A retrospective case comparison study of the relationship between an Integrated Care Pathway for people diagnosed with schizophrenia in acute mental health care and service users’ length of stay, readmission rates and follow-up within 7 days of discharge

2017 ◽  
Vol 24 (6) ◽  
pp. 348-357 ◽  
Author(s):  
J. Attfield ◽  
S. Brown ◽  
T. Carter ◽  
P. Callaghan
Keyword(s):  
Mental Health ◽  
Care Pathway ◽  
Service Users ◽  
Comparison Study ◽  
Retrospective Case ◽  
Readmission Rates ◽  
Case Comparison ◽  
Integrated Care Pathway ◽  
The Relationship

Is Everything in the Garden Rosy? An Integrated Care Pathway for Acute Inpatient Mental Health Care, from Development to Evaluation: Part 2

2005 ◽  
Vol 9 (3) ◽  
pp. 101-105
Author(s):  
Robert Grant ◽  
Julie Hall ◽  
Roger Pritlove
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Integrated Care ◽  
Care Pathway ◽  
Service Users ◽  
Inpatient Mental Health ◽  
Integrated Care Pathway ◽  
Health Care Records ◽  
The Impact

This is the second paper of two, which considers the development, use and evaluation of an integrated care pathway (ICP) for acute inpatient mental health care. This paper reports an evaluation that was carried out to measure the impact of an ICP (described in Part 1) on the interventions it was designed to guide. The methodology used was pre- and post-ICP comparison of activities/care recorded in health-care records using delineating measures. Data were gathered from the notes of 23 service-users who had two inpatient stays within a year, one pre-ICP and one post-ICP. The findings suggested an overall improved provision of interventions, although as the ICP progressed the likelihood of receiving interventions fell. Three specific aspects were not affected by the ICP, these were giving information about observation levels to service-users, care planning and medical interventions. These issues are discussed and the conclusion raise implications for further ICP development and implementation.

scholarly journals A comparison of clinical outcomes, service satisfaction, and well-being in people using Acute Day Units and Crisis Resolution Teams: a cohort study in England

2020 ◽  
Author(s):  
Danielle Lamb ◽  
Thomas Steare ◽  
Louise Marston ◽  
Alastair Canaway ◽  
Sonia Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Care Pathway ◽  
Well Being ◽  
Service Users ◽  
Mental Health Crisis ◽  
Crisis Resolution ◽  
Readmission Rates ◽  
Health Crisis ◽  
Crisis Resolution Teams

AbstractBackgroundFor people in mental health crisis, Acute Day Units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to Crisis Resolution Teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly in comparison to those receiving CRT care alone.AimsTo investigate readmission rates, satisfaction, and wellbeing outcomes for ADU and CRT service users.MethodsA cohort study comparing readmission to acute mental health care during a six-month period for ADU and CRT participants. Secondary outcomes included satisfaction (CSQ), wellbeing (SWEMWBS), and depression (CES-D).ResultsWe recruited 744 participants (ADU: 431, 58%; CRT 312, 42%) across 4 NHS Trusts/health regions. There was no statistically significant overall difference in readmissions; 21% of ADU participants (versus 23% CRT) were readmitted over 6 months (adjusted HR 0.78, 95%CI 0.54, 1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire (CSQ) scores (2.5, 95% CI 1.4 to 3.5, p<0.001) and wellbeing scores (1.3, 95%CI 0.4 to 2.1, p=0.004), and lower depression scores (−1.7, 95%CI −2.7 to −0.8, p<0.001) than CRT participants.ConclusionsService users who accessed ADUs demonstrated better outcomes for satisfaction, wellbeing, and depression, and no significant differences in risk of readmission compared to those who only used CRTs. Given the positive outcomes for service users, and the fact that ADUs are inconsistently provided across the country, their value and place in the acute care pathway needs further consideration and research.

Relationship Between Mental Health, Resilience, and Physical Activity in Older Adults: A 2-Year Longitudinal Study

2021 ◽  
pp. 1-9
Author(s):  
Maria Priscila Wermelinger Ávila ◽  
Jimilly Caputo Corrêa ◽  
Alessandra Lamas Granero Lucchetti ◽  
Giancarlo Lucchetti
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Regression Models ◽  
Linear Regression Models ◽  
Physically Active ◽  
Effective Interventions ◽  
Self Sufficiency ◽  
The Relationship

The aim of this study was to longitudinally investigate the association between resilience and mental health in older adults and to determine the influence of physical activity on this relationship. A total of 291 older adults were included in a 2-year follow-up study. Adjusted linear regression models evaluated the association between resilience at baseline and mental health after 2 years in sufficiently and insufficiently physically active older adults. A negative correlation was found between resilience at baseline and depression, anxiety, and stress after 2 years for the overall sample. This association changed after stratifying the group. Sufficiently physically active individuals made greater use of the resilience components “Self-Sufficiency” and “Perseverance,” whereas insufficiently physically active individuals made greater use of “Meaning of Life” and “Existential Singularity.” Physical activity can influence the relationship between resilience and mental health. These results can help guide the devising of more effective interventions for this age group.

The relationship between exclusion from school and mental health: a secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007

2017 ◽  
Vol 48 (4) ◽  
pp. 629-641 ◽  
Author(s):  
T. Ford ◽  
C. Parker ◽  
J. Salim ◽  
R. Goodman ◽  
S. Logan ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Psychiatric Disorder ◽  
Health Surveys ◽  
Secondary Analysis ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The Impact ◽  
The Relationship

BackgroundChildren with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded.MethodPsychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress.ResultsExclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up.ConclusionsWe detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.

The relationship between disability and suicide: prospective evidence from the Ten to Men cohort

2018 ◽  
Vol 41 (4) ◽  
pp. 707-713 ◽  
Author(s):  
Allison Milner ◽  
Anne-Marie Bollier ◽  
Eric Emerson ◽  
Anne Kavanagh
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
People With Disabilities ◽  
Cross Sectional ◽  
Longitudinal Cohort ◽  
The Past ◽  
The Relationship

Abstract Background People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. Methods We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. Results After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Conclusions Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.

scholarly journals A randomized study of a smartphone application compared with booklet to improve service user’s knowledge of their legal rights

2017 ◽  
Vol 34 (4) ◽  
pp. 287-293
Author(s):  
B. O’Donoghue ◽  
E. Roche ◽  
A. Naji ◽  
R. Daly ◽  
K. Madigan ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Affective Disorder ◽  
Randomized Study ◽  
Smartphone Application ◽  
Legal Rights ◽  
Service Users ◽  
Information Booklet ◽  
Paper Form ◽  
The Mean

BackgroundThe Mental Health Act 2001 has introduced significant changes to the process of admission to hospital for individuals affected by mental health disorders. This study aimed to determine whether a newly designed smartphone application could result in an improvement in service users’ knowledge of their rights compared with the paper booklet.MethodsThis was a randomized study conducted in an outpatient and day-hospital in North Dublin. Participants were randomized to receive the information booklet as either a smartphone application or in the paper form. A questionnaire which was scored from 0 to 10 was devised and was completed at baseline and at 1-week follow-up.ResultsA total of 42 individuals completed the baseline and follow-up questionnaire and of these, 53.7% were female and the mean age was 38.2 years (s.d.±13.5). A total of 34.1% had a diagnosis of a psychotic disorder, 29.3% had a depressive disorder and 22% had bipolar-affective disorder. The mean score before the intervention in the total group was 3.5 (s.d.±2.2) and this increased to 5.8 (s.d.±2.2) at follow-up. Participants randomized to the smartphone application improving by a mean of 2.5 (s.d.±2.5), while those randomized to the booklet improving by a mean of 2.3 (s.d.±2.6), which was not statistically significant.ConclusionsBoth forms of the information booklet showed improvement in service users’ knowledge of their legal rights. It is possible that each individual will have preference for either a paper form or a smartphone form and this study suggests that both forms should be offered to each individual service user.

scholarly journals Understanding the Relationship Between Physical Therapist Participation in Interdisciplinary Rounds and Hospital Readmission Rates: Preliminary Study

2016 ◽  
Vol 96 (11) ◽  
pp. 1705-1713 ◽  
Author(s):  
Zahra Kadivar ◽  
Alexis English ◽  
Brian D. Marx
Keyword(s):  
Physical Therapists ◽  
Physical Therapist ◽  
Interdisciplinary Team ◽  
Small Sample ◽  
Discharge Process ◽  
Readmission Rates ◽  
Medical Diagnoses ◽  
Discharge Disposition ◽  
The Relationship

Abstract Background Providing patients with optimal discharge disposition and follow-up services could prevent unplanned readmissions. Despite their qualifications, physical therapists are rarely represented on the interdisciplinary team. Objective This study aimed to determine the relationship between the participation of physical therapists in interdisciplinary discharge rounds and readmission rates. Methods In this retrospective observational study, patients discharged by 2 interdisciplinary teams with or without a physical therapist's participation were followed for 5 months. Adherence to the physical therapist's recommendations for follow-up services and unplanned 30-day readmissions were tracked. Multiple logistic regression and random forest models were used to determine factors contributing to 30-day readmission rates. Results The odds of 30-day readmissions were 3.78 times greater when a physical therapist was absent from the interdisciplinary team compared with the odds of 30-day readmissions when a physical therapist participated in the interdisciplinary team. In addition, the odds of 30-day readmission for patients discharged to their home were 2.47 times greater than those who were not discharged to their home. An increased lack of postdischarge services was noted when a physical therapist was not included in the interdisciplinary team. Limitations The nonrandom selection of patients into groups, the small sample size, and the inability to adjust risk for unknown factors (eg, medical diagnoses, comorbidities, funding, and functional measures) limited interpretation of the results. Conclusion Significantly higher readmission rates were noted for patients whose interdisciplinary team did not have a physical therapist and for those patients who were discharged to their home. These preliminary findings suggest that discharge from the acute care setting is an elaborate process and should be designed carefully. In order to identify the optimal discharge process, future research should account for patient complexities in addition to the composition of the interdisciplinary discharge team.

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