scholarly journals Collaborative Tele-Neuropsychiatry Consultation Services for Patients in Central Prisons

2019 ◽  
Vol 10 (01) ◽  
pp. 101-105 ◽  
Author(s):  
Preethi Pansari Agarwal ◽  
Narayana Manjunatha ◽  
Guru S. Gowda ◽  
M. N. Girish Kumar ◽  
Neelaveni Shanthaveeranna ◽  
...  
Keyword(s):  
Mental Illness ◽  
Inpatient Care ◽  
South India ◽  
Clinical Care ◽  
Healthcare Delivery ◽  
Clinical Settings ◽  
Prison Inmates ◽  
Specialist Doctor ◽  
Patient Model ◽  
Consultation Services

ABSTRACT Background: Tele-medicine helps to provide clinical care comparable to in-person treatment in various clinical settings. It is a novel system of healthcare delivery in both low-resource settings and sites where adequate medical care continues to pose greatest challenge like in prison’s in India and worldwide. Aim: To study the sociodemographic and clinical profile of patients from Central Prisons, having received collaborative Tele-Neuropsychiatric Care. Methodology: Psychiatry, neurology, and neurosurgery specialists provided tele-neuropsychiatry consultation through Specialist–Doctor–Patient model as part of the state-run program for the two central prisons from July 1, 2014, to June 30, 2016. A retrospective file review was done of the tele-neuropsychiatry case records at Tele-Medicine Centre, Located at Tertiary Neuro Psychiatric centre of South India. Results: A total of 53 patients were provided tele-neuropsychiatric consultation over 2-year period. Of these, 48 (90.6%) were male and 34 (64.1%) were aged more than 30 years. In total, 20.7% of them had severe mental illness, i.e., schizophrenia and mood disorders, 20.7% with substance use disorder (alcohol and cannabis), 17% had anxiety disorders while 17% with seizure disorder. Nearly 81.1% of patients (inmates) were advised pharmacotherapy while 18.9% were suggested further evaluation of illness and inpatient care at the higher center. Conclusion: The collaborative care was successful in delivering psychiatry, neurology, and neurosurgery consultation with a Specialist–Doctor–Patient model to prison inmates.

scholarly journals Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization

2018 ◽  
Vol 63 (7) ◽  
pp. 492-500 ◽  
Author(s):  
David Rudoler ◽  
Claire de Oliveira ◽  
Binu Jacob ◽  
Melonie Hopkins ◽  
Paul Kurdyak
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Saving ◽  
Cost Analysis ◽  
Severe Mental Illness ◽  
Inpatient Care ◽  
Cost Savings ◽  
Support Housing ◽  
High Support

Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. Results: The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. Conclusions: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

scholarly journals IMPACT AND SATISFACTION WITH E-CONSULTATION: A PERCEPTION OF ALLIED HEALTH PROFESSIONALS

2021 ◽  
Vol 10 (2) ◽  
pp. 19-24
Author(s):  
Mubashir Siddiqui
Keyword(s):  
Health Professionals ◽  
Allied Health ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Cross Sectional Survey ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Google Docs ◽  
Consultation Services ◽  
Good Substitute

BACKGROUND AND AIMS The havoc caused by COVID-19 leads to have an adverse impact on medical priorities for consultation however e-consultation has been used widely by practitioners to aid the patient and healthcare providers. METHODOLOGY A cross-sectional survey was conducted on allied health professionals, considering physical and occupational therapists. A self-administered questionnaire regarding impact assessment and level of attained satisfaction was distributed to participants in Google Docs via email or Whatsapp groups. RESULTS A total number of 109 responses obtained from the participants showed (34.9%) were agreed to understand the completed condition of the patient, (38.5%) but (41.3%) disagreed to treat the patient same as physical appointment and (35.58%) disagreed to work more productively. Only (32.1%) were agreed to be satisfied during their consultation, (49.5%) agreed that e-consultation can never be adopted as a good substitute of physical appointments. CONCLUSION It was concluded that limited number of therapists were satisfied with their e-consultation services while majority were agreed that the service cannot be a good substitute for a physical appointment. Therefore, further trials needs to be conducted to evaluate the factors causing hindrance in healthcare delivery.

scholarly journals Voice-Based Screening For SARS-CoV-2 Exposure In Cardiovascular Clinics

2021 ◽  
Author(s):  
Abhinav Sharma ◽  
Emily Oulousian ◽  
Jiayi Ni ◽  
Renato Lopes ◽  
Matthew Pellan Cheng ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Clinical Care ◽  
Health Centre ◽  
Healthcare Delivery ◽  
Signs And Symptoms ◽  
Kappa Statistic ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Mcgill University ◽  
Strongly Agree

Abstract Aims Artificial intelligence (A.I) driven voice-based assistants may facilitate data capture in clinical care and trials; however, the feasibility and accuracy of using such devices in a healthcare environment are unknown. We explored the feasibility of using the Amazon Alexa (‘Alexa’) A.I. voice-assistant to screen for risk-factors or symptoms relating to SARS-CoV-2 exposure in quaternary care cardiovascular clinics. Methods We enrolled participants to be screened for signs and symptoms of SARS-CoV-2 exposure by a healthcare provider and then subsequently by the Alexa. Our primary outcome was interrater reliability of Alexa to healthcare provider screening using Cohen’s Kappa statistic. Participants rated the Alexa in a post-study survey (scale of 1 to 5 with 5 reflecting strongly agree). This study was approved by the McGill University Health Centre ethics board. Results We prospectively enrolled 215 participants. The mean age was 46 years (17.7 years standard deviation [SD]), 55% were female, and 31% were French speakers (others were English). In total, 645 screening questions were delivered by Alexa. The Alexa mis-identified one response. The simple and weighted Cohen’s kappa statistic between Alexa and healthcare provider screening was 0.989 (95% CI: 0.982, 0.997) and 0.992 (955 CI 0.985, 0.999) respectively. The participants gave an overall mean rating of 4.4 (out of 5, 0.9 SD). Conclusion Our study demonstrates the feasibility of an A.I. driven multilingual voice-based assistant to collect data in the context of SARS-CoV-2 exposure screening. Future studies integrating such devices in cardiovascular healthcare delivery and clinical trials are warranted. Registration https://clinicaltrials.gov/ct2/show/NCT04508972

scholarly journals Drug-Drug Interaction between Psychiatric Medications and Experimental Treatments for Coronavirus Disease-19: A Mini-Review

2020 ◽  
Vol 8 (T1) ◽  
pp. 216-228
Author(s):  
Hananeh Baradaran ◽  
Nazanin Gorgzadeh ◽  
Houman Seraj ◽  
Anahita Asadi ◽  
Danial Shamshirian ◽  
...  
Keyword(s):  
Mental Illness ◽  
Drug Interaction ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Care ◽  
Mood Stabilizers ◽  
Care Staff ◽  
Experimental Drugs ◽  
The World ◽  
Sedative Hypnotics ◽  
Experimental Treatments

The pandemic of coronavirus disease (COVID)-2019 has been affected many people all around the world. Patients with mental disorders are not as safe as others; also, they might be more vulnerable in such situations. These patients take various medications, which can lead to numerous drug-drug interactions with experimental drugs uses against COVID-19. According to the potential critical interactions, we reviewed the reputable databases to find the interactions between main categories of psychiatric medications (e.g., antidepressants, anti-psychotics, sedative/hypnotics, and mood stabilizers) when used in concomitant with COVID-19 experimental agents (e.g., hydroxychloroquine, lopinavir/ritonavir, atazanavir, and chloroquine). We hope the list provided in this review helps the clinical care staff in treating patients with mental illness infected with severe acute respiratory syndrome coronavirus 2 during the COVID-19 pandemic.

A Novel Computer-Based Virtual Counselor-Delivered Alcohol Reduction Intervention: Acceptability, Adaptability and Feasibility among Adults with HIV or TB in Indian Clinical Settings (Preprint)

2021 ◽  
Author(s):  
Nishi Suryavanshi ◽  
Gauri Dhumal ◽  
Samyra Cox ◽  
Shashikala Sangle ◽  
Andrea DeLuca ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Health Care Providers ◽  
Clinical Care ◽  
Clinical Settings ◽  
Care Hospital ◽  
Care Providers ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Computer Based ◽  
Alcohol Reduction

BACKGROUND Unhealthy alcohol use is associated with increased morbidity and mortality among persons with HIV and/or TB. Computer-Based interventions (CBI) can reduce unhealthy alcohol use, are scalable, and may improve outcomes among patients with HIV or TB. OBJECTIVE We assessed the acceptability, adaptability, and feasibility of a novel CBI for alcohol reduction in HIV and TB clinical settings in Pune, India. METHODS We conducted 10 in-depth interviews (IDIs) with persons with alcohol use disorder (AUD); [TB (n=6), HIV (n=2), HIV-TB co-infected (n=1) selected using convenience sampling method, No HIV or TB disease (n=1)], one focus group (FG) with members of alcoholics anonymous (AA) (n=12, and two FGs with health care providers (HCPs) of a tertiary care hospital (n=22). All participants reviewed and provided feedback on a CBI for AUD delivered by a 3-D virtual counselor. Qualitative data were analyzed using structured framework analysis. RESULTS Majority (n=9) of IDI respondents were male with median age 42 (IQR; 38-45) years. AA FG participants were all male (n=12) and HCPs FG participants were predominantly female (n=15). Feedback was organized into 3 domains: 1) Virtual counselor acceptability; 2) Intervention adaptability; and 3) feasibility of CBI intervention in clinic settings. Overall IDI participants found the virtual counselor to be acceptable and felt comfortable honestly answering alcohol-related questions. All FG participants preferred a human virtual counselor to an animal virtual counselor so as to potentially increase CBI engagement. Additionally, interaction with a live human counselor would further enhance the program’s effectiveness by providing more flexible interaction. HCP FGs noted the importance of adding information on the effects of alcohol on HIV and TB outcomes because patients were not viewed as appreciating these linkages. For local adaptation, more information on types of alcoholic drinks, additional drinking triggers, motivators and activities to substitute for drinking alcohol were suggested by all FG participants. Intervention duration (~20 minutes) and pace were deemed appropriate. HCPs reported that CBI provides systematic, standardized counseling. All FG and IDI reported that CBI could be implemented in Indian clinical settings with assistance from HIV or TB program staff. CONCLUSIONS With cultural tailoring to patients with HIV and TB in Indian clinical care settings, a virtual counselor-delivered alcohol intervention is acceptable, appears feasible to implement, particularly if coupled with person-delivered counseling.

Digitally disconnected: A qualitative study of patient perspectives on the digital divide and potential solutions (Preprint)

2021 ◽  
Author(s):  
Maria Alcocer Alkureishi ◽  
Z-Yi Choo ◽  
Ali Rahman ◽  
Kimberly Ho ◽  
Jonah Benning-Shorb ◽  
...  
Keyword(s):  
Digital Divide ◽  
Low Income ◽  
Medical Center ◽  
Clinical Care ◽  
Healthcare Delivery ◽  
Patient Perspectives ◽  
Valuable Insight ◽  
Theory Approach ◽  
Technology Access ◽  
Broadband Internet

BACKGROUND As telemedicine utilization increased during the COVID-19 pandemic, divergent usage patterns for video and audio-only telephone visits emerged. Older, low-income, minority, and non-English speaking Medicaid patients especially are at highest risk of experiencing technology access and digital literacy barriers. This raises concern for disparities in healthcare access and widening of the “digital divide”, the separation of those with technological access and knowledge and those who do not. While studies demonstrate correlation between racial and socioeconomic demographics and technological access and ability, individual patients' perspectives of the divide and its impacts remain unclear. OBJECTIVE We aimed to interview patients to understand their perspectives on 1) the definition, causes, and impact of the digital divide, 2) whose responsibility it is to address, and 3) potential solutions to mitigate the digital divide. METHODS Between December 2020-March 2021, we conducted 54 semi-structured telephone interviews with adult patients and parents of pediatric patients who had virtual visits (phone and/or video) sometime between March and September 2020 at the University of Chicago Medical Center primary care clinics. A grounded theory approach was used to analyze interview data. RESULTS Patients were keenly aware of the digital divide and described impacts beyond healthcare, including employment, education, community and social contexts, and personal economic stability. Patients described that individuals, government, libraries, schools, healthcare organizations, and even private businesses all shared the responsibility to address the divide. Proposed solutions to address the divide included conducting community technology needs assessments and improving technology access, literacy training, and resource awareness. Recognizing that some individuals will never cross the divide, patients also emphasized continued support of low-tech communication methods and healthcare delivery to prevent widening of the digital divide. Furthermore, patients viewed technology access and literacy as drivers of the social determinants of health (SDOH), profoundly influencing how SDOHs function to worsen or improve health disparities. CONCLUSIONS Patient perspectives provide valuable insight into the digital divide and can inform solutions to mitigate health and resulting societal inequities. Future work is needed to understand the digital needs of disconnected individuals and communities. As clinical care and delivery continue to integrate telehealth, studies are needed to explore whether having a video or audio-only phone visit results in different patient outcomes and utilization. Advocacy efforts to disseminate public and private resources can also expand device and broadband internet access, improve technology literacy, and increase funding to support both high- and low-tech forms of healthcare delivery for the disconnected.

Prejudice, ethnic discrimination, and double jeopardy in migrants

2021 ◽  
pp. 39-44
Author(s):  
Cameron Watson ◽  
Edgardo Juan Tolentino ◽  
Dinesh Bhugra
Keyword(s):  
Mental Illness ◽  
Negative Attitude ◽  
Mental Healthcare ◽  
Ethnic Discrimination ◽  
Clinical Settings ◽  
Human Beings ◽  
Double Jeopardy ◽  
Potential Factors ◽  
Prejudice And Discrimination ◽  
The Right

Prejudice is a universal phenomenon and all human beings carry at least one prejudice in them, whether this is against individuals with mental illness or migrants. Often potential factors can also cause prejudice. In many clinical settings, migrants with mental illness can face double jeopardy, leading to facing further discriminations at a number of levels. Individuals with mental illness in many countries do not have the right to vote, marry, make a will or inherit property, or the right to employment. Migrants in many countries do not have full rights as citizens. Double or triple jeopardy means that migrants with mental healthcare needs often fail to get their needs met at a number of levels. Prejudice and discrimination are learned behaviours, whereas stigma is often a negative attitude. Racism is a form of discrimination, but it takes the form of xenoracism if the migrant is white, although shared whiteness does not exclude the possibility of racism.

Clinical Applications and Investigation of the Acceptance of Mental Illness

2016 ◽  
pp. 146-158
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Culturally Diverse ◽  
Clinical Care ◽  
Clinical Applications ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Potential Development ◽  
Peer Specialists ◽  
Diverse Groups

This chapter reviews the 14 key principles of the process of acceptance of mental illness among culturally diverse groups that emerged from the findings in this book. Each principle is accompanied by clinical recommendations for facilitating the process of acceptance of mental illness. Examples are provided as to how clinicians, peer specialists, and researchers might respond to issues of acceptance of mental illness to facilitate hope and recovery. A number of acceptance-related techniques and theories in clinical care are also discussed. To further understanding and promote the process of acceptance of mental illness among persons in recovery, areas of potential development for future research are reviewed. An “Acceptance of Mental Illness Checklist” with scoring information is provided to assess the dimensions of acceptance and barriers and facilitators among people with serious mental illness and to aid further clinical and research examination of this construct.

Acceptance of Mental Illness Among Women

2016 ◽  
pp. 90-101
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Clinical Care ◽  
Clinical Recommendations ◽  
Stigma And Discrimination ◽  
Clinical Strategies ◽  
Multiple Levels ◽  
The Impact ◽  
Experiences Of Women

This chapter reviews the experiences of women with serious mental illness and the various disparities encountered by them. These disparities include higher rates of victimization, unemployment, poverty, homelessness, and inequities in clinical care. The impact of these disparities and associated stigma on the acceptance process is presented. This chapter centers on a discussion of intersectional stigma, or overlapping, multiple levels of stigma and discrimination, faced by women with serious mental illness. Several participant case narratives are presented in order to demonstrate the impact of intersectional stigma on the process of acceptance for women with serious mental illness. Clinical recommendations are provided to facilitate acceptance among women who experience intersectional stigma. A clinical strategies list, discussion questions, activities, the “Intersectional Stigma Worksheet,” and an explanatory table are included at the close of the chapter.

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