Drug services in England and Wales: a survey of treatment providers and their medical leads

Aims and MethodWe undertook a postal questionnaire survey of drug action teams in England and Wales with the aim of clarifying the nature of statutory specialist drug services.ResultsOf 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. Other providers were primary care and acute trusts, the non-statutory sector and social services. The majority of medical leads were psychiatrists (123 senior posts with 20% vacant/occupied by a locum), then general practitioners (GPs) (42) and other specialists (4).Clinical ImplicationsSpecialist drug services are offered by a range of treatment providers, with the medical lead being taken by GPs and other specialists in some areas. In view of the current difficulty in recruiting psychiatrists, we propose that alternative training pathways are considered for addiction specialists.

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Communication regarding adverse drug reactions between secondary and primary care: a postal questionnaire survey of general practitioners

Journal of Clinical Pharmacy and Therapeutics ◽

10.1046/j.1365-2710.1999.00210.x ◽

1999 ◽

Vol 24 (2) ◽

pp. 133-139 ◽

Cited By ~ 8

Author(s):

C. F. Green ◽

D. R. Mottram ◽

M. Pirmohamed ◽

R. Horner ◽

P. H. Rowe

Keyword(s):

Primary Care ◽

General Practitioners ◽

Adverse Drug Reactions ◽

Questionnaire Survey ◽

Postal Questionnaire ◽

Drug Reactions

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Usage of clozapine and the new neuroleptics

Psychiatric Bulletin ◽

10.1192/pb.23.8.478 ◽

1999 ◽

Vol 23 (8) ◽

pp. 478-480

Author(s):

M. F. Bristow

Keyword(s):

General Practitioner ◽

General Practitioners ◽

Atypical Antipsychotic ◽

Response Rate ◽

Postal Questionnaire ◽

Clinical Implications ◽

England And Wales

Aims and methodTo explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used – postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.ResultsThere was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.Clinical implicationsOptimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.

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Secondary mental healthcare in prisons in England and Wales: results of a postal questionnaire

The Psychiatrist ◽

10.1192/pb.bp.110.033274 ◽

2011 ◽

Vol 35 (12) ◽

pp. 445-448 ◽

Cited By ~ 2

Author(s):

Nick Kosky ◽

Clifford Hoyle

Keyword(s):

Mental Health ◽

National Health Service ◽

Health Service ◽

National Health ◽

Mental Healthcare ◽

Postal Questionnaire ◽

Service Development ◽

Clinical Implications ◽

England And Wales ◽

Prison Capacity

Aims and methodPrison mental health inreach teams (PMHITs) were introduced in response to policy from 2003. This provision comes under the responsibility of the National Health Service. Service development and structure was not defined in policy. A total of 97 prisons of an estimated 100 known to have a PMHIT were targeted by postal questionnaire and responses covered 62 prisons. Team structures were captured in the data with specific regard to the number of available professional sessions.ResultsFindings determine there is generally no correlation between input and prison capacity, although there was some evidence of correlation in the high secure (category A) estate and that the female estate was generally better served.Clinical implicationsIt is evident from this study that PMHITs have evolved piecemeal, with no clear standards or equity across the estate. This is of concern.

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Correspondence from substance misuse services – what do general practitioners really want?

Psychiatric Bulletin ◽

10.1192/pb.30.8.292 ◽

2006 ◽

Vol 30 (8) ◽

pp. 292-294

Author(s):

Devatha Radhae Shyam ◽

Hugh Williams

Keyword(s):

General Practitioners ◽

Questionnaire Survey ◽

Substance Misuse ◽

Quality Standards ◽

Management Plan ◽

Postal Questionnaire ◽

Clinical Implications ◽

Medication Prescribing

Aims and MethodTo improve the quality of correspondence by identifying what general practitioners (GPs) regarded as the important attributes in patient letters from a substance misuse service. A postal questionnaire survey was carried out to determine the views of general practitioners in Brighton and Hove City.ResultsResponses were obtained from 32 out of 45 GP surgeries (71%) and indicated that correspondence should be prompt, concise and regular. An assessment summary, management plan and clear medication prescribing arrangements between primary and secondary services were considered particularly important.Clinical ImplicationsNew quality standards for correspondence to GPs have been implemented by the Brighton Substance Misuse Service. These might be of interest to other such services.

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Droperidol dropped; consultants not consulted

Psychiatric Bulletin ◽

10.1017/s0955603600002786 ◽

2003 ◽

Vol 27 (08) ◽

pp. 301-304

Author(s):

Gavin Reid ◽

Mark Hughson

Keyword(s):

Questionnaire Survey ◽

Clinical Care ◽

Postal Questionnaire ◽

Clinical Implications ◽

The West ◽

Abrupt Withdrawal ◽

Before And After ◽

Adequate Evaluation ◽

Psychiatric Profession ◽

The Impact

Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

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Challenging care work: General practitioners’ perspectives on caring for young adults with complex psychosocial problems

Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine ◽

10.1177/1363459319874100 ◽

2019 ◽

pp. 136345931987410

Author(s):

Julie Høgsgaard Andersen ◽

Tine Tjørnhøj-Thomsen ◽

Susanne Reventlow ◽

Annette Sofie Davidsen

Keyword(s):

Mental Health ◽

Primary Care ◽

Young Adults ◽

General Practitioners ◽

Mental Health Problems ◽

Psychosocial Problems ◽

Health Problems ◽

Care Work ◽

Psychiatric Nurses ◽

Provision Of Care

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners’ perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners’ care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto’s concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults’ difficulties with accessing and receiving available care.

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Evaluation of a mental health website for teenagers

Psychiatric Bulletin ◽

10.1192/pb.30.5.175 ◽

2006 ◽

Vol 30 (5) ◽

pp. 175-178 ◽

Cited By ~ 5

Author(s):

Sukru Ercan ◽

Andrew Kevern ◽

Leo Kroll

Keyword(s):

Mental Health ◽

Social Workers ◽

General Practitioners ◽

School Nurses ◽

The Self ◽

Clinical Implications ◽

Self Assessment ◽

Perceived Need ◽

Screening Questionnaires ◽

Assessment Questionnaire

Aim and MethodRu-ok.com is a recently developed website that includes a self-assessment questionnaire. The aim of this study was to evaluate the website and compare the self-assessment questionnaire with established screening questionnaires. A total of 105 teenagers from schools completed three paper-based questionnaires and the online ru-ok.com questionnaire.ResultsThe website receives 730 visits a week. Visits to the advice section and stories about mental health and relationships account for 35% of activity. Of the returned questionnaires, 80% were positive about the website. There were modest and expected correlations between the website questionnaire (RU–OK) and the Mood and Feelings (MFQ) and Strength and Difficulties (SDQ) questionnaires.Clinical ImplicationsInternet-based self-assessment is feasible and acceptable to teenagers. Self-assessment of perceived need by teenagers may be a useful tool for tier one professionals, including teachers, general practitioners, school nurses, social workers and learning mentors.

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Facilities for carers of in-patients in forensic psychiatric services in England and Wales

The Psychiatrist ◽

10.1192/pb.bp.109.025833 ◽

2010 ◽

Vol 34 (9) ◽

pp. 381-384 ◽

Cited By ~ 2

Author(s):

Irene Cormac ◽

Drew Lindon ◽

Hannah Jones ◽

Trevor Gedeon ◽

Michael Ferriter

Keyword(s):

Mental Health ◽

Postal Survey ◽

Psychiatric Services ◽

Clinical Implications ◽

England And Wales ◽

Mental Health Settings ◽

Forensic Psychiatric ◽

Minority Ethnic ◽

Psychiatric Facilities

Aims and methodA postal survey of forensic psychiatric facilities in England and Wales was undertaken to obtain information about the services provided for carers of in-patients within these services.ResultsForensic psychiatric services vary in the support and facilities provided for carers. Many do not comply with current legislation for carers. Most units informed carers of their rights to have an assessment, but only a minority provided facilities for carers from Black and minority ethnic backgrounds.Clinical implicationsForensic psychiatric services should meet standards for the involvement and support of carers in mental health settings, and comply with legislation for carers.

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