Percentage of persons seen within mental health waiting times target set in each country

2021 ◽  
Keyword(s):  
Mental Health ◽  
Waiting Times ◽  
Target Set

Principles of capacity management, applied in the mental health context

2018 ◽  
Vol 42 (4) ◽  
pp. 438
Author(s):  
Kathryn Zeitz ◽  
Darryl Watson
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Average Length ◽  
Patient Flow ◽  
Waiting Times ◽  
Capacity Management ◽  
Mental Health Setting ◽  
Mental Health Consumer ◽  
Mental Health Consumers ◽  
Flow Improvement

Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5 h compared with 8.5 h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24 h was 26% (n = 112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs. What are the implications for practitioners? No single improvement will reduce access block in the ED for mental health consumers. Reductions in waiting times require a concerted, multifocal approach across all components of the acute mental health journey.

scholarly journals Potential predictors of unmet health needs among the elderly: a population-based study in Serbia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Šantrić Milićević ◽  
M Kostadinović ◽  
D Nikolić ◽  
J Todorovic ◽  
Z Terzic-Supic
Keyword(s):  
Mental Health ◽  
Waiting Times ◽  
Wealth Index ◽  
The Elderly ◽  
Health Needs ◽  
Daily Activities ◽  
Personal Care ◽  
Mental Health Needs ◽  
Unmet Health Needs ◽  
Unmet Mental Health

Abstract Background This study assessed the prevalence of unmet health needs of the elderly and the associated factors regarding socioeconomic, health and functional status. Methods A secondary analysis of the 2013 National Health Survey data was conducted on a representative sample of 3540 persons aged sixty-five and older (the lowest response rate was 99.7%). Participants characteristics such as socioeconomic status, health self-perception, diagnosed chronic disease, physical functional limitations, performing essential daily activities in the home and daily personal care were explored with logistic regression analysis (Odds Ratio - OR and 95% Confidence Interval) in relation to five aspects of unmet health needs. Results 15.8% participants had unmet health needs due to the long waiting times, 16.1%, had unmet needs for medical care, 17.7% for dental care, 15.2% for drugs prescription and 96.9% participants for mental health care. Common predictors exist for medical, dental drug prescription and due to long waiting times unmet needs including older age years, middle education, rural residence, lower wealth index, single persons, with average or bad self-perceived health, chronic disease and difficult daily performance of personal care and of home activities. Unmet mental health needs by 61% less likely had participants with average wealth index, while a greater likelihood had participants with average and bad self-perceived health by 3.7 times and 8.4 times (p = 0.035, p = 0.001) respectively, by 6.2 times those with difficulties (p < 0.001) and by 5.9 times unable (p = 0.045) to perform daily activities of personal care and by 1.7 times those with difficulties (p = 0.037) to perform home activities. Conclusions Unmet health needs reported less than 20% of the elderly but almost all have unmet mental health needs. Unmet health needs are associated with negative health outcomes, age, low education level, single persons, rural settings, poorer households, and limited daily activities. Key messages Unmet mental health needs of the elderly are an extremely important problem for the health system and healthy ageing in Serbia. A strong association of unmet health needs of old, low educated elderly without partners, from rural settings and poor households with health and functional outcomes, requires responsive policies.

scholarly journals Survey on the physical and mental health among migrants and refugees in ten European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Karnaki ◽  
D Zota ◽  
E Riza ◽  
A Gil-Salmerón ◽  
E Durá-Ferrandis ◽  
...  
Keyword(s):  
Mental Health ◽  
Quantitative Research ◽  
Health Care Services ◽  
Waiting Times ◽  
Physical And Mental Health ◽  
Medical Problems ◽  
Migration Flow ◽  
Eu Member States ◽  
Care Services ◽  
Breast And Cervical Cancer

Abstract This study discusses the main findings of the quantitative research conducted within the Mig-HealthCare consortium countries to explore the physical and mental health of migrants and refugees. The study population is defined as migrants/refugees who have been residing in Europe, for at least 6 months and up to 5 years. In order to be able to capture the recent migration flow, the analysis was based on 1169 questionnaires collected in 10 EU-Member States, answered by adult migrants residing less than 5 years in the specific country. A total of 29% of migrants stated that their health is poor or fair. Overall, 56.9% of migrants needed health care services during the last 6 months, however approximately one in four did not have access to them. The most frequent problems were long waiting times, not being able to organize an appointment, not knowing where to go, lack of communication and long distances. The most frequent chronic health problem migrants/refugees face is caries and headaches/migraines, followed by psychological disease and sleep disorders. Approximately one in three women have been pregnant since entering the current EU country, whereas one in four have had a miscarriage or abortion and 21.5% are currently pregnant. Summing up, most of the migrants face common medical problems such as bad teeth, headaches and psychological problems. However long waiting times, not knowing where to go and lack of communication are barriers to accessing healthcare. The fact that the immunization status of migrants/refugees is unclear, a significant number suffer from serious chronic diseases and the limited breast and cervical cancer screening of female migrants/refugees pose serious threats to their health and important challenges for the health services of Europe.

scholarly journals Impact of transforming mental health services for young people in England on patient access, resource use and health: a quasi-experimental study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034067 ◽  
Author(s):  
Stephen Rocks ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Waiting Times ◽  
Patient Access ◽  
Trade Offs ◽  
South East England ◽  
First Contact ◽  
Access Resource

ObjectiveTo evaluate the impact of child and adolescent mental health services (CAMHS) transformation in South East England on patient access, resource utilisation and health outcomes.DesignIn an observational study, we use difference-in-differences analysis with propensity score matching to analyse routinely collected patient level data.SettingThree CAMHS services in South East England.ParticipantsAll patients attending CAMHS between April 2012 and December 2018, with more than 57 000 spells of care included.Main outcome measuresThe rate and volume of people accessing CAMHS; waiting times to the first contact and waiting times between the first and second contact; and health outcomes, including the Strengths and Difficulties Questionnaire (SDQ) and the Revised Child Anxiety and Depression Scale (RCADS).ResultsThe intervention led to 20% (incidence rate ratio: 1.20; 95% CI: 1.15 to 1.24) more new patients starting per month. There was mixed evidence on waiting times for the first contact. The intervention led to 10% (incidence rate ratio: 1.10; 95% CI: 1.02 to 1.18) higher waiting time for the second contact. The number of contacts per spell (OR: 1.08; 95% CI: 0.94 to 1.25) and the rereferral rate (OR: 1.06; 95% CI: 0.96 to 1.17) were not significantly different. During the post intervention period, patients in the intervention group scored on average 3.3 (95% CI: −5.0 to −1.6) points lower on the RCADS and 1.0 (95% CI: −1.8 to -0.3) points lower on the SDQ compared with the control group after adjusting for the baseline score.ConclusionsOverall, there are signs that transformation can help CAMHS achieve the objectives of greater access and improved health outcomes, but trade-offs exist among different performance metrics, particularly between access and waiting times. Commissioners and providers should be conscious of any trade-offs when undertaking service redesign and transformation.

scholarly journals Impact of a fast-track assessment clinic on waiting times and non-attendance rates for new referrals to a community mental health centre

2005 ◽  
Vol 29 (11) ◽  
pp. 413-415 ◽  
Author(s):  
Akinwande Ogunbamise ◽  
Marion Reardon ◽  
Mo Mohoboob ◽  
Paul Lelliott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Fast Track ◽  
Waiting Times ◽  
Health Centre ◽  
Assessment Process ◽  
Community Mental Health Centre ◽  
Assessment Clinic ◽  
Mental Health Team ◽  
Mental Health Centre

Aims and MethodA new fast-track assessment (FTA) clinic was established by a community mental health team (CHMT) in SouthEast London. Previously, those who responded to an opt-in letter were offered an appointment with a duty worker or at an out-patient clinic. In the new system, all routine referrals are booked into a single fortnightly clinic staffed by two doctors and two to three other CMHT staff with post-clinic discussion of all cases (2–6 min per case). A total of 100 consecutive referrals before the introduction of the FTA clinic were compared with 100 following the introduction.ResultsThe interval between receipt of referral to first appointment offered was reduced from 55 to 18 days and to actual assessment from 71 to 26 days. Eighty-four referrals to the FTA were offered a first appointment date that was within 21 days of receipt of a referral, compared with four before the introduction of the FTA. These differences were highly significant. There was a trend for more patients to attend for assessment after the FTA clinic was introduced (79 compared with 68).Clinical ImplicationsThis simple re-engineering of the assessment process within a CMHT has achieved its objective of reducing waiting times to first assessment appointment. It also appears to have reduced the number of referrals that do not result in an assessment.

scholarly journals Problem severity and waiting times for young people accessing mental health services

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Jessica Deighton
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Waiting Times ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Area Deprivation ◽  
Multinomial Regression

Background Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. Aims The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services. Method Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services. Results There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services. Conclusions The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.

Mental Health Triage in Emergency Medicine

1999 ◽  
Vol 33 (1) ◽  
pp. 57-66 ◽  
Author(s):  
David Smart ◽  
Cecily Pollard ◽  
Bryan Walpole
Keyword(s):  
Mental Health ◽  
Medical Information ◽  
Mental Health Problems ◽  
Waiting Times ◽  
Health Problems ◽  
Mental Health Disorder ◽  
Liaison Psychiatry ◽  
Structured Education ◽  
Transit Times ◽  
Mental Health Patients

Objective: The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. Method: We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. Results: Afour-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health ‘did not waits’ showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. Conclusions: Asystematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

Systematic review of effectiveness and satisfaction evaluation in child and adolescent mental health services in Ireland

2021 ◽  
pp. 1-12
Author(s):  
D. Leahy ◽  
F. McNicholas
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
User Satisfaction ◽  
Service User ◽  
Waiting Times ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Sound Studies ◽  
Satisfaction Evaluation

Objectives: Increasing numbers of youth experience mental illness, and also require and benefit from specialist child and adolescent mental health services (CAMHS). Worldwide, such services are underfunded and under-resourced, and services in Ireland are no different. It is vital that existing services are regularly reviewed for both efficacy and acceptability. Our objective was to review published studies evaluating service user satisfaction with CAMHS in Ireland and CAMHS therapeutic efficacy. Methods: MEDLINE, PsycINFO and CINAHL databases were systematically searched. Studies were included if they reported on service user satisfaction or an evaluation of CAMHS in Ireland. Results: From an initial 125 articles identified, 15 studies meet the inclusion criteria: four reporting on overall CAMHS satisfaction, three on satisfaction where a specific diagnosis was present, while eight evaluated various interventions offered. Whilst most service users perceived services to be satisfactory, important issues relating to accessibility were present. Evidence of efficacy was present for a small number of interventions, but studies were limited by methodological issues. Conclusions: There is a dearth of studies evaluating CAMHS in Ireland. The extant literature suggests a positive experience once accessed, but long waiting times and poor collaboration are seen to limit services users’ experience. More robust methodologically sound studies are urgently required. Given the expected increased demand linked to the current COVID-19 pandemic, coupled with the resultant compromised financial position, it is essential that scant resources are appropriately directed.

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