The Challenges of Providing Community Psychiatric Services in the COVID-19 Era: The Probability of Soaring Rehospitalization and Caregivers’ Burden of People with Severe Mental Illnesses

Abstract Background: Still, in a larger part of the world, people with mental illnesses first consult general practitioners (non-psychiatrist practitioners) to treat their mental illness. Many such patients seek psychiatric consultation with reluctance after being referred by general practitioners due to stigma. The study aimed to assess the attitude of general medical practitioners towards consultation-liaison psychiatric services.Methods: In this cross-sectional survey, a total of 61 general medical practitioners, specialists, and subspecialist physicians, surgeons from a city of North India were evaluated in a questionnaire which was designed based on previous studies and observations to assess their attitudes towards liaison psychiatric services.Findings: Nearly 98% of the general practitioners deal with the patient of psychiatric illness, out of which nearly 30% treat the patient of their own. Nearly 88% of practitioners referring a patient to psychiatrists. More than 90% of general practitioners reported psychiatric problems are associated with medical illness. More than 40%prescribe psychotropic medication, out of which benzodiazepine is the most commonly prescribed one. Depression is commonly encountered in general medical practice. More than 70% of practitioners are not comfortable prescribing psychotropic medications. About 16.39% of general practitioners faced difficulty in referring patients to a psychiatrist for various reasons. Conclusion: General practitioners treat many patients with psychiatric illness though they are not comfortable prescribing psychotropic medications.

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Ontario's Community Mental Health Program

Canadian Psychiatric Association Journal ◽

10.1177/070674376400900305 ◽

1964 ◽

Vol 9 (3) ◽

pp. 221-226

Author(s):

H. W. Henderson

Keyword(s):

Mental Health ◽

Community Mental Health ◽

Mental Health Program ◽

Professional Staff ◽

Psychiatric Services ◽

Standards Of Care ◽

Effective Utilization ◽

Community Psychiatric ◽

Community Mental Health Program ◽

Local Agencies

Future planning and development of psychiatric services in Ontario is based on the concept of community psychiatric centres. The implementation of this program will require: 1) the utilization of general hospitals and mental hospitals to provide a more complete and comprehensive system of community psychiatric services; 2) increasing concern with the standards of care in psychiatric facilities across the Province; 3) continued and increasing involvement of local agencies and services in the community mental health effort; 4) the identification of priorities of need that will assure most effective utilization of the available professional staff. It is to be expected that efforts made to consolidate our gains, will bring issues such as these into sharper focus. As the administrative responsibility for clinical services is shifted from a central to a local authority, psychiatrists will look to their professional association more and more to represent their interests. It is to be hoped that those identified with Government will continue to respect the interest and concern of the organized profession with these problems, which must be resolved in order to further advance the practice of psychiatry in this Province.

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2. Collaboration between general practice and community psychiatric services for people with chronic mental illness

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1997.tb125052.x ◽

1997 ◽

Vol 167 (5) ◽

pp. 266-271 ◽

Cited By ~ 11

Author(s):

Nicholas A Keks ◽

Tobie L Sacks ◽

B Malcolm Altson ◽

Harry H Hustig ◽

Amgad Tanaghow

Keyword(s):

Mental Illness ◽

General Practice ◽

Psychiatric Services ◽

Chronic Mental Illness ◽

Community Psychiatric

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Clinical interventions for treatment non-adherence in psychosis: Meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.183.3.197 ◽

2003 ◽

Vol 183 (3) ◽

pp. 197-206 ◽

Cited By ~ 114

Author(s):

Michela Nosé ◽

Corrado Barbui ◽

Richard Gray ◽

Michele Tansella

Keyword(s):

Meta Analysis ◽

Scientific Evidence ◽

Educational Programme ◽

Psychiatric Services ◽

Controlled Clinical Trials ◽

Clinical Interventions ◽

Psychotherapeutic Interventions ◽

Community Psychiatric ◽

Randomised Controlled ◽

Dichotomous Outcomes

BackgroundStudies investigating the efficacy of clinical interventions for reducing treatment non-adherence have generated contrasting findings, and treatment non-adherence remains common in clinical practice.AimsTo systematically review whether there are effective clinical interventions that community psychiatric services can implement to reduce non-adherence.MethodSystematic review and metaregression analysis of randomised controlled trials (RCTs) and controlled clinical trials (CCTs) were used to assess the efficacy of interventions to enhance adherence.ResultsWe reviewed 24 studies, more than half of which were RCTs. In 14 studies the experimental intervention was an educational programme. Five studies evaluated pre-discharge educational sessions, three studies explored the benefit of psychotherapeutic interventions and two studies looked at the effect of telephone prompts. The overall estimate of the efficacy of these interventions produced an odds ratio of 2.59 (95% Cl 2.21–3.03) for dichotomous outcomes, and a standardised mean difference of 0.36 (95% Cl 0.06–0.66) for continuous outcomes.ConclusionsCommunity psychiatric services can potentially use effective clinical interventions, backed by scientific evidence, for reducing patient non-adherence.

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