scholarly journals Early detection of antipsychotic side-effects

1999 ◽  
Vol 23 (11) ◽  
pp. 657-660 ◽  
Author(s):  
Robert Chaplin ◽  
Julie Gordon ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Community Mental Health ◽  
Early Detection ◽  
Rating Scales ◽  
Drug Dose ◽  
Clinical Implications ◽  
Detection Rates ◽  
Before And After ◽  
Antipsychotic Side Effects

Aims and methodsStaff from five community mental health teams (CMHTs) were trained to use structured rating scales for akathisia, tardive dyskinesia and Parkinsonism. Detection rates of these side-effects were compared for the six months before and after the intervention.ResultsFifty-seven per cent of the target professionals participated, screening 200 (52%) eligible patients. This resulted in significant increases in the recording of all three side-effects as positive but no increase in their formal diagnosis.Clinical implicationsDetection rates of these side-effects can be increased to those predicted by research with significant reductions in drug dose and non-adherence and without clinical deterioration.

scholarly journals Impact of functionalised community mental health teams on in-patient care

2006 ◽  
Vol 30 (6) ◽  
pp. 213-215 ◽  
Author(s):  
Martin Commander ◽  
Lallana Disanyake
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Inner City ◽  
Patient Care ◽  
Manic Depression ◽  
Clinical Implications ◽  
The Past ◽  
Before And After ◽  
The Uk ◽  
Single Living

Aims and MethodA before-and-after design was used to evaluate whether the routine implementation of functionalised community mental health teams (CMHTs) would reduce demand for in-patient care. Residents of west Birmingham, aged 16–64 years, who were in hospital between 23 March 1992 and 22 September 1992 were identified. The same period was studied in 2003 by which time the newly introduced teams were well established.ResultsThe number of people in hospital fell by one-third between 1992 and 2003. There was no change in the number of admissions by each patient or the length of stay. The percentage identified as Black, single, living with other adults, resident in hostels and unemployed increased, as did the proportion with schizophrenia or manic depression and those detained compulsorily.Clinical ImplicationsFunctionalised CMHTs can decrease the use of in-patient care in inner-city areas. They may also attenuate, but by no means halt, the rise in compulsory admissions seen across the UK in the past decade.

scholarly journals The Mental Health Clustering Tool for people with severe intellectual disability

2012 ◽  
Vol 36 (12) ◽  
pp. 454-458 ◽  
Author(s):  
Vishwa Radhakrishnan ◽  
Kevin Smith ◽  
Jean O'Hara
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Community Mental Health ◽  
Learning Disability ◽  
Rating Scales ◽  
Disability Services ◽  
Clinical Implications ◽  
Current Form ◽  
Severe Intellectual Disability ◽  
Integrated Mental Health

Aims and methodWe assessed 92% (117/127) of the patients in our community mental health learning disability team using the Mental Health Clustering Tool (MHCT) to establish whether their needs could be captured sufficiently well to enable assignment to a care cluster for payment by results in mental health. We explored the characteristics of those assigned to Cluster 0 to identify how they differed from those who could be assigned to Clusters 1-21.ResultsAs expected, nearly half of the case-load (48%) could not be assigned to any cluster except Cluster 0, the variance cluster, which is used when the needs of patients cannot be captured by the current 21 care clusters but a service is, or will be, provided.Clinical implicationsThe MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development. This is expected to include new rating scales and new clusters, however until the development is completed and validated it will not be possible to implement payment by results in mental health in learning disability services.

scholarly journals The impact of suicide on community mental health teams: findings and recommendations

2002 ◽  
Vol 26 (2) ◽  
pp. 50-52 ◽  
Author(s):  
Stuart Linke ◽  
Jenny Wojciak ◽  
Samantha Day
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Adverse Effects ◽  
Clinical Implications ◽  
Professional Lives ◽  
Patient Suicide ◽  
Personal Impact ◽  
Sources Of Support ◽  
Team Functioning ◽  
The Impact

Aims and MethodThe study investigated the personal impact of patient suicides on the members of community mental health teams and the sources of support utilised for coping with adverse effects.ResultsForty-four questionnaires were returned. Eighty-six per cent of staff reported having had at least one patient suicide, with an average of 4.2 suicides. The majority of staff reported that patient suicides had significant adverse effects on their personal and professional lives. Some of the effects were long-lasting (greater than 1 month). Staff found that peer support, reviews, dedicated staff meetings and support from senior colleagues were of most value.Clinical ImplicationsStaff require skilled and dedicated support following a patient suicide in order to minimise its detrimental effects on personal, professional and team functioning.

scholarly journals Psychiatric admission for homeless people: the impact of a specialist community mental health team

1997 ◽  
Vol 21 (5) ◽  
pp. 260-263 ◽  
Author(s):  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Homeless People ◽  
Discharge Process ◽  
Community Mental Health Team ◽  
Psychiatric Admission ◽  
Mental Health Team ◽  
Health Team ◽  
Before And After ◽  
The Impact

The difficulty in achieving good quality community mental health care for homeless people has received increasing attention during the last few years. Less consideration has been given to the provision of inpatient care. By comparing data collected before and after its inception, we examined the impact of a specialist community mental health team for homeless people on ‘no fixed abode’ admissions in Birmingham. Although the team was successfully involved in the admission and discharge process in a substantial proportion of cases, many admissions still took place out of hours and involved the police, while discharge was often against medical advice and occurred without follow-up. These findings and their implications for the provision of homeless services are discussed.

scholarly journals Check the effects: systematic assessment of antipsychotic side-effects in an inpatient cohort

2020 ◽  
Vol 10 ◽  
pp. 204512532095711
Author(s):  
Caroline Hynes ◽  
Stephen McWilliams ◽  
Mark Clarke ◽  
Ita Fitzgerald ◽  
Larkin Feeney ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scales ◽  
Rating Scale ◽  
Standard Dose ◽  
Well Being ◽  
High Dose ◽  
Negative Consequences ◽  
Adherence Assessment ◽  
Dose Combination ◽  
Antipsychotic Side Effects

Background: Antipsychotics are associated with a range of side-effects that can influence patients’ subjective well-being negatively resulting in poor adherence. In order to limit the negative consequences of side-effects, they should be regularly systematically assessed. The aim of this study was to systematically assess antipsychotic side-effects in an inpatient cohort using validated rating scales. Methods: Eligible individuals prescribed an antipsychotic for at least 2 weeks were invited to have their side-effects assessed systematically. Results: A total of 208 individuals were assessed systematically for antipsychotic side-effects; 71.5% ( n = 138) stated that they had not reported side-effects to their clinician prior to the assessment. The most commonly reported side-effects were daytime drowsiness (75%), dry mouth (58.2%) and weight gain (50.0%), while the most distressing side-effects reported were erectile dysfunction (35.0%), sexual dysfunction (26.3%) and amenorrhoea (26.3%). There was no evidence of an association between side-effect severity/number of side-effects reported/distress caused by those taking high dose/combination antipsychotics versus standard dose monotherapy. Conclusion: Side-effects must be regularly and systematically assessed using a validated rating scale. As distress caused by side-effects plays a major role in non-adherence, assessment should examine distress and data on distressing side-effects should be available to those choosing an antipsychotic. Given the lack of correlation between high dose/combination antipsychotics and side-effects, treatment should be tailored to the individual based on response/tolerance and dose reduction/avoidance of polypharmacy should not be recommended to minimise side-effects.

scholarly journals What is the impact of research champions on integrating research in mental health clinical practice? A quasiexperimental study in South London, UK

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016107 ◽  
Author(s):  
Sherifat Oduola ◽  
Til Wykes ◽  
Dan Robotham ◽  
Tom K J Craig
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Intervention Group ◽  
Research Participation ◽  
Clinical Activity ◽  
Clinical Services ◽  
National Health Service Foundation ◽  
Apply Research ◽  
Before And After ◽  
The Impact

ObjectivesKey challenges for mental health healthcare professionals to implement research alongside clinical activity have been highlighted, such as insufficient time to apply research skills and lack of support and resources. We examined the impact of employing dedicated staff to promote research in community mental health clinical settings.DesignQuasiexperiment before and after study.SettingSouth London and Maudsley National Health Service Foundation Trust.Participants4455 patients receiving care from 15 community mental health teams between 1 December 2013 and 31 December 2014.Outcome measuresThe proportion of patients approached for research participation in clinical services where research champions were present (intervention group), and where research champions were not present (comparison group).ResultsPatients in the intervention group were nearly six times more likely to be approached for research participation (Adj. OR=5.98; 95% CI 4.96 to 7.22).ConclusionsInvesting in staff that promote and drive research in clinical services increases opportunities for patients to hear about and engage in clinical research studies. However, investment needs to move beyond employing short-term staff.

Psychiatric out-patient services: origins and future

2006 ◽  
Vol 12 (5) ◽  
pp. 309-319 ◽  
Author(s):  
Helen Killaspy
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Alternative Model ◽  
Community Mental Health Services ◽  
Psychiatric Services ◽  
Early 20Th Century ◽  
Clinical Implications ◽  
Missed Appointments ◽  
Cost Implications

Psychiatric out-patient services originated in the early-20th century to enable triage of new referrals to the asylum in order to differentiate between treatable and untreatable cases. They evolved to provide community follow-up of patients discharged from hospital and assessment of those newly referred to psychiatric services. Non-attendance at out-patient appointments represents an enormous waste of clinical and administrative resources and has potentially serious clinical implications for those who are most psychiatrically unwell. The place of out-patient clinics in modern community mental health services is explored with reference to the reasons for, and clinical and cost implications of, missed appointments. An alternative model is described that incorporates recent UK government guidance on the roles and implementation of community mental health teams, liaison with primary care and new roles for consultant psychiatrists.

Suicidal Behavior and Community Mental Health Care in Emilia-Romagna (Italy)

1996 ◽  
Vol 33 (3) ◽  
pp. 193-206 ◽  
Author(s):  
P. Crepet ◽  
S. Caracciolo ◽  
D. Fabbri ◽  
A. Tomelli ◽  
S. Tugnoli ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Community Mental Health Service ◽  
Before And After ◽  
Previous Contact ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Parasuicide and aftercare treatment in a Community Mental Health Service (CMHS) were studied both retrospectively and prospectively. Data were extracted from CMHS Epidemiological Register. Six hundred and fifty persons were recruited (450 F, 200 M), referring to 779 parasuicide episodes. Higher rates (102/100,000) were observed in females in the age class fifteen to twenty-four, while the general rate was 52.79. Psychiatric care was studied for 311 suicide attempters, subsequently divided in three Groups. Thirty-nine subjects (12.5%) previously unknown at CMHS resulted to receive psychiatric treatment after follow up (GROUP 1), while seventy-two attempters (23.15%) with previous contact (GROUP 2) remained mostly (16.4%) in contact; two-hundred subjects (64.3%) without previous contact were still unknown after parasuicide (GROUP 3). Parasuicide repetition was higher for Group 2, while suicide incidence was higher for Group 1. Results suggest that most peclple skip psychiatric care before and after parasuicide.

scholarly journals Weekend new patient reviews in psychiatry: evaluation of activity over 3 months

2017 ◽  
Vol 41 (6) ◽  
pp. 337-340
Author(s):  
Michael Rutherford ◽  
Mark Potter
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Average Length ◽  
Clinical Implications ◽  
Out Of Hours ◽  
Feasible Method ◽  
Average Length Of Stay ◽  
South West ◽  
Before And After ◽  
The Mean

Aims and methodSouth West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.ResultsA total of 88 patients were seen: 84.4% of patients were seen within 24 h of admission. Higher trainees instituted some changes in 78.9% of patients. The most frequent action was to modify medication, in 47.8%. The average length of stay after the introduction of weekend reviews was not significantly different.Clinical implicationsWeekend reviews of newly admitted patients by higher trainees is a feasible method for providing senior input to patients admitted out of hours.

scholarly journals Gatekeeping access to community mental health teams

2002 ◽  
Vol 26 (2) ◽  
pp. 56-58 ◽  
Author(s):  
P. McEvoy ◽  
S. Colgan ◽  
D. Richards
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Affective Disorders ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Health Problems ◽  
Primary Diagnosis ◽  
Psychiatric Nurses ◽  
Clinical Implications ◽  
Community Psychiatric

Aims and MethodA retrospective survey to explore how consultant psychiatrists, senior house officers and community psychiatric nurses prioritised referrals to four sectorised community mental health teams.ResultsReferral outcomes appeared to be comparable for patients with psychoses, sub-threshold mental health problems and personality disorders. However, differences in the outcomes were apparent for patients with a primary diagnosis of drug/alcohol misuse, as well as for patients with affective disorders and neuroses.Clinical ImplicationsIt may be necessary to establish clearer, consistent boundaries in order to consolidate services for patients with severe mental health problems.

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