A Twelve Month Follow-Up Study of Psychogeriatric Admissions to Mental Health Services and Geriatric Service Hospitals

1970 ◽  
Vol 4 (3) ◽  
pp. 131-136 ◽  
Author(s):  
P. W. Burvill
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Western Australia ◽  
Hospital Admissions ◽  
Public Health Department ◽  
Home Setting ◽  
Geriatric Service ◽  
Psychogeriatric Patients

Eighty-five (100 per cent) consecutive psychogeriatric patients admitted to the Public Health Department Geriatric Service of Western Australia and eighty (94 per cent) of the original 85 psychogeriatric patients admitted to the Mental Health Services of Western Australia were re-examined by the author 12 months after admission. Twenty-five Geriatric Service patients had died, 19 were alive in the community, and 41 alive in hospital; the corresponding Mental Health Services figures were 15, 33 and 32. Differences in movement pattern and outcome between the two services, and between mental hospital admissions in the United Kingdom and Western Australia, were documented. There was a considerable number of repeated transfers from one hospital or nursing home setting to another during the 12 months among those patients living in hospital at follow-up, and to a less extent among those who died. Outcome of the patients was related to a number of factors for each service.

Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A Randomized Controlled Trial

2021 ◽  
pp. 1-14
Author(s):  
Nina Reinholt ◽  
Morten Hvenegaard ◽  
Anne Bryde Christensen ◽  
Anita Eskildsen ◽  
Carsten Hjorthøj ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Major Depressive ◽  
Outpatient Mental Health ◽  
End Of Treatment

<b><i>Introduction:</i></b> The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. <b><i>Objective:</i></b> This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. <b><i>Methods:</i></b> In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. <b><i>Results:</i></b> At end-of-treatment, WHO-5 mean scores for patients in UP (<i>n</i> = 148) were non-inferior to those of patients in dCBT (<i>n</i> = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. <b><i>Conclusions:</i></b> This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.

The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives

2016 ◽  
Vol 51 (12) ◽  
pp. 1227-1239 ◽  
Author(s):  
Nickolai Titov ◽  
Blake F Dear ◽  
Lauren G Staples ◽  
James Bennett-Levy ◽  
Britt Klein ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Public Awareness ◽  
Treatment Options ◽  
Service Utilisation ◽  
Clinical Effects ◽  
Post Traumatic Stress ◽  
Project Objectives

Objective: The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments. Method: Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale–Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist–Civilian Version, administered at assessment, post-treatment and 3-month follow-up. Results: The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18–94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects ( d: 0.7–2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%. Conclusion: Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services.

scholarly journals Screening and Referral is Not Enough: A Qualitative Exploration of Barriers to Access and Uptake of Mental Health Services in Patients With Cardiovascular Diseases

2020 ◽  
Author(s):  
Catherine M Collopy ◽  
Suzanne M Cosh ◽  
Phillip J Tully
Keyword(s):  
Mental Health ◽  
Cardiovascular Diseases ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Service Use ◽  
Information Provision ◽  
Cardiac Events ◽  
Structured Interviews

Abstract Background: Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, and guidelines recommending routine depression screening and referral, uptake of mental healthcare in CVD populations remains low. Reasons for the underutilisation of mental health and psychological services for this population remain largely unknown.Methods: Thirteen CVD patients with clinically significant psychological symptoms (depression, anxiety and/or stress) participated in one-on-one in-depth semi-structured interviews. Data were analysed using inductive thematic analysis.Results: Barriers to uptake included the timing of referral and screening, with patients reporting a need for longer term follow-up. A lack of information provision and understanding around mental health and services, especially following cardiac-events were further barriers. A reluctance to report mental health or engage in services was also identified, with patients indicating a preference for informal peer support networks. A range of practical barriers such as mobility, transport and cost were also reported. Conclusions: Longer term follow-up and routine mental health assessment may be beneficial to facilitate use of mental health services. Upskilling of practitioners around mental health may be a further avenue to promote information provision and enhance service use. Further focus on enhancing informal peer support may be a valuable initial approach for the CVD population. The implications for improving services and enhancing service use are discussed.

scholarly journals Service and treatment engagement of people with very late-onset schizophrenia-like psychosis

2016 ◽  
Vol 40 (4) ◽  
pp. 185-186 ◽  
Author(s):  
Chun Chiang Sin Fai Lam ◽  
Suzanne J. Reeves ◽  
Robert Stewart ◽  
Robert Howard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Late Onset ◽  
Treatment Engagement ◽  
Antipsychotic Treatment ◽  
Clinical Implications ◽  
Electronic Patient Records ◽  
Lost To Follow Up

Aims and methodElectronic patient records were used to investigate the level of engagement and treatment that patients with very late-onset schizophrenia-like psychosis (VLOSLP) had with mental health services.ResultsOf 131 patients assessed and diagnosed, 63 (48%) were taking antipsychotic treatment at 3 months, 46 (35%) at 6 months and 36 (27%) at 12 months. At discharge from mental health services, 54% of patients had failed to engage with services or became lost to follow-up, 18% had engaged with services but were not taking antipsychotic medication and only 28% were taking treatment.Clinical implicationsResults showed that less than half of the patients with VLOSLP were commenced on antipsychotic treatment and less than a third remained on treatment at 1 year or at point of discharge. This highlights the need for services to consider being more assertive in taking potentially effective treatment to this patient group.

Parent Medication Concerns Predict Underutilization of Mental Health Services for Minority Children With ADHD

2011 ◽  
Vol 51 (1) ◽  
pp. 65-76 ◽  
Author(s):  
Evelyn Berger-Jenkins ◽  
Mary McKay ◽  
Jeffrey Newcorn ◽  
William Bannon ◽  
Danielle Laraque
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Mental Health Services ◽  
Health Services ◽  
Minority Children ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Cohort Design ◽  
Adhd Treatment

Objective. Disparities in attention deficit hyperactivity disorder (ADHD) treatment are recognized with minority children using services less than nonminority children. The authors examine minority parents’ knowledge and perceptions of ADHD as they relate to service utilization. Methods. Using a longitudinal cohort design, parents of children with untreated ADHD were surveyed regarding their knowledge and perceptions of ADHD and then followed for 3 to 6 months to determine whether they used services. Results. Seventy parents of 5- to 18-year-old children with untreated ADHD were enrolled. Of the 70 children, 33 (47.1%) had not attended any mental health appointments and 51 (72.9%) had not used any treatments by 3- to 6-month follow-up. Logistic regression indicated that increasing age and medication concerns were associated with less follow-up at mental health appointments ( P < .05) and less utilization of treatments ( P < .05). Conclusions. The results of this study highlight the importance of addressing medication concerns, when referring minority children to mental health services or offering treatments.

scholarly journals The Long-Term Effectiveness of Psychoeducation for Bipolar Disorders in Mental Health Services. A 4-Year Follow-Up Study

2019 ◽  
Vol 10 ◽  
Author(s):  
Chiara Buizza ◽  
Valentina Candini ◽  
Clarissa Ferrari ◽  
Alberto Ghilardi ◽  
Francesco Maria Saviotti ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Bipolar Disorders ◽  
Follow Up Study

Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

2001 ◽  
Vol 31 (7) ◽  
pp. 1181-1191 ◽  
Author(s):  
WEN-HUNG KUO ◽  
J. J. GALLO ◽  
A. Y. TIEN
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorders ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Community Sample ◽  
Suicide Behaviour

Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non-fatal suicide behaviour) in a community sample, to evaluate antecedent sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.Method. Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.Results. The incidence of suicide attempts was estimated at 148·8 per 100000 person-years and ideation at 419·9 per 100000 person-years. Persons in the youngest age group, in the lowest socio-economic status, and previously married persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6·09, 95% CI 2·58–14·36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.Conclusions. Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.

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