scholarly journals Personal experience: Suicide and psychiatric care – a lament

2015 ◽  
Vol 39 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Jeremy Holmes
Keyword(s):  
Family Therapy ◽  
Personal Experience ◽  
Psychiatric Care ◽  
Mental Healthcare ◽  
Psychiatric Services ◽  
Current Provision

SummaryA personal bereavement from suicide prompts a critique of current mental healthcare. Fragmentation, lack of long-term attachment to a tenured professional, the dearth of family therapy, and professional ambivalence are identified as weaknesses in current provision. Implicit is the case for change in UK psychiatric services, both structural (need for long-term therapies) and cultural (need for a mentalising rather than protocol-driven, ‘choice’-led ethos).

scholarly journals Psychiatric services in Algeria

2017 ◽  
Vol 14 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Zoubir Benmebarek
Keyword(s):  
Mental Health ◽  
Human Resources ◽  
Child Psychiatry ◽  
Psychiatric Care ◽  
International Standards ◽  
Psychiatric Services ◽  
Education Training ◽  
Current Provision

The paper describes the current provision of psychiatric services in Algeria – in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

Accommodation History and Continuity of Care in Patients with Psychosis

2005 ◽  
Vol 39 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Alex C.N. Holmes ◽  
Mark A. Hodge ◽  
Gail Bradley ◽  
Alan Bluhm ◽  
Jane Hodges ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Continuity Of Care ◽  
Psychiatric Care ◽  
Psychiatric Services ◽  
Demographic Information ◽  
Urban Mental Health ◽  
History Of ◽  
The Relationship

Objectives: The objective of this study was to determine the relationship between accommodation history and management outcome in patients with psychosis. Method: Demographic information, diagnosis and an accommodation history were taken from patients with psychosis accepted for case management by the Inner West Area Mental Health Service over a 12-month period. The patients were followed up 2 years later to determine their continuity of care and discharge outcome. Results: One hundred 42 patients completed the assessments. Forty-eight percent of patients had spent at least 1 day in a homeless setting in the previous 12 months. Twentytwo percent of patients had long-term (between 2 and 12 months) and six percent chronic (more than 12 months) homelessness. The duration of previous homelessness was significantly inversely correlated with the length of engagement with the service, continuity of psychiatric care at discharge or likelihood of transfer to primary care. Previous interstate mobility was significantly associated with discontinuity of care at discharge. Conclusions: A history of homelessness is common in patients with psychosis using inner urban mental health services and is associated with poorer engagement with psychiatric services.

Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Clinical Experience ◽  
Personal Experience ◽  
Therapeutic Response ◽  
Systemic Disease ◽  
Severe Psoriasis ◽  
Adequate Treatment ◽  
Scalp Psoriasis ◽  
Number Of Patients ◽  
Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

scholarly journals Global mental health should engage with the ethics of involuntary admission

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Marisha N. Wickremsinhe
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Health Services ◽  
Clinical Ethics ◽  
Psychiatric Care ◽  
Global Mental Health ◽  
Mental Healthcare ◽  
Involuntary Admission ◽  
Persons With Disabilities ◽  
Psychosocial Disability

AbstractGlobal mental health, as a field, has focused on both increasing access to mental health services and promoting human rights. Amidst many successes in engaging with and addressing various human rights violations affecting individuals living with psychosocial disabilities, one human rights challenge remains under-discussed: involuntary inpatient admission for psychiatric care. Global mental health ought to engage proactively with the debate on the ethics of involuntary admission and work to develop a clear position, for three reasons. Firstly, the field promotes models of mental healthcare that are likely to include involuntary admission. Secondly, the field aligns much of its human rights framework with the UN Convention on the Rights of Persons with Disabilities, which opposes the discriminatory use of involuntary admission on the basis of psychosocial disability or impairment. Finally, global mental health, as a field, is uniquely positioned to offer novel contributions to this long-standing debate in clinical ethics by collecting data and conducting analyses across settings. Global mental health should take up involuntary admission as a priority area of engagement, applying its own orientation toward research and advocacy in order to explore the dimensions of when, if ever, involuntary admission may be permissible. Such work stands to offer meaningful contributions to the challenge of involuntary admission.

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

Detained – what's my choice? Part 1: Discussion

2008 ◽  
Vol 14 (3) ◽  
pp. 172-180 ◽  
Author(s):  
Glenn Roberts ◽  
Eluned Dorkins ◽  
James Wooldridge ◽  
Elaine Hewis
Keyword(s):  
Mental Health ◽  
Personal Experience ◽  
Social Inclusion ◽  
Mental Health Problems ◽  
Personal Responsibility ◽  
Health Problems ◽  
Psychiatric Services ◽  
Psychiatric Practice ◽  
Personal Recovery ◽  
Collaborative Dialogue

Choice, responsibility, recovery and social inclusion are concepts guiding the ‘modernisation’ and redesign of psychiatric services. Each has its advocates and detractors, and at the deep end of mental health/psychiatric practice they all interact. In the context of severe mental health problems choice and social inclusion are often deeply compromised; they are additionally difficult to access when someone is detained and significant aspects of personal responsibility have been temporarily taken over by others. One view is that you cannot recover while others are in control. We disagree and believe that it is possible to work in a recovery-oriented way in all service settings. This series of articles represents a collaborative dialogue between providers and consumers of compulsory psychiatric services and expert commentators. We worked together, reflecting on the literature and our own professional and personal experience to better understand how choice can be worked with as a support for personal recovery even in circumstances of psychiatric detention. We were particularly interested to consider whether and how detention and compulsion could be routes to personal recovery. We offer both the process of our co-working and our specific findings as part of a continuing dialogue on these difficult issues.

scholarly journals Can Chatbots Help Support a Person’s Mental Health? Perceptions and Views from Mental Healthcare Professionals and Experts

2021 ◽  
Vol 2 (3) ◽  
pp. 1-15
Author(s):  
Colm Sweeney ◽  
Courtney Potts ◽  
Edel Ennis ◽  
Raymond Bond ◽  
Maurice D. Mulvenna ◽  
...  
Keyword(s):  
Mental Health ◽  
User Interfaces ◽  
Personal Experience ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Health Perceptions ◽  
Human Emotion ◽  
Health And Wellbeing ◽  
Perceived Importance

The objective of this study was to understand the attitudes of professionals who work in mental health regarding the use of conversational user interfaces, or chatbots, to support people’s mental health and wellbeing. This study involves an online survey to measure the awareness and attitudes of mental healthcare professionals and experts. The findings from this survey show that more than half of the participants in the survey agreed that there are benefits associated with mental healthcare chatbots (65%, p < 0.01). The perceived importance of chatbots was also relatively high (74%, p < 0.01), with more than three-quarters (79%, p < 0.01) of respondents agreeing that mental healthcare chatbots could help their clients better manage their own health, yet chatbots are overwhelmingly perceived as not adequately understanding or displaying human emotion (86%, p < 0.01). Even though the level of personal experience with chatbots among professionals and experts in mental health has been quite low, this study shows that where they have been used, the experience has been mostly satisfactory. This study has found that as years of experience increased, there was a corresponding increase in the belief that healthcare chatbots could help clients better manage their own mental health.

scholarly journals Psychiatric Services in Saskatchewan under Medicare*

1970 ◽  
Vol 15 (1) ◽  
pp. 63-72 ◽  
Author(s):  
Wilfred A. Cassell ◽  
Colin M. Smith ◽  
Maggie Grandy Rankin
Keyword(s):  
Private Practice ◽  
Urban Areas ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Treatment Session ◽  
Psychiatric Services ◽  
Treatment Services ◽  
Hospital Visits ◽  
To Receive

This study has examined the nature and extent of services provided to psychiatric patients under ‘Medicare’. An analysis of the records of 864,128 residents of Saskatchewan revealed that in 1965, 13,950 males and 27,009 females received a psychiatric diagnosis from physicians in private practice. Psychoneurotic conditions were frequent. General practitioners provided the majority of treatment services for this group. Physicians practising in urban areas were found to complete more psychiatric treatment than their rural counterparts. Female patients were found to receive relatively more psychiatric care than males. The latter obtained more consultations, hospital visits and somatic investigations. Lastly, the rate of service was infrequent, averaging less than one treatment session per patient.

Working in psychiatry: staff perception of the Brazzaville hospital and university centre

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Mbou Essie
Keyword(s):  
Working Conditions ◽  
Psychiatric Care ◽  
Psychiatric Service ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
University Hospital ◽  
Cross Sectional ◽  
Psychiatric Staff ◽  
Heavy Workload ◽  
Congo Brazzaville

Abstract Background In Congo-Brazzaville, there is a lake of mental healthcare providers and facilities specialized in psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and Methods We conducted a cross-sectional descriptive, prospective survey; conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: (i) socio-professional data, (ii) perceptions (assignment, role, workload and working conditions) and (iv) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.2.2.6. Results Thirty out of 42 staff had responded (71.4%), 16 were male and at their first psychiatric assignment (28/30), with an average age of 44,7±7 and seniority of 8,4 ±8,3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusions Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care. Key messages Staff perceived heavy workload due to lack of staff and poor working conditions. Lake of workforce will be deeply acute in psychiatry.

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