scholarly journals Trends in the administration of electroconvulsive therapy in England

2009 ◽  
Vol 33 (2) ◽  
pp. 61-63 ◽  
Author(s):  
David Bickerton ◽  
Adrian Worrall ◽  
Robert Chaplin
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Number Of Patients

Aims and MethodWe measured the use of electroconvulsive therapy (ECT) over 3 months in England in 2006 and compared that with studies from 1999 and 2002. Questionnaires were completed by hospital ECT staff and returned by post with data collected prospectively on ECT use from National Health Service organisations.ResultsTwo-thirds (56 of 76) of the trusts providing ECT at 109 clinics responded. the number of clinics providing ECT and the number of patients receiving ECT has declined. There has been an increase in the proportion of people receiving ECT when detained under the Mental Health Act 1983.Clinical ImplicationsThe number of ECT clinics is likely to continue to decrease and psychiatrists may have decreasing experience of treating patients with ECT.

Effect of recent changes to the Mental Health Act 1983 on sections and appeals: possible unintended consequences

2011 ◽  
Vol 35 (8) ◽  
pp. 305-307 ◽  
Author(s):  
Tom Walker-Tilley ◽  
Tim Exworthy ◽  
Martin Baggaley ◽  
Laura Wilkinson ◽  
Ramin Nilforooshan
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Unintended Consequences ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Before And After

Aims and methodWe examined the effect on civil sections and the rate of appeals against them of the amendments made to the Mental Health Act 1983 as a result of the Mental Health Act 2007. We gathered data for the year before and after the introduction of these changes.ResultsWe found increased use of Section 2 (56.8% before and 65.8% after (P < 0.001)) and decreased use of Section 3 (39.5% before and 31.2% after (P < 0.001)). The number of appeals against civil sections decreased (697 before and 692 after) but there was an 8.0% increase in the proportion of appeals to mental health tribunals. There was a decrease in admissions under these sections (817 before and 733 after).Clinical implicationsThese changes may be unintended consequences of the new law, resulting in increased workloads for psychiatrists and costs to the National Health Service.

scholarly journals Research productivity of staff in NHS mental health trusts: comparison using the Leiden method

2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Research Productivity ◽  
Social Care ◽  
Clinical Implications ◽  
Clinical Services ◽  
Health And Social Care

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

scholarly journals A suitable waiting room? Hospital transfer outcomes and delays from two London prisons

2009 ◽  
Vol 33 (11) ◽  
pp. 409-412 ◽  
Author(s):  
Andrew Forrester ◽  
Christopher Henderson ◽  
Simon Wilson ◽  
Ian Cumming ◽  
Miriam Spyrou ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Clinical Implications ◽  
Waiting Room ◽  
Total Saving ◽  
Hospital Transfer ◽  
Clinical Records ◽  
Timely Treatment

Aims and MethodTo describe a group of prisoners who required transfer to mental health units from two London prisons. Data were collected from prison clinical records.ResultsOverall, 149 patient-prisoners were transferred over a 17-month period. Around a quarter were not previously known to services. the aggregate wait was 36.5 years (averaging between 93 and 102 days per prisoner) and the total saving to the National Health Service (NHS) has been estimated at £6.759 million.Clinical ImplicationsBoth prisons manage a large number of prisoners with untreated psychosis. While in prison, they save the NHS considerable sums of money, but transfer delays prevent timely treatment and could now be legally challenged.

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

2011 ◽  
Vol 35 (12) ◽  
pp. 445-448 ◽  
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.

An evaluation of the practice of electroconvulsive therapy (ECT) in a Victorian health service before and after the Mental Health Act 2014

2020 ◽  
Vol 28 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Jia L Lee ◽  
Kuruvilla George ◽  
Leah Price ◽  
Jeremy Couper
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Electroconvulsive Therapy ◽  
Eastern Health ◽  
Mental Health Act ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
Clinical File

Objective: The aim of the project was to identify changes in the practice of electroconvulsive therapy (ECT) in a metropolitan mental health service before and after the Mental Health Act 2014 (2014 Act) in Victoria. Method: Retrospective clinical file audit of ECT administration across all three sites at Eastern Health (EH) two years before and two years after introduction of the 2014 Act. Results: There was a statistically significant decrease in the number of compulsory ECT treatments and in the number of patients who had compulsory ECT across the three hospitals at EH in the two years following the 2014 Act compared to the two years prior to the 2014 Act. There was no significant difference in the number of voluntary ECT treatments and in the number of patients who had voluntary ECT. Conclusion: The review showed that there has been a significant decrease in the number of compulsory ECT treatments and in the number of patients who had compulsory ECT after the introduction of the 2014 Act. Potential reasons for the changes are discussed.

scholarly journals Effects of opt-in letters in a National Health Service psychotherapy service

2010 ◽  
Vol 34 (12) ◽  
pp. 507-510 ◽  
Author(s):  
Simon Houghton ◽  
Dave Saxon ◽  
Amanda Smallwood
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Health Problems ◽  
Clinical Implications ◽  
Attendance Rates ◽  
Common Mental Health Problems ◽  
Published Research ◽  
Historical Controls

Aims and methodUp to a third of clients referred to National Health Service (NHS) mental health services will miss their first appointment. Opt-in systems are widely used to reduce non-attendance but there has been little published research examining the effects of such methods on clients. A cohort study with non-randomised historical controls was used to examine the introduction of an opt-in letter as the route to a first appointment in an NHS psychotherapy service.ResultsThe introduction of the opt-in letter slightly reduced non-attendance rates for first appointments, but this was at the expense of overall access to the service for the highest prevalence disorders.Clinical implicationsIt appears that although an opt-in system can reduce non-attendance at first appointments, it may have an unintended consequence of denying access to clients with the most common mental health problems such as anxiety disorders and depression.

scholarly journals Consultant psychiatrists' views on the supervision register

1998 ◽  
Vol 22 (7) ◽  
pp. 409-411 ◽  
Author(s):  
Francesco L. Lowe-Ponsford ◽  
Paul Wolfson ◽  
James Lindesay
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Response Rate ◽  
Mentally Disordered ◽  
The Public ◽  
Mental Health Act ◽  
One Year ◽  
Do So

A questionnaire on attitudes to the supervision register, about one year after its introduction, was sent to all consultant psychiatrists identified as working in the National Health Service South Thames Region. A response rate of 72.3% was obtained. Half of the respondents felt that the supervision register was not likely to reduce the risk of violence to the public by mentally disordered people and a quarter was unsure. Just over half felt confident in predicting violence, and over half felt that they had been reasonably trained to do so. Most had not changed their practice in admitting or discharging patients, or in the use of the Mental Health Act. There were criticisms of the register, for example: lack of resources needed to implement it, increased paperwork, stigmatisation of patients and the lack of a formal appeal mechanism. Fifty per cent felt the register should be abolished, only 25.5% felt it should not be.

scholarly journals Postcode lottery? Hospital transfers from one London prison and responsible catchment area

2010 ◽  
Vol 34 (4) ◽  
pp. 140-142 ◽  
Author(s):  
Simon Wilson ◽  
Katrina Chiu ◽  
Janet Parrott ◽  
Andrew Forrester
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Catchment Area ◽  
Clinical Implications ◽  
Hospital Unit ◽  
Transfer Data ◽  
Hospital Transfer

Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.

scholarly journals Specialist personality disorder services in England: a case for managed clinical networks?

2005 ◽  
Vol 29 (10) ◽  
pp. 365-368 ◽  
Author(s):  
Kingsley Norton ◽  
Julian Lousada ◽  
Kevin Healy
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Personality Disorder ◽  
Health Service ◽  
Personality Disorders ◽  
National Health ◽  
Clinical Networks ◽  
Department Of Health ◽  
Specialist Services

Following the publication by the National Institute for Mental Health in England (NIMHE) of Personality Disorder: No Longer A Diagnosis of Exclusion (National Institute for Mental Health in England, 2003), it is perhaps surprising that so soon after there have been threats to the survival of some of the small number of existing specialist personality disorder services to which it refers. Indeed, one of the few in-patient units specialising in such disorders (Webb House in Crewe) closed in July 2004. Such closures or threats argue for closer collaboration in planning between the relevant secondary and tertiary services and also between the Department of Health, the NIMHE and local National Health Service commissioners. Not safeguarding existing tertiary specialist services, at a time of increasing awareness of the needs of patients with personality disorders, may be short-sighted.

Is Electroencephalographic Monitoring of Electroconvulsive Therapy Clinically Useful?

1989 ◽  
Vol 154 (2) ◽  
pp. 229-231 ◽  
Author(s):  
R. G. McCreadie ◽  
K. Phillips ◽  
A. D. T. Robinson ◽  
G. Gilhooly ◽  
W. Crombie
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Clinical Efficacy ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Medical Staff ◽  
Eeg Monitoring ◽  
Future Work

Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.

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