scholarly journals Mental health clustering and diagnosis in psychiatric in-patients

2015 ◽  
Vol 39 (3) ◽  
pp. 119-123 ◽  
Author(s):  
Liam Trevithick ◽  
Jon Painter ◽  
Patrick Keown
Keyword(s):  
Mental Health ◽  
Affective Disorders ◽  
Clinical Utility ◽  
Substance Misuse ◽  
Primary Diagnosis ◽  
Clinical Implications ◽  
National Health Service Trust ◽  
Working Age ◽  
The Relationship ◽  
Complex Distribution

Aims and methodThis paper investigates the relationship between cluster (Mental Health Clustering Tool, MHCT) and diagnosis in an in-patient population. We analysed the diagnostic make-up of each cluster and the clinical utility of the diagnostic advice in the Department of Health's Mental Health Clustering Booklet. In-patients discharged from working-age adult and older people's services of a National Health Service trust over 1 year were included. Cluster on admission was compared with primary diagnosis on discharge.ResultsOrganic, schizophreniform, anxiety disorder and personality disorders aligned to one superclass cluster. Alcohol and substance misuse, and mood disorders distributed evenly across psychosis and non-psychosis superclass clusters. Two-thirds of diagnoses fell within the MHCT ‘likely’ group and a tenth into the ‘unlikely’ group.Clinical implicationsCluster and diagnosis are best viewed as complimentary systems to describe an individual's needs. Improvements are suggested to the MHCT diagnostic advice in in-patient settings. Substance misuse and affective disorders have a more complex distribution between superclass clusters than all other broad diagnostic groups.

scholarly journals Gatekeeping access to community mental health teams

2002 ◽  
Vol 26 (2) ◽  
pp. 56-58 ◽  
Author(s):  
P. McEvoy ◽  
S. Colgan ◽  
D. Richards
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Affective Disorders ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Health Problems ◽  
Primary Diagnosis ◽  
Psychiatric Nurses ◽  
Clinical Implications ◽  
Community Psychiatric

Aims and MethodA retrospective survey to explore how consultant psychiatrists, senior house officers and community psychiatric nurses prioritised referrals to four sectorised community mental health teams.ResultsReferral outcomes appeared to be comparable for patients with psychoses, sub-threshold mental health problems and personality disorders. However, differences in the outcomes were apparent for patients with a primary diagnosis of drug/alcohol misuse, as well as for patients with affective disorders and neuroses.Clinical ImplicationsIt may be necessary to establish clearer, consistent boundaries in order to consolidate services for patients with severe mental health problems.

scholarly journals Severe and enduring mental health problems within an established substance misuse treatment partnership

2014 ◽  
Vol 38 (5) ◽  
pp. 216-219 ◽  
Author(s):  
Kathryn Walsh ◽  
Alex Copello
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Suicide Risk ◽  
Substance Misuse ◽  
Mental Health Problems ◽  
Health Problems ◽  
Clinical Implications ◽  
The Past ◽  
Self Harm ◽  
Effective Service

Aims and methodThe study reports findings of an investigation into the presence of severe and enduring mental health problems within the four statutory and non-statutory teams of an established substance misuse treatment partnership.ResultsOf a total of 772 clients in the four teams surveyed, 69 (8.9%) were identified as having severe and enduring mental health problems and problem substance use in the past 12 months. Alcohol was the most prevalent substance used by this predominantly male group. Different rates were found across the four teams, with higher numbers in the non-statutory teams. The clients displayed significant levels of self-harm and suicide risk and were responsible for 131 acute service contacts over the past 12 months.Clinical implicationsClients with severe and enduring mental health problems engaged with substance misuse services display high levels of complex need. It is important to identify the best and most effective service response to this group.

Mental Health in Africa: II. the Nature of Mental Disorder in Africa Today

1987 ◽  
Vol 151 (4) ◽  
pp. 440-446 ◽  
Author(s):  
G. Allen German
Keyword(s):  
Mental Health ◽  
Developing Countries ◽  
Mental Disorder ◽  
Affective Disorders ◽  
Clinical Issues ◽  
Physiological Abnormalities ◽  
Relationship Of ◽  
The Relationship

Aspects of clinical psychiatric syndromes described in Africa which are discussed include the issue of schizophrenic disorders having a better prognosis in developing countries; controversy over this is by no means at an end. There is an increasing realisation as to the frequency of affective disorders in Africa; while somatisation is common, cherished beliefs, such as the absence of guilt, have not been confirmed by more recent research. Nor is suicide as infrequent as has been suggested. The relationship of background physiological abnormalities of cerebral functioning may be relevant to some of the clinical issues that are currently under discussion in African psychiatry.

scholarly journals THOSE LEFT BEHIND

2021 ◽  
pp. 1-33
Author(s):  
Alexis C. Dennis
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
African Americans ◽  
Educational Attainment ◽  
Traumatic Events ◽  
Equation Modeling ◽  
Science Literature ◽  
The Social ◽  
Working Age ◽  
The Relationship

Abstract While the socioeconomic status (SES)–psychological distress gradient is well-documented in the social science literature, less attention has been devoted to how this relationship varies within sociodemographic subgroups. I contribute to this small but growing literature by first examining the relationship between multiple dimensions of SES and two measures of psychological distress (depression and anxiety) among working-age African Americans. I then test whether three social mediators explain the SES–psychological distress relationship, and whether gender modifies these associations and/or the social mediators that shape them. To address these aims, I analyze two waves of population-representative data from the Detroit Neighborhood Health Study (N=685). Data were collected between 2008 and 2010 in the wake of the Great Recession. I utilize structural equation modeling with latent variables to assess these relationships, and test indirect and conditional effects to detect the presence of mediation and/or moderation, respectively. Findings revealed associations between higher total household income and lower levels of depression/anxiety, as well as unemployment and increased depression/anxiety among working-age African Americans. Furthermore, higher educational attainment was associated with reduced anxiety, but not depression, in this population. Gender moderated these findings such that unemployment was associated with higher levels of depression/anxiety among women but not men. I also found that trauma mediated the relationship between unemployment and depression/anxiety as well as educational attainment and anxiety. Gender, however, moderated the association between unemployment and depression/anxiety via traumatic events such that the relationship was stronger among women than men. Collectively, these findings contribute to our limited understanding of African Americans’ mental health and underscore the importance of how both socioeconomic forces and life course experiences with traumatic events contribute to poor mental health among this population.

scholarly journals An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist

2017 ◽  
Vol 41 (3) ◽  
pp. 151-155 ◽  
Author(s):  
Elspeth A. Guthrie ◽  
Aaron T. McMeekin ◽  
Sylvia Khan ◽  
Sally Makin ◽  
Ben Shaw ◽  
...  
Keyword(s):  
Mental Health ◽  
Teaching Hospital ◽  
Mental Health Problems ◽  
Medication Management ◽  
Case Series ◽  
Clinical Implications ◽  
Tertiary Referral ◽  
Liaison Psychiatry ◽  
Face To Face ◽  
Working Age

Aims and methodThis article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital.ResultsThe service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason.Clinical implicationsA substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our analysis suggests that in the majority of cases the input of a liaison psychiatrist is required.

scholarly journals Working in partnership with probation

1999 ◽  
Vol 23 (7) ◽  
pp. 405-408 ◽  
Author(s):  
Andrea Cohen ◽  
Nick Bishop ◽  
Matthew Hegarty
Keyword(s):  
Mental Health ◽  
Predominantly White ◽  
Substance Misuse ◽  
Clinical Effectiveness ◽  
Safety Net ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Mental Health Worker ◽  
Mental Health Systems ◽  
Probation Service

Aims and methodTo describe the characteristics of probationers assessed (n=83) and supported (n=31) by a mental health worker (MHW) attached to a probation service. A survey of cases and case descriptions.ResultsReferrals were predominantly White, unemployed males on probation orders. Most had acquisitive/property and violent convictions along with substance misuse problems and personality disorder diagnoses. The MHW supported probationers already in contact with psychiatric services and provided a safety net and sometimes sole support, to those who were not.Clinical implicationsThe MHW helped to bridge the gap between criminal justice and mental health systems by facilitating contact between probationers and psychiatric services. The clinical effectiveness of the scheme should now be examined.

scholarly journals The Institutional Foundations of Medicalization: A Cross-national Analysis of Mental Health and Unemployment

2017 ◽  
Vol 58 (3) ◽  
pp. 272-290 ◽  
Author(s):  
Veerle Buffel ◽  
Jason Beckfield ◽  
Piet Bracke
Keyword(s):  
Mental Health ◽  
Mental Healthcare ◽  
Working Age ◽  
High Level ◽  
National Analysis ◽  
The Relationship ◽  
Institutional Foundations ◽  
Economic Capacity ◽  
Country Specific ◽  
Cross National

In this study, we question (1) whether the relationship between unemployment and mental healthcare use, controlling for mental health status, varies across European countries and (2) whether these differences are patterned by a combination of unemployment and healthcare generosity. We hypothesize that medicalization of unemployment is stronger in countries where a low level of unemployment generosity is combined with a high level of healthcare generosity. A subsample of 36,306 working-age respondents from rounds 64.4 (2005–2006) and 73.2 (2010) of the cross-national survey Eurobarometer was used. Country-specific logistic regression and multilevel analyses, controlling for public disability spending, changes in government spending, economic capacity, and unemployment rate, were performed. We find that unemployment is medicalized, at least to some degree, in the majority of the 24 nations surveyed. Moreover, the medicalization of unemployment varies substantially across countries, corresponding to the combination of the level of unemployment and of healthcare generosity.

scholarly journals Use of psychotropic medication among psychiatric out-patients with personality disorder

2010 ◽  
Vol 34 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Elena Baker-Glenn ◽  
Mark Steels ◽  
Chris Evans
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Psychotropic Medication ◽  
Primary Diagnosis ◽  
Total Annual Cost ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Aims and methodThis survey was conducted to ascertain the use of psychotropic medication in the treatment of patients with a primary diagnosis of personality disorder within a community mental health team. A sample of 113 patients were identified, their notes were reviewed, and details of current medications and diagnoses recorded.ResultsFour-fifths of patients were prescribed at least one psychotropic medication. The most commonly prescribed medication class was antidepressant, comprising almost half of prescriptions. The total annual cost across 107 patients was £37 000.Clinical implicationsMedication is commonly prescribed to people with personality disorder but more needs to be known about why prescriptions are started and stopped, what the benefits are, and how these are judged by patients and care teams.

scholarly journals Psychiatric morbidity and health service use among attendees at a winter shelter

2007 ◽  
Vol 31 (9) ◽  
pp. 326-329 ◽  
Author(s):  
Marianne Hayward
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Service Use ◽  
Medical Service ◽  
Substance Misuse ◽  
Psychiatric Symptoms ◽  
Psychiatric Morbidity ◽  
Health Service Use ◽  
Clinical Implications ◽  
Medication Prescription

Aims and MethodHomelessness is associated with raised psychiatric morbidity. Case records for 597 consecutive attendees at a winter shelter medical service were retrospectively reviewed to assess routine recording of psychiatric morbidity and to examine associations between current psychiatric symptoms and health service use.ResultsPrevious psychiatric morbidity was recorded in 36.0% of attendees, including 20.4% with comorbid substance misuse. Current psychiatric morbidity was recorded in 31.3% of attendees, and was associated with reduced total medication prescription, increased referral to other services and increased re-presentation to the shelter medical service.Clinical ImplicationsPsychiatric morbidity was frequently recorded in this population. Current psychiatric symptoms were associated with increased health service use. Improved training of shelter staff should be instituted to increase engagement with mainstream mental health services.

scholarly journals The relationship of resilience with social connectedness and self-esteem in street involved youth: a secondary analysis

2021 ◽  
Author(s):  
Karen Albert
Keyword(s):  
Mental Health ◽  
Social Connectedness ◽  
Substance Misuse ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Demographic Characteristics ◽  
The Face ◽  
Relationship Of ◽  
The Relationship ◽  
Bounce Back

Resilience, the ability to bounce back in the face of adversity or trauma, plays a crucial role in street-involved youth’s (SIY) capacity to overcome risks. Social connectedness and self-esteem have been identified as possible protective factors in the lives of SIY. A secondary analysis of 155 SIY was conducted to explore the relationship between social connectedness and self-esteem with resilience. Correlations of study variables with demographic characteristics and mental health descriptors were also examined. Results indicate that resilience is positively and significantly correlated with social connectedness and self-esteem. Additionally, those with higher levels of resilience, social connectedness and self-esteem had lower levels of depression, hopelessness, suicidality and substance misuse. Enhancing social connectedness and self-esteem may strengthen resilience, enabling youth to move forward despite the deleterious conditions associated with homelessness.

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