scholarly journals Psychiatric inpatient beds for youths in China: data from a nation-wide survey

2020 ◽  
Author(s):  
Feng Geng ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Tingfang Liu ◽  
Yuanli Liu ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Mental Illnesses ◽  
Limited Resources ◽  
Inpatient Service ◽  
Discharged Patients ◽  
The Mean ◽  
Nation Wide Survey ◽  
Psychiatric Beds

Abstract Background The development of child psychiatry in China is slow and very limited resources have been allocated to it. To investigate the current resources of inpatient psychiatric facilities for youth in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized in an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric bed was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients hospitalized in adult units. Conclusion Our findings highlight a dire situation of youth inpatient service in China, especially in less developed regions. There is an urgent need to change the policy and develop mental health services, including inpatient services for child and adolescent patients.

scholarly journals Psychiatric inpatient beds for youths in China: data from a nation-wide survey

2020 ◽  
Author(s):  
Feng Geng ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Tingfang Liu ◽  
Yuanli Liu ◽  
...  
Keyword(s):  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Child And Adolescent ◽  
Mental Illnesses ◽  
Child Psychiatric ◽  
Psychiatric Units ◽  
Adolescent Inpatient ◽  
Nation Wide Survey ◽  
Psychiatric Inpatient Services ◽  
Psychiatric Beds

Abstract Background The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric beds was 27.7±22.9 in these hospitals and 6/29 hospitals had no youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units. Conclusion Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.

scholarly journals Psychiatric inpatient beds for youths in China: data from a nation-wide survey

2020 ◽  
Author(s):  
Feng Geng ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Tingfang Liu ◽  
Yuanli Liu ◽  
...  
Keyword(s):  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Child And Adolescent ◽  
Mental Illnesses ◽  
Child Psychiatric ◽  
Psychiatric Units ◽  
Adolescent Inpatient ◽  
Nation Wide Survey ◽  
Psychiatric Inpatient Services ◽  
Psychiatric Beds

Abstract Background The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric beds was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units. Conclusion Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.

Elementi per una valutazione epidemiologica dell'attività di un Servizio Psichiatrico di Diagnosi e Cura

1992 ◽  
Vol 1 (3) ◽  
pp. 165-175 ◽  
Author(s):  
Marco Piccinelli ◽  
Pierluigi Politi
Keyword(s):  
General Hospital ◽  
Service Utilization ◽  
Psychiatric Inpatient ◽  
Sono State ◽  
Annual Number ◽  
Clinical Aspects ◽  
Inpatient Service ◽  
Daily Number ◽  
Number Of Patients ◽  
The Mean

RiassuntoScopo - Analizzare l'attività del Servizio Psichiatrico di Diagnosi e Cura di Pavia nel periodo compreso tra il 1978 (anno dell'apertura del servizio) ed il 1990. Disegno - Analisi retrospettiva dei dati contenuti in un archivio computerizzato, nel quale, a partire dal 1978, sono state raccolte informazioni relative alle caratteristiche socio-demografiche e nosologiche dei pazienti ricoverati, nonché alia modalità ed all'andamento dei ricoveri. Setting - Il Servizio Psichiatrico di Diagnosi e Cura di Pavia, il cui bacino di utenza è costituito dall'ULSS 77, comprendente la città di Pavia e 61 comuni limitrofi. Principali indici utilizzati - Per ciascun anno considerato sono stati ricavati: indicatori d'uso (primi ricoveri, ricoveri complessivi, giornate di degenza, pazienti ricoverati); presenza media giornaliera e media annuale dei massimi mensili di pazienti ricoverati; indicatori d'intensita d'uso o di flusso (degenza media, indice di occupazione media dei posti-letto, indice di turnover, indice di rotazione dei posti-letto). La produttivita del servizio è stata indagata utilizzando il monogramma di Barber. Risultati - Tra il 1978 ed il 1983 si è verificato un progressivo incremento nel numero dei pazienti ricoverati, dei ricoveri complessivi e delle giornate di degenza; è seguito un periodo stazionario protrattosi fino al 1987; infine, durante gli ultimi tre anni il numero dei ricoveri complessivi e quello dei pazienti ricoverati sono leggermente diminuiti, mentre le giornate di degenza sono rimaste sostanzialmente stabili. Il numero annuale dei pazienti entrati in contatto per la prima volta con il servizio ha segnato due picchi negli anni 1979 e 1983 (N = 250), diminuendo poi progressivamente fino ai valori di 139 nel 1989 e di 152 nel 1990. Le frazione percentuali dei primi ricoveri rispetto ai ricoveri complessivi e rispetto ai pazienti ricoverati si sono ridotte nel corso del periodo considerato: nel 1990 esse erano pari a 30% e 50% rispettivamente. Presenza media giornaliera e media annuale dei massimi mensili di pazienti ricoverati sono aumentate tra il 1979 ed il 1983, passando da 12 a 21 pazienti/die, e da 14 a 25 pazienti/die, rispettivamente; negli ultimi otto anni i due parametri si sono stabilizzati su valori di 20-21 e 24-25 pazienti/die rispettivamente. II nomogramma di Barber, costruito sulla base dei valori assunti dagli indicatori d'intensita d'uso nel corso di ciascun anno considerato, ha mostrato che tutti gli anni in esame si sono distribuiti entro la zona di produttivita accettabile, ad eccezione del 1980 e del 1981. Conclusioni - Dopo una fase iniziale di progressiva espansione, il servizio sembra aver raggiunto una fase di equilibrio dinamico con il suo bacino di utenza, fornendo per la maggior parte del periodo considerato un livello di produttività accettabile.Parole chiaveservizi psichiatrici, utilizzazione, dei servizi, produttività.SummaryObjective – To analyze the activity of a General Hospital Psychiatric Inpatient Service in Pavia between 1978 (when the service was set up) and 1990. Design - Retrospective analysis of data stored in a computerized database, in which, since 1978, information has been collected on sociodemographic and nosological characteristics of patients admitted to the service, as well as on clinical aspects of all admissions. Setting – A General Hospital Psychiatric Inpatient Service in Pavia, whose catchmentarea (ULSS 77) includes the town of Pavia and 61 close municipalities. Main outcome measures -For each yearover the period considered we reported on: the indices of service utilization (first admissions, total admissions, days of stay, number of admitted patients); the mean daily number of inpatients, and the mean of the largest daily numbers of inpatients by month; the indices of intensity of service utilization (mean lenght of stay, index of bed occupation, index of turnover, index of bed rotation). The service productivity was determined according to the Barber's nomogram. Results – Between 1978 and 1983 patients admitted to the service, total admissions, and days of stay gradually increased; a steady period then followed until 1987; over the last three years, total admissions and the number of admitted patients slightly decreased, while daysof stay remained substantially stable. The annual number of patients admitted for the first time to the service marked two peaks in 1979 and 1983 (N = 250), and then gradually decreased to 139 in 1989 and 152 in 1990. The percent ratio of first admissions by total admissions and that of first admissions by the number of admitted patients showed a reduction over the period considered: in 1990 they were 30% and 50% respectively. The mean daily number of inpatients and the mean of the largest daily numbers of inpatients by month increased between 1979 and 1983, from 12 to 21 and from 14 to 25 patients/day respectively; over the last eight years the values remained rather constant, around 20-21 and 24-25 patients/day respectively. The Barber's nomogram, obtained on the basis of the indices of intensity of service utilization over the period considered, showed that each year fell within the area of acceptable productivity, with the exception of 1980 and 1981. Conclusions – After an initial phase of gradual expansion, the service then reached asteadystate, providing an acceptable productivity over most of the period considered.

scholarly journals Fractured minds to flourishing minds

2021 ◽  
Author(s):  
◽  
Rebecca Wallace
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
New Zealand ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Mental Illnesses ◽  
High Rate ◽  
Youth Suicide ◽  
Health And Wellbeing ◽  
Self Harm

<p>Youth suicide and self-harm are major public health concerns worldwide. The high rate of youth suicide and intentional self-harm in New Zealand, illustrates that there is a large amount of youth experiencing severe mental illness, as mental illness corresponds to suicidal/harmful behavior. Although more youth are seeking and receiving help, a large portion who are suffering are unwilling to engage in services, due to stigma surrounding mental health. Characteristics of the built environment can effect wellbeing and therefore architecture holds significant implications for the mental health of individuals.  Inpatient environments are an effective intervention for the treatment of a range of severe mental illnesses, however there is a definitive lack of acute inpatient facilities for youth in New Zealand. A shift in the way mental healthcare services are provided has meant that large psychiatric hospitals have been closed or downsized and compulsory inpatient treatment has given way to voluntary engagement with community mental health services. This has not eliminated the need for inpatient care and there still remains a need for these highly specialized environments. These current specialized environments are generally not designed to benefit the mental health and wellbeing of patients, but are just regarded as settings in which recovery takes place.  This thesis aims to explore how architecture can act therapeutically to support the wellbeing of individuals suffering mental illness. It looks at how architecture can retain the dignity of these patients, and challenge conventional norms of prior mental healthcare environments. This thesis aims to integrate Maori and Pacific models of health and wellbeing in order to allow improved care and treatment for Maori and Pacific groups. It responds to the lack and unsuccessful architectural responses for youth in New Zealand and in particular, the central region and aims to design a new mental health inpatient and outpatient facility specifically for youth suffering mental illness.</p>

scholarly journals Resources and Workforce in Top-Tier Psychiatric Hospitals in China: A Nationwide Survey

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Xia ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Yulong Zhang ◽  
Yudong Shi ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Lower Limit ◽  
Mental Health Professionals ◽  
Health Resources ◽  
Psychiatric Hospitals ◽  
Outpatient Services ◽  
The Past ◽  
Psychiatric Staff ◽  
Psychiatric Beds

Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China.Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation.Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio.Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.

scholarly journals Changing patterns in the use of the Mental Health Act 1983 in England, 1984–1996

2000 ◽  
Vol 176 (5) ◽  
pp. 479-484 ◽  
Author(s):  
Matthew Hotopf ◽  
Sharon Wall ◽  
Alec Buchanan ◽  
Simon Wessely ◽  
Rachel Churchill
Keyword(s):  
Mental Health ◽  
Hospital Admissions ◽  
Psychiatric Hospitals ◽  
Home Office ◽  
Mental Health Act ◽  
Department Of Health ◽  
Changing Patterns ◽  
Prison Populations ◽  
Psychiatric Beds ◽  
Near Future

BackgroundThe Mental Health Act 1983 (MHA) is due to be revised by Parliament in the near future.AimsTo explore changes in the use of the Act since its introduction.MethodThe Department of Health and the Home Office routinely collect data on the numbers of patients admitted to psychiatric hospitals under the MHA. We present absolute figures, by year, for the total numbers admitted under each section of the Act. We used the total psychiatric hospital admissions and total prison populations as denominator data.ResultsFormal admissions rose from 16 044 in 1984 to 26 308 in 1996, a 63% increase. Admissions under the MHA have increased as a proportion of all admissions. The increase is mainly accounted for by changes in the use of Part II of the Act, in particular sections 2 and 3. The use of forensic sections (Part III) has also increased, with a marked increase of sections 47 and 48. Use of Part X of the Act (sections 135 and 136) declined in the late 1980s but rose again in the 1990s.ConclusionsFormal admissions are more common than they were in 1984, despite there being fewer psychiatric beds. This is probably due to changes in the provision of psychiatric services, and changing societal pressures on psychiatrists away from libertarianism and towards coercion.

scholarly journals Letter from Australia: mental healthcare in Victoria

2011 ◽  
Vol 17 (1) ◽  
pp. 2-4 ◽  
Author(s):  
David J. Castle
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Intellectual Disability ◽  
Mentally Ill ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Mental Illnesses ◽  
Government Agencies ◽  
The Past

SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.

Civil Commitment Trends in Ontario: The Effect of Legislation on Clinical Practice

1985 ◽  
Vol 30 (4) ◽  
pp. 259-264 ◽  
Author(s):  
B.A. Martin ◽  
K.D. Cheung
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Psychiatric Inpatient ◽  
Civil Commitment ◽  
Psychiatric Hospitals ◽  
The Other ◽  
Mental Health Legislation ◽  
History Of ◽  
Health Legislation ◽  
Over Time

The rationale for and history of civil commitment legislation in Ontario are reviewed The civil commitment rate in Ontario from 1926 to 1980 for provincial psychiatric hospitals, and from 1974 to 1980 for all psychiatric inpatient facilities was analyzed to detect variation in the rate over time and with relevant legislation. The findings indicate that mental health legislation has had little effect on commitment practices in Ontario. In addition, the variation in the commitment rate over the period reviewed cannot be ascribed to inconsistent application by physicians. The other variables affecting the rate are discussed in this context. The need for more descriptive studies of the major determinants of the commitment rate is emphasized.

The Yantai Model of Community Care for Rural Psychiatric Patients

1994 ◽  
Vol 165 (S24) ◽  
pp. 107-113 ◽  
Author(s):  
Qingtong Wang ◽  
Yuzhu Gong ◽  
Kezhen Niu
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Health Workers ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Home Care Services ◽  
Mental Illnesses ◽  
Mental Health Workers ◽  
Advisory Group ◽  
Community Mental Health Workers

The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics (‘village doctors’) who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.

Needs-oriented discharge planning for high utilisers of psychiatric services: multicentre randomised controlled trial

2011 ◽  
Vol 20 (2) ◽  
pp. 181-192 ◽  
Author(s):  
B. Puschner ◽  
S. Steffen ◽  
K. A. Völker ◽  
C. Spitzer ◽  
W. Gaebel ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Discharge ◽  
Service Use ◽  
Discharge Planning ◽  
Psychiatric Inpatient ◽  
Intervention Group ◽  
Outpatient Service ◽  
Critical Time ◽  
Psychiatric Hospitals ◽  
High Utilisation

Aims.Attempts to reduce high utilisation of mental health inpatient care by targeting the critical time of hospital discharge are rare. In this study, we test the effect of a needs-oriented discharge planning intervention on number and duration of psychiatric inpatient treatment episodes (primary), as well as on outpatient service use, needs, psychopathology, depression and quality of life (secondary).Methods.Four hundred and ninety-one adults with a defined high utilisation of mental health care gave informed consent to participate in a multicentre RCT carried out at five psychiatric hospitals in Germany (Düsseldorf, Greifswald, Regensburg, Ravensburg and Günzburg). Subjects allocated to the intervention group were offered a manualised needs-led discharge planning and monitoring intervention with two intertwined sessions administered at hospital discharge and 3 months thereafter. Outcomes were assessed at four measurement points during a period of 18 months following discharge.Results.Intention-to-treat analyses showed no effect of the intervention on primary or secondary outcomes.Conclusions.Process evaluation pending, the intervention cannot be recommended for implementation in routine care. Other approaches, e.g. team-based community care, might be more beneficial for people with persistent and severe mental illness.

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