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Acute mental health admissions in inner London: changes in patient characteristics and clinical admission thresholds between 1988 and 1998
- Authors:
- FITZPATRICK N.K., et al
- Journal article citation:
- Psychiatric Bulletin, 27(1), January 2003, pp.7-11.
- Publisher:
- Royal College of Psychiatrists
The authors undertook a retrospective case-note review of three cohorts of mental health admissions to determine the extent to which patient and service characteristics changed between 1988 and 1998. Changes in clinical admission thresholds were investigated by a psychiatrists' review of handwritten medical admission assessments. Patients admitted in 1998 were demographically less stable and clinically more complex than those admitted 10 years earlier. Clinical admission thresholds remained consistent. Findings suggest that the perceived increase in pressure on psychiatric services over this period was a response to a change in population need. This study highlights important questions about the clinical decision-making process leading to use of alternatives to admission and the appropriateness of acute admissions.
We will keep you out of hospital
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 3.8.00, 2000, pp.30-31.
- Publisher:
- Reed Business Information
Reports on a north London crisis team which is striving to make care in the community work for people with mental health problems by working with clients in their homes and preventing their crises from leading to hospitalisation.
Changing patterns in the use of the Mental Health Act 1983 in England, 1984-1996
- Author:
- HOTOPF Matthew
- Journal article citation:
- British Journal of Psychiatry, 176, May 2000, pp.479-484.
- Publisher:
- Cambridge University Press
The Mental Health Act 1983 (MHA) is due to be revised by Parliament in the near future. This article aims to explore changes in the use since the Act's introduction. Presents absolute figures, by year, on the numbers of patients admitted to psychiatric hospitals under the MHA for the total numbers admitted under each section of the Act.
Service evaluation of the need for care and clinical risk management procedures using the Health of the Nation Outcome Scale (HoNOS) secure
- Authors:
- LIDDIARD Kim, et al
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.61-70.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore whether the current forensic mental health inpatient population within a medium secure unit is more or less complex (i.e. clinical and risk presentations) than former years using the Health of the Nation Outcome Scale (HoNOS) secure. Additionally, the use of the HoNOS secure as a service-wide measure is discussed in terms of its usefulness. Clinical implications and recommendations are offered for the continued use of the HoNOS secure in services more widely. Design/methodology/approach: A retrospective case review of completed HoNOS secure assessments for 130 patients over three time intervals 2012, 2015 and 2018 was used. A multivariate analysis was performed on the data using SPSS version 25. Findings: The findings revealed that contrary to clinical opinion, inpatients’ clinical and risk presentations had not changed significantly overtime. Research limitations/implications: The study shows the benefits of using the HoNOS secure at a service-wide level to explore and understand similarities and differences in inpatient admissions over time. It also highlights the usefulness of the HoNOS secure for considering different ward characteristics and the needs of patients residing in these environments. Originality/value: Although much research exists surrounding the individual use of the HoNOS secure in relation to outcomes, there is limited research focusing on use of the HoNOS secure at the service level. The paper therefore provides evidence of the utility and value of the HoNOS secure as a service-level outcome measure.
Relative invisibility: an integrative review of carers' lived experiences of a family member’s emergency mental health crisis
- Author:
- LAVOIE Jennifer A. A.
- Journal article citation:
- Social Work in Mental Health, 16(5), 2018, pp.601-626.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
An integrative review to evaluate and synthesise the current state of knowledge of family carers’ experiences of emergency psychiatric crises of an adult relative. A literature review was performed by searching key terms in EBSCO (CINAHL, Criminal Justice Abstracts, Social Work Abstracts), and Proquest (MEDLINE, PsycINFO) citation databases; 3,350 citations were retrieved and screened for inclusion. Data synthesis of 25 articles meeting inclusion criteria revealed the following five themes: building to crisis; conflicted emotional experience; police apprehension; invisible experts; and “need to know.” Findings provide essential insight into family carers experiences and needs during crisis that is informative for emergency mental health response practices. (Edited publisher abstract)
Stronger code: better care. Government response to the Consultation on the Mental Health Act 1983: code of practice
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2014
- Pagination:
- 90
- Place of publication:
- London
This document summarises responses and key theme identified from the consultation on revising the Mental Health Act 1983: Code of Practice. The consultation gave respondents an opportunity to evaluate how policies are being delivered and realised in practice, in areas including the use of restrictive interventions, seclusion, use of police powers to detain people in places of safety, and the use of community treatment orders. The consultation received almost 350 responses. Details are provide of the major changes made to the specific Code chapters and what respondents wanted to change, but have remained as they are. (Edited publisher abstract)
Mental Health Act 1983: code of practice
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2015
- Pagination:
- 457
- Place of publication:
- Norwich
This code of practice provides guidance to mental health professionals and other practitioners on how they should carry out their duties under the Mental Health Act. As well as providing guidance for professionals, the revised code of practice also guides patients, their families and carers on their rights. Chapters are grouped into seven areas: Using the Act; Protecting patient's rights and autonomy; Assessment, transport and admission to hospital; Additional considerations for the needs of specific patients; Care, support and treatment in hospital; Leaving hospital; and additional information for professional with specific responsibilities under the Act. Subjects covered in individual chapters include: the nearest relative; independent mental health advocates; mental capacity and deprivation of liberty; detention in hospital; police community treatment orders; guardianship; after care; and care programme approach. The code of practice will come into force on 1 April 2015, depending on Parliamentary approval. (Edited publisher abstract)
‘You don’t bring me flowers any more’: an investigation into the experience of stigma by psychiatric in-patients
- Authors:
- BROMLEY Joanna S., CUNNINGHAM Sara J.
- Journal article citation:
- Psychiatric Bulletin, 28(10), October 2004, pp.371-374.
- Publisher:
- Royal College of Psychiatrists
A structured interview-based questionnaire was used to measure the number of cards and gifts received by 40 people undergoing psychiatric in-patient treatment, compared with an age- and gender-matched group of medical in-patients. The study also assessed the amount of disclosure of admission and diagnosis to family and friends in the two groups. The psychiatric patients received about half as many cards as the medical patients (60 v. 112). Gifts to the psychiatric patients were often practical in nature and seldom included luxury items such as flowers. Disclosure of admission for mental illness (compared with the physical illness group) was significantly lower, both to family members (139 v. 193, P=0.041) and friends (74 v. 332, P=0.0001). The stigma of mental illness is reflected in the secrecy surrounding disclosure of hospital admission and the lack of tokens of support. Clinicians should be aware of the resulting sense of isolation and shame, and the consequences for mental health in view of reduced social networks increasing the risk of future relapse rates. Reduced contact with mentally ill patients has implications for society as a whole in maintaining the status quo of stigma.
Brunswick House: a weekend crisis house in North Staffordshire
- Authors:
- HODGSON Richard, CARR Darren, WEALLEANS Lynne
- Journal article citation:
- Psychiatric Bulletin, 26(11), December 2002, pp.453-455.
- Publisher:
- Royal College of Psychiatrists
Brunswick House provides an alternative to NHS facilities for people in crisis. Describes Brunswick House, the first crisis house in North Staffordshire, and assesses the use of acute psychiatric wards and the local accident and emergency department by Brunswick House residents. A mirror design study compared the use of these facilities in the year before with the year after a resident's first admission to Brunswick House.
Safeguard under threat?
- Author:
- LAURENT Claire
- Journal article citation:
- Community Care, 9.8.01, 2001, p.12.
- Publisher:
- Reed Business Information
Reports on how plans to end the role of approved social workers in consenting to a patient's company admission to hospital have provoked fears that an important safety net will be removed.