of the current research evidence and clinical practice in the field of risk assessment, risk management and outcome measurement with offenders with intellectual disability. It will summarise the findings of a recent NIHR funded systematic review by the author, which pertains to this area, and will point to future developments in the field.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals A psychiatric clinic for the single homeless in a primary care setting in Inner London

1990 ◽  
Vol 14 (5) ◽  
pp. 270-271 ◽  
Author(s):  
P. L. A. Joseph ◽  
J. A. Bridgewater ◽  
S. S. Ramsden ◽  
D. J. El Kabir
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Care Setting ◽  
Direct Evidence ◽  
Primary Care Setting ◽  
Psychiatric Morbidity ◽  
Psychiatric Hospitals ◽  
Psychiatric Clinic ◽  
The Uk ◽  
Reception Centre

It is well recognised that there is an increased psychiatric morbidity, in particular psychosis, personality disorder and substance abuse, among the single homeless (Lodge Patch et al, 1971). The reasons for this are complex. There is evidence that these people are mentally ill before becoming homeless and that their illness may be a cause of their homelessness. In a study of newly presenting patients at the DHSS Reception Centre in Camberwell, London, Tidmarsh & Wood found that 87% of those with mental illness had been staying recently with their families just before their first hospital admission, suggesting that mental illness may have led to homelessness in these patients (Tidmarsh & Wood, 1972). Although direct evidence is scant in the UK, it is felt that the closure of long-stay psychiatric hospitals could lead to some of their in-patients becoming homeless.

Context

2013 ◽  
Author(s):  
Edward Shorter
Keyword(s):  
Internal Medicine ◽  
Psychiatric Hospitals ◽  
The Body ◽  
Entire Body ◽  
Mental Hospitals ◽  
Large Numbers ◽  
German Speaking ◽  
Subway Train ◽  
Serious Disease ◽  
Almost All

Consider the current landscape of depression. In an ABC poll in 2002, 15% of Americans said they felt “really depressed” once a week or more. Another 17% said once a month. That means that one-third of the American population believes itself to be depressed in a given month. If you are riding on a subway train with a hundred other people, one-third of them will be currently depressed, or have just been, or are about to be. That is a lot. In fact, it is way too many. We know that only 3% of the population is chronically sad. We know that the serious disease, melancholia, is only a fraction of the ranks of the depressed. Far too many people have received the diagnosis of depression. Whose fault is this? At the beginning of our story, psychiatry spoke German. From around 1870 to 1933, German-speaking Europe was the epicenter of world psychiatry. This was so for two reasons. One, German, Swiss, and Austrian psychiatrists saw large numbers of very sick individuals because they practiced in mental hospitals, leaving outpatients to other practitioners. Of course this was true of alienists elsewhere, but there were more mental hospitals in Germany affiliated with universities because Germany had so many universities. Almost all had university psychiatric hospitals. This was not true elsewhere. So German psychiatry was oriented toward the academic study of large numbers of patients, and a genial figure such as Emil Kraepelin used these resources to make big strides. Second, German psychiatrists had a thorough familiarity with internal medicine because they were also trained as neurologists. From the viewpoint of subject matter, neurology has always been treated as a subspecialty of internal medicine, even though in Central Europe it was hived off to the nerve specialists. In learning so much neurology, German psychiatrists acquired a feeling for brain illness as involving the entire body: They were indeed attuned to looking at the body as a whole, in contrast to Anglo-Saxon psychiatrists, who usually did not also train as internists.

Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design

2020 ◽  
pp. medhum-2020-011887
Author(s):  
Rebecca Mclaughlan ◽  
Codey Lyon ◽  
Dagmara Jaskolska
Keyword(s):  
Psychiatric Hospital ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Advisory Panel ◽  
Design Practice ◽  
Hospital Design ◽  
Hospitalised Patients ◽  
The Usa ◽  
Forensic Psychiatric ◽  
The Uk

History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.

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