scholarly journals Irish Psychiatric Association survey of psychiatric services in Ireland

2004 ◽  
Vol 28 (10) ◽  
pp. 364-367 ◽  
Author(s):  
V. O'Keane ◽  
A. Jeffers ◽  
E. Moloney ◽  
S. Barry
Keyword(s):  
Mental Health ◽  
Catchment Area ◽  
Response Rate ◽  
Negative Relationship ◽  
Postal Survey ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Survey Form ◽  
Catchment Areas

Aims and MethodThe Irish Psychiatric Association conducted a national survey of psychiatric services in Ireland to examine clinical resources in relation to the relative affluence of catchment areas. A consultant psychiatrist from each catchment area was sent a postal survey form (August 2002) and the data received were cross-referenced with measures of relative affluence.ResultsThere was a 72% response rate. A negative relationship emerged between indices of need and both the number of acute beds and the number of consultant psychiatrists per head of the population.Clinical ImplicationsThe results of this survey indicate that clinical resources in mental health in Ireland are not concentrated in areas of greatest need, but paradoxically have been best developed in areas of greatest affluence.

scholarly journals Old age psychiatry: a speciality in transition

1999 ◽  
Vol 23 (6) ◽  
pp. 331-335 ◽  
Author(s):  
John Wattis ◽  
Andrew MacDonald ◽  
Paul Newton
Keyword(s):  
Old Age ◽  
Response Rate ◽  
Academic Development ◽  
Postal Survey ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Early Onset Dementia ◽  
Catchment Areas ◽  
Old Age Psychiatry

Aims and methodsWe aimed to update Information on the development of old age psychiatric services using a postal survey of consultants.ResultsThe response rate (51%) was lower than previous surveys in the 1980s. Senior academic appointments showed little increase and academic posts were largely National Health Service (NHS) funded. Services had smaller catchment areas and increased numbers of staff in medicine, nursing and social work, but not in occupational therapy, physiotherapy and psychology. Relative workload was increasing and most services included early-onset dementia. There was a decrease in provision of NHS long-stay beds with only marginal changes in other facilities.Clinical implicationsServices were offering more to patients than previously. Weakness in academic development may cause problems for the future; the results suggested that recruitment in some disciplines may already be problematical. There is a need to develop the role of NHS long-stay facilities.

scholarly journals Facilities for carers of in-patients in forensic psychiatric services in England and Wales

2010 ◽  
Vol 34 (9) ◽  
pp. 381-384 ◽  
Author(s):  
Irene Cormac ◽  
Drew Lindon ◽  
Hannah Jones ◽  
Trevor Gedeon ◽  
Michael Ferriter
Keyword(s):  
Mental Health ◽  
Postal Survey ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
England And Wales ◽  
Mental Health Settings ◽  
Forensic Psychiatric ◽  
Minority Ethnic ◽  
Psychiatric Facilities

Aims and methodA postal survey of forensic psychiatric facilities in England and Wales was undertaken to obtain information about the services provided for carers of in-patients within these services.ResultsForensic psychiatric services vary in the support and facilities provided for carers. Many do not comply with current legislation for carers. Most units informed carers of their rights to have an assessment, but only a minority provided facilities for carers from Black and minority ethnic backgrounds.Clinical implicationsForensic psychiatric services should meet standards for the involvement and support of carers in mental health settings, and comply with legislation for carers.

scholarly journals Availability and acceptability of home treatment for acute psychiatric disorders

2000 ◽  
Vol 24 (5) ◽  
pp. 169-171 ◽  
Author(s):  
Andrew J. Owen ◽  
S. P. Sashidharan ◽  
Lyse J. Edwards
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
Home Treatment ◽  
Clinical Implications ◽  
Health Authorities ◽  
Low Levels ◽  
The Uk ◽  
Do So ◽  
Future Plans

Aims and MethodsTo ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.ResultsOne hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.Clinical ImplicationsDespite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.

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.

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.

scholarly journals Capacity, compliance and electroconvulsive therapy (ECT): the practice of ECT among consultant psychiatrists

2006 ◽  
Vol 30 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Richard Law-Min ◽  
John Patrick Stephens
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Best Practice ◽  
Response Rate ◽  
Common Law ◽  
Good Practice ◽  
Legal Framework ◽  
Clinical Implications ◽  
Clinical Vignettes

Aims and MethodThe aim of this study was to seek the views of consultant psychiatrists on the legal framework they would use when considering treatment with electroconvulsive therapy (ECT). A questionnaire, consisting of three clinical vignettes, was sent to 70 consultants in the Wessex rotation (East Dorset/Hampshire region).ResultsA total of 56 questionnaires were returned; a response rate of 80%. Most consultant psychiatrists agree when giving ECT to capacitated and non-consenting patients. However, there was a lack of consensus when dealing with seemingly incapacitated but compliant patients.Clinical ImplicationsMore clarification in this area is needed. Trusts can assist clinicians by devising their own policies based on nationally agreed standards of best practice. The treatment of mentally incapacitated but compliant patients is an area of practice where uncertainty exists. If proceeding under common law in such cases, it is good practice to discuss with relatives/carers and obtain a second opinion from a consultant colleague. The most recent Bournewood judgement and the new Mental Health Bill will have further implications for clinical practice.

scholarly journals The supervision register: one year on

1996 ◽  
Vol 20 (3) ◽  
pp. 143-145 ◽  
Author(s):  
Phillip J. Vaughan
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
First Year ◽  
Regional Health ◽  
Adult Mental Health ◽  
Health Authorities ◽  
Regional Health Authorities ◽  
One Year

A postal survey was conducted within four regional Health Authorities to ascertain how widely the supervision register had been applied in its first year of operation in adult mental health. A 72% response rate was achieved. The results showed that the register has been absorbed organisationally but is less accepted professionally. One hundred and nineteen of the 367 consultants in the sample (32%) had no entries on the register at 31st March 1995. The provision of training on its use had a significant effect on compliance, although London-based services had marginally less registrations per consultant than their colleagues elsewhere. Very few outside agencies had required access to the register.

scholarly journals Complaints about care in a mental health trust

2000 ◽  
Vol 24 (10) ◽  
pp. 372-376 ◽  
Author(s):  
Iris Pitarka-Carcani ◽  
George Szmukler ◽  
Claire Henderson
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Psychiatric Services ◽  
Disciplinary Action ◽  
Psychotic Symptoms ◽  
Clinical Aspects ◽  
Clinical Implications ◽  
Equal Split ◽  
Health Trust

Aims and MethodA retrospective review of a random sample of written complaints made by, or on behalf of, users of psychiatric services to determine: (a) the number and nature of written complaints against clinical aspects of services in a mental health trust over a 1-year period; and (b) what information complaints provide about deficiencies in the quality of care.ResultsOut of 325 recorded complaints in 1997, 192 concerned clinical aspects of services; 89% of complainants complained once. There was a roughly equal split between complaints about technical v. interpersonal aspects of care. Complaints were far higher from in-patient than from out-patient settings. Evidence that the complaints related to psychotic symptoms was rare. All complaints were resolved locally, but 28 responses by the team were judged unsatisfactory. In 39 cases further action was taken as a result of the complaint, but no disciplinary action was taken against medical staff.Clinical ImplicationsPoor communication is likely to be at the root of many complaints. Room for improvement was found with respect to responses to complaints.

scholarly journals Psychiatry of learning disability – a future with mental health?

2002 ◽  
Vol 26 (8) ◽  
pp. 299-301 ◽  
Author(s):  
R. Alexander ◽  
A. Regan ◽  
S. Gangadharan ◽  
S. Bhaumik
Keyword(s):  
Mental Health ◽  
Learning Disability ◽  
Social Services ◽  
Service Provision ◽  
Postal Survey ◽  
Clinical Implications ◽  
Current Management ◽  
Process Of Change ◽  
Management Changes ◽  
Integrated Mental Health

Aims and MethodA postal survey was sent to all consultants in the psychiatry of learning disability from four English regions. Their views on job satisfaction, their core roles and the management re-structuring of services were elicited.ResultsThe proportion agreeing or strongly agreeing with each management option was 79% for integrated mental health–learning disability trusts, 61% for specialist learning disability trusts, 47% for care trusts, 10% for primary care trusts and 5% for social services. Only 34% felt consulted or able to influence the process of change and only 33% were satisfied with the current management changes within their trust but 67% were satisfied overall with their jobs.Clinical ImplicationsManagement from integrated mental health–learning disability trusts is the most preferred option for psychiatrists in learning disability. A large number of consultants, though otherwise satisfied with their jobs, feel excluded or unable to influence the current changes in management structures. A model of integrated service provision in line with the government's learning disability strategy is presented.

scholarly journals Residential care homes for the mentally ill

2001 ◽  
Vol 25 (2) ◽  
pp. 58-61 ◽  
Author(s):  
C. Kinane ◽  
K. Gupta
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mentally Ill ◽  
Catchment Area ◽  
Care Homes ◽  
Rehabilitation Services ◽  
Clinical Implications ◽  
Care Provision ◽  
Total Cost ◽  
Cost Implications

Aims and MethodThis study describes residents in seven care homes, reviews their usage of mental health services and evaluates cost implications of psychiatric health care provision.ResultsThe patients are predominantly male with multiple diagnoses who are receiving psychiatric health care, but in general lack structured rehabilitation services. Forty-seven per cent of the residents moved into the trust catchment area in order to occupy the placement.The cost associated with the provision of differing models of out-patients care varies considerably.Clinical ImplicationsThese vulnerable residents are costing the mental health service relatively little, although the total cost to society is higher.This study points to the necessity of multiagency planning for 'new long-stay' patients.

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