scholarly journals Attitudes to referral to community mental health teams: a questionnaire study

2005 ◽  
Vol 29 (6) ◽  
pp. 213-214 ◽  
Author(s):  
P. Walker ◽  
O.G. Haeney ◽  
P.C. Naik
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
General Practitioners ◽  
Psychotic Disorders ◽  
Acute Stress ◽  
Severe Depression ◽  
Mild Depression ◽  
Referral Patterns ◽  
Panic Disorders ◽  
Acute Stress Reaction

Aims and MethodThere are no data or guidelines on who should be referred to community mental health teams (CMHTs), resulting in enormous variability in referral patterns. General practitioners (GPs) and psychiatrists were surveyed using a purpose-designed questionnaire to assess their attitudes regarding referral of individuals with different psychiatric disorders.ResultsThere was consensus among GPs and psychiatrists that individuals with psychotic disorders, mania, severe depression and phobias should be referred to CMHTs. GPs were more likely to refer personality disorder, whereas the reverse was true for moderate depression and anxiety/ panic disorders. There was disagreement within groups about referral for acute stress reaction, mild depression and adjustment disorders.Clinical ImplicationsUncertainty about appropriate referral causes variability in referral patterns and service provisions. This needs resolution through the Royal Colleges of Psychiatrists and General Practitioners, to provide guidance leading to equality of care for all.

scholarly journals Patient factors associated with the use of psychotropic polypharmacy in patients under the care of a community mental health team in the West of Ireland

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S106-S106
Author(s):  
Karthika Srikumar ◽  
Richard Walsh ◽  
Donnchadh Walsh ◽  
Sonn Patel ◽  
Sheila O'Sullivan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychotic Disorders ◽  
Drug Regimen ◽  
Psychotropic Medications ◽  
Community Mental Health Team ◽  
Patient Factors ◽  
Mental Health Team ◽  
Health Team ◽  
Factors Associated

AimsPsychiatric polypharmacy refers to the prescription of two or more psychotropic medications to any one patient. This definition is purely quantitative and does not take into account whether such a prescription is detrimental, or unnecessary. In many cases, polypharmacy has been implemented in challenging illnesses, and some studies have shown that it can improve overall outcomes for certain patients. Evidence suggests that the prevalence of psychotropic polypharmacy is increasing, despite advances in psychosocial interventions. The aim of this study was to assess the current prevalence of polypharmacy among patients being treated by a community mental health team (CMHT), and the patient factors associated with its use.MethodWe performed a cross-sectional study of all patients registered with a CMHT in a mixed urban/rural area on a single date. Case records were examined to determine the most recently prescribed drug regimen for each patient. Clinical chart diagnoses were recorded and each one independently verified by the team consultant using ICD-10. A number other sociodemographic variables were recorded. Using Microsoft Excel, we analysed the medications prescribed as well as rates and levels of polypharmacy based on multiple different patient characteristics.ResultOf the 245 patients, the mean age was 56.3 and 51.2% (n = 126) were female. Psychotropic polypharmacy was seen in 62% (n = 152) of patients. 33% (n = 82) of patients were on two psychotropic medications, and of this subset, a combination of one antipsychotic and one antidepressant was the most common drug regimen, seen in 16.7% (n = 41) of all patients. Polypharmacy was more prevalent in females, with 68% (n = 85) being on two or more psychotropics, in comparison to 58% of male patients. In relation to age, patients aged between 51 to 65 years had the highest prevalence of polypharmacy, at a rate of 71% (n = 49). Among all primary diagnoses, polypharmacy was most common in patients with affective disorders, with 80% (n = 40) of this patient cohort on two or more medications. Second to this was psychotic disorders, with polypharmacy seen in 65% (n = 62) of this group.ConclusionWe found that psychotropic polypharmacy is highly prevalent in psychiatric patients being treated in a community setting. Certain demographics and patient factors, such as age, gender and psychiatric diagnosis influenced the rate of polypharmacy and certain drug combinations were more commonly prescribed than others.

scholarly journals La depresión: una realidad masculina

Enfoques ◽  
2014 ◽  
Vol 1 (1) ◽  
pp. 45
Author(s):  
Nubia Álvarez Vargas ◽  
Ángela Paola Ochoa Gaitán
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Severe Depression ◽  
Mild Depression ◽  
Male Population ◽  
Cross Sectional ◽  
Implementation Phase ◽  
Adult Men ◽  
Descriptive Approach ◽  
Cross Sectional Design

 Currently Depression is a serious mental health problem, which significantly affects the individuals; thus requires an appropriate psychological management. Numerous studies have been conducted around this problem which repeatedly shows the presence of depression in women more than in men. However, considering that in the male population has increased the risk of the disease, especially if you consider that has not produced a specific etiology of depression in the male population; making it difficult for mental health professionals make diagnoses and treatments. Thus, the present study aims to determine the existence of depression in male employees of an institution of higher education. The research corresponds to a non-experimental cross-sectional design, quantitative and descriptive approach. The non-random sample of intentional or convenience way consisted of 45 men. The instrument of data collection is known as CDH (Questionnaire depression for men) through which to assess depressive symptoms in adolescent and adult men. Partial results helped identify 44% no depression, 40% mild depression, 11% with moderate depression and 5% severe depression. The discussion and analysis of the results will be finalized on completion of the implementation phase. 

scholarly journals Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lars Hestmark ◽  
Maria Romøren ◽  
Kristin Sverdvik Heiervang ◽  
Bente Weimand ◽  
Torleif Ruud ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Family Involvement ◽  
Psychotic Disorders ◽  
Psychosocial Health ◽  
Health Care Personnel ◽  
National Guidelines ◽  
Cluster Randomised ◽  
Health Centres

Abstract Background Family involvement for persons with psychotic disorders is under-implemented in mental health care, despite its firm scientific, economic, legal and moral basis. This appears to be the case in Norway, despite the presence of national guidelines providing both general recommendations on family involvement and support in the health- and care services, and specific guidance on family interventions for patients with psychotic disorders. The aim of this project is to improve mental health services and the psychosocial health of persons with psychotic disorders and their relatives, by implementing selected recommendations from the national guidelines in community mental health centres, and to evaluate this process. Methods The trial is cluster randomised, where 14 outpatient clusters from community mental health centres undergo stratified randomisation with an allocation ratio of 1:1. The seven intervention clusters will receive implementation support for 18 months, whereas the control clusters will receive the same support after this implementation period. The intervention consists of: 1. A basic level of family involvement and support. 2. Family psychoeducation in single-family groups. 3. Training and guidance of health care personnel. 4. A family coordinator and 5. Other implementation measures. Fidelity to the intervention will be measured four times in the intervention arm and two times in the control arm, and the differences in fidelity changes between the arms constitute the primary outcomes. In each arm, we aim to include 161 patients with psychotic disorders and their closest relative to fill in questionnaires at inclusion, 6 months and 12 months, measuring psychosocial health and satisfaction with services. Clinicians will contribute clinical data about patients at inclusion and 12 months. Use of health and welfare services and work participation, for both patients and relatives, will be retrieved from national registries. We will also perform qualitative interviews with patients, relatives, health care personnel and leaders. Finally, we will conduct a cost-effectiveness analysis and a political economy analysis. Discussion This project, with its multilevel and mixed methods approach, may contribute valuable knowledge to the fields of family involvement, mental health service research and implementation science. Trial registration ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.

Descriptive study of patients with intellectual disability attended in a community mental health care center

2017 ◽  
Vol 41 (S1) ◽  
pp. S599-S600
Author(s):  
S. Oller Canet ◽  
E. Pérez Sánchez ◽  
L. Alba Pale ◽  
E. Mur Mila ◽  
B. Samsó Buixareu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Aggressive Behavior ◽  
Psychotic Disorders ◽  
Care Center ◽  
Community Mental Health Care ◽  
Health Care Center

IntroductionThe rate of mental illness among people with intellectual disability is at least 2.5 times higher than in the general population [1].ObjectiveTo describe the clinical and sociodemographic characteristics of all patients with intellectual disability treated in a community mental health care center (CMH) located in a city of 120,000 inhabitants on the outskirts of Barcelona with a high poverty index.MethodsDocuments and patient records were reviewed. Clinical, sociodemographic and other treatment data of patients with intellectual disability treated at the CMH were collected.ResultsThe sample consisted of 118 patients. Mean age: 39.5 (SD: 15), 54% men. 92% single and 23.7% legally incapacitated. 46.6% never completed basic education and 44.1% completed primary school. Employment status: 14.4% unemployed, 14.4% currently active, and 50% pensioned. Patients living mainly with their family (parents:) 86%. 68.6% of patients showed aggressive behavior, but the rate of hospital psychiatric admissions was low (mean: 1.1 (SD: 2.3)). Organic comorbidity: 44.9%. Functionality measured with GAF mean: 45 (SD: 12). Level of intellectual disability was mostly mild (62%). Psychiatric diagnoses were: psychotic disorders: 49.25%, affective disorders: 6.8%, personality disorder: 3.4%, Obsessive-compulsive disorder: 3.4%, autism: 11.9% and other diagnoses: 37.3%. Patients treated with anti-psychotics: 78.8%, anti-depressants: 40.7%, and mood stabilizers: 70.5%.ConclusionsIntellectually disabled patients from our sample showed high comorbidity with psychotic disorders, were highly medicated and often exhibited aggressive behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Treatment Engagement of Psychotic Patients with a Mobile Mental Health Unit in Rural Areas in Greece: A Five-Year Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Athina Tatsioni ◽  
Nefeli Menti ◽  
Aikaterini Grammeniati ◽  
Vassiliki Fotopoulou ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Low Income ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Low Income Countries ◽  
Community Mental Health Service ◽  
Health Unit ◽  
Mobile Mental Health ◽  
Mental Health Unit

Objectives. Treatment of psychotic disorders is impended by high rates of disengagement from mental health services and poor adherence to antipsychotic medication. This study examined the engagement rates of psychotic patients with a community mental health service during a 5-year period.Methods. The Mobile Mental Health Unit of Ioannina and Thesprotia (MMHU I-T) delivers services in remote, rural, mountainous areas using the resources of the primary care system. Clinical and demographic information for patients with a diagnosis of schizophrenia and related psychoses was obtained from the medical records of our unit.Results. A total of 74 psychotic patients initially engaged in treatment with our unit. In half of cases treatment was home-based. With the exclusion of patients who died or discharged, engagement rates were 67.2%. Statistical analysis was performed for 64 patients, and no differences were found between engaged and disengaged patients regarding clinical and demographic parameters. All engaged patients regularly refilled their antipsychotic prescriptions.Conclusion. Engagement rates in our study were comparable to previous research, involving urban settings and shorter follow-up duration. Community mental health teams may ensure treatment continuation for psychotic patients in deprived, remote areas. This is important for low-income countries, affected by economic crisis, such as Greece.

scholarly journals The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study

2002 ◽  
Vol 11 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Stefan Priebe ◽  
Rosemarie McCabe ◽  
Jens Bullenkamp ◽  
Lars Hansson ◽  
Wulf Rössler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Psychotic Disorders ◽  
Outcome Measurement ◽  
Treatment Decisions ◽  
Community Mental Health Care

SUMMARYThree issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings. This, however, is more likely to happen, if it provides a direct benefit to clinicians and patients. C) Whilst user involvement is relatively ?" easy to achieve on a political level, new mechanisms may have to be established to make the views of patients feed into individual treatment decisions. The MECCA study is a cluster randomised controlled trial following the same protocol in community mental health teams in six European countries. In the experimental group, patients' subjective quality of life, treatment satisfaction and wishes for different or additional help are assessed in key worker-patient meetings every two months and intended to inform the therapeutic dialogue and treatment decisions. The trial tests the hypothesis that the intervention – as compared to current best standard practice – will lead to a better outcome in terms of quality of life and other criteria in patients with psychotic disorders over a one year period. This more favourable outcome is assumed to be mediated through different treatment input based on more appropriate joint decisions or a more positive therapeutic relationship in line with a partnership model of care or both. Moreover, the study will hopefully reveal new insights into how therapeutic processes in community mental health care work and how they can be optimised.

scholarly journals Using evidence-based dissemination and implementation strategies to improve routine communication between general practitioners and community mental health teams

2004 ◽  
Vol 28 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Tracy White ◽  
Sarah Marriott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
General Practitioners ◽  
Good Practice ◽  
Implementation Strategies ◽  
Dissemination And Implementation ◽  
Care Providers ◽  
Mental Health Team ◽  
Clinical Communication

Aims and MethodTo improve the quality of written communication between general practitioners (GPs) and community mental health team (CMHT) members concerning patients newly referred to two inner-city CMHTs. Following a benchmark audit of a random sample of referral and assessment letters, locally agreed good practice protocols were shared widely, accompanied by a dissemination and implementation strategy.ResultsSignificant improvements occurred in both GP and CMHT letters; these were most dramatic after 1 year, but tailed off considerably in the second year despite continued efforts to implement the protocols' standards.Clinical ImplicationsPlanned dissemination and implementation strategies can help to improve routine clinical communication between CMHTs and GPs through the use of good practice protocols, thus improving shared working between primary and secondary care providers.

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