Search results for ‘Subject term:"mental health problems"’ Sort:
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Regional reviews of tier 4 child and adolescent mental health services: summary and comment
- Author:
- KURTZ Zarrina
- Publisher:
- Care Services Improvement Partnership. Children, Young People and Families Programme
- Publication year:
- 2007
- Pagination:
- 93p.
- Place of publication:
- London
In-patient care, provided at Tier 4 level, is a specialised field aimed at provision of high-quality care for young people with serious mental health problems. This report summarises analyses and comments upon the findings from Reviews of Tier 4 Child and Adolescent Mental Health Services (CAMHS),undertaken during the past year or two, in the nine regions of England.
Attitudes to mental illness 2007
- Author:
- CARE SERVICES IMPROVEMENT PARTNERSHIP. Shift
- Publisher:
- Great Britain. National Statistics
- Publication year:
- 2007
- Pagination:
- 46p., tables
- Place of publication:
- London
Since March 1993, the Department of Health has placed a set of questions on TNS’ Face-to-Face Consumer Omnibus. From 1993 to 1997 the questions were asked on an annual basis, thereafter they have been asked every third year up until 2003. The current 2007 survey follows four years after the previous survey. These surveys serve as a tracking mechanism, and in this report, the most recent results are compared with those from previous years. The respondents in the surveys were presented with a number of statements about mental illness. They covered a wide range of issues from attitudes towards, and perceptions of people with mental illness, to opinions on services provided for people with mental health problems.
Guardianship of people with mental disorders
- Authors:
- MELAMED Yuval, DORON Israel, SHNITT Dan
- Journal article citation:
- Social Science and Medicine, 65(6), September 2007, pp.1118-1123.
- Publisher:
- Elsevier
The duty of a guardian is to protect a patient who is unable to care for himself or herself. Guardianship has been considered an abrogation of autonomy while conversely it often prevents irreversible harm to the patient. We examined the decision-making process for appointing a guardian in 60 cases from one mental health center in Israel, by examining the patients’ medical records and court appeals. The results of our study suggest that guardians are usually appointed only in extreme cases, though alternative solutions are rarely sought, and that clear criteria for physicians when recommending guardianship are lacking.
The development of the Profile of Adaptation to Life within a medically ill population: PAL-M
- Authors:
- BRINTZENHOFESZOC Karlynn, et al
- Journal article citation:
- Social Work in Health Care, 45(2), 2007, pp.43-58.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The social work department at a biomedical research hospital was challenged to improve efficiency and accountability regarding psychosocial care of its patients. This article presents the process of selecting and revising the Profile of Adaptation to Life (PAL) into a screening instrument that identifies the hospital's most vulnerable patients who need to have a full psychosocial assessment completed by the social worker. The PAL was selected because it includes identifiable risk factors across the psychosocial spectrum, is cost-effective, and easy to administer and score. Factor analysis and reliability analysis resulted in a promising instrument, the Profile for Adaptation to Life-Medical (PAL-M), for use in rapid, psychosocial risk screening with medically ill patients. Based on the analysis, the authors updated the PAL's original language, clarified introductory wording of some questions, and expanded demographic information. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Reliability and validity of a performance-based measure of skills for communicating with doctors for older people with serious mental illness
- Authors:
- PRATT Sarah I., et al
- Journal article citation:
- Journal of Mental Health, 16(5), October 2007, pp.569-579.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Older people with serious mental illnesses (SMI) have high rates of medical comorbidity and impaired social skills, including basic communication skills that are imperative for medical encounters. The aim was to examine two role-plays developed to evaluate communication in a health care visit. A total of 152 people over age 50 with SMI were rated on two standardized medical visit role-plays. This assessment had excellent inter-rater reliability and test-retest reliability. Performance was not related to gender or age, although participants with a mood disorder had better social skill performance than those with schizophrenia or schizoaffective disorder. Performance was strongly related to the Social Skills Performance Assessment (SSPA), designed to assess basic communication skills in older people with SMI. Performance was also correlated with self-care skills, social functioning, number of medical visits within the past six months, and informant rating of the effect of physical condition on functioning. This assessment demonstrates acceptable psychometric properties, including reliability and convergent validity, and may be a useful tool to assess basic communication skills for discussing health care concerns.
Mental capacity in psychiatric patients: systematic review
- Authors:
- OKAI David, et al
- Journal article citation:
- British Journal of Psychiatry, 191(10), October 2007, pp.291-297.
- Publisher:
- Cambridge University Press
Mental capacity is central to legal and ethical debates on the use of compulsion in psychiatry. The aim was to describe the clinical epidemiology of mental incapacity in patients with psychiatric disorders, including interrater reliability of assessments, frequency in the psychiatric population and associations of mental incapacity. Cross-sectional studies of capacity to consent to treatment for psychiatric patients were systematically reviewed from Medline, EMBASE and PsycInfo databases. Information on the reliability of assessments, frequency and associations of mental incapacity was extracted. Out of 37 papers reviewed, 29 different capacity assessment tools were identified. Studies were highly heterogeneous in their measurement and definitions of capacity. Interrater reliabilities between tools were high. Studies indicate incapacity is common (median 29%) but the majority of psychiatric in-patients are capable of making treatment decisions. Psychosis, severity of symptoms, involuntary admission and treatment refusal were the strongest risk factors for incapacity. Mental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio-demographic variables do not have a major impact but clinical ones do.
Roles of general adult psychiatrists in follow-up clinics
- Authors:
- MEHTA Sunil, SALVAJI Abhijeetha, ABED Riadh
- Journal article citation:
- Psychiatric Bulletin, 31(10), October 2007, pp.381-384.
- Publisher:
- Royal College of Psychiatrists
Core features of New Ways of Working include concentrating on service users with complex needs, acting in a consultative role and carrying out interventions that are timely rather than routine. In this service-mapping exercise a retrospective analysis of 150 case notes was performed to evaluate clinical activity in general adult out-patient clinics and to attempt to measure the complexity of the workload. Analysis of care programme approach (CPA) level revealed that 40% of patients were not on CPA and 16% of patients were on enhanced CPA. Only a third of the sample had a non-medical care coordinator. Absolutely no changes were made to the management plan in around half of the sample. A minority of patients needed to be seen acutely, within a month, or had their appointment brought forward. Current out-patient activity of consultant teams does not appear to be consistent with New Ways of Working. Psychiatrists will be required to reflect on their roles in out-patient clinics to avoid ‘routine’ appointments and to use their time more efficiently.
Psychiatrists’ smoking cessation activities with Ohio community mental health center patients
- Authors:
- PRICE James H., et al
- Journal article citation:
- Community Mental Health Journal, 43(3), June 2007, pp.251-266.
- Publisher:
- Springer
This study describes a survey of Ohio community mental health center psychiatrists’ perceptions and practices regarding smoking cessation activities using the 5A’s method of smoking cessation. Of the 150 psychiatrists surveyed, 80 (53%) were returned. The majority of psychiatrists reported asking their patients about cigarette smoking status as well as giving advice to quit. However, the practice of actually facilitating quit attempts (i.e. with social support, nicotine replacement therapy, referrals, and follow-up visits) was lacking. This demonstrates that although cigarette smoking in individuals with mental illness is recognized as a major problem by adult psychiatrists, too little is being done to adequately address the issue.
Treating violence: a guide to risk management in mental health
- Author:
- MADEN Tony
- Publisher:
- Oxford University Press
- Publication year:
- 2007
- Pagination:
- 189p., bibliog.
- Place of publication:
- Oxford
Treating Violence deals with the problem of violence by mental health patients. Over the last twenty years violence by the mentally ill has grown from just a peripheral concern to dominate debate about services. Scientific studies have established beyond reasonable doubt that mental disorders lead to violence in a minority of sufferers, whilst a series of homicide inquiries brought the media spotlight to bear on the real and imagined failings of mental health services. Consequently, health services have had violence risk assessment thrust upon them by worried managers and politicians. Clinicians were bewildered by the growing number of risk scales and they felt vulnerable to criticism when things went wrong. This book provides a way out of the confusion. It summarises the evidence, critically reviews risk assessment methods, and presents a strong case for improving management through structured clinical assessment. In this account, standardised risk assessment is discussed in a critical, non-technical way, with a reminder that nobody can predict the future. There is advice for the clinician on when and how to use standardised assessment, along with a strong defence of clinical methods. Topics include: research on violence, mental health, and risk prediction; the ethics of violence risk assessment; homicide inquiries in the UK, with the results of a new study reviewing their findings; a discussion of professional attitudes towards violence risk; a description of risk assessment tools and recommendations for their use; and a strong defence of structured clinical assessment as the best way of managing risk. This is a book that should be read by anybody working in front line mental health services or criminal justice. It will also be of interest to those who have read the headlines about mental illness and violence and want to know more about the facts and the controversies that lie behind them.
A model of integrated primary care for HIV-positive patients with underlying substance use and mental illness
- Authors:
- ZALLER N., GILLANI F.S., RICH J.D.
- Journal article citation:
- AIDS Care, 19(9), October 2007, pp.1128-1133.
- Publisher:
- Taylor and Francis
There is a high burden of underlying substance use and mental illness in HIV-infected populations. HIV-care settings provide an important opportunity to assess substance and mental health needs among HIV-positive patients and to provide or make referrals for appropriate treatment services. In 2003, with funding from the Center for Substance Abuse Treatment (CSAT), a model of integrated substance-use counselling and referral for treatment was developed within a primary care HIV-care setting at The Miriam Hospital in Providence, Rhode Island. The project uses a multidisciplinary approach to provide linkage to treatment services for substance use and mental illness as well as to help participants with social service needs, such as housing and medical coverage, to ensure continuity of care and optimal HIV treatment adherence. Twelve percent of the 965 HIV-infected patients in care at the center have been enrolled in the project. Of these, all have a current substance-use disorder and 79.3% have been diagnosed with a mental illness. In addition, most participants are hepatitis C-positive (HCV) (65.5%). The majority of participants are on antiretroviral therapy (76.7%). Participants have been referred for the following treatment modalities: intensive outpatient services, methadone, buprenorphine, outpatient services and residential as well as individual and group counselling. The model has been successful in assessing the substance-use and mental health needs of HIV-infected individuals with numerous co-morbidities and referring them for ancillary medical and social services.