scholarly journals Serving meals and mopping floors: the consultant psychiatrist working differently during the covid-19 pandemic

BMJ ◽  
2020 ◽  
pp. m2218
Author(s):  
Marika Davies
Keyword(s):  
Consultant Psychiatrist

Comment: ‘Devining’ The Role of the Consultant Psychiatrist in a Public Mental Health Service

1998 ◽  
Vol 32 (5) ◽  
pp. 612-615 ◽  
Author(s):  
Alan Rosen
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Public Mental Health ◽  
Consultant Psychiatrist ◽  
Persistent Mental Illness ◽  
Public Mental Health Service ◽  
Key Players ◽  
Recovery Program

We admitted to ourselves, …and to our colleagues that we cannot treat people with severe and persistent mental illness as independent practitioners, and asked to be key players on the multidisciplinary team (Extract from A 12-Step Recovery Program for Psychiatrists [1]).

The crucible of early career psychiatry

2018 ◽  
Vol 27 (3) ◽  
pp. 245-248
Author(s):  
Lillian Ng ◽  
Richard Steane ◽  
Natalie Scollay ◽  
Stephen Harris ◽  
Jasminka Milosevic ◽  
...  
Keyword(s):  
Collective Learning ◽  
Early Career ◽  
Role Transition ◽  
Career Stage ◽  
Career Trajectory ◽  
Consultant Psychiatrist ◽  
Deep Impact ◽  
Early Stages ◽  
Written Reflection

Objective: To capture the voices of psychiatrists as they reflect on challenges at the early stages of the career trajectory. Method: Early career psychiatrists contributed reflections that identified various challenges in the transition from trainee to consultant psychiatrist. Results: Common difficulties included negotiating role transition and conflict. Specific events had deep impact such as involvement with a patient who had committed suicide. Conclusions: Challenges in the early career stage as a consultant psychiatrist may have lasting or career defining impact. Written reflection is a valuable tool that can impart collective learning, provide validation and engender support among peers.

scholarly journals Psychiatric in-patients, violence and the criminal justice system

2012 ◽  
Vol 36 (2) ◽  
pp. 41-44 ◽  
Author(s):  
Simon Wilson ◽  
Kevin Murray ◽  
Mike Harris ◽  
Michael Brown
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Cognitive Abilities ◽  
Justice System ◽  
Security Management ◽  
Management Service ◽  
Consultant Psychiatrist ◽  
Change In Practice ◽  
Violent Offences

SummaryThere is ambivalence about prosecuting psychiatric in-patients for violent offences. This ambivalence is reflected in the Memorandum of Understanding that exists between the Crown Prosecution Service and the NHS Security Management Service. This has led to an unwelcome change in practice when the police ask for information from an individual's consultant psychiatrist, the police requesting information about the individual's cognitive abilities at the time of the alleged offence and using this to make decisions about prosecution. However, there is also guidance on this area from other sources. We describe this and make further suggestions for dealing with these requests.

Prevalence and Recognition of Depressive Disorders in General Medical Inpatients

1988 ◽  
Vol 17 (4) ◽  
pp. 341-349 ◽  
Author(s):  
Michiel W. Hengeveld ◽  
Frans A. J. M. Ancion ◽  
Harry G. M. Rooijmans
Keyword(s):  
Depressive Disorder ◽  
Depressive Disorders ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Psychiatric Consultation ◽  
Consultant Psychiatrist ◽  
Symptoms Of Depression ◽  
Medical Inpatients ◽  
Medical Wards ◽  
Depressive Patients

The Beck Depression Inventory (BDI) was administered to 220 of 340 patients consecutively admitted to three general medical wards of a University Hospital, whose length of hospital stay was more than five days. At least mild symptoms of depression (BDI ≥ 13) were reported by 70/220 (32%) of the patients. Alternate BDI depressive patients underwent psychiatric consultation. The psychiatric consultant established a DSM-III depressive disorder in 10/33 (30%) of these patients. Only 3/10 (30%) of the DSM-III depressive patients had been referred to the consultant psychiatrist by their physician.

Retirement intentions of older consultant psychiatrists

2004 ◽  
Vol 28 (4) ◽  
pp. 130-132 ◽  
Author(s):  
Alex Mears ◽  
Tim Kendall ◽  
Cornelius Katona ◽  
Carole Pashley ◽  
Sarah Pajak
Keyword(s):  
Early Retirement ◽  
Response Rate ◽  
Important Determinant ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Health Officer ◽  
Decisions To Leave ◽  
The Mean ◽  
The Uk ◽  
Retirement Intentions

Aims and MethodThis survey gathered data on the retirement intentions of consultant psychiatrists over the age of 50 years, in order to address retention issues. A questionnaire was sent to all 1438 consultants over this age in the UK.ResultsA total of 848 questionnaires were returned, an adjusted response rate of 59%. The mean age at which consultants intended to retire in this sample was 60 years (s.d. 4.16), suggesting a potential loss of 5725 consultant years. Reasons for early retirement are complex: factors encouraging retirement include too much bureaucracy, lack of free time and heavy case-loads; those discouraging retirement include enjoyment of work, having a good team and money. Mental Health Officer status is an important determinant in the decision to retire early.Clinical ImplicationsWith numerous vacancies in consultant psychiatrist posts throughout the UK, premature retirement is a cause for concern, possibly contributing to an overall reduction in consultant numbers of 5%. Addressing factors that influence consultants' decisions to leave the health service early should form an important part of an overall strategy to increase consultant numbers.

scholarly journals Commissioning mental health services: role of the consultant psychiatrist

2000 ◽  
Vol 6 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Chris Simpson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practitioner ◽  
National Health Service ◽  
Health Service ◽  
Health Services ◽  
Consultant Psychiatrist ◽  
Health Authorities ◽  
Care Groups

The current National Health Service (NHS) approach to commissioning health services is in flux. The purchasing of care from providers by general practitioner fundholders (GPFHs) and health authorities has changed with the new White Papers. GPFHs no longer exist and the commissioning role is being handed over from health authorities to primary care groups (PCGs). An understanding of the reasons for change and current arrangements will aid the consultant psychiatrist in influencing this process.

scholarly journals Improving quality and assessment of referrals to the Enfield Crisis Resolution and Home Treatment Team (ECRHTT)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S202-S202
Author(s):  
Margarita Kousteni ◽  
John Cousins ◽  
Ajay Mansingh ◽  
Maja Elia ◽  
Yumnah Ras ◽  
...  
Keyword(s):  
Home Treatment ◽  
Absolute Difference ◽  
List Type ◽  
Treatment Team ◽  
Crisis Resolution ◽  
Post Intervention ◽  
Improvement Project ◽  
Consultant Psychiatrist ◽  
The Impact

AimsTriaging referrals to crisis resolution and home treatment teams is a significant undertaking requiring experienced and dedicated staff. We observed that the volume of inappropriate referrals to ECRHTT was high, and that staff processing these often felt inexperienced or lacking in confidence to discharge them back to the referrers and signpost them to appropriate services.The aims of this quality improvement project (QIP) were: a)to reduce the number of inappropriate referrals received by the teamb)to reduce the number of inappropriate referrals accepted by the teamThis would significantly improve access and flow to the service and facilitate better patient care.MethodA pilot study was first completed of the quality (appropriateness/ inappropriateness) and source of all referrals to ECRHTT in January 2019 (n = 177).Subsequently, the consultant psychiatrist for ECRHTT based himself within the assessment team. He was able to closely monitor the referrals, at the same time as providing medical input to patients at their first point of contact. To evaluate the impact of this intervention, the percentage of inappropriate referrals accepted pre- and post-change was compared by re-auditing all referrals received in February 2019 (n = 175).Further interventions were instigated to improve referral quality. These included continuation of psychiatric medical input to the assessment team, teaching sessions for GPs and the crisis telephone service, and weekly meetings with psychiatric liaison and community mental health teams (CMHTs). Change was measured by reassessing the quality of all referrals made to ECRHTT in February 2020 (n = 215).Result46.9% of inappropriate referrals to ECRHTT were accepted in January 2019 compared to 16.9% in February 2019 following the addition of medical input to the assessment team. The absolute difference was 30% (95% CI: 14%–44%, p < 0.001).71% of referrals from GPs were inappropriate in January 2019 compared to 36% in February 2020 post-intervention (difference 35%, 95% CI: 8.84%–55.4%, p < 0.05). Inappropriate referrals from CMHTs decreased from 55.5% to 12% (difference 43.5%, 95% CI: 9.5%–70.3%, p < 0.05). Overall, the percentage of inappropriate referrals fell from 38% to 27.4%, a difference of 10.6% (95% CI: 1.3%–19.8%, p < 0.05). The percentage of inappropriate referrals from liaison teams did not change significantly.ConclusionThis piece of work shows that better engagement with referral sources significantly improved the quality of referrals made to ECRHTT. Interventions included medical input at the point of referral, teaching sessions for general practitioners as well as ongoing liaison with referring teams.

5 Models of the world: from perception to hallucination

2020 ◽  
Vol 91 (8) ◽  
pp. e2.3-e2
Author(s):  
Paul Fletcher
Keyword(s):  
Model Building ◽  
Processing System ◽  
Human Perception ◽  
Predictive Processing ◽  
External Reality ◽  
Consultant Psychiatrist ◽  
University Of Cambridge ◽  
The World ◽  
The University ◽  
The Brain

Paul Fletcher is Wellcome Investigator and Bernard Wolfe Professor of Health Neuroscience at the University of Cambridge. He is also Director of Studies for Preclinical Medicine at Clare College and Honorary Consultant Psychiatrist with the Cambridgeshire and Peterborough NHS Foundation Trust. He studied Medicine, before carrying out specialist training in Psychiatry and taking a PhD in cognitive neuroscience. He researches human perception, learning and decision-making in health and mental illness.We do not have direct contact with external reality. We must rely on messages from the sense organs, conveying information about the state of the world and our bodies. These messages are not easy to decipher, being noisy and ambiguous, but from them we have to construct models of the world. I will discuss this challenge and how we are very adept at creating a model of reality based on achieving a balance between what our senses are telling us and our expectations of what should be the case. This is often referred to as the predictive processing framework.Relying on this balance comes at a cost, rendering us vulnerable to illusions and biases and, in more extreme cases, to creating a reality that diverges from that experienced by others. This can arise for a variety of reasons but, at the root, I suggest, lies the nature of the brain as a model-building organ. Though this divergence from reality – psychosis – often seems inexplicable and incomprehensible, I suggest that a few core principles can help us to understand it and offers ways of thinking about how phenomena like hallucinations can be understood. Interestingly, the framework suggests ways in which apparently similar phenomena like hallucinations can arise from distinct alterations to the function of a predictive processing system.

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