scholarly journals Impact of lockdown due to COVID-19 pandemic on psychiatric patients

2021 ◽  
Vol 8 (9) ◽  
pp. 4378
Author(s):  
R. Bhuvaneswari ◽  
Chandini Raj S. N. ◽  
Neethu Raj ◽  
Sakthivel Vaiyapuri ◽  
K. C. Muraleedharan
Keyword(s):  
Mental Health ◽  
Rating Scales ◽  
Psychiatric Patients ◽  
Community Mental Health Services ◽  
Daily Activities ◽  
Standard Protocol ◽  
Safe Place ◽  
Psychiatric Intervention ◽  
Inpatient Department

Background: There was sudden reorganization of services during lockdown due to COVID-19. Care of psychiatric patients was in threat due to closure of inpatient department and conversion of hospitals into COVID treatment centres.Methods: List of follow-up patients not attending our outpatient department during lockdown was obtained. They were contacted through telephone. Evaluation was done with Brief psychiatry rating scales (BPRS) and WHODAS2 scales. Statistical analysis of obtained data was done.Results: Comparison of BPRS total score, WHODAS domain scores and total score between outpatients and inpatients was done using independent samples ‘t’ test. It was found to be statistically significant (p<0.05). Anxiety and distractibility are the more prominent symptoms in majority of psychiatry patients.Conclusions: Psychiatric patients needs safe place, with people to talk and to take care of daily activities. It is highly recommended urgent need of creating awareness program on COVID-19 pandemic which targets this vulnerable population. It is essential to provide continued psychiatric intervention using tele-psychiatric platform and ensure their social support using community mental health services during the pandemic. A standard protocol on the management of patients with serious mental illness during an infectious disaster should be developed.

scholarly journals Community mental health care after self-harm: A retrospective cohort study

2016 ◽  
Vol 51 (7) ◽  
pp. 727-735 ◽  
Author(s):  
Matthew J Spittal ◽  
Fiona Shand ◽  
Helen Christensen ◽  
Lisa Brophy ◽  
Jane Pirkis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Inpatient ◽  
Community Mental Health Services ◽  
Community Mental Health Care ◽  
Self Harm

Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.

Psychiatric out-patient services: origins and future

2006 ◽  
Vol 12 (5) ◽  
pp. 309-319 ◽  
Author(s):  
Helen Killaspy
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Alternative Model ◽  
Community Mental Health Services ◽  
Psychiatric Services ◽  
Early 20Th Century ◽  
Clinical Implications ◽  
Missed Appointments ◽  
Cost Implications

Psychiatric out-patient services originated in the early-20th century to enable triage of new referrals to the asylum in order to differentiate between treatable and untreatable cases. They evolved to provide community follow-up of patients discharged from hospital and assessment of those newly referred to psychiatric services. Non-attendance at out-patient appointments represents an enormous waste of clinical and administrative resources and has potentially serious clinical implications for those who are most psychiatrically unwell. The place of out-patient clinics in modern community mental health services is explored with reference to the reasons for, and clinical and cost implications of, missed appointments. An alternative model is described that incorporates recent UK government guidance on the roles and implementation of community mental health teams, liaison with primary care and new roles for consultant psychiatrists.

scholarly journals Linking abuse and recovery through advocacy: an observational study

2013 ◽  
Vol 23 (1) ◽  
pp. 99-113 ◽  
Author(s):  
K. Trevillion ◽  
S. Byford ◽  
M. Cary ◽  
D. Rose ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Community Mental Health ◽  
Unmet Needs ◽  
Controlled Trial ◽  
Psychiatric Service ◽  
Community Mental Health Services ◽  
Service Users ◽  
Quasi Experimental

Aims.High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial.Methods.Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' (n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' (n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected.Results.Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up (p < 0.05). Service users receiving the intervention reported significant reductions in violence (p < 0.001) and unmet needs at follow-up (p < 0.05).Conclusions.Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.

Suicide in recently discharged psychiatric patients: a case-control study

2008 ◽  
Vol 39 (3) ◽  
pp. 443-449 ◽  
Author(s):  
I. M. Hunt ◽  
N. Kapur ◽  
R. Webb ◽  
J. Robinson ◽  
J. Burns ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Suicide Risk ◽  
Case Control Study ◽  
Clinical Symptoms ◽  
Risk Measures ◽  
Psychiatric Patients ◽  
Case Control ◽  
Control Study

BackgroundFew controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge.MethodWe conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls.ResultsForty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide.ConclusionsThe weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

scholarly journals History of psychosurgery at Sainte-Anne Hospital, Paris, France, through translational interactions between psychiatrists and neurosurgeons

2017 ◽  
Vol 43 (3) ◽  
pp. E9 ◽  
Author(s):  
Marc Zanello ◽  
Johan Pallud ◽  
Nicolas Baup ◽  
Sophie Peeters ◽  
Baris Turak ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Hospital ◽  
18Th Century ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Public Institution ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of

Sainte-Anne Hospital is the largest psychiatric hospital in Paris. Its long and fascinating history began in the 18th century. In 1952, it was at Sainte-Anne Hospital that Jean Delay and Pierre Deniker used the first neuroleptic, chlorpromazine, to cure psychiatric patients, putting an end to the expansion of psychosurgery. The Department of Neuro-psychosurgery was created in 1941. The works of successive heads of the Neurosurgery Department at Sainte-Anne Hospital summarized the history of psychosurgery in France.Pierre Puech defined psychosurgery as the necessary cooperation between neurosurgeons and psychiatrists to treat the conditions causing psychiatric symptoms, from brain tumors to mental health disorders. He reported the results of his series of 369 cases and underlined the necessity for proper follow-up and postoperative re-education, illustrating the relative caution of French neurosurgeons concerning psychosurgery.Marcel David and his assistants tried to follow their patients closely postoperatively; this resulted in numerous publications with significant follow-up and conclusions. As early as 1955, David reported intellectual degradation 2 years after prefrontal leucotomies.Jean Talairach, a psychiatrist who eventually trained as a neurosurgeon, was the first to describe anterior capsulotomy in 1949. He operated in several hospitals outside of Paris, including the Sarthe Psychiatric Hospital and the Public Institution of Mental Health in the Lille region. He developed stereotactic surgery, notably stereo-electroencephalography, for epilepsy surgery but also to treat psychiatric patients using stereotactic lesioning with radiofrequency ablation or radioactive seeds of yttrium-90.The evolution of functional neurosurgery has been marked by the development of deep brain stimulation, in particular for obsessive-compulsive disorder, replacing the former lesional stereotactic procedures.The history of Sainte-Anne Hospital’s Neurosurgery Department sheds light on the initiation—yet fast reconsideration—of psychosurgery in France. This relatively more prudent attitude toward the practice of psychosurgery compared with other countries was probably due to the historically strong collaboration between psychiatrists and neurosurgeons in France.

Utilisation and costs of community mental health services

1998 ◽  
Vol 173 (5) ◽  
pp. 391-398 ◽  
Author(s):  
Paul McCrone ◽  
Graham Thornicroft ◽  
Michael Phelan ◽  
Frank Holloway ◽  
Til Wykes ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Use ◽  
Community Mental Health Services ◽  
Supported Accommodation ◽  
Health Services Need ◽  
Time Periods ◽  
The Cost

BackgroundThe costs and the effectiveness of mental health services need to be evaluated if provision is to be efficient. Service use and costs are described for two geographical areas in south London.MethodService use was measured comprehensively for clients in both sectors for two six-month time periods using the Client Service Receipt Interview This information was combined with unit costs to calculate service costs. The ‘hidden’ costs of informal care and unsupported accommodation were also calculated.ResultsAt baseline significantly more intensive sector clients had in-patient stays but by the follow-up this difference had disappeared. There was significantly more use of supported accommodation in the intensive sector during both time periods. Baseline and follow-up total service costs were significantly higher for the intensive sector. Costs were spread disproportionately and a small number of services accounted for a large proportion of cost.ConclusionsWhile the cost at Time 2 was significantly greater in the intensive sector, this was largely due to the high use of supported accommodation. There was some convergence in cost between the sectors over time.

scholarly journals Phone-based outpatients’ follow-up in mental health centers during the COVID-19 quarantine

2020 ◽  
pp. 002076402097973
Author(s):  
Alessandro Gentile ◽  
Julio Torales ◽  
Marcelo O’Higgins ◽  
Pamela Figueredo ◽  
Joao Mauricio Castaldelli-Maia ◽  
...  
Keyword(s):  
Mental Health ◽  
Rating Scales ◽  
Rating Scale ◽  
Stable Phase ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Catchment Areas ◽  
The Impact ◽  
Large Catchment

Background: The current COVID-19 pandemic is affecting mental health of global population and, particularly, of people suffering from preexisting mental disorders. Aims: This study aims to report on findings from a phone-based clinical follow-up conducted in two large catchment areas in Italy and Paraguay, during the COVID-19 lockdown, in order to provide psychiatric assessments and measure the level of stress related to the quarantine in a large sample of psychiatric outpatients. Methods: A clinical phone-based follow-up has been conducted in two large catchment areas in the province of Chieti (Vasto, Italy) and City of Asunción (Paraguay), during the COVID-19 national lockdown. The following rating scales have been employed: Hamilton Anxiety Rating Scale (HAM-A); Hamilton Depression Rating Scale (HAM-D); 18-items Brief Psychiatric Rating Scale (BPRS-18). The psychological distress related to the outbreak has been assessed employing the Impact of Event Scale – Revised (IES-R). Results: A total of 110 outpatients were consecutively included and followed among those reporting a stable phase of illness before the COVID-19 lockdown. Findings confirmed a significant increase of general psychopathology, anxiety and fear as well as mild levels of stress related to the quarantine. Also, significant weight gain during the lockdown was detected among patients. Conclusions: This study confirmed the impact of COVID-19 lockdown on mental health of people suffering from psychiatric disorders and may also add evidence on the employment of digital psychiatry in the current pandemic.

Validity and reliability of the Health of the Nation Outcome Scales in psychiatric patients in the community

1999 ◽  
Vol 174 (5) ◽  
pp. 409-412 ◽  
Author(s):  
Martin Orrell ◽  
Paula Yard ◽  
Julia Handysides ◽  
Robert Schapira
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rating Scales ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Validity And Reliability ◽  
Wide Range ◽  
Day Hospitals ◽  
Age Range

BackgroundThe Health of the Nation Outcome Scales (HoNOS) have been developed for assessing the effectiveness of mental health services.AimsTo investigate the validity and reliability of the HoNOS in patients in contact with mental health services.MethodSubjects (age range 19–64) came from day hospitals, acute in-patient units and out-patient clinics in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity.ResultsOne hundred patients were assessed using the package of rating scales. Interrater and test–retest reliability were good for some items and poor for others. The HoNOS had good criterion validity: acute in-patients had higher scores than day patients and out-patients. HoNOS also had good concurrent validity, correlating well with other scales. Comments suggested that the HoNOS was a useful and suitable scale for this population but psychotic symptoms and certain social factors were not sufficiently covered.ConclusionThe HoNOS had good validity but variable reliability. It may be better than existing scales because of the wide range of areas which it covers.

Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination

2020 ◽  
pp. 107839031989731
Author(s):  
Diane Goedde ◽  
Astri Zidack ◽  
Ya-Huei Li ◽  
Diane Arkava ◽  
Elizabeth Mullette ◽  
...  
Keyword(s):  
Mental Health ◽  
Trend Analysis ◽  
Role Model ◽  
Depression Scale ◽  
Health Clinic ◽  
Mental Health Clinic ◽  
Fully Integrated ◽  
Safe Place ◽  
Best Response

BACKGROUND: A fully integrated Obstetric Mental Health Clinic (OBMHC) was established in 2007 in the rural northwest United States to address perinatal depression. AIMS: The purpose of this mixed methods study was to examine depression outcomes in women receiving outpatient psychiatric services between 2007 and 2017 at a fully integrated OBMHC and to explore patient and obstetric team perceptions of OBMHC experiences. METHOD: A retrospective database study was employed; depression was measured at baseline and follow-up visits using the Edinburgh Postnatal Depression Scale. Descriptive statistics, regression models, and trend analysis were employed to determine effectiveness. A subset of patients participated in telephone interviews; the obstetric team was surveyed regarding perceptions of the service. RESULTS: The sample included 192 women (195 pregnancies). Approximately 72% experienced less depression by the first follow-up visit. Patients taking three or more psychiatric medications attended more OBMHC visits. Trend analysis indicated that women with the highest levels of depression had the best response to the intervention. Three qualitative themes emerged: Safe Place, Mental/Emotional Stability, and Integrated Personalized Approach. Obstetric team members ( n = 11) perceived the clinic to be helpful and noted improved access to mental health care. CONCLUSION: OBMHCs can be effective when psychiatric nurses are embedded within an outpatient obstetric service. Improved access, timely services, and patient reassurance can lead to an improved pregnancy experience and reduced depressive symptoms. The longevity of this clinic’s experience serves as a role model for other centers to replicate this successful integrated model of care.

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