An Evaluation of Community-Based Psychiatric Care for People with Treated Long-Term Mental Illness

1995 ◽  
Vol 167 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Greg Wilkinson ◽  
Marco Piccinelli ◽  
Ian Falloon ◽  
Haroutyon Krekorian ◽  
Sheila McLees
Keyword(s):  
Mental Illness ◽  
Affective Disorders ◽  
Psychiatric Care ◽  
Adaptive Functioning ◽  
Social Performance ◽  
Structured Interview ◽  
Rural Setting ◽  
Community Based ◽  
Treatment Measures

BackgroundWe evaluated integrated, multidisciplinary, community-based care for a cohort of people with treated long-term mental illness over two years in a field trial set in a semi-rural setting. The aim was to organise local psychiatric services on an extramural basis with general practitioner teams as the key element.MethodTrained research workers used a structured interview to collect standardised baseline and three-monthly socio-demographic, clinical, social, family adjustment and burden, and treatment measures from patients, informants, and key-workers. Analysis included descriptive statistics and, for longitudinal data, analysis of best-fitted straight lines.ResultsWe studied 34 patients (14 with schizophrenia, 11 with major affective disorders, and 9 with minor (non-major) affective disorders and anxiety disorders) who had a mean of 12 years continuous illness. At baseline, they were mainly characterised by research workers as mildly ill with fair social adaptive functioning, and by lay informants as having moderate target symptom severity and disturbance of social performance. Over two years, there were statistically significant, slight improvements in clinical global impressions ratings by research workers, and in informants ratings of target symptoms and social performance. Most patients continued to receive prescriptions for psychotropic drugs throughout follow-up, and they had a mean of 47 therapeutic contacts, mainly from nurses. Two patients were admitted to psychiatric hospital. There were few differences between patients in different diagnostic groups.ConclusionsIntegrated, multidisciplinary, community-based psychiatric care for people with treated long-term mental illness is feasible in a semi-rural setting: patients receiving pharmacotherapy and regular psychosocial treatments remained relatively stable on clinical and social measures over two years. The unique way in which the service was monitored, by making regular, systematic assessments of patients and carers, serves as an example for other services.

Peer Commentaries on ‘An Evaluation of Community-based Psychiatric Care for People with Treated Long-Term Mental Illness’

1995 ◽  
Vol 167 (1) ◽  
pp. 38-40 ◽  
Author(s):  
Ian Pullen ◽  
Tony Kendrick
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Community Based

The following two commentaries were invited by the editor, and add to a series of reviews and comments that are published together with particular papers.

scholarly journals Admission profile: towards community based services

1992 ◽  
Vol 16 (6) ◽  
pp. 336-337
Author(s):  
R. S. Augustine ◽  
P. N. Kurian ◽  
A. Michael
Keyword(s):  
Mental Illness ◽  
Psychiatric Hospital ◽  
General Practitioners ◽  
Psychiatric Care ◽  
Total Population ◽  
Mentally Handicapped ◽  
Community Based ◽  
Special Groups ◽  
First Contact ◽  
Community Based Services

This audit examined 65 consecutive admissions to a psychiatric hospital in the Irish Midlands over six months. The admissions came from a defined sector with a total population of 39,000. In the year prior to the study major changes in the delivery of psychiatric care in the sector were instituted. These changes included the introduction of admission guidelines and extra resources in the community. The general practitioners who see mental illness at first contact were informed of these changes. Attempts were made by the sector psychiatrist team to screen for appropriateness of admission with regard to the special groups such as alcoholics, the aged and the mentally handicapped.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the Patient Survey and the 630 Survey

2020 ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean ◽  
Using Data

Abstract BackgroundThe number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge.MethodsUsing data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients.ResultsIn 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040.ConclusionsWe believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

“Not Everybody’s an Athlete, But They Certainly Can Move”: Facilitators of Physical Activity Maintenance in Older Adults in a Northern and Rural Setting

2020 ◽  
Vol 28 (6) ◽  
pp. 854-863 ◽  
Author(s):  
Kirsten Ward ◽  
Anne Pousette ◽  
Chelsea A. Pelletier
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Engagement ◽  
Healthy Aging ◽  
Rural Setting ◽  
Community Based ◽  
Semistructured Interviews ◽  
Individual Program ◽  
Physical Activity Maintenance

Although the benefits of maintaining a physical activity regime for older adults are well known, it is unclear how programs and facilities can best support long-term participation. The purpose of this study is to determine the facilitating factors of physical activity maintenance in older adults at individual, program, and community levels. Nine semistructured interviews were conducted with individuals aged 60 years and older and long-term participants (>6 months) in community-based group exercise at a clinical wellness facility in northern British Columbia, Canada. Interviews were audio recorded, transcribed, and analyzed via inductive thematic analysis. Themes identified as facilitators of physical activity included (a) social connections, (b) individual contextual factors, and (c) healthy aging. Older adults are more likely to maintain physical activity when environments foster healthy aging and provide opportunity for social engagement.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the patient survey and the 630 survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean ◽  
Using Data

Abstract Background The number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge. Methods Using data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients. Results In 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040. Conclusions We believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

scholarly journals COVID-19 reinfection in a patient with a serious mental illness within a long-term inpatient psychiatric care hospital

2021 ◽  
Vol 11 (5) ◽  
pp. 292-296
Author(s):  
Brianna Englett ◽  
Amy Magdalany ◽  
Tiffany L. Gordon ◽  
Kelly Holladay
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Psychiatric Care ◽  
Case Reports ◽  
Polymerase Chain Reaction Test ◽  
Care Hospital ◽  
Inpatient Psychiatric Care ◽  
Polymerase Chain ◽  
Chain Reaction Test

Abstract There is an increasing number of case reports of COVID-19 reinfection. The mechanism of reinfection is poorly understood and evolving. Prevention of the transmission of severe acute respiratory syndrome coronavirus 2 for those with a serious mental illness (SMI) living in a congregate setting presents unique challenges. In this case report, we describe an individual with an SMI in a long-term inpatient psychiatric care hospital who was initially diagnosed in June 2020 with COVID-19 infection via a polymerase chain reaction test. Approximately 6 months later, the patient presented with a COVID-19 reinfection and more severe COVID-like symptoms.

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