scholarly journals Factors in psychiatric admissions: before and during the COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S40-S40
Author(s):  
Robyn McCarron ◽  
Peter Swann ◽  
Fiona Thompson ◽  
Graham Murray
Keyword(s):  
Mental Health ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
The Elderly ◽  
Community Treatment ◽  
Mixed Methods Design ◽  
Retrospective Case ◽  
Social Stressors ◽  
Psychiatric Admissions ◽  
Case Note Review

AimsThe COVID-19 pandemic has impacted community mental health, but the effect on psychiatric admissions is unknown. We investigated factors contributing to acute psychiatric admissions, and whether this changed during the first UK lockdown.MethodA retrospective case-note review study with an exploratory mixed-methods design was used to examine factors in psychiatric admissions following the first UK 2020 lockdown compared to the same time periods in 2019 and 2018.ResultThemes of psychopathology, risk, social stressors, community treatment issues, and physical health concerns were generated. The mean number of codes per case was 6⋅19 (s.d. = 2⋅43), with a mean number of categories per case of 3⋅73, (s.d. = 0⋅98). Changes in routines and isolation were common factors in the study year; accommodation and substance abuse were more prominent in the control year. Relationship stressors featured strongly in both groups. There were significantly more women (χ2(1, N = 98) = 20⋅80, p < 0⋅00001) and older adults (χ2(1, N = 98) = 8⋅61, p = 0⋅0033) in the study group than the control. Single people, compared to those in a relationship (χ2(1, N = 45) = 4.46, p = 0⋅035), and people with affective disorders compared to psychotic disorders ((χ2(1, N = 28) = 5.19, p = 0⋅023), were more likely to have a COVID-19 related admission factor.ConclusionThe COVID-19 pandemic amplified pre-existing psychosocial vulnerabilities with a disproportionate psychiatric admissions impact on the mental health of women, the elderly and those with affective disorders.

scholarly journals Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study

BJPsych Open ◽  
2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Georg Høyer ◽  
Olav Nyttingnes ◽  
Jorun Rugkåsa ◽  
Ekaterina Sharashova ◽  
Tone Breines Simonsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Incidence Rates ◽  
Community Treatment ◽  
Prevalence Rates ◽  
Community Treatment Orders ◽  
Retrospective Case ◽  
Case Register ◽  
Mental Health Act ◽  
Catchment Areas ◽  
Involuntary Care

Background In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs). Aims The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs. Method This retrospective case register study included two catchment areas serving 16% of the Norwegian population (aged ≥18). In total, 760 patients subject to 921 CTOs between 1 January 2015 and 31 December 2019 were included to compare the use of CTOs 2 years before and 2 years after the legal reform. Results CTO incidence rates and duration did not change after the reform, whereas prevalence rates were significantly reduced. This was explained by a sharp increase in termination of CTOs in the year of the reform, after which it reduced and settled on a slightly higher leven than before the reform. We found an unexpected significant increase in the use of involuntary treatment orders for patients on CTOs after the reform. Conclusions The expected impact on CTO use of introducing a capacity-based criterion in the Norwegian Mental Health Act was not confirmed by our study. Given the existing challenges related to defining and assessing decision-making capacity, studies examining the validity of capacity assessments and their impact on the use of coercion in clinical practice are urgently needed.

Psychiatric consultations for nursing home residents: a perspective from Turkey and the implications for comparable countries

2008 ◽  
Vol 20 (4) ◽  
pp. 752-763 ◽  
Author(s):  
Eylem Sahin Cankurtaran ◽  
Ibrahim Kutluer ◽  
Murat Senturk ◽  
Gulten Bircan Erzin ◽  
Devrim Gursoy ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Institutional Care ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Study Data ◽  
Psychotic Symptoms ◽  
Rehabilitation Centers ◽  
Homes For The Elderly ◽  
Consultation Services

ABSTRACTBackground: No specialized geriatric psychiatry consultation services are available for elderly people in the institutional care system in Turkey. Our aim was to evaluate psychiatric consultations among the residents of three homes for the elderly in a country with a rapidly aging population, and to investigate possible problems regarding psychiatric consultations.Methods: The residents of three homes for the elderly, which served partially as “care and rehabilitation centers” (equivalent to nursing homes), were chosen for the study. Data on the use of psychiatric services (mainly patient consultations with a visiting psychiatrist) were collected and analyzed.Results: The percentage of patients in the three homes for the elderly who had psychiatric consultations between 2005 and 2007 was 31.8% (172/540). The main reasons for referral were forgetfulness (61%), depressive symptoms (37.7%), agitation and disruptive behavior (29.6%), and psychotic symptoms (27.9%). Of these patients, 46.5% were diagnosed with dementia, 20.9% with depression, 20.5% with behavioral and psychotic symptoms of dementia, and 18.6 % with primary psychotic disorders such as schizophrenia.Conclusion: Homes for the elderly in Turkey are not adequate in terms of consultations for psychiatric problems. Integration of these institutions with hospitals and organizing routine consultation visits from the psychiatry units would enhance the mental health of the elderly. Supporting the staff, maintaining good cooperation between them, and organizing educational programs in the field of mental health of the elderly are also required.

STEPPS in The Netherlands

2016 ◽  
pp. 51-67
Author(s):  
Horusta Freije
Keyword(s):  
Mental Health ◽  
United States ◽  
The Netherlands ◽  
Psychotic Disorders ◽  
The United States ◽  
Community Treatment ◽  
Mental Health Agencies ◽  
Health Agencies ◽  
Community Mental Health Agencies ◽  
Dutch Language

This chapter describes the introduction and implementation of STEPPS (and STAIRWAYS) in The Netherlands, starting in 1998. The program was translated into the Dutch language (VERS I and VERS II) and has been gradually implemented nationwide. Apart from the United States, The Netherlands has the largest number of STEPPS programs. Research conducted in The Netherlands on STEPPS is reviewed, including controlled and uncontrolled studies. Several STEPPS-based training formats have been developed, including those for adolescents, family members of patients, and patients who are parents. The basic VERS I program has also been implemented as a part of assertive community treatment for patients with psychotic disorders and comorbid personality problems, and it is used in community mental health agencies, forensic facilities, and addiction clinics. A brief version of STEPPS has also been developed.

scholarly journals Mental health presentations to acute psychiatric services: 3-year study of prevalence and readmission risk for personality disorders compared with psychotic, affective, substance or other disorders

BJPsych Open ◽  
2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Kate L. Lewis ◽  
Mahnaz Fanaian ◽  
Beth Kotze ◽  
Brin F. S. Grenyer
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Cox Regression ◽  
Mixed Effects ◽  
Naturalistic Study ◽  
Hospital Patients ◽  
Readmission Risk

BackgroundThe relative burden and risk of readmission for people with personality disorders in hospital settings is unknown.AimsTo compare hospital use of people with personality disorder with that of people with other mental health diagnoses, such as psychoses and affective disorders.MethodNaturalistic study of hospital presentations for mental health in a large community catchment. Mixed-effects Cox regression and survival curves were generated to examine risk of readmission for each group.ResultsOf 2894 people presenting to hospital, patients with personality disorder represented 20.5% of emergency and 26.6% of in-patients. Patients with personality disorder or psychoses were 2.3 times (95% CI 1.79–2.99) more likely than others to re-present within 28 days. Personality disorder diagnosis increases rate of readmission by a factor of 8.7 (s.e. = 0.31), marginally lower than psychotic disorders (10.02, s.e. = 0.31).ConclusionsPersonality disorders place significant demands on in-patient and emergency departments, similar to that of psychoses in terms of presentation and risk of readmission.Declaration of interestNone.

scholarly journals A description of the use of zuclopenthixol decanoate long-acting injection in a large mental health trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S340-S340
Author(s):  
Shay-Anne Pantall ◽  
Emily Whitehouse ◽  
Lisa Brownell
Keyword(s):  
Mental Health ◽  
Adverse Effects ◽  
Psychotic Disorders ◽  
Bipolar Affective Disorder ◽  
Primary Diagnosis ◽  
Patient Choice ◽  
List Type ◽  
Retrospective Case ◽  
Long Acting ◽  
Zuclopenthixol Decanoate

AimsAdherence with antipsychotic medication is an important factor in the prevention of relapse in psychotic disorders such as schizophrenia. Long acting antipsychotic injections promote improved adherence. In recent years, second generation antipsychotic long-acting injections have become increasingly popular, and little has been written about the use of the older depot medications. Here, we explore the current use of one of the first-generation antipsychotic long acting injections in Birmingham and Solihull Mental Health NHS Foundation Trust.MethodAn 18-month retrospective case-note review of all patients who started zuclopenthixol decanoate during the first 6 months of 2018 (n = 45)ResultKey findings included: - ⋅71% were male⋅The mean age was 37 (range 19-65)⋅The most common diagnoses were: schizophrenia (51%), bipolar affective disorder (18%) and schizoaffective disorder (13%). We noted that 2 individuals (4%) had a primary diagnosis of recurrent depressive disorder, 2 (4%) had a primary diagnosis of emotionally unstable personality disorder.⋅60% of those who were prescribed zuclopenthixol decanoate discontinued it within the 18-month follow-up period.⋅The vast majority of discontinuation occurred within the first 6 months, and after this, few individuals stopped treatment.⋅The most common reason for discontinuation was side effects (57%), with other reasons including patient choice (7%), non-compliance (7%), pregnancy (4%), or needle phobia (4%).ConclusionZuclopenthixol decanoate has been used for individuals with both schizophrenia and paranoid psychosis (where it is licenced) and also occasionally for other indications. A high proportion discontinued the zuclopenthixol within 6 months, this generally being attributed to adverse effects. Those who were still receiving this medication at 6 months were very likely to continue to take it throughout the 18 months. We would therefore recommend robust monitoring for and management of adverse effects in the early phases of treatment.

scholarly journals Judicial involuntary admission under the Mental Health Act in Goa, India: profile, outcome and implications

2012 ◽  
Vol 9 (4) ◽  
pp. 98-101 ◽  
Author(s):  
Anil Rane ◽  
Abhijit Nadkarni ◽  
Shilpa Waikar ◽  
H. A. Borker
Keyword(s):  
Mental Health ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mental Healthcare ◽  
Involuntary Admission ◽  
Care Hospital ◽  
Retrospective Case ◽  
Affective Psychosis ◽  
Mental Health Act ◽  
Case Note Review

Reception order (RO) by a magistrate is a mode of involuntary admission provided under the Indian Mental Health Act of 1987. To the best of our knowledge there has been no evaluation of this provision in clinical practice. The present paper is a descriptive study through retrospective case-note review of patients admitted by way of RO to a tertiary care hospital in Goa. Compared with those admitted voluntarily, those admitted by RO tended to be single, middle aged (40–60 years old) and non-Goan; on average they had a significantly longer hospital stay than voluntarily admitted patients. Non-affective psychosis and substance use disorders were the more common diagnoses. While admissions by RO serve a useful role in bringing patients who are not under proper care into the mental healthcare system, they do not address the issue of aftercare.

Study of Presentations for Involuntary Admission to a Cork Approved Centre

2012 ◽  
Vol 29 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Elaine Dunne ◽  
Eamonn Moloney
Keyword(s):  
Mental Health ◽  
Working Hours ◽  
Involuntary Admission ◽  
Retrospective Case ◽  
Training And Education ◽  
Specific Data ◽  
Emergency Situations ◽  
Ongoing Training ◽  
Mental Health Unit ◽  
Case Note Review

AbstractObjectives: To describe the characteristics of patients who present to an approved centre with Mental Health Act 2001 forms, and secondly, to compare those who were subsequently detained to those who were not detained.Methods: Specific data on patients who presented to South Lee Mental Health Unit with application and recommendation forms for Involuntary Admission over a 22 month period was gathered from a retrospective case note review. Information on both groups was compared statistically using Graph Pad Prism software.Results: 71% (n=121) of patients presenting for involuntary admission did so outside of normal working hours. Those who were not subsequently detained were more likely to have had their application made by the Gardai and their recommendation made by someone other than their own General Practitioner (GP). GPs were more likely than Consultant Psychiatrists to cite risk to self or others as the reason for involuntary admission.Conclusion: Although involuntary admissions most often occur in emergency situations, every effort should be made to ensure that those who are known to the patient are involved in the process of application and recommendation. In addition, there is a need for ongoing training and education of those most commonly involved, such as the Gardai and General Practitioners, as well as feedback to these groups when a patient presents who does not require involuntary admission.

scholarly journals Continuity of supply of psychiatric medicines for newly received prisoners

2011 ◽  
Vol 35 (7) ◽  
pp. 244-248 ◽  
Author(s):  
Lamiece Hassan ◽  
Jane Senior ◽  
Dawn Edge ◽  
Jenny Shaw
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Clinical Assessment ◽  
Mental Health Policy ◽  
Case Note ◽  
Additional Stress ◽  
Clinical Implications ◽  
Psychiatric Medication ◽  
Retrospective Case ◽  
Case Note Review

Aims and methodA retrospective case-note review was undertaken at five English prisons between June 2008 and March 2009 to estimate the proportion of psychiatric medicines (antidepressants, antipsychotics and hypnotics/anxiolytics) reported at prison reception that are discontinued on entry to prison.ResultsOf the 1006 records sampled, the review showed that 18% of prisoners had been prescribed psychiatric medication before being placed in custody. Altogether, 240 separate psychiatric medicines were recorded among prisoners at reception. Of these, 47% were not prescribed during the first week of custody. In only 11% of cases where medication was discontinued had psychiatric assessment been completed.Clinical implicationsPrison mental health policy states that psychiatric medication should not be withdrawn in custody without proper clinical assessment. Denial of medication in the absence of clinical assessment during early custody has the potential to create additional stress in individuals during a period of increased vulnerability and risk.

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