Search results for ‘Subject term:"mental health problems"’ Sort:
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Factors associated with experienced discrimination among people using mental health services in England
- Authors:
- HAMILTON S., et al
- Journal article citation:
- Journal of Mental Health, 25(4), 2016, pp.350-358.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Research has found considerable variation in how far individuals with a diagnosis of mental illness experience discrimination. Aims: This study tested four hypotheses: (i) a diagnosis of schizophrenia will be associated with more discrimination than depression, anxiety or bipolar disorder; (ii) people with a history of involuntary treatment will report more discrimination than people without; (iii) higher levels of avoidance behaviour due to anticipated discrimination will be associated with higher levels of discrimination and (iv) longer time in contact with services will be associated with higher levels of discrimination. Method: Three thousand five hundred and seventy-nine people using mental health services in England took part in structured telephone interviews about discrimination experiences. Results: A multiple regression model found that study year, age, employment status, length of time in mental health services, disagreeing with the diagnosis, anticipating discrimination in personal relationships and feeling the need to conceal a diagnosis from others were significantly associated with higher levels of experienced discrimination. Conclusion: Findings suggest that discrimination is not related to specific diagnoses but rather is associated with mental health problems generally. An association between unemployment and discrimination may indicate that employment protects against experiences of discrimination, supporting efforts to improve access to employment among people with a diagnosis of mental illness. (Publisher abstract)
Improving psychiatric diagnosis in multidisciplinary child and adolescent mental health services
- Authors:
- MICHELSON Daniel, et al
- Journal article citation:
- Psychiatrist (The), 35(12), December 2011, pp.454-459.
- Publisher:
- Royal College of Psychiatrists
Obtaining an accurate clinic diagnosis is a critical process in mental healthcare pathways. This study was designed to develop and test a new one-day diagnostic training intervention for multidisciplinary practitioners (n=63) in out-patient child and adolescent mental health services. The authors examined learning outcomes, practice impacts and the implementation processes. The work was conducted in an inner London area where previous audits had revealed large inconsistencies in rates of recorded diagnoses. Training was viewed positively by most participants and was associated with significant increases in practitioner self-efficacy; this effect was sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (less than 40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning. Support for implementation within teams was inconsistent. The authors conclude that a brief training workshop may have some impact on practitioners’ behaviour so that diagnoses are made more promptly and appropriately recorded. However, they suggest that future workforce development initiatives should consider more comprehensive and diversified strategies, including targeted post-training support, if increased self-efficacy following training is to be translated into sustained changes in diagnostic practice.
A prospective study of PTSD following recovery from first-episode psychosis: the threat from persecutors, voices, and patienthood
- Authors:
- BRUNET Kat, et al
- Journal article citation:
- British Journal of Clinical Psychology, 51(4), November 2012, pp.418-433.
- Publisher:
- Wiley
Focusing on post-traumatic symptoms and people with psychosis, this prospective study tested hypotheses based on retrospective findings that threat appraisals of voices, persecutors, or the new label of 'mental health patient' predict symptoms of post-traumatic stress disorder (PTSD). Fifty patients in Birmingham in the acute phase of a first psychotic episode were assessed for appraisals of threat from voices, other persecutors, and the diagnosis. 39 patients completed the follow-up stage 18 months later, which was designed to establish PTSD symptom levels and diagnosis. The article describes the study methodology, analysis, and results. It reports that 31% of participants who completed the follow up phase met criteria for PTSD diagnosis, and 49% were still distressed by memories of their psychosis or the associated treatment. Appraisals of threat from voices and persecutors during the acute phase of psychosis were generally not predictive of subsequent post-traumatic stress. The authors discuss the findings and suggest that further research is required to assess the true impact of psychosis on PTSD.
Service users' experience of receiving bad news about their mental health
- Authors:
- GALLAGHER Ann, et al
- Journal article citation:
- Journal of Mental Health, 19(1), February 2010, pp.34-42.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The breaking and receipt of bad news is little referred to in the mental health literature. This paper reports findings from a qualitative pilot study which set out to document service users’ experience of good and bad news from mental health professionals, to explore the impact of that news upon them, and to identify strategies used by professionals when breaking bad news. Semi-structured interviews were conducted with 10 mental health service users. The participants recounted key moments when good or bad news was delivered to them and described the impact of that news on their psychological well being. The results showed that the receiving of a diagnosis could be perceived as bad news or a cause of confusion where a diagnosis is changed. The importance of trust in professionals, the use of adequate time and information was considered important in buffering the impact of potentially bad news. The technique of comparing a mental disorder to a physical disorder is not always helpful. The article concludes that the delivery of bad news in mental health is more complex than a “good or bad news” paradigm and it should be done in the context of a good therapeutic alliance. An individualised approach to delivering news about diagnosis is advocated.
The evolution of mental disorder as a legal category in England and Wales
- Authors:
- FORRESTER Andrew, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(4), December 2008, pp.543-560.
- Publisher:
- Taylor and Francis
The Mental Health Act 2007 offers a significant conceptual departure from prior legislation in England and Wales. By abolishing important medical sub-categories and ignoring calls for capacity-based legislation, it refuses to recognise important differences between syndromes that have been carefully delineated over centuries, and denies medicine and the law common language. These ideological changes are set alongside important changes in services, but signify a new potential for mass preventive detention that will confuse detaining professionals, result in unnecessarily complex legal questions, and create a new potential for blame within a profession that has recently been inquiry (and blame) laden. The authors argue for the retention of sub-categorisation through a Code of Practice which has yet to be produced, or subsequent clinical practice. Professional restraint and good common sense will be necessary in the meantime.
Anxiety disorders: QS53
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2014
- Place of publication:
- Manchester
This quality standard covers the identification and management of anxiety disorders in primary, secondary and community care for children, young people and adults. These include generalised anxiety disorder, social anxiety disorder, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder and body dysmorphic disorder. The standard sets out the following four quality statements: people with a suspected anxiety disorder receive an assessment that identifies whether they have a specific anxiety disorder, the severity of symptoms and associated functional impairment; people with an anxiety disorder are offered evidence-based psychological interventions; they are not prescribed benzodiazepines or antipsychotics unless specifically indicated; and people receiving treatment for an anxiety disorder have their response to treatment recorded at each treatment session. (Edited publisher abstract)
Attention deficit hyperactivity disorder: QS39
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Place of publication:
- Manchester
This quality standard covers the diagnosis and management of attention deficit hyperactivity disorder (ADHD) in children aged 3 years and older, young people and adults. The standard comprises seven statements that describe high quality care for service users. These are: children and young people with symptoms of ADHD are referred to a specialist for an assessment; adults with symptoms of ADHD who have not had a diagnosis in childhood are referred to a specialist for an assessment; adults who had ADHD when they were younger and who still have symptoms of ADHD are referred to general adult psychiatric services; parents and carers of children and young people with symptoms of ADHD who meet NICE eligibility criteria are offered a referral to a parent training programme to help them manage their child’s behaviour; children and young people with moderate ADHD are offered a referral to a psychological group treatment programme; people with ADHD who are starting medication have their initial medication dose adjusted by a specialist, who should also check how well the medication is working; and people who are taking medication to treat ADHD have their medication reviewed by a specialist at least once a year. (Edited publisher abstract)
Therapeutic identification of depression in young people: lessons from the introduction of a new technique in general practice
- Authors:
- ILIFFE Steve, et al
- Journal article citation:
- British Journal of General Practice, 62(596), March 2012, pp.134-135.
- Publisher:
- Royal College of General Practitioners
Mild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. However, depression in teenagers is considered to be underdiagnosed and undertreated. Earlier recognition has the potential to reduce the burden of depression in adulthood. This qualitative study assessed the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY). The study was carried out across four group practices in northwest London. Face-to-face semi-structured interviews were conducted with twenty-five GPs and six nurses practitioners who had been trained in the use of the TIDY technique. The key themes that emerged from the interviews were: practitioners were `making sense of teenage depression' when interpreting signs and symptoms; the training in the technique was variable in its impact on practitioners' attitudes and practice; and time factors constrained practitioners in the application of the technique. The authors concluded that TIDY is usable in routine practice, but only if practitioners are allowed to use it selectively. This need for selectivity is based on concerns about time management and avoiding medicalisation of psychological distress in young people. The perceived usefulness of TIDY appeared to depend on the practitioner's prior knowledge, experience, and awareness.
Detection of patient psychological distress and longitudinal patient-doctor relationships: a cross-sectional study
- Authors:
- RIDD Matthew, et al
- Journal article citation:
- British Journal of General Practice, 62(596), March 2012, pp.132-133.
- Publisher:
- Royal College of General Practitioners
Research suggests that psychological distress and common mental health problems often go undetected in primary care. Although both disclosure and detection are thought to be influenced by how well the patient and doctor know each other this has received little attention in the literature. This cross-sectional study examined whether patient-doctor depth of relationship is associated with identification of psychological distress. Adult patients from general practices around Bristol completed a questionnaire and were consented for review of their electronic medical records. Study GPs independently assessed patient psychological distress. There were 643 eligible appointments with 31 GPs; 541 (84.1%) patients returned questionnaires and 490 (76.2%) consented to their records being reviewed. Patient-doctor depth of relationship was not associated with GP detection of mild to severe patient psychological distress but, in secondary analyses, it was associated with the identification of moderate to severe distress. GPs reported more patient psychological distress in patients who reported a greater depth of relationship but this did not relate to patients' 12-item General Health Questionnaire scores. The authors conclude that the evidence to support an association between patient-doctor depth of relationship and improved GP detection of psychological distress was weak, except in those patients who GPs thought were more distressed. It is suggested that GPs may overestimate emotional distress in patients who report deeper patient-doctor relationships.
Mary’s story
- Author:
- SCRAGG Terry
- Journal article citation:
- Social Care and Neurodisability, 2(1), 2011, pp.15-20.
- Publisher:
- Emerald
Prion diseases are progressive conditions affecting the brain and nervous systems. They impair brain function resulting in memory and personality changes and adversely affect movement over time. This article describes the impact of a prion on a family where the original diagnosis took four years to make. It describes the onset and first symptoms in 2001/2, the progressive deterioration in 2002/4, the need for services in 2005, and the diagnosis and final year in 2005/6. The article highlights the impact of caring on ‘Mary’, the husband of ‘Robert’, the difficulty in the diagnosis, and the distress and personal difficulties faced in arranging services due to Roberts increasing resistance to support from outside the family. The author highlights the importance of early diagnosis and support from health and social services, showing the even when the prognosis is terminal, the knowledge gained is preferable to the distress that uncertainty causes the individual and their families. The author concludes that when families ask for support from social and health services, it is often an indication that their resources are deplete, and are in crisis.