scholarly journals Wait times for psychiatric care in Ontario

2017 ◽  
Vol 86 (2) ◽  
pp. 48-50
Author(s):  
Rachel Loebach ◽  
Sasha Ayoubzadeh
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Inpatient ◽  
Wait Time ◽  
Mandatory Reporting ◽  
Psychiatric Services ◽  
Wait Times ◽  
Time Data ◽  
Developed Nations

Mental illness is a prevalent and costly health care issue. Lengthy wait times for psychiatric services in Ontario are a barrier to adequate mental health care for adults, children and youth. The objective of this paper is to highlight the current state of psychiatric wait times in Ontario by looking at provincial policies and comparing data to physical health services, as well as between provinces and other developed nations. The Ontario government has successfully implemented mandatory reporting of wait-time data for many medical and surgical services. However, such policies have yet to be implemented for psychiatric services. As a result, availability of current data for comparison is limited. Nova Scotia is currently the only province to government mandate reporting of wait times for mental health. Furthermore, The Organisation for Economic Co-operation and Development ranks Canada below average on measures related to accessibility of psychiatric inpatient services compared to other developed nations. While Ontario has implemented new initiatives to address the issue of timely mental health care, there is still insufficient evidence to determine if they are effective. Continued advocacy for mandatory wait-time reporting at the provincial level and further analysis of current initiatives worldwide are essential steps toward reducing wait times.

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.

Nature-based Group Therapy Reflections: A Grounded Theory Study

2020 ◽  
Vol 42 (12) ◽  
pp. 1129-1136
Author(s):  
Kelly Carlson ◽  
Jeanette Kingsley ◽  
Caroline Strimaitis ◽  
Shira Birnbaum ◽  
Theresa Quinn ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Grounded Theory ◽  
Mental Health Care ◽  
Therapy Group ◽  
Psychiatric Inpatient ◽  
Inpatient Setting ◽  
Grounded Theory Study ◽  
Beneficial Effects ◽  
Patient Responses

Nature-based therapies have a long history in mental health care. Beneficial effects have been documented for nature-based therapies in a variety of other health care settings. The aims of this grounded theory study were to understand the processes of maintaining nature-based therapeutic groups and the value of the activities to patients in a psychiatric inpatient setting. Over a nine-month period, semi-structured surveys of patient responses to nature-based activities were administered to patients in a pilot therapy group assessing the feasibility of a nature-based group program. Findings indicated that the group promoted use of the senses, social interaction, and care of self/others. Perceptions of benefits led to a nuanced understanding of the effects of being in contact with nature. Based on our findings we offer a preliminary theoretical model for patient engagement with nature-based programming in inpatient mental health care.

Psychiatry and the Need for Mental Health Care in Australia: Findings from the National Survey of Mental Health and Wellbeing

2002 ◽  
Vol 36 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Graham Meadows ◽  
Bruce Singh ◽  
Philip Burgess ◽  
Irene Bobevski
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
National Survey ◽  
Adult Population ◽  
Psychiatric Services ◽  
Care Providers ◽  
Perceived Needs ◽  
Health And Wellbeing

Objective: This paper describes the pattern of consultations reported with psychiatrists and primary mental health care providers in the Australian adult population. It explores whether inequalities found in utilization of psychiatric services according to area are different in degree from inequalities in utilization of medical and surgical specialists, and describes the meeting of perceived needs for mental health care within those seen by psychiatrists. Method: The National Survey of Mental Health and Wellbeing (NSMHW) was a community survey employing clustered probability sampling, with a computerized field questionnaire which included sections of the composite international diagnostic interview (CIDI), as well as self-reported service utilization and perceived needs for care. Results: By survey estimates, 1.8% of the Australian population consulted a psychiatrist in the last year. Among people with an ICD 10-diagnosed mental disorder, 7.3% consulted a psychiatrist. Only about one in five people seen by a psychiatrist report the psychiatrist as the only mental health care provider. Disadvantaged areas of the cities and remote areas, when compared with the least deprived areas of the cities, showed lower rates of utilization. This effect is stronger in psychiatry than in other specialities. Patients seeing psychiatrists seem to be a more satisfied group than those seeing only other providers; nonetheless, some needs are not well met, and the role of the psychiatrist cannot be isolated as the cause of this satisfaction. Conclusions: Most care delivered by psychiatrists is de facto shared care. Psychiatrists as clinical professionals need to be continually mindful of the need to communicate with others providing care. Psychiatric services in Australia are not delivered in an equitable manner, and the inequalities are greater for psychiatric services than for other medical specialities.

Impact of socioeconomic position and distance on mental health care utilization by incident users of antidepressants. A Danish nationwide follow-up study

2017 ◽  
Vol 41 (S1) ◽  
pp. S341-S341
Author(s):  
A. Packness ◽  
F. Waldorff ◽  
L. Hastrup ◽  
E. Simonsen ◽  
M. Vestergaard ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Mental Health Care ◽  
Psychiatric Services ◽  
Equal Access ◽  
Care Utilization ◽  
Follow Up Study ◽  
Mental Health Care Utilization

IntroductionEqual access to health care treatment is a highly prioritized goal in most OECD countries. Timely access has become a priority too; in Denmark now with a 4-week deadline from referral to diagnosis. When mental health services become more centralized and allocation of patients to treatment further away from home become more common, it could have a negative impact on the goal of equal access.ObjectiveTo determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.MethodA nationwide, Danish, register based, follow-up study on frequencies of contacts to out-patient psychiatric services, psychologist consultations supported by public funding and therapeutic talks by general practice.Preliminary resultsOutpatient-psychiatric services were reached more often by patients in low SEP measured by income, but their frequencies of visits were less. Contacts to psychologists were less than half for patients in low SEP and less frequent too. Mental health service by GP showed low SEP associated with low contact. No difference in use of emergency or inpatient psychiatric services was found. Distance to provider showed interaction with SEP and contact to psychologist and frequencies of contact to outpatient psychiatrists. When distance increased by 5 km, contact to psychologist fell by 11% among lowest income group and frequencies of visits to outpatient psychiatrist fell by 5%.Preliminary conclusionLower SEP is associated with lower mental health care utilization. Increased distance to provider increases inequity in mental health service utilization.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Cross-Sectional Study of Private Psychiatric Practices under a Single-Payer Health Care System

1997 ◽  
Vol 42 (4) ◽  
pp. 395-401 ◽  
Author(s):  
Keith Anderson ◽  
Alistair Catterson ◽  
Michael Gaudet ◽  
Mamta Gautam ◽  
Peter J Kerr ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care System ◽  
Low Income ◽  
Universal Access ◽  
Psychiatric Services ◽  
Single Payer ◽  
Axis I ◽  
Care System

Objectives: To examine current concerns that in the Canadian single-payer mental health care system, the “rich worried well” (that is, wealthy individuals who are worried yet mentally well) may overuse psychiatric services, while low-income, uninsured mentally ill individuals may remain undertreated. The current study focuses on the mental health care in the Canadian region of Ottawa-Carleton, where a single-payer system provides universal access to mental health services, to assess how psychiatric services are provided by psychiatrists in private practice. Method: One hundred and seven private psychiatrists working in the region of Ottawa-Carleton completed a questionnaire which contained questions about the sociodemographic characteristics and background of the psychiatrists themselves and which asked the psychiatrists specific questions about the sociodemographic status, diagnosis, and treatment of each patient seen on November 10, 1994. Results: Approximately 93% of the patients seen met criteria for one or more Axis I disorders, of which mood and anxiety disorders were the most common. Wealthier patients were relatively underrepresented among the patients treated by the private psychiatrists. In addition, we found no significant differences in the distribution of Axis I, Axis II, and Axis III disorders between patients earning below $30 000 per year compared with patients earning above $60 000 per year. Conclusions: Our results suggest that outpatient psychiatric care delivered by private psychiatrists in a Canadian single-payer system targets primarily individuals with major psychiatric disorders and does not seem to favour “the worried well.” Larger epidemiological studies with independent assessments of psychiatric populations are necessary to confirm our findings.

Clinicians’ perceptions of the Australian Paediatric Mental Health Service System: Problems and solutions

2021 ◽  
pp. 000486742098424
Author(s):  
Kate Paton ◽  
Lynn Gillam ◽  
Hayley Warren ◽  
Melissa Mulraney ◽  
David Coghill ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health System ◽  
General Practitioners ◽  
Child And Adolescent ◽  
Developed Countries ◽  
Optimal System ◽  
Wait Times ◽  
High Quality

Objectives: Despite substantial investment by governments, the prevalence of mental health disorders in developed countries remains unchanged over the past 20 years. As 50% of mental health conditions present before 14 years of age, access to high-quality mental health care for children is crucial. Barriers to access identified by parents include high costs and long wait times, difficulty navigating the health system, and a lack of recognition of the existence and/or severity of the child’s mental health disorder. Often neglected, but equally important, are clinician views about the barriers to and enablers of access to high-quality mental health care. We aimed to determine perspectives of Australian clinicians including child and adolescent psychiatrists, paediatricians, psychologists and general practitioners, on barriers and enablers within the current system and components of an optimal system. Methods: A total of 143 clinicians (approximately 35 each of child and adolescent psychiatrists, paediatricians, child psychologists and general practitioners) from Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings: Clinician-identified barriers included multi-dimensional family factors, service fragmentation, long wait times and inadequate training for paediatricians and general practitioners. Rural and regional locations provided additional challenges but a greater sense of collaboration resulting from the proximity of clinicians in rural areas, creating an opportunity to develop support networks. Suggestions for an optimal system included novel ways to improve access to child psychiatry expertise, training for paediatricians and general practitioners, and co-located multidisciplinary services. Conclusion: Within the current mental health system for children, structural, training and workforce barriers prevent optimal access to care. Clinicians identified many practical and systemic ideas to improve the system. Implementation and evaluation of effectiveness and cost effectiveness of these ideas is the next challenge for Australia’s children’s mental health.

scholarly journals Continuing Care for Mentally Stable Psychiatric Patients in Primary Care: Patients' Preferences and Views

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Vincent I. O. Agyapong
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Health Centre ◽  
Psychiatric Services ◽  
Community Mental Health Centre

Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.

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