Reducing hospitalisation among people living with severe mental illness

2016 ◽  
Vol 40 (2) ◽  
pp. 124 ◽  
Author(s):  
Shannon McDermott ◽  
Jasmine Bruce ◽  
Kristy Muir ◽  
Ioana Ramia ◽  
Karen R. Fisher ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Small Sample ◽  
Supported Housing ◽  
Health Records ◽  
Individual Level ◽  
Over Time

Objective People with severe mental illness have high rates of hospitalisation. The present study examined the role that permanent housing and recovery-oriented support can play in reducing the number and length of psychiatric hospital admissions for people with severe mental illness. Methods The study examined de-identified, individual-level health records of 197 people involved in the New South Wales Mental Health Housing and Accommodation Support Initiative (HASI) to compare changes in hospitalisation over a continuous 4-year period. Results On average, HASI consumers experienced significant reductions in the number of psychiatric hospital admissions and length of stay after entering the HASI program, and these reductions were sustained over the first 2 years in HASI. Male consumers and consumers under 45 years of age experienced the largest reductions in the number and length of hospital admissions. Conclusions The findings of the present study add support to the hypothesis that supported housing and recovery-oriented support can be effective approaches to reducing hospital admissions for people with chronic mental illness, and that these changes can be sustained over time. What is known about this topic? People living with severe mental illness are heavy users of health and hospitalisation services. Research into the effects of partnership programs on preventing unnecessary admissions is limited because of short periods of comparison and small sample sizes. What does this paper add? The present study extends previous research by analysing de-identified individual-level health records over a continuous 4-year period and showing that reductions in hospitalisation among people with severe mental illness can be sustained over time. What are the implications for practitioners? These findings provide further evidence that community-based recovery-oriented supported housing programs can assist consumers to manage their mental health and avoid hospital admissions. Although the provision of recovery-oriented community services requires an investment in community mental health, the reduction in consumers’ use of hospital services makes this investment worthwhile.

scholarly journals Supported Housing as a recovery option for long-stay patients with severe mental illness in a psychiatric hospital in South India: Learning from an innovative de-hospitalization process

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0230074
Author(s):  
Archana Padmakar ◽  
Emma Emily de Wit ◽  
Sagaya Mary ◽  
Eline Regeer ◽  
Joske Bunders-Aelen ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
South India ◽  
Supported Housing

scholarly journals Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048341
Author(s):  
Milena Falcaro ◽  
David Osborn ◽  
Joseph Hayes ◽  
Gary Coyle ◽  
Lisa Couperthwaite ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Smoking Cessation ◽  
Cohort Study ◽  
Severe Mental Illness ◽  
Smoking Status ◽  
Smoking Cessation Advice ◽  
Quit Attempts ◽  
Over Time

ObjectivesTo investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without.DesignLongitudinal cohort study using primary healthcare records.SettingEnglish primary care.Participants882 849 patients registered with participating practices recorded as current smokers during 2007–2014, including three groups: (1) 13 078 with SMI, (2) 55 630 with no SMI but recent depression and (3) 814 141 with no SMI nor recent depression.OutcomesRecorded advice to quit smoking, referrals to smoking cessation services, prescriptions for smoking cessation medication, recorded quit attempts and changes of smoking status.ResultsThe majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups. Bupropion and varenicline prescribing was very low and lower for those with SMI. Few smokers (<5%) had referrals to stop smoking services, though this increased over time, but no significant differences were observed between those with and without mental health problems.ConclusionsThere was no evidence of consistent inequalities in access to GP-delivered smoking cessation interventions for people with mental health conditions. Smoking cessation advice was widely reported as taking place in all groups. In order to address the widening gap in smoking prevalence in those with poor mental health compared with those without, the emphasis should be on addressing the quality of advice and support given.

Which Type Of Management Is Most Suited For Patients With A Diagnosis Of False Self Personality (FSP) Within A Psychodynamically-Oriented Institutional Day Hospital? A Study

2016 ◽  
Vol 33 (S1) ◽  
pp. S530-S530
Author(s):  
G. Giorgio ◽  
F. Marmo
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Hospital Admissions ◽  
Small Sample ◽  
Good Effect ◽  
Data Sets ◽  
Day Hospital ◽  
Psychodynamically Oriented ◽  
Competing Interest ◽  
Different Response

IntroductionOur work team have already found that our Institutional Psychiatric Open Light Treatment (IPOLT) model allows the patient affected by severe mental illness (SMI) to more easily express her/his personal coping skills rather than behaving passively thanks to the “real free spaces” separating a structured intervention from another. Our work consisted in evaluating how patients with FSP respond to IPOLT.ObjectivesThis paper describes observations of psychotic patients operating from the position of FSP in order to evaluate how they respond to IPOLT compared with other patients according to three standards (day hospital attendance, psychotic episodes and hospital admissions).AimsIdentify the core factors for management of patients with FSP in the context of IPOLT.MethodsWe isolated a sample including patients affected by severe mental illness (SMI); within this sample, we selected a small group of patients with FSP. During the last three years, we have been evaluating patients with FSP in terms of day hospital attendance, number of psychotic episodes and number of hospital admissions compared with data obtained from other patients with SMI without diagnosis of FSP.ResultsThe two data sets revealed no statistically significant differences in terms of the three standards.ConclusionsOur preliminary study showed a good effect for IPOLT treatment on patients with SMI. We expected that patients affected by SMI with FSP would have a different response to IPOLT, but it was not. We do not know whether such results depend on a too small sample of patients or inappropriate descriptors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The physical health of Māori with bipolar disorder

2020 ◽  
Vol 54 (11) ◽  
pp. 1107-1114
Author(s):  
Ruth Cunningham ◽  
James Stanley ◽  
Tracy Haitana ◽  
Suzanne Pitama ◽  
Marie Crowe ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Hospital Admissions ◽  
Risk Of Death ◽  
Death From Natural Causes

Aims: There is very little empirical evidence about the relationship between severe mental illness and the physical health of Indigenous peoples. This paper aims to compare the physical health of Māori and non-Māori with a diagnosis of bipolar disorder in contact with NZ mental health services. Methods: A cohort of Māori and non-Māori with a current bipolar disorder diagnosis at 1 January 2010 were identified from routine mental health services data and followed up for non-psychiatric hospital admissions and deaths over the subsequent 5 years. Results: Māori with bipolar disorder had a higher level of morbidity and a higher risk of death from natural causes compared to non-Māori with the same diagnosis, indicating higher levels of physical health need. The rate of medical and surgical hospitalisation was not higher among Māori compared to non-Māori (as might be expected given increased health needs) which suggests under-treatment of physical health conditions in this group may be a factor in the observed higher risk of mortality from natural causes for Māori. Conclusion: This study provides the first indication that systemic factors which cause health inequities between Māori and non-Māori are compounded for Māori living with severe mental illness. Further exploration of other diagnostic groups and subgroups is needed to understand the best approach to reducing these inequalities.

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 Attitudes of patients with severe mental illness towards COVID-19 vaccinations: A preliminary report from a public psychiatric hospital

2021 ◽  
Vol 143 ◽  
pp. 16-20
Author(s):  
Renana Danenberg ◽  
Sharon Shemesh ◽  
Dana Tzur Bitan ◽  
Hagai Maoz ◽  
Talia Saker ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Preliminary Report

scholarly journals A Taxonomy for Homework Used by Mental Health Case Managers When Working with Individuals Diagnosed with Severe Mental Illness

2007 ◽  
Vol 43 (6) ◽  
pp. 565-581 ◽  
Author(s):  
Peter J. Kelly ◽  
Frank P. Deane ◽  
Robert King ◽  
Nikolaos Kazantzis ◽  
Trevor P. Crowe
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Case Managers

scholarly journals Access to public mental health services among older adults with severe mental illness

2009 ◽  
Vol 24 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Todd P. Gilmer ◽  
Victoria D. Ojeda ◽  
Dahlia Fuentes ◽  
Viviana Criado ◽  
Piedad Garcia
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Public Mental Health ◽  
Public Mental Health Services
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