scholarly journals Police involvement, characteristics and outcomes of place of safety referrals in the Scottish Highlands

2020 ◽  
Vol 44 (6) ◽  
pp. 244-250
Author(s):  
Struan Simpson ◽  
Jude Eze
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
High Risk ◽  
Personality Disorder ◽  
Emergency Management ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Factors Associated ◽  
Scottish Highlands ◽  
Risk Areas

Aims and methodTo characterise police involvement with those detained under place of safety legislation and determine factors associated with admission to hospital. Place of safety referrals over a 1-year period were identified retrospectively and evaluated.ResultsPlace of safety legislation is generally used with regard to concerns about suicide. Individuals are often removed from high-risk areas and referrals to police are frequently initiated by individuals themselves. A diagnosis of mental illness or personality disorder predicted hospital admission. Presence of senior nursing staff at assessment, but not the seniority of the doctor, was associated with discharge.Clinical implicationsCloser multiagency working is required as police are currently being recruited to fill a void between mental health services and the population they serve. Junior doctors require more senior support in making complex, and often risky, emergency management decisions with this population.

scholarly journals Joint assessment out of hours: assessing the benefits for patients and junior doctors

2013 ◽  
Vol 37 (8) ◽  
pp. 272-275
Author(s):  
Laura Boyd ◽  
Colin Crawford ◽  
Eugene Wong
Keyword(s):  
Mental Health ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Assessment Protocol ◽  
Admission Rates ◽  
Mental Health Nurse ◽  
Health Nurse ◽  
The Impact ◽  
Joint Assessment

Aims and methodWe examined the impact of implementing a new Acute Mental Health Emergency Assessment Protocol (AMHEAP) on joint psychiatric assessments out of hours within Forth Valley, Scotland, over the course of 4 calendar months. The protocol states that assessments should be carried out by a junior doctor and a registered, qualified mental health nurse. The impact measures were taken as admission rates and experience of the doctor in training.ResultsIn the 4 months that were examined (1 June–30 September 2011), 79.5% of out-of-hours emergency assessments were performed jointly. Admission rates were significantly decreased (P<0.001) compared with a similar period in 2008, before the AMHEAP protocol was developed. Most junior doctors valued the experience of joint assessment.Clinical implicationsJoint assessment can enhance patient experience, reduce hospital admission, and provide a learning opportunity for junior doctors in emergency psychiatric assessments. However, it represents a move away from the doctor as sole decision maker.

scholarly journals Socioeconomic gradients and mental health: implications for public health

2015 ◽  
Vol 206 (6) ◽  
pp. 461-465 ◽  
Author(s):  
Sarah Stewart-Brown ◽  
Preshila Chandimali Samaraweera ◽  
Frances Taggart ◽  
Ngianga-Bakwin Kandala ◽  
Saverio Stranges
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Employment Status ◽  
Linear Trend ◽  
Well Being ◽  
Odds Ratios ◽  
Factors Associated ◽  
Middle Range ◽  
The Unemployed ◽  
Mental Well Being

BackgroundResearch on mental well-being is relatively new and studies of its determinants are rare.AimsTo investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.MethodUsing logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.ResultsIndependent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.ConclusionsOdds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.

scholarly journals Household poverty in people with severe mental illness in rural China: 1994–2015

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Yue-Hui Yu ◽  
Wei Luo ◽  
Man-Xi He ◽  
Xin Yang ◽  
Bo Liu ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Socioeconomic Development ◽  
Rural China ◽  
Work And Family ◽  
Factors Associated ◽  
Household Poverty ◽  
Poor Households ◽  
Icd 10

Background Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. Aims This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. Method Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses. Results The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015. Conclusions This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.

scholarly journals Civil and forensic patients in secure psychiatric settings: A comparison

2017 ◽  
Vol 41 (3) ◽  
pp. 156-159 ◽  
Author(s):  
Nuwan Galappathie ◽  
Sobia Tamim Khan ◽  
Amina Hussain
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Implications ◽  
Treatment Needs ◽  
Forensic Patients ◽  
Adult Services ◽  
Frequent Episodes ◽  
Self Harm ◽  
Male Patients ◽  
The Uk

Aims and methodTo evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.ResultsOverall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.Clinical implicationsSecure hospitals should ensure treatment programmes are tailored to each patient's needs. Civil patients require greater emphasis on treatment of their mental illness, whereas forensic patients have additional offence-related treatment needs. Regular liaison between forensic and general adult services is essential to help ensure patients can return to appropriate settings at the earliest opportunity in their recovery.

scholarly journals Security needs among patients referred for high secure care in Broadmoor Hospital England

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Kate Williams ◽  
Madhri Senanayke ◽  
Callum C. Ross ◽  
Rob Bates ◽  
Mary Davoren
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cohort Study ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Final Decision ◽  
Forensic Mental Health ◽  
Vulnerable Group ◽  
Secure Care

Background Security needs among patients referred to forensic mental health services have rarely been systematically studied. Aims To ascertain security needs among patients referred to a high secure hospital, Broadmoor High Secure Hospital, England. We also aimed to compare the security needs for those referred to mental illness services with those referred to personality disorder services in the hospital. Method A retrospective complete cohort study of all referrals to Broadmoor Hospital over a 2-year period was conducted. All referred patients (n = 204) were assessed for need for high secure care by two Broadmoor clinicians. The final decision on need for admission was taken by a multidisciplinary admission panel. Independent of the panel, researchers rated need for security using the DUNDRUM-1 triage security scale. Results Those admitted to Broadmoor Hospital had higher triage security scores than those declined (F = 4.209, d.f. = 1, P = 0.042). Referrals to the personality disorder pathway had higher security needs than those referred to the mental illness pathway high secure service (F = 6.9835, d.f. = 1, P = 0.0089). Overall security needs among referrals to Broadmoor were extremely high, both by comparison with previous needs identified in UK medium secure services and international medium and high secure services. Conclusions High secure patient cohorts represent a uniquely vulnerable group within mental health services, with extremely high security needs identified in this study. This has significant implications for services given the high levels of resources needed to provide therapeutically safe and secure care and treatment to this group.

Mental health services for single homeless people

2020 ◽  
pp. 1-11
Author(s):  
Philip Timms ◽  
Jenny Drife
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Personality Disorder ◽  
Health Services ◽  
Substance Misuse ◽  
Homeless People ◽  
Psychiatric Services ◽  
Background Information ◽  
The Past ◽  
The Uk

SUMMARY Homelessness has long been associated with high rates of psychosis, alcohol and substance misuse, and personality disorder. However, psychiatric services in the UK have only recently engaged actively with homeless people. This article provides some background information about homelessness and mental illness and describes the elements of inclusion health and some of the models of service for homeless people that have been established over the past 30 years.

Mind Matters: a psychoeducation programme for individuals with intellectual disabilities and co-morbid diagnoses of mental disorder

2017 ◽  
Vol 8 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Sarah Ashworth ◽  
Krista Jansen ◽  
Lydia Bullock ◽  
Paul Mooney
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Intellectual Disabilities ◽  
Psychological Intervention ◽  
Content Type ◽  
Group Members

Purpose The purpose of this paper is to describe a feasibility study into the development and pilot of a psychoeducational group for people with intellectual disability and co-morbid mental disorder (including mental illness and personality disorder) within forensic settings. Design/methodology/approach “Mind Matters”, a psychoeducational programme for people with an intellectual disability and co-morbid mental disorders is a group based programme in a medium secure hospital, adapted and developed to be suitable for people with intellectual disability therapist multidisciplinary approach was key to its development. An open group on a 16-bedded ward for individuals with mild to moderate intellectual disability and co-morbid mental illness was delivered over a six-week period. Findings The group was positively received in pilot by participants and members of the clinical teams. Attendance and engagement of participants were key measures of the success of the programme. In addition to the apparent increased social skills and motivation to engage with future psychological intervention. Practical implications The authors believe that this approach benefitted both the group members and staff on ward, reinforcing strategies for maintaining positive mental health. It also stimulated engagement, discussion about mental disorders including mental illness, personality disorder and intellectual disabilities. Originality/value This paper shows how a psychoeducational approach to mental disorder and mental health in individuals with an intellectual disability is possible, beneficial and well received.

scholarly journals Dangerous and severe personality disorder and in need of treatment

2007 ◽  
Vol 190 (S49) ◽  
pp. s3-s7 ◽  
Author(s):  
Paul E. Mullen
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Personality Disorder ◽  
Social Functioning ◽  
Order Reaction ◽  
Evidence Based ◽  
Law And Order ◽  
Real Progress ◽  
Offenders With Mental Illness ◽  
Severe Personality Disorder

SummaryThe Dangerous and Severe Personality Disorder Programme was born out of a populist law and order reaction, developed on false premises, but is now evolving into an exciting initiative for providing effective services to a group of offenders with mental illness who psychiatry, and the justice services, have so long ignored. Enthusiasm, flexibility and an evidence-based approach may yet lead to real progress towards the improved management of disturbed high-risk offenders, improving the psychological and social functioning of the offenders as well as delivering a safer community.

scholarly journals Introducing a nurse-led deliberate self-harm assessment service

2001 ◽  
Vol 25 (6) ◽  
pp. 212-214 ◽  
Author(s):  
Gill Griffin ◽  
Jonathan I. Bisson
Keyword(s):  
Mental Health ◽  
Training Needs ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Mental Health Nurses ◽  
Deliberate Self Harm ◽  
Mental Health Nurse ◽  
Health Nurse ◽  
Nurse Assessment ◽  
Self Harm

Aims and MethodThis study considered patients admitted to hospital following deliberate self-poisoning. The characteristics of the patients and the outcomes of assessments by trainee psychiatrists and a mental health nurse were compared.ResultsThere were no significant differences in the outcome of 68 assessments performed by a trainee psychiatrist and 77 by a mental health nurse. The nurse assessment service was well-received by the poisons unit, a medical ward specialising in overdose treatment, and trainee psychiatrists.Clinical ImplicationsPsychosocial assessments following self-poisoning can be provided by appropriately trained and supervised mental health nurses. The introduction of a nurse-led service should enhance relationships with the local poisons unit and reduce the workload of junior doctors without compromising their training needs.

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