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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)
Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP)
- Authors:
- TAK Erwin C.P.M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(7), 2016, pp.755-764.
- Publisher:
- Wiley
Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation. Methods: A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ-12)), depression (Geriatric Depression Scale 15-item version (GDS-15)), anxiety and suspicion (Symptom Checklist-90 (SCL-90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini-Mental State Examination (MMSE)). Results: GPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ-12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre-set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas. Conclusion: The Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. (Publisher abstract)
Mental health toolkit
- Author:
- ROYAL COLLEGE OF GENERAL PRACTITIONERS
- Publisher:
- Royal College of General Practitioners
- Publication year:
- 2016
- Place of publication:
- London
This toolkit brings together a range of resources for general practitioners (GPs) and healthcare professionals regarding the diagnosis and treatment of mental health problems. It includes trigger questions, diagnostic tools, and current guidance for healthcare professionals supporting those with mental illness. It also provides resources that may help GPs and primary care health professionals communicate better with patients. Sections of the toolkit include: suicide and crisis care; children and young people's mental health; mental health in palliative care and older adults, including dementia; prevention and wellbeing resources; information for commissioners; and resources to support healthcare professionals manage their own mental health. Links to relevant e-learning resources are also included. (Edited publisher abstract)
Quality of diagnosis and treatment plans after using the ‘diagnostic guideline for anxiety and challenging behaviours’ in people with intellectual disabilities: a comparative multiple case study design
- Authors:
- PRUIJSSERS Addy, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(4), 2016, pp.305-316.
- Publisher:
- Wiley
Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. Materials and Methods: A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. Results: The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Conclusions: Working with the ‘Diagnostic Guideline for Anxiety and CB’ leads to improved diagnoses and treatment plans compared with care as usual. (Publisher abstract)
Attention deficit hyperactivity disorder: diagnosis and management: CG72
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2016
This guideline makes recommendations for the diagnosis and management of attention deficit hyperactivity disorder (ADHD) in children, young people and adults. It aims to improve the diagnosis and the quality of care and support for people with ADHD and updates NICE guideline CG72 (published September 2008). The document provides guidance on: prerequisites of treatment and care for all people with ADHD; identification, pre-diagnostic intervention in the community and referral to secondary services; diagnosis of ADHD; post-diagnostic advice; treatment for children and young people; transition to adult services; treatment of adults with ADHD; and how to use drugs for the treatment of ADHD. The main updates to the guidance cover recommendations about dietary advice. The guideline was previously called 'Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults.' (Edited publisher abstract)