The evolution of a successful telemedicine mental health service

2002 ◽  
Vol 8 (3_suppl) ◽  
pp. 24-26 ◽  
Author(s):  
David Hailey ◽  
Tim Bulger ◽  
Sharlene Stayberg ◽  
Douglas Urness
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Effectiveness ◽  
Pilot Project ◽  
Provincial Government ◽  
Decision Makers ◽  
Health Board ◽  
Local Stakeholders ◽  
Care Decision

summary Development of telemedicine mental health services in Alberta evolved via a pilot project, the delivery of routine services to a small group of centres and subsequent expansion to a province-wide programme. Success of the service was linked to support for telehealth by the provincial government and consultation between the Alberta Mental Health Board (AMHB) and local stakeholders. Assessments by the AMHB have shown that telepsychiatry is acceptable and sustainable at a realistic cost. However, there are few measures of clinical effectiveness available and none of cost-effectiveness. A detailed economic evaluation of the telemedicine mental health network would now be a major task. The expansion of telemedicine mental health services has increased the expectations of health-care decision makers. In addition, the complexity of the network has increased and new initiatives, such as the use of telepsychology, have been introduced. Management of this successful telehealth programme continues to be time consuming and challenging.

Expanding arts therapies provision: a pilot project in Older Adult Mental Health Services, Aneurin Bevan University Health Board

Public Health ◽  
2021 ◽  
Vol 194 ◽  
pp. 270-273
Author(s):  
M. Elliott ◽  
Jimmy Jones ◽  
Melissa Elliott ◽  
Sarah Challenger ◽  
Lynnsey Coull Gwynedd ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older Adult ◽  
Pilot Project ◽  
Health Board ◽  
Adult Mental Health

scholarly journals Structured Professional Judgment to Assist the Evaluation and Safety Planning of Suicide Risk: The Risk of Suicide Protocol (RoSP)

2021 ◽  
Vol 12 ◽  
Author(s):  
Nicola S. Gray ◽  
Ann John ◽  
Aimee McKinnon ◽  
Stephanie Raybould ◽  
James Knowles ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Evaluation ◽  
Suicide Risk ◽  
Professional Judgment ◽  
Health Board ◽  
Safety Planning ◽  
Nice Guidelines ◽  
Structured Professional Judgment

Background: The Risk of Suicide Protocol (RoSP) is a structured professional judgment (SPJ) scheme designed in line with NICE guidelines to improve clinicians' ability to evaluate and manage suicide risk.Aims: This study aimed to evaluate the efficacy of RoSP in two settings: (1) unexpected deaths of people in the community who were known to mental health services; and (2) an inpatient hospital specializing in the assessment and treatment of patients with personality disorder.Method: In Study 1, information from a database of unexpected deaths (N = 68) within an NHS health board was used to complete a RoSP assessment (blind to cause of death) and information from the Coroner's Court was used to assign people to suicide vs. natural causes/accidental death. In Study 2, patients (N = 62) were assessed on the RoSP upon admission to hospital and their self-injurious behaviors were recorded over the first 3 months of admission.Results: (1) Evaluations using RoSP were highly reliable in both samples (ICCs 0.93–0.98); (2) professional judgment based on the RoSP was predictive of completed suicide in the community sample (AUC = 0.83) and; (3) was predictive of both suicide attempts (AUC = 0.81) and all self-injurious behaviors (AUC = 0.80) for the inpatient sample.Conclusion: RoSP is a reliable and valid instrument for the structured clinical evaluation of suicide risk for use in inpatient psychiatric services and in community mental health services. RoSP's efficacy is comparable to well-established structured professional judgment instruments designed to predict other risk behavior (e.g., HCR-20 and the prediction of violence). The use of RoSP for the clinical evaluation of suicide risk and safety-planning provides a structure for meeting NICE guidelines for suicide prevention and is now evidence-based.

A systematic review of current approaches to managing demand and waitlists for mental health services

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kerry A. Thomas ◽  
Annelise M. Schroder ◽  
Debra J. Rickwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Clinical Effectiveness ◽  
Research Literature ◽  
Inclusion Criteria ◽  
Content Type

Purpose Timely access to effective treatment is a primary goal for mental health services; however, when demand exceeds available resources, services may place clients on a waitlist or restrict services. This paper aims to identify approaches used by mental health services to manage service demand and waitlists. Design/methodology/approach A review of research literature between 2009 and 2019 was conducted using the Medline, PsycINFO, CINAHL, Embase and Cochrane databases. Articles were screened and assessed against inclusion criteria and the methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings In total, 20 articles were located that met the inclusion criteria. Five demand management approaches were identified, namely, walk-in models, triage processes, multi-disciplinary care, patient-led approaches and service delivery changes. Research limitations/implications This review identifies effective approaches that services can consider adapting to their local setting; however, further research is needed to demonstrate the clinical effectiveness of services provided under these models. Originality/value This review makes a valuable contribution to mental health care service delivery by detailing the strategies that services have adopted to manage demand and, where available, comparative outcomes with traditional service delivery models.

scholarly journals China's National Comprehensive Management Pilot Project for Mental Health

2017 ◽  
Vol 14 (2) ◽  
pp. 44-46 ◽  
Author(s):  
Wufang Zhang ◽  
Ning Ma
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Pilot Project ◽  
Disabled Persons ◽  
Model Of Care ◽  
Intervention Programme ◽  
Collaborative Model ◽  
Comprehensive Management ◽  
Community Collaborative

The National Continuing Management and Intervention Programme for Psychoses, also known as the 686 Programme, was launched in China in 2004, marking a shift to a hospital-and-community collaborative model of care for patients with psychoses. An updated programme, the National Comprehensive Management Pilot Project for Mental Health, was launched in 2015 with the cooperation of six government ministries and bodies, including the China Disabled Persons Federation. Mechanisms for multi-sector cooperation in mental health services are being put in place in China.

scholarly journals Clinicians’ ratings of the Health of the Nation Outcome Scales (HoNOS) show sensitivity/bias that may affect patients’ progress: analyses of routine administrative data

2020 ◽  
Author(s):  
Jonathan Williams
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Rational Design ◽  
Inpatient Admission ◽  
Bipartite Network ◽  
Health Board ◽  
List Type ◽  
Chronic Patients

ABSTRACTObjectives(1) To estimate clinician sensitivity/bias in rating the HoNOS. (2) To test if high or low clinician sensitivity determines slower resolution of patients’ problems or earlier inpatient admission.DesignThe primary analysis used many-facet Item Response Theory to construct a multi-level Graded Response Model that teased apart clinician sensitivity/bias from the severity of patients’ problems in routine HoNOS records. Secondary analyses then tested if patients’ outcomes depend on their clinicians’ sensitivity/bias.Outcome measuresThe outcome measures were (1) overall differences in sensitivity/bias between (a) individual clinicians and (b) different Community Mental Health Teams (CMHTs); (2) clinical outcomes, comprising (a) the rate of resolution of patients’ problems and (b) the dependence of the time to inpatient admission on clinician sensitivity/bias.SettingAll archival electronic HoNOS records for all new referrals to all CMHTs providing mental health services in secondary care in a New Zealand District Health Board during 2007-2015.ParticipantsThe initial sample comprised 2170 adults of working age who received 5459 HoNOS assessments from 186 clinicians. From these initial data, I derived an opportunistic, connected, bipartite, longitudinal network, in which (i) every patient received HoNOS ratings from 2 or more clinicians and (ii) every clinician assessed more than 5 patients. The bipartite network comprised 88 clinicians and 778 patients; 112 patients underwent later inpatient admission.ResultsSensitivity/bias differed importantly between individual clinicians and CMHTs. Patients whose clinicians had more extreme sensitivity/bias showed slower resolution of their problems and earlier inpatient admission.ConclusionsRaw HoNOS ratings reflect the sensitivity/bias of clinicians almost as much as the severity of patients’ problems. Additionally, low or high clinician sensitivity can adversely affect patients’ outcomes. Hence, the HoNOS’s main value may be to measure clinician sensitivity. Accounting for clinician sensitivity could enable the HoNOS to fulfil its goal of improving mental health services.Strengths and limitations of the studyThe study derived a connected network of clinicians and patients that approximates a rational design for estimating clinicians’ sensitivity/bias.The opportunistic network sample was atypical, with chronic patients and experienced clinicians – so the study may under-estimate clinician bias.The study’s statistical methods were appropriate to the ordinal nature of HoNOS ratings.The study used earlier estimates of clinician sensitivity/bias to predict later outcomes – so that effects of clinician sensitivity/bias on outcomes may be causalThe study assumed that all HoNOS items tap a single dimension of the severity of patients’ problems.

scholarly journals Professional leadership for social work in state mental health services in Aotearoa New Zealand

2009 ◽  
Vol 21 (4) ◽  
pp. 103-108
Author(s):  
David McNabb
Keyword(s):  
Mental Health ◽  
Social Work ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Governance ◽  
Health Board ◽  
District Health ◽  
The Future ◽  
Professional Leadership

This paper recounts the changes in the New Zealand government-run health services over the past 15 years and the subsequent changes to social work leadership in mental health services. Drawing on two pieces of local research, the article will explore social work mental health leadership in New Zealand. The first piece of research investigates the views of social work professional leaders (PL) about their roles and the prospects for social work in mental health in the future. The second piece of research investigates a new type of professional leadership role in the mental health services of the Auckland District Health Board. Clinical governance is an emerging phenomenon in health services internationally that is aimed at advancing quality improvement. This paper links developments in social work professional leadership with the activities of clinical governance in mental health services. It concludes that there is evidence of an improvement to the leadership infrastructure and of the contribution of leaders to clinical governance in district health boards (DHBs). However, many challenges remain for social work leaders into the future.

scholarly journals A visual step-by-step guide for clinicians to use video consultations in mental health services: NHS examples of real-time practice in times of normal and pandemic healthcare delivery

2020 ◽  
Vol 44 (6) ◽  
pp. 277-284 ◽  
Author(s):  
Gemma Johns ◽  
Jacinta Tan ◽  
Anna Burhouse ◽  
Mike Ogonovsky ◽  
Catrin Rees ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Real Time ◽  
Healthcare Delivery ◽  
Sustainable Use ◽  
Health Board ◽  
Ethical Guidelines ◽  
Workflow Systems ◽  
Set Up

Despite the increasingly widespread use of video consultations, there are very few documented descriptions of how to set up and implement video consultations in real-time practice. This step-by-step guide will describe the set-up process based on the authors’ experience of two real-time National Health Service (NHS) examples: a single health board use (delivered in normal time), and an All-Wales National Video Consultation Service roll-out (delivered during an emergency pandemic as part of the COVID-19 response). This paper provides a simple visual step-by-step guide for using telepsychiatry via the remote use of video consultations in mental health services, and outlines the mandatory steps to achieving a safe, successful and sustainable use of video consultations in the NHS by ensuring that video consultations fit into existing and new NHS workflow systems and adhere to legal and ethical guidelines.

The Imperative of the Redevelopment of Patient Record Systems for use in Mental Health Services

1997 ◽  
Vol 5 (6) ◽  
pp. 279-280 ◽  
Author(s):  
Tom Callaly ◽  
Graeme Hollis ◽  
Paul Hantzand ◽  
Peter Faulkner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Delivery Of Care ◽  
Outcomes Measurement ◽  
Continuous Quality ◽  
Effective Delivery ◽  
Clinical Utilisation

The major reorganisational tasks which confront mental health services over the next few years are clear. Each service must adopt a comprehensive case or care management system which ensures continuity of care and develops systems which support continuous quality monitoring and clinical effectiveness including the production and implementation of evidence-based clinical guidelines, clinical outcomes measurement and cost effective delivery of care. This will demand realtime monitoring of clinical, utilisation and cost data. Although there is now a veritable avalanche of material in the literature on the development of computerised information systems, particularly in relation to management information and also on the need for focusing on outcomes measurement, we can find little by way of descriptions or advice on the development of patient records to complement these challenees.

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