Search results for ‘Subject term:"mental health problems"’ Sort:
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Tribune group
- Author:
- SPENCER John
- Journal article citation:
- Health Service Journal, 23.9.99, 1999, p.28.
- Publisher:
- Emap Healthcare
Explains how the right of psychiatric patients to challenge their detention through a tribunal provides challenges for managers and clinicians.
Somatoform disorders: a help or hindrance to good patient care
- Authors:
- SHARPE Michael, MAYOU Richard
- Journal article citation:
- British Journal of Psychiatry, 184(6), June 2004, pp.465-467.
- Publisher:
- Cambridge University Press
Somatoform disorders include a hetero-geneous group of diagnoses united only by their tendency to present with somatic complaints. In DSM–III–R the specific subcategories included somatisation disorder, hypochondriasis, body dysmorphic disorder, conversion disorder and chronic pain disorder, but the classification proved inadequate to the clinical task and the most recent edition of DSM (DSM–IV) added the non-specific category of undifferentiated somatoform disorder. This diagnosis, which amounts to little more than relabelling the patient’s own complaint, has turned out in practice to be the most common of the somatoform diagnoses.
Social inclusion: what psychiatrists can do about it
- Authors:
- GLEESON Setfan, KINGDON David
- Journal article citation:
- A Life in the Day, 12(2), May 2008, pp.28-31.
- Publisher:
- Emerald
This article explores how the social inclusion agenda is changing the way psychiatrists assess and support patients. Practical steps are suggested to enable psychiatrists to promote a socially inclusive and better quality of life for their patients. The article concludes by focusing on employment as an area presenting considerable barriers to reintegration into society.
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.
Use of an in-patient psychiatric service by learning disabled children
- Authors:
- HOPPER Felicity, ROSE Gillian
- Journal article citation:
- British Journal of Learning Disabilities, 32(3), September 2004, pp.119-122..
- Publisher:
- Wiley
Despite recent political commitment to increasing access to all levels of health service provision for learning disabled people, there is still limited access to in-patient child psychiatric care for learning disabled children. Describes the experiences of an in-patient unit integrating learning disabled children into a peer group, the majority of whom have normal intellectual function. A case note review was undertaken of all children with a global learning disability admitted to the Collingham Gardens in-patient unit between January 2000 and December 2001. Discusses how similar services may be developed to be more inclusive for learning disabled children.
Audit of disposal of clinically confidential information
- Authors:
- DIETRICH Craige, KHAN Zahir, WARNER James
- Journal article citation:
- Psychiatric Bulletin, 28(9), September 2004, pp.324-325.
- Publisher:
- Royal College of Psychiatrists
The authors conducted a 3-cycle audit of disposal of clinically sensitive information in a mental health unit, in order to identify and reduce potential breaches in patients’ confidentiality. Material from waste bins in administrative areas of a mental health unit was examined every evening during each period of the audit. The first search, conducted over a 3-week period, yielded 11 documents containing highly-sensitive information about patients. After feedback to staff and improvement of shredding facilities, no sensitive information was found during the follow-up 3-week survey, 3 months later. However, a third survey 2 years later found 24 highly-sensitive items after one week, despite shredding facilities being maintained. Changes in behaviour identified in this audit appear to be due to education rather than improved facilities. All staff involved in patient care need to maintain awareness of the need for safe disposal of confidential material.
Audit of psychiatric discharge summaries: completing the cycle
- Authors:
- CROSSNAN Isabelle, CURTIS David, ONG Yong-Lok
- Journal article citation:
- Psychiatric Bulletin, 28(9), September 2004, pp.329-331.
- Publisher:
- Royal College of Psychiatrists
The aim was to examine and attempt to improve the recording of information within psychiatric discharge summaries in an adult psychiatry department, by means of audit and feedback. Psychiatric discharge summaries from an acute adult psychiatric department were examined to determine the recording of ten selected items. Following feedback and discussion, the audit was repeated after 6 months. Fifty-one discharge summaries were examined on the first occasion and 53 on the second. There was considerable variability in the standard of recording across the selected items, but the patterns of recording were similar at both stages. No improvement was found in the recording of information at the second audit. Audit and feedback alone may have little effect in changing clinical practice. This study examines the experience of undertaking clinical audit from a trainee’s perspective, illustrates barriers to change and highlights the possible limitations of audit as a clinical tool.
Non-attendance rates among patients attending different grades of psychiatrist and a clinical psychologist within a community mental health clinic
- Authors:
- McIVOR Ronan, EK Emma, CARSON Jerome
- Journal article citation:
- Psychiatric Bulletin, 28(1), January 2004, pp.5-7.
- Publisher:
- Royal College of Psychiatrists
Examines non-attendance rates in patients seen by psychiatrists of different grades and a consultant clinical psychologist. Rates were obtained from the patient administration system over a 21-month period. A planned linear contrast showed that the clinical psychologist's patients had the lowest rate of non-attendance (7.8%), followed in turn by those of consultant psychiatrists (18.6%), specialist registrars (34%) and senior house officers (37.5%). Factors such as continuity of care, perceived clinical competence and the provision of non-medical interventions might have an impact on attendance rates. These results indicate the difficulty in reconciling the training needs of junior doctors with the provision of continuity and quality of care for patients. Reminder systems for people seeing training doctors might be an effective way of reducing non-attendance rates.
Professor Sir Ernst Gombrich, OM : a'hands-on' advocate of music therapy in mental hospitals
- Author:
- ROLLIN H. R.
- Journal article citation:
- Psychiatric Bulletin, 27(1), January 2003, pp.28-29.
- Publisher:
- Royal College of Psychiatrists
One of the major attractions of the music therapy project was to hold monthly concerts featuring members of the group for the entertainment of other patients at the hospital, any interested members of staff, and a surprisingly large number of patients' relatives, who came mainly from London.