Consultant psychiatrists' experiences and attitudes following the introduction of the Mental Health Act 2001: a national survey

2009 ◽  
Vol 26 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Brian O'Donoghue ◽  
Paul Moran
Keyword(s):  
Mental Health ◽  
Substance Misuse ◽  
Response Rate ◽  
Child And Adolescent Psychiatry ◽  
Postal Survey ◽  
Junior Doctors ◽  
Mental Health Act ◽  
The Republic ◽  
Similar Risk

AbstractObjective: This study explored the attitudes and experiences of consultant psychiatrists regarding the Mental Health Act 2001.Method: A postal survey was distributed to all consultant psychiatrists (n=238) in the Republic of Ireland. All specialties were included except Child and Adolescent Psychiatry.Results: A response rate of 70% was achieved. Care of involuntarily admitted patients has improved according to 32%, but 48% found that the care of voluntary patients has deteriorated. Sixty-nine per cent of consultant psychiatrists acknowledge that involuntarily admitted patients are being changed to voluntary early to avoid a tribunal, and 21 % believe it occurs in over 40% of cases. Fourteen per cent of consultant psychiatrists have re-admitted a patient involuntarily immediately after a tribunal revoked the original Involuntary Order. Junior doctors' training by consultant psychiatrists has been reduced in 57% of placements as a result of the increased demands of the MHA 2001. Eighty-seven per cent report an increase in their on call service workload but only 23% report a sufficient increase in the number of consultants within their service. While 78% agree that patients should not be admitted involuntarily solely on the grounds that the person is suffering from a personality disorder, 58% feel that there is a risk in such patients not being involuntarily admitted in situations in which it is clinically necessary. Fifty-six per cent feel that there is a similar risk in patients with a diagnosis of substance misuse.Conclusion: Resources required to implement the Mental Health Act 2001 have not been sufficient leading to poorer quality of service and negatively affecting NCHDs training.

scholarly journals Comparison of quality of life outcomes following different mastoid surgery techniques

2015 ◽  
Vol 129 (9) ◽  
pp. 835-839 ◽  
Author(s):  
J Joseph ◽  
A Miles ◽  
S Ifeacho ◽  
N Patel ◽  
A Shaida ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Response Rate ◽  
Chronic Otitis Media ◽  
Postal Survey ◽  
Life Outcomes ◽  
Subjective Change ◽  
Glasgow Benefit Inventory ◽  
Significant Difference ◽  
Mastoid Surgery

AbstractBackground:Mastoid surgery carried out to treat chronic otitis media can lead to improvement in objective and subjective measures post-operatively. This study investigated the subjective change in quality of life using the Glasgow Benefit Inventory relative to the type of mastoid surgery undertaken.Method:A retrospective multicentre postal survey of 157 patients who underwent mastoid surgery from 2008 to 2012 was conducted.Results:Eighty-three questionnaire responses were received from patients who underwent surgery at one of three different hospitals (a response rate of 53 per cent). Fifty-seven per cent of patients had a Glasgow Benefit Inventory score of 0, indicating no change in quality of life post-operatively. Thirty-five per cent scored over 50, indicating significant improvement. The only significant difference found was that women fared worse after surgery than men.Conclusion:The choice of mastoid surgery technique should be determined by clinical need and surgeon preference. There is no improvement in quality of life for most patients following mastoid surgery.

scholarly journals The psychiatry virtual-on-call experience: Can it improve confidence of foundation and GP trainees with out-of-hours work in psychiatry?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S28-S29
Author(s):  
Charlotte Harrison ◽  
Helen Blamey ◽  
Alistair Roddick ◽  
Kate Saunders ◽  
Tina Malhotra
Keyword(s):  
Mental Health ◽  
Interpersonal Communication ◽  
Multiple Testing ◽  
Learning Experience ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Mental Health Act ◽  
Telephone Advice ◽  
Introductory Lecture ◽  
Perceived Preparedness

AimsOut-of-hours (‘on-call’) work can be perceived by junior doctors to be a daunting experience, associated with feeling unprepared and less supported. Simulated on-call programmes have been used to great effect in medicine and surgery to improve junior doctors’ skills in task prioritisation, interpersonal communication and confidence on-call. However, few psychiatry-specific programmes exist.We aimed to: i) Develop a psychiatry specific virtual-on-call programme, ii) Investigate if the virtual-on-call programme improved confidence amongst junior trainees in key areas of psychiatry practice.MethodThe Psychiatry Virtual-On-Call programme commenced in December 2020. It involves attending an introductory on-call lecture, followed later in the rotation by a 2-hour simulated on-call shift. All trainees are expected to attend during their attachment and the simulated shifts are ongoing. During the shift, trainees are ‘bleeped’ with different psychiatry specific tasks. They work through the tasks, using local intranet policies and telephone advice from the on-call psychiatry registrar. Due to COVID-19 the sessions were delivered virtually. Participants completed a questionnaire evaluating confidence in ten domains, rated on a Likert scale from 0–10. Questionnaires were completed at four time-points during the programme; pre- and post-introductory lecture and pre- and post-simulated shift. Scores were compared using Mann-Whitney U tests. Significance was defined as P < 0.05 with Bonferroni correction applied for multiple testing.ResultTwenty-nine trainees attended the introductory lecture, 25 and 21 trainees completed the pre- and post-lecture questionnaire respectively. A non-significant improvement in confidence was reported in three domains: seclusions reviews, prescribing, detention under the mental health act.At the time of writing, ten trainees had attended the on-call shift. All participants completed a pre- and post-session questionnaire. The on-call shift was a useful learning experience (median score 9), and significantly increased perceived preparedness for on-call work from 3/10 to 7/10 (p < 0.001). Confidence was significantly improved in seven domains, most markedly in seclusion reviews, prescribing and mental health act tasks.ConclusionThe psychiatry virtual-on-call programme fills a niche in the training curriculum and is perceived by trainees to be a useful learning experience. The introductory lecture improved confidence in several domains, but not as effectively as the on-call shift. The on-call shift was well received by participants and significantly improved confidence in 7/10 domains. In summary, the virtual-on-call experience improves preparedness for out-of-hours psychiatry work. Follow-up of participants at the end of their psychiatry rotation will ascertain if they felt the programme to be useful during out-of-hours work.

scholarly journals Junior doctors in their first year: mental health, quality of life, burnout and heart rate variability

2013 ◽  
Vol 3 (2) ◽  
pp. 136-143 ◽  
Author(s):  
Marcus A. Henning ◽  
John Sollers ◽  
Joanna M. Strom ◽  
Andrew G. Hill ◽  
Mataroria P. Lyndon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
First Year ◽  
Junior Doctors ◽  
Health Quality ◽  
Health Quality Of Life

scholarly journals Forward Feeding in Graduate Medical Education: Results of a National Survey

2019 ◽  
Vol 51 (4) ◽  
pp. 326-330 ◽  
Author(s):  
Alexei O. DeCastro ◽  
Lisa D. Mims ◽  
Mark B. Stephens ◽  
Alexander W. Chessman
Keyword(s):  
Mental Health ◽  
Early Identification ◽  
Overall Response Rate ◽  
Response Rate ◽  
Clinical Performance ◽  
Program Directors ◽  
Residency Programs ◽  
And Performance ◽  
Types Of Information

Background and Objectives: “Forward feeding” is defined as the sharing of information regarding learner behaviors and performance outside of formal institutional committee structures. The purpose of this study was to establish baseline opinions and policies of forward feeding in family medicine residency programs. Methods: Data for this study were obtained as part of the 2015 CERA Program Directors Fall Survey. Program directors indicated whether they felt that faculty should and do engage in forward feeding. Respondents were asked to rate the importance of various types of information about learners (academic performance, clinical performance, professionalism, physical health, and mental health), reasons for promoting, and concerns regarding forward feeding on a 5-point Likert scale. Results: The overall response rate was 49% (227/461). Most agreed that faculty should (87%) and do (83%) engage in forward feeding. Concerns regarding professionalism and clinical performance were reported as most important to share. The most important reason identified for forward feeding was the early identification of struggling residents, followed by the ability to direct teaching to the resident’s specific needs, and improving the quality of feedback. Fear of creating bias was the most commonly cited concern for engaging in forward feeding, followed by fear of violating confidentiality and difficulty maintaining confidentiality. Fear of litigation was the least common concern. Conclusions: Despite concerns, the majority of program directors feel that faculty should and do engage in forward feeding. Our study confirms the importance of clinical performance and professionalism as two important themes of information shared by attendings about residents.

scholarly journals Factors Impacting the Implementation of a Psychoeducation Intervention Within the Mental Health System: a Multisite Study Using the Consolidation Framework for Implementation Research

2020 ◽  
Author(s):  
Agnes Higgins ◽  
Rebecca Murphy ◽  
Carmel Downes ◽  
Jennifer Barry ◽  
Mark Monahan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Implementation Research ◽  
Mental Health System ◽  
Full Range ◽  
National Policy ◽  
Evidence Base ◽  
Successful Implementation ◽  
The Republic

Abstract Background Despite a strong evidence base and policy recommendation supporting the implementation of psychoeducation interventions within the mental health system, equitable access for many service users and family members has not been achieved. To enhance translation, developing an evidence-base around the factors that influence implementation of interventions is critical.Methods The aim of the study was to explore the factors influencing implementation of a group cofacilitated recovery focused psychoeducation intervention. The study design was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews with key stakeholders (n=75) involved with the implementation within 14 mental health sites in the Republic of Ireland. The Consolidation Framework for Implementation Research (CFIR) was used as a conceptual framework to guide data collection and analysis. Results Key enablers and barriers were identified across all CFIR domains of the framework with some factors (depending on context) being both an enabler and a barrier. National policy; structural stability with national systems; leadership at all levels; peer payment system; local champions and support from multidisciplinary team members; evidence strength and quality of the programme design; availability of resources; referral pathways; knowledge, beliefs and self-efficacy of facilitators, as well as local culture influenced implementation. While some were specific to the programme, many barriers reflected systemic and structural challenges within health services more generally. Conclusion: Findings from this study provide an enhanced understanding of the different layers of determinants to implementation of an intervention. Overcoming challenges will involve positive and ongoing engagement and collaboration across the full range of stakeholders that are active within each domain, including policy and operational levels. The quality of leadership at each domain level is of crucial importance to successful implementation.

scholarly journals Availability and acceptability of home treatment for acute psychiatric disorders

2000 ◽  
Vol 24 (5) ◽  
pp. 169-171 ◽  
Author(s):  
Andrew J. Owen ◽  
S. P. Sashidharan ◽  
Lyse J. Edwards
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
Home Treatment ◽  
Clinical Implications ◽  
Health Authorities ◽  
Low Levels ◽  
The Uk ◽  
Do So ◽  
Future Plans

Aims and MethodsTo ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.ResultsOne hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.Clinical ImplicationsDespite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.

scholarly journals The supervision register: one year on

1996 ◽  
Vol 20 (3) ◽  
pp. 143-145 ◽  
Author(s):  
Phillip J. Vaughan
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
First Year ◽  
Regional Health ◽  
Adult Mental Health ◽  
Health Authorities ◽  
Regional Health Authorities ◽  
One Year

A postal survey was conducted within four regional Health Authorities to ascertain how widely the supervision register had been applied in its first year of operation in adult mental health. A 72% response rate was achieved. The results showed that the register has been absorbed organisationally but is less accepted professionally. One hundred and nineteen of the 367 consultants in the sample (32%) had no entries on the register at 31st March 1995. The provision of training on its use had a significant effect on compliance, although London-based services had marginally less registrations per consultant than their colleagues elsewhere. Very few outside agencies had required access to the register.

Mental health review tribunal medical reports

1998 ◽  
Vol 22 (10) ◽  
pp. 615-618 ◽  
Author(s):  
Khalida Ismail ◽  
Shubulade Smith ◽  
Tony Maden
Keyword(s):  
Mental Health ◽  
Forensic Psychiatry ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Mental Health Act ◽  
Acceptable Standard ◽  
Medical Reports ◽  
Health Review

Aims and methodMedical reports submitted to mental health review tribunals should be of a clinically acceptable standard. We examined 100 medical reports to assess whether they stated the four criteria for detention under Section 3 of the Mental Health Act 1983. We compared the standard of reports according to the seniority, qualifications and speciality of the doctor, and with the outcome from the tribunal.ResultsThe majority of the reports were written by junior doctors and did not fulfil the criteria laid down by the Mental Health Act 1983. Consultant and forensic psychiatry status were associated with completed reports.Clinical implicationsThis study was performed in one hospital only but highlights the ongoing need to review and improve the workings of the Mental Health Act before reform is considered.

scholarly journals Mental Health Issues Someone Who Has Divorce

2020 ◽  
Author(s):  
Andria Pragholapati
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Disorders ◽  
Well Being ◽  
Health Issues ◽  
Mental Health Issues ◽  
The Law ◽  
The Republic

Mental health is a state of well-being associated with happiness, joy, satisfaction, achievement,optimism, or hope. While mental disorders are behavioral or psychological patterns that areshown by individuals that cause distress, dysfunction, and reduce the quality of life (Stuart,2013). Based on the Law of the Republic of Indonesia Number 18 Year 2014, mental health is acondition where an individual can develop physically, mentally, spiritually, and socially so thatthe individual is aware of his own abilities, can deal with stress, can work productively, and isable to contribute to the community.

scholarly journals A time to keep silent and a time to speak

1999 ◽  
Vol 23 (12) ◽  
pp. 705-706
Author(s):  
A. S. Zigmond
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Work Load ◽  
Final Report ◽  
Scoping Study ◽  
Mental Health Act ◽  
Study Committee ◽  
Mental Health Legislation ◽  
Burn Out ◽  
Health Legislation

The final report of the Scoping Study Committee (Richardson Committee) reviewing the Mental Health Act 1983 is eagerly awaited. All psychiatrists, either individually or through the College, had an opportunity to express their views on what changes in legislation are needed and to comment on the draft proposals (Scoping Study Committee, 1999). Many psychiatrists did neither. Yet to use modem terminology, psychiatrists are one of the major ‘stakeholders' of mental health legislation. A valuable way of ascertaining colleagues' views in a structured way is by surveys of the type conducted by Buchanan & Gunn (1999, this issue). Given that the Richardson Committee has yet to publish proposals for ‘Part III’ the survey is timely. The response rate is, of course, very important and one is left wondering why a third of the general and community psychiatrists did not respond. Work load, burn-out or lack of familiarity with Part III of the Act are possible explanations.

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