Journal articles on the topic 'Psychiatry hospitals'
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1
Gehri, Beatrice, Stefanie Bachnick, René Schwendimann, and Michael Simon. "Matching Registered Nurse Services With Changing Care Demands in Psychiatric Hospitals: Protocol for a Multicenter Observational Study (MatchRN Psychiatry Study)." JMIR Research Protocols 10, no. 8 (August 17, 2021): e26700. http://dx.doi.org/10.2196/26700.
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Background The quality of care is often poorly assessed in mental health settings, and accurate evaluation requires the monitoring and comparison of not only the outcomes but also the structures and processes. The resulting data allow hospital administrators to compare their patient outcome data against those reported nationally. As Swiss psychiatric hospitals are planned and coordinated at the cantonal level, they vary considerably. In addition, nursing care structures and processes, such as nurse staffing, are only reported and aggregated at the national level, whereas nurse outcomes, such as job satisfaction or intention to leave, have yet to be assessed in Swiss psychiatric hospitals. Because they lack these key figures, psychiatric hospitals’ quality of care cannot be reasonably described. Objective This study’s purpose is to describe health care quality by exploring hospital structures such as nurse staffing and the work environment; processes such as the rationing of care; nurse outcomes, including job satisfaction and work-life balance; and patients’ symptom burden. Methods MatchRN Psychiatry is a multicenter observational study of Swiss psychiatric hospitals. The sample for this study included approximately 1300 nurses from 113 units of 13 psychiatric hospitals in Switzerland’s German-speaking region. In addition, routine patient assessment data from each participating hospital were included. The nurse survey consisted of 164 items covering three dimensions—work environment, patient safety climate, and the rationing of care. The unit-level questionnaire included 57 items, including the number of beds, number of nurses, and nurses’ education levels. Routine patient data included items such as main diagnosis, the number and duration of freedom-restrictive measures, and symptom burden at admission and discharge. Data were collected between September 2019 and June 2021. The data will be analyzed descriptively by using multilevel regression linear mixed models and generalized linear mixed models to explore associations between variables of interest. Results The response rate from the nurse survey was 71.49% (1209/1691). All data are currently being checked for consistency and plausibility. The MatchRN Psychiatry study is funded by the participating psychiatric hospitals and the Swiss Psychiatric Nursing Leaders Association (Vereinigung Pflegekader Psychiatrie Schweiz). Conclusions For the first time, the MatchRN Psychiatry study will systematically evaluate the quality of care in psychiatric hospitals in Switzerland in terms of organizational structures, processes, and patient and nurse outcomes. The participating psychiatric hospitals will benefit from findings that are relevant to the future planning of nurse staffing. The findings of this study will contribute to improvement strategies for nurses’ work environments and patient experiences in Swiss psychiatric hospitals. International Registered Report Identifier (IRRID) DERR1-10.2196/26700
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Perlman, Christopher M., Jane Law, Hui Luan, Sebastian Rios, Dallas Seitz, and Paul Stolee. "Geographic Clustering of Admissions to Inpatient Psychiatry among Adults with Cognitive Disorders in Ontario, Canada: Does Distance to Hospital Matter?" Canadian Journal of Psychiatry 63, no. 6 (February 6, 2018): 404–9. http://dx.doi.org/10.1177/0706743717745870.
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Objective: This study examined relationships among hospital accessibility, socio-economic context, and geographic clustering of inpatient psychiatry admissions for adults with cognitive disorders in Ontario, Canada. Method: A retrospective cross-sectional analysis was conducted using admissions data from 71 hospitals with inpatient psychiatry beds in Ontario, Canada between 2011 and 2014. Data included 7,637 unique admissions for 4,550 adults with a DSM-IV diagnosis of Delirium, Dementia, Amnestic and other Cognitive Disorders. Bayesian spatial Poisson regression was employed to examine the relationship between accessibility of general hospitals with psychiatric beds and psychiatric hospitals, area-level marginalization, and hospitalization rate with the risk of admission to inpatient psychiatry among adults with cognitive disorders across 516 Forward Sortation Areas (FSA) in Ontario. Results: Residential instability and the overall hospitalization rate were significantly associated with an increase in the relative risk of admissions to inpatient psychiatry. Accessibility to general hospitals and psychiatric hospitals were marginally insignificant at the 95% credible interval in the final model. Significant geographic clustering of admissions was identified where individuals residing in FSA's with the highest relative risk were 2.0 to 7.1 times more likely to be admitted to inpatient psychiatry compared to the average. Conclusions: Geographic clustering of inpatient psychiatry admissions for adults with cognitive disorders exists across the Province of Ontario, Canada. At the geographic level, the risk of admission was positively associated with residential instability and the overall hospitalization rate, but not distance to the closest general or psychiatric hospital.
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Harpøth, A., H. Kennedy, and L. Sørensen. "Modernized architecture may reduce coercion." European Psychiatry 64, S1 (April 2021): S127—S128. http://dx.doi.org/10.1192/j.eurpsy.2021.357.
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IntroductionPrevention and treatment of aggression in psychiatric hospitals is achieved through appropriate medical treatment, professional skills, and optimized physical environment and architecture. Coercive measures are used as a last resort. In 2018 Aarhus University Hospital Psychiatry moved from 19th-century asylum buildings to a newly built modern psychiatric hospital. Advances within psychiatric care have rendered the old psychiatric asylum hospitals inadequate for modern treatment of mental disorders.ObjectivesTo examine if relocating from a psychiatric hospital, dating from 19th century to a new, modern psychiatric hospital decreased the use of coercive measures.MethodsThis is a retrospective longitudinal study, with a follow-up from 2017 to 2019. We use two designs; 1) a pre-post analysis of the use of coercive measures at Aarhus University Hospital Psychiatry before and after the relocation and 2) a case-control analysis of Aarhus University Hospital Psychiatry and the other psychiatric hospitals in the Central Region. Data will be analyzed in STATA using an interrupted time-series analysis or similar method. Additionally case-mix and sensitivity analysis will be performed.ResultsPreliminary results show a 45% decrease in the total number of coercive measures and a 52% decrease in the use of mechanical restraint. The reduction that may reasonably be attributed to the relocation is still to be determined and will be presented at the congress.ConclusionsThe study may illuminate how future development and planning of psychiatric facilities might improve psychiatric treatment and increase the understanding of how structural changes might contribute the prevention of the use of coercive measures.DisclosureNo significant relationships.
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Fraser, R. M., and Rosemary Healy. "Psychogeriatric Liaison: A Service to a District General Hospital." Bulletin of the Royal College of Psychiatrists 10, no. 11 (November 1986): 312–14. http://dx.doi.org/10.1192/pb.10.11.312.
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Liaison psychiatry has been an influential element in hospital psychiatric practice for over a decade now. It is concerned with the ‘diagnosis, treatment, study, and prevention of psychiatric disorders among patients in non-psychiatric health care institutions, especially in general hospitals’. This paper describes and evaluates a project in which the principles of liaison psychiatry were incorporated into a psychogeriatric service.
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Black, Eddie, Richard Moore, and Tony Whitehead. "A Psychiatric Service Almost Without a Psychiatric Hospital." Bulletin of the Royal College of Psychiatrists 10, no. 2 (February 1986): 29–31. http://dx.doi.org/10.1192/s0140078900026651.
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For the past twenty years or more it has been suggested that all our large psychiatric hospitals should be closed and psychiatry transferred to the community. This idea has generated a large amount of discussion, innumerable papers and much anxiety. More recently it has become the stated objective of the Department of Health, and now every region in the country is making concrete plans to transfer psychiatry from the mental hospital to facilities in the community with the definite objective of closing down psychiatric hospitals within a measurable time. Naturally this has generated even more discussion—and even more anxiety.
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Mayou, Richard. "The History of General Hospital Psychiatry." British Journal of Psychiatry 155, no. 6 (December 1989): 764–76. http://dx.doi.org/10.1192/bjp.155.6.764.
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General hospital psychiatry in Britain began in 1728, and thereafter several new voluntary hospitals provided separate wards for lunatics, but none survived beyond the middle of the 19th century. Less severe nervous organic disorder has always been common in the general wards of voluntary hospitals, and was accepted as the responsibility of neurologists and other physicians; all forms of disorder were admitted to the infirmaries of workhouses. During the present century psychiatrists began to take an interest in non-certifiable mental illnesses and in working in general hospitals. Out-patient clinics became more common following the Mental Treatment Act 1930. The growth of general hospital psychiatric units in the last 30 years began amidst controversy, but has received little recent critical attention.
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Foster, Paul. "Working in consultation-liaison psychiatry in the USA." Psychiatric Bulletin 13, no. 3 (March 1989): 123–26. http://dx.doi.org/10.1192/pb.13.3.123.
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Consultation-liaison psychiatry had its inception in North America, the term making its first appearance in the 1930s to describe the department at Colorado General Hospital in Denver. As Mayou (1987) points out, when comparing British and American liaison services, the role, boundaries, and organisation of this subspecialty are very different in the two countries. Money and resources do not exist in Britain within the National Health Service to provide the extent of involvement liaison psychiatry now enjoys with the general wards of many American hospitals. Thomas (1985) refers to basic differences between the countries. He points out that few British district general hospitals have consultation psychiatric units now in place and that the theoretical background of psychiatrists in the two countries are different. In addition, he suggests that there may well be differences in the referral patterns and expectations with regard to psychiatric consultation requirements of general hospital doctors in the two health care systems.
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Marlowe, Karl. "Psychiatry in Bermuda." Psychiatric Bulletin 23, no. 4 (April 1999): 236–37. http://dx.doi.org/10.1192/pb.23.4.236.
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Bermuda has one psychiatric hospital, which is organised along a programme model; an acute programme, a rehabilitation programme, a child and adolescent programme, a substance misuse programme and a learning disability programme. Bermuda has good resources and the majority of staff are trained in British hospitals. There has been a shift away from the stigma of mental hospitals towards a more community-oriented mental health service.
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Yeatman, Richard. "A Survey of Alcohol and Drug Services to General Hospitals in Australia." Australasian Psychiatry 13, no. 2 (June 2005): 124–28. http://dx.doi.org/10.1080/j.1440-1665.2005.02174.x.
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Objective: To determine the structure and function of alcohol and drug services to general hospitals in Australia, and to examine the role psychiatry plays in those services. Method: A survey of 15 large metropolitan hospitals was conducted. Results: Services differed considerably between hospitals, and psychiatric involvement was not prominent in most. Conclusions: One of the challenges is to structure the administration of services so that they have a profile within the general hospital as well as close connectionwith community services. Psychiatrists must become more proactive in the area to reinforce what they have to offer these patients and to provide mentorship and training to psychiatric trainees in the field.
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Suzuki, Akihito. "Japanese imperial psychiatry in Tokyo: two Korean immigrants in a psychiatric hospital, 1920-1945." História, Ciências, Saúde-Manguinhos 29, suppl 1 (2022): 47–59. http://dx.doi.org/10.1590/s0104-59702022000500004.
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Abstract During the first half of the twentieth century, Western psychiatry was quickly absorbed in Japan, particularly the versions from Germany and Austria. By 1940, over 130 psychiatric hospitals were caring for approximately thirty thousand patients in cities, while in rural areas about sixty thousand people still depended on family members for care. Japan’s empire expanded during this same period, and many immigrants came to the country. Growth in immigration from Korea was particularly important. Korean immigrants encountered Japanese psychiatric hospitals during the second quarter of the twentieth century, and this paper examines the complex nature of their hospital stays.
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Leff, Julian. "Evaluating the Transfer of Care from Psychiatric Hospitals to District-Based Services." British Journal of Psychiatry 162, S19 (April 1993): 6. http://dx.doi.org/10.1192/s0007125000292180.
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In July 1983 the Regional Medical Officer of the North East Thames Regional Health Authority (NETRHA) appeared on television to announce the closure of Claybury Hospital and much of Friern Hospital over a ten-year period.When NETRHA announced its decision, the policy to be pursued was innovative because it involved psychiatric hospitals serving inner-city populations, and because there was apparently no intention to achieve its aim by decanting patients into other psychiatric hospitals, as had been done with the closures of St Wulstan's and Banstead Hospitals. Although the run-down of psychiatric hospitals had been occurring at a steady rate in the United States and in England and Wales since the early 1950s, there had been few attempts to evaluate the policy, and none had been in any sense comprehensive (this supplement, paper 7). Clinicians and research workers in the field of social psychiatry were well aware of the need for large-scale evaluative studies, since protagonists and opponents of the policy of deinstitutionalisation were locked in a polemical argument which was pursued with increasing stridency through lack of reliable information.
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Lay, B., C. Nordt, and W. Rössler. "Variation in use of coercive measures in psychiatric hospitals." European Psychiatry 26, no. 4 (May 2011): 244–51. http://dx.doi.org/10.1016/j.eurpsy.2010.11.007.
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AbstractPurposeThe use of coercive measures in psychiatry is still poorly understood. Most empirical research has been limited to compulsory admission and to risk factors on an individual patient level. This study addresses three coercive measures and the role of predictive factors at both patient and institutional levels.MethodsUsing the central psychiatric register that covers all psychiatric hospitals in Canton Zurich (1.3 million people), Switzerland, we traced all inpatients in 2007 aged 18–70 (n = 9698). We used GEE models to analyse variation in rates between psychiatric hospitals.ResultsOverall, we found quotas of 24.8% involuntary admissions, 6.4% seclusion/restraint and 4.2% coerced medication. Results suggest that the kind and severity of mental illness are the most important risk factors for being subjected to any form of coercion. Variation across the six psychiatric hospitals was high, even after accounting for risk factors on the patient level suggesting that centre effects are an important source of variability. However, effects of the hospital characteristics ‘size of the hospital’, ‘length of inpatient stay’, and ‘work load of the nursing staff’ were only weak (‘bed occupancy rate’ was not statistically significant).ConclusionThe significant variation in use of coercive measures across psychiatric hospitals needs further study.
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VandenBerg, Amy M., and Diana Mullis. "Integrating psychiatric PharmD services into an emergency department psychiatry team." Mental Health Clinician 4, no. 6 (November 1, 2014): 279–82. http://dx.doi.org/10.9740/mhc.n207279.
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Typical services for psychiatric pharmacists include inpatient psychiatry units and outpatient psychiatry clinics. An increasingly common portal of entry to psychiatric hospitals, however, is the emergency department (ED). We describe a new clinical pharmacy service for psychiatric patients in the ED at our institution.
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Tyrer, Peter. "The Hive System." British Journal of Psychiatry 146, no. 6 (June 1985): 571–75. http://dx.doi.org/10.1192/bjp.146.6.571.
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Psychiatry has an advantage over other medical disciplines in that its skills are ones that can be practised in almost any setting. Although this is a truism it is worth repeating as psychiatry is still strongly associated with hospital treatment in the public mind. This view is endorsed by the activities of most psychiatrists, who spend their working lives in psychiatric hospitals or in extensions of them such as out-patient clinics or day hospitals. The reasons for this are at least partly historical. The great mental hospital building programme of the 19th century was planned deliberately to set up hospitals in isolated areas away from the centre of the community they served (Scull, 1979). Many countries are still left with this legacy of mental quarantine and find it difficult to overcome its geographical handicaps. Although it is appreciated that more patients can be treated successfully outside hospital it is often easier to follow the maxim, “if in doubt don't keep them out” and admit patients who seem to need further assessment. This is understandable whilst most personnel are based within the hospital and is certainly easier than setting up alternative systems of care away from the hospital base.
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Ikkos, George. "Psychiatric Discharge Summaries in Mental Handicap Settings." Bulletin of the Royal College of Psychiatrists 11, no. 7 (July 1987): 228–29. http://dx.doi.org/10.1192/s0140078900017223.
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Selective abstraction of information and good communication are essential in the practice of psychiatry. A good psychiatric discharge summary performs both these functions and can therefore be a significant aid in patient management. The need for a good psychiatric discharge summary is no less necessary in the psychiatry of mental handicap than in general adult psychiatry. However, the psychiatry of mental handicap does differ in some respects from that of general adult psychiatry. This difference therefore should be reflected in the psychiatric discharge summary in mental handicap settings if the summary is to represent accurately the clinical process. This fact was recognised by the Medical Executive Committee of Leavesden Hospital and it was therefore decided to provide specific guidelines on the writing of discharge summaries in a mental handicap in-patient setting to junior trainees in that hospital. Below is a document which I prepared at the request of the Medical Executive Committee, and which has now been officially accepted by them. It is hoped that its publication will be of interest to readers working in other mental handicap hospitals.
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Touyz, Stephen, Alex Blaszczynski, Erol Digiusto, and Donald Byrne. "The Emergence of Clinical Psychology Departments in Australian Teaching Hospitals." Australian & New Zealand Journal of Psychiatry 26, no. 4 (December 1992): 554–59. http://dx.doi.org/10.3109/00048679209072088.
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Over recent years, clinical psychological services have diversified within the health sector, leading to a breakdown in the traditional nexus between clinical psychology and psychiatry, and to the emergence of the interdisciplinary field of behavioural medicine. From their earlier limited role as providers of psychometric assessments in educational and psychiatric hospital settings, clinical psychologists now provide a wide range of therapeutic services and research skills to general hospitals, universities, community health centres, and the private sector. This evolving trend has significant implications for the future structure and direction of clinical practices in clinical psychology, psychiatry and medicine.
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Swanwick, Gregory, and Anthony Clare. "Inpatient liaison psychiatry: the experience of two Irish general hospitals without psychiatric units." Irish Journal of Psychological Medicine 11, no. 3 (September 1994): 123–25. http://dx.doi.org/10.1017/s0790966700014804.
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AbstractObjective: The aim of this study was to examine the provision of psychiatric care to inpatients in two Irish general hospitals without psychiatric units and to comment on (a) how this service model compares with previous Irish studies, (b) whether it meets the goals of liaison psychiatry, and (c) the implications for future service planning. Method: Demographic and clinical details relating to all the psychiatric consultations to inpatients (i.e. there was no emergency service to the casualty department) in two general hospitals were collected over a six month period. Results: Although the service was provided on a nonemergency basis the referral rate [1.6% of total admissions], patient characteristics, reasons for referral, diagnoses, and suggested management strategies were very similar to previous Irish studies. Assessment of deliberate self-harm cases was the most common reason for referral [37.9% of 145 referrals]. Notably, there was a high level of diagnostic accuracy from non-psychiatric colleagues in this liaison model. Conclusions: This study, of a service model characterised by an emphasis on liaison, points to efforts on the part of the psychiatrist to improve communication with medical and surgical colleagues as being of primary importance in the development of general hospital psychiatry services.
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Fahy, Thomas A., Donald Bermingham, and John Dunn. "Police Admissions to Psychiatric Hospitals: A Challenge to Community Psychiatry?" Medicine, Science and the Law 27, no. 4 (October 1987): 263–68. http://dx.doi.org/10.1177/002580248702700405.
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Compulsory police admissions from an urban and a rural catchment area with admission rates higher than the national average were studied. A comparison was made with a group of patients admitted involuntarily following assessment by a doctor and a social worker. Police admissions differed in several ways from the comparison group and it is suggested that they were less likely to benefit from hospitalization. Taking into account the likelihood of an increase in the number of contacts between the police and the mentally ill, a number of alterations in the assessment procedure are suggested.
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Corbascio, Guelfa C., and Paolo Henry. "How Can Psychiatry Survive Without Psychiatric Hospitals? The Italian Experience." International Journal of Social Psychiatry 40, no. 4 (December 1994): 269–75. http://dx.doi.org/10.1177/002076409404000404.
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Lloyd, G. G. "A Sense of Proportion: The Place of Psychiatry in Medicine." Journal of the Royal Society of Medicine 89, no. 10 (October 1996): 563–67. http://dx.doi.org/10.1177/014107689608901007.
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Psychiatric disorders have a high prevalence in medical and surgical patients and the need for an effective liaison psychiatry service is widely accepted. However, the development of liaison psychiatry may be jeopardised by the trend towards establishing psychiatric facilities in the community rather than in hospitals. Alternative methods of funding may need to be established if the future of liaison psychiatry is to be safeguarded.
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Thompson, A. E. "Psychogeriatric day hospitals: open to audit?" Psychiatric Bulletin 14, no. 5 (May 1990): 277–78. http://dx.doi.org/10.1192/pb.14.5.277.
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Day care has been called one of psychiatry's gifts to medicine. The British psychiatric day hospital movement began in the post war years and its philosophy continues to flourish with the decline of institutional care.
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Cammell, Paul. "Emergency psychiatry: a product of circumstance or a growing sub-speciality field?" Australasian Psychiatry 25, no. 1 (September 26, 2016): 53–55. http://dx.doi.org/10.1177/1039856216665286.
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Objectives: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation–liaison psychiatry. Conclusions: Emergency psychiatry, and in particular the application of specialised psychiatric models of in-reach service and short stay units, is an increasingly important and growing field of psychiatry that warrants further exploration in research. The Emergency Psychiatry Service at Flinders Medical Centre has developed a distinct group of assessment and treatment approaches that exemplifies this growing field.
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Szabo, Katalin A., Christopher L. White, Stephen E. Cummings, Raziya S. Wang, and Cameron D. Quanbeck. "Inpatient aggression in community hospitals." CNS Spectrums 20, no. 3 (February 26, 2015): 223–30. http://dx.doi.org/10.1017/s1092852914000820.
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Physical violence is a frequent occurrence in acute community psychiatry units worldwide. Violent acts by patients cause many direct injuries and significantly degrade quality of care. The most accurate tools for predicting near-term violence on acute units rely on current clinical features rather than demographic risk factors. The efficacy of risk assessment strategies to lower incidence of violence on acute units is unknown. A range of behavioral and psychopharmacologic treatments have been shown to reduce violence among psychiatric inpatients.
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Figueiredo, A. R., M. Silva, A. Fornelos, P. Macedo, S. Nunes, and M. Viseu. "Liasion psychiatry–1 year review in psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro, Portugal." European Psychiatry 33, S1 (March 2016): S388—S389. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1399.
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IntroductionLiasion psychiatry is a clinical area of psychiatry that includes psychiatric assistant activities in other medical and surgical areas of a general hospital. In Portugal, it has developed as a result of psychiatry integration in general hospitals. Historically, it started at the beginning of 1930s in USA. In Portugal, the law 413 of 1971 definned the articulation of mental health services with other health services–liasion psychiatry.ObjectiveWe aim to define patients evaluated in the context of liasion psychiatry, as well as other medical and surgical areas needs of psychiatry collaboration.MethodsRetrospective analyses of collaboration requests realized to psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro–Vila Real, between October 2014 and October 2015.DiscussionMost of collaboration requests came from Internal Medicine Service. Authors systematize the reasons for the requests, the time of response to those, the existence of psychiatric history, the type of intervention, the number of observations in the same patient, the most frequent diagnosis and treatment. This psychiatric service consists of four specialists and activity evaluated in this article is one of the clinical areas where these professionals intervene. Depending on the results, it is interesting then to assess needs and optimize available resources.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Eisele, Frank, Erich Flammer, and Tilman Steinert. "Incidents of aggression in German psychiatric hospitals: Is there an increase?" PLOS ONE 16, no. 1 (January 5, 2021): e0245090. http://dx.doi.org/10.1371/journal.pone.0245090.
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Introduction In a meta-analysis of international studies, 17% of admitted patients in psychiatric hospitals had exhibited violent behavior toward others. Reported data from studies in Germany were considerably lower until recent years. However, studies examining only single hospitals, as well as the quality of the data itself, have raised questions as to the validity of these findings. Indeed, a debate currently exists as to whether there has, in fact, been an increase of violent incidents in German mental institutions. Methods In a group of 10 hospitals serving about half the population of the Federal State of Baden-Wuerttemberg with 11 million inhabitants, the Staff Observation Aggression Scale–Revised (SOAS-R) was introduced into patients’ electronic charts as part of routine documentation. Data recording was strongly supported by staff councils and unions. A completed data set is now available for the year 2019. For one hospital, data are available since 2006. Due to some doubts with respect to fully covering self-directed aggression, we restricted the analysis to aggression toward others and toward objects. Results In 2019, 17,599 aggressive incidents were recorded in 64,367 admissions (1,660 staying forensic psychiatric inpatients included). 5,084 (7.90%) of the admitted cases showed aggressive behavior toward others. Variation between hospitals was low to modest (SD = 1.50). The mean SOAS-R score was 11.8 (SD between hospitals 1.20%). 23% of the incidents resulted in bodily harm. The percentage of patients showing violent behavior was highest among patients with organic disorders (ICD-10 F0) and lowest among patients with addictive or affective disorders (F1, F3, F4). Forensic psychiatry had the highest proportion of cases with aggressive behavior (20.54%), but the number of incidents per bed was lower than in general adult psychiatry and child and adolescent psychiatry (indicating a lower risk for staff). In the hospital with longer-term recordings available, an increase could be observed since 2010, with considerable variation between years. Conclusions This is the most robust estimate of the frequency of violent incidents in German psychiatric hospitals thus far. The incidence is about half of what has been reported internationally, probably due to sample selection bias in previous studies and a relatively high number of hospital beds in Germany. Available data suggest an increase of violent incidents over the last ten years; however, it is unclear to which extent this is due to increased reporting.
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Totman, Jonathan, Farhana Mann, and Sonia Johnson. "Is locating acute wards in the general hospital an essential element in psychiatric reform? The UK experience." Epidemiology and Psychiatric Sciences 19, no. 4 (December 2010): 282–86. http://dx.doi.org/10.1017/s1121189x00000592.
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AbstractLocating psychiatric wards in general hospitals has long been seen in many countries as a key element in the reform of services to promote community integration of the mentally ill. In the UK, however, this is no longer a policy priority, and the recent trend has been towards small freestanding inpatient units, located either within the communities they serve, or on general hospital sites, but separate from the main building. Whether locating the psychiatric wards in the general hospital is essential to psychiatric reform has been little discussed, and we can find no relevant evidence.Perceived strengths of general hospital psychiatric wards are in normalisation of mental health problems, accessibility to local communities, better availability of physical health care resources, and integration of psychiatry with the rest of the medical profession, which may faclilitate recruitment. However, difficulties seem to have been encountered in establishing well-designed psychiatric wards with access to open space in general hospitals. Also, physical proximity may not be enough to achieve the desired reduction in stigma, and complaints from the general hospital may sometimes result in undue restrictions on psychiatric ward patients. There are strong arguments both for and against locating psychiatric wards in general hospitals: an empirical evidence base would be helpful to inform important decisions about the best setting for wards.Declaration of Interest: None.
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Gómez Sánchez-Lafuente, C., R. Reina Gonzalez, and E. M. Rodríguez Sánchez. "Developing a guide to choose psychiatry in Spain." European Psychiatry 41, S1 (April 2017): s895—s896. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1826.
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IntroductionChoosing a medical specialty is not easy. In Spain, when medical students finish the university degree, they have to take an exam called popularly MIR if they want to start a specialty. If the exam is passed, that person receives a number result of his academic record during university and test result. The number indicates the order of election, so number 1 chooses specialty and hospital first and so on. The Spanish healthcare system offers between 220 and 250 places to start the Specialty of Psychiatry in 121 hospitals across Spain.MethodsWe designed a semi-structured questionnaire with 30 questions specific for the purpose of this work. The questionnaire was spread by social networks and email to reach as many medical doctors undertaking postgraduate training in psychiatry as we could.ResultsOne hundred and thirty people responded to the questionnaire. Fifteen were not psychiatry trainees. We obtained information from 80 hospitals (66%). Thirty-three hospitals (41%) have specific training in psychotherapy. Sixty-nine (86%) apply electroconvulsive therapy regularly. Teaching during training is given together with psychologists and nurses in 36 hospitals (45%), with psychologists in 32 (40%), only psychiatry trainees in 12 (15%). Psychiatry trainees do general emergency guards in 62 hospitals (77%).ConclusionAt the moment of writing this, the guide has been consulted by 14,600 people and visited over 40,000 times. This guide may help medical students to discover Psychiatry Training and to choose the best hospital that fits their interests.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Holley, Heather L., Betty Jeffers, and Phyllis Hodges. "Potential for Community Relocation among Residents of Alberta's Psychiatric Facilities: A Needs Assessment." Canadian Journal of Psychiatry 42, no. 7 (September 1997): 750–57. http://dx.doi.org/10.1177/070674379704200708.
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Objective: To identify the proportion of residents in Alberta's psychiatric hospitals who would be relocatable to community-based alternatives to care if appropriate programs were made available. Methods: A survey of a representative sample of residents in all psychiatric hospitals and care centres was undertaken, excluding patients in specialized programs for forensic psychiatry, brain injury, and substance abuse. Results: Findings indicate that 11% of institutionalized patients could be considered good candidates for relocation to community-based alternative care. A further 35% were considered to have potential for relocation provided an intensive and complex array of services was first made available. Conclusion: Results support a phased-in approach to hospital downsizing and the need for considerable transitional funding. Because hospital downsizing is unlikely to save dollars, at least in the short term, reforms must remain guided by humanitarian motivations to improve quality of life for persons with severe and persistent mental illnesses.
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Thornicroft, Graham. "Homelessness, outreach and advocacy: Current themes in North American community psychiatry." Bulletin of the Royal College of Psychiatrists 12, no. 7 (July 1988): 286–88. http://dx.doi.org/10.1192/s0140078900020642.
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With the process of closing psychiatric hospitals and establishing community-based alternatives more than 20 years old in the United States, psychiatric practice there is in the post-deinstitutionalisation age. In Britain we are now starting on this same path. Against this background, I attended the annual conference convened by the journal Hospital and Community Psychiatry in October 1987. Held in Boston, in the same week that Major Koch of New York sanctioned the compulsory reinstitutionalisation of homeless mentally ill people from the streets of Manhattan, the conference emphasised four themes: homelessness, outreach programmes, systems of case management, and compulsory out-patient treatment.
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Reiss, David, and Sherelle Chamberlain. "A survey of forensic psychiatry teaching in UK medical schools." Psychiatric Bulletin 25, no. 8 (August 2001): 299–301. http://dx.doi.org/10.1192/pb.25.8.299.
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Aims and MethodTo survey forensic psychiatry teaching in UK medical schools. A questionnaire was sent to all 24 deans.ResultsTwenty-one schools responded, 15 (71%) provided forensic psychiatry teaching. Thirteen organised one or more lectures and 13 organised visits to forensic psychiatric settings, predominantly high security hospitals, but these were usually only available to a proportion of the students in each year. Clinical placements, seminars or workshops and tutorials or supervisions were each arranged in about half of the schools. Only four schools offered special study modules (SSMs).Clinical ImplicationsForensic psychiatry teaching would benefit from further development, with additional use being made of medium secure hospital units and prisons for the purposes of clinical placements and visits. More SSMs should be organised.
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Roelands, Marc, Reginald Deschepper, and Johan Bilsen. "Psychiatric Consultation and Referral of Persons Who Have Attempted Suicide." Crisis 38, no. 4 (July 2017): 261–68. http://dx.doi.org/10.1027/0227-5910/a000445.
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Abstract. Background: Persons who have attempted suicide are often admitted to a hospital's emergency department (ED). The risk of them repeating their attempt is lower if they have had access to a psychiatrist in hospital and had been referred to mental health care services. However, the literature suggests this is often lacking. Aims: To describe perceived barriers to and supportive factors for psychiatric consultation and appropriate referral of suicide attempters in the ED. Method: The perspective of the heads of emergency and psychiatry departments in all hospitals with an ED in Brussels-Capital Region was investigated with a qualitative study. Data were obtained with semistructured personal interviews and analyzed in the tradition of content analysis. Results: Eight emergency physicians and 11 psychiatrists participated. Perceived barriers can be summarized as a lack of resources in the ED in terms of psychiatrists, psychiatric beds, and a room for counseling. Intense collaboration between physicians and psychiatrists and integration in a network of mental health services were perceived as being supportive factors. Conclusion: According to the heads of department, psychiatric consultation and referral of suicide attempters could be improved by an increase and more even distribution of beds for temporary psychiatric hospitalization in the ED and a more appropriate financing of the psychiatry function in the ED.
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Engstrom, Eric J., and Ivan Crozier. "Race, alcohol and general paralysis: Emil Kraepelin’s comparative psychiatry and his trips to Java (1904) and North America (1925)." History of Psychiatry 29, no. 3 (June 4, 2018): 263–81. http://dx.doi.org/10.1177/0957154x18770601.
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This article examines Emil Kraepelin’s notion of comparative psychiatry and relates it to the clinical research he conducted at psychiatric hospitals in South-East Asia (1904) and the USA (1925). It argues that his research fits awkwardly within the common historiographic narratives of colonial psychiatry. It also disputes claims that his work can be interpreted meaningfully as the fons et origio of transcultural psychiatry. Instead, it argues that his comparative psychiatry was part of a larger neo-Lamarckian project of clinical epidemiology and was thus primarily a reflection of his own long-standing diagnostic practices and research agendas. However, the hospitals in Java and America exposed the institutional constraints and limitations of those practices and agendas.
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Grob, Gerald N. "American Psychiatry: An Ambivalent Specialty." Prospects 12 (October 1987): 149–74. http://dx.doi.org/10.1017/s0361233300005561.
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American psychiatry, perhaps more so than other medical specialties, has had a troubled and ambivalent past. For much of its history its members were employed in public mental hospitals and thus lacked the autonomy and independence of their colleagues in private practice. More significantly, psychiatry was indissolubly linked with the fate of public institutions, whose image and reputation often left much to be desired.The ambivalent character of psychiatry has given rise to two distinct and polar interpretations of its past. On the one side is a Whiggish scholarship that indentifies the evolution of psychiatry with scientific progress. The barriers to the creation of a psychiatric utopia result from the actions of malevolent or narrow-minded individuals and groups unwilling to provide appropriate resources. Furthermore, there is a presumption that psychiatric scientific and objective knowledge provided the basis for policies capable of resolving many of the troublesome problems associated with mental illness. On the other side are those who maintain that psychiatrists were involved with the social control of deviant and troublesome individuals. Mental hospitals, therefore, were simply institutions that confined and brutalized individuals whose only crime was their inability to conform to traditional behavioral norms. Embedded in this approach is the assumption that mental disease is a social rather than a medical category.
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Holloway, Frank. "‘Elderly graduates’ and a hospital closure programme: the experience of the Camberwell Resettlement Team." Psychiatric Bulletin 15, no. 6 (June 1991): 321–23. http://dx.doi.org/10.1192/pb.15.6.321.
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The closure of Britain's large psychiatric hospitals, long foreseen, is now rapidly becoming a reality. Surprisingly little is known about the process and outcome of the relocation of long-stay hospital residents. One area of particular concern is the fate of ‘elderly graduate’ patients, who are by convention defined as long-stay patients aged over 65 years who came into continuous psychiatric contact before the age of 65. (More cynically they might be defined as those elderly patients whom our colleagues specialising in the psychiatry of the elderly choose not to take over). This paper documents the experience of a specialist resettlement team working within a declining mental hospital attempting to place ‘elderly graduate’ hospital residents into community provision.
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Mitrofanov, Ruslan. "Alexander Frese and the establishment of psychiatry in the Russian Empire." History of Psychiatry 31, no. 2 (February 12, 2020): 194–207. http://dx.doi.org/10.1177/0957154x20901648.
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Previous historiography has already paid particular attention to well-known ‘metropolitan’ biographies of I. Balinsky, V. Bekhterev and others, as well as their role in the establishment of a scientific approach in the treatment of mental illnesses in the Russian Empire. Little attention has been paid to ‘provincial’ physicians and the importance of their scientific activity in bridging the gap between the Russian and European institutions of psychiatry. The primary aim of this article is to show how Alexander Frese’s ‘mobile’ and ‘imperial’ career influenced the emergence of the transnational origins of Russian psychiatry. It describes his travels to foreign psychiatric hospitals, and his subsequent critical assessment of them. I argue that his ideas, which had been formulated during these trips, determined the design of emerging psychiatric institutions (district hospitals) in the Russian Empire.
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Nolan, Peter. "History of psychiatry, patients and hospitals." Current Opinion in Psychiatry 13, no. 6 (November 2000): 717–20. http://dx.doi.org/10.1097/00001504-200011000-00042.
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Walker, Andrew, Jessica Rose Barrett, William Lee, Robert M. West, Elspeth Guthrie, Peter Trigwell, Alan Quirk, Mike J. Crawford, and Allan House. "Organisation and delivery of liaison psychiatry services in general hospitals in England: results of a national survey." BMJ Open 8, no. 8 (August 2018): e023091. http://dx.doi.org/10.1136/bmjopen-2018-023091.
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ObjectivesTo describe the current provision of hospital-based liaison psychiatry services in England, and to determine different models of liaison service that are currently operating in England.DesignCross-sectional observational study comprising an electronic survey followed by targeted telephone interviews.SettingAll 179 acute hospitals with an emergency department in England.Participants168 hospitals that had a liaison psychiatry service completed an electronic survey. Telephone interviews were conducted for 57 hospitals that reported specialist liaison services additional to provision for acute care.MeasuresData included the location, service structures and staffing, working practices, relations with other mental health service providers, policies such as response times and funding. Model 2-based clustering was used to characterise the services. Telephone interviews identified the range of additional liaison psychiatry services provided.ResultsMost hospitals (141, 79%) reported a 7-day service responding to acute referrals from the emergency department and wards. However, under half of hospitals had 24 hours access to the service (78, 44%). One-third of hospitals (57, 32%) provided non-acute liaison work including outpatient clinics and links to specialist hospital services. 156 hospitals (87%) had a multidisciplinary service including a psychiatrist and mental health nurses. We derived a four-cluster model of liaison psychiatry using variables resulting from the electronic survey; the salient features of clusters were staffing numbers, especially nursing; provision of rapid response 24 hours 7-day acute services; offering outpatient and other non-acute work, and containing age-specific teams for older adults.ConclusionsThis is the most comprehensive study to date of liaison psychiatry in England and demonstrates the wide availability of such services nationally. Although all services provide an acute assessment function, there is no uniformity about hours of coverage or expectation of response times. Most services were better characterised by the model we developed than by current classification systems for liaison psychiatry.
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Semple, Margaret M., Brian R. Ballinger, and Elizabeth Irvine. "Prescribing for patients attending old age psychiatry day hospitals." Psychiatric Bulletin 20, no. 6 (June 1996): 335–37. http://dx.doi.org/10.1192/pb.20.6.335.
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A review of the drug treatment of 163 patients attending two old age psychiatric day hospitals showed that 29 received medication from the day hospital, 44 from general practitioners and 60 from both sources. Many of the patients' knowledge of their drug treatment was incomplete. Of those individuals interviewed, approximately equal numbers expressed a preference for day hospital and general practitioner prescriptions. The origin of the prescription did not bear any obvious relationship to subsequent admission to hospital or continued attendance at the day hospital.
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Theochari, A., O. Mouzas, and N. Angelopoulos. "P01-404-Differences in hospitals create different models of functioning in consultation-liaison service." European Psychiatry 26, S2 (March 2011): 407. http://dx.doi.org/10.1016/s0924-9338(11)72115-0.
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The aim of this study is to investigate differences in Consultation-Liaison (C-L) service between two General Hospitals in Greece in order to provide better health services to our patients.We try to examine referral causes from C-L Psychiatry Unit of an urban General hospital (G.H.) and a local University hospital (U.H.) and find out potential differences. 492 data were gathered (G.H = 96 U.H. = 396) within a 6 months period.Most liaison referrals (n = 260, 52,8%) were of Internal Medicine Units. The bulk of referrals were either drug adjustment (n = 157 31,9%) or suicide attempts (n = 122 24,8%). According to our findings the vast majority were diagnosed of depression (n = 67 22,9%) or delirium. 153 patients had Psychiatric history and in 86 of them (56,2%) we were called for help with their drug therapy (rearranging drug doses or preventing side effects with recent medication). 71 patients although were found of no psychiatric problem and cause of referral were management behavioral problems, such as patients negation or irritation.Both hospitals found out of similar needs in most examined elements. C-L service is the link between psychological process and physical illness. Further research in sociodemographic characteristics and cause of referrals in different kind of Hospitals may enlighten the needs of C-L service in each case.
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Diefenbacher, A., D. Georgescu, and W. Gaebel. "Guidelines in Consultation-liaison-psychiatry: A Critical Comment (TRAC-NR. 1824 5-17-2008)." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70449-3.
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Background and aims:Psychiatric comorbidity of general hospitals inpatients leads to complicated courses of illness and to increased health car costs as compared to patients that suffer from somatic illnesses alone. Such patients are cared for by psychiatric Consultation-Liaison (CL) services. When analyze guidelines that deal with the organization of psychiatric CL-services in USA and the UK, as well with a guideline developed for psychosomatic CL-services in Germany, and an Dutch guideline released in 2008Methods:Literature search and review of guidelines.Results:Existing guidelines in CL-psychiatry are in part controversial with regard to recommendation for treatments, preferences as to concentrate on clinical, or on organizational issues, and differ even in the grade of evidence given to single topics, such as effectiveness of CL-interventions.Conclusions:To improve the efficiency of CL-psychiatry, guidelines might be important, as well for the treatment of psychiatric diseases in general, but even more so for diseases that are frequent in general hospitals such as delirium. However, reliability of guidelines in CL-psychiatry differing among countries should be improved.
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McCreadie, Robin G., James W. Affleck, and Andrew D. T. Robinson. "The Scottish Survey of Psychiatric Rehabilitation and Support Services." British Journal of Psychiatry 147, no. 3 (September 1985): 289–94. http://dx.doi.org/10.1192/bjp.147.3.289.
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Rehabilitation and support services in psychiatric hospitals and general hospital psychiatric units serving two-thirds of the population of Scotland were reviewed. Although there are wide between-hospital differences, especially between rural and urban areas, the National Health Service in Scotland is making considerable efforts to provide staffing, accommodation, occupational activities, and support services for the long term mentally ill. Services provided by local authorities, with the exception of group homes, are seriously deficient. The total number of services provided by an individual hospital correlated highly with an assessment of its adequacy in providing such services in relation to other hospitals. A simple count of services may therefore be used to assess adequacy. There was also a correlation between the range of a hospital's services and numbers of misplaced new chronic in-patients.
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McGennis, Aidan. "Psychiatric units in general hospitals — the Irish experience." Irish Journal of Psychological Medicine 9, no. 2 (November 1992): 129–34. http://dx.doi.org/10.1017/s0790966700013653.
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AbstractObjective: Psychiatric units in general hospitals are becoming a key feature of Irish psychiatric practice. This is in accordance with national policy as laid down in “Planning for the Future” in 1984. To date these units have not been the subject of much research. This paper presents baseline data, gives some clinical impressions of how these units are operating, and discusses the implications of these findings. Method: Questionnaires were sent to the medical directors of all 12 psychiatric units in general hospitals in Ireland. In addition, statistical data was collected from the Health Research Board and from the Mental Health Services Section of the Department of Health. Results: All the questionnaires were returned and the results showed that these units were operating in a largely self sufficient way with little usage of local psychiatric hospitals. Outside Dublin 35% of all Health Board admissions are now going to such units, a figure comparable to England and Wales. There was little evidence of patient selectivity as units seemed to be treating the full range of psychiatric disorders. Conclusion: The picture given of general hospital units in Ireland is, in the main, very encouraging. The main problems encountered were the management of disturbed patients and the heavy demands of liaison psychiatry and these two areas would need to be further researched.
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Farid, B. T. "Psychiatric day hospitals." Psychiatric Bulletin 13, no. 8 (August 1989): 454. http://dx.doi.org/10.1192/pb.13.8.454.
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Swenson, John Robert, and Jacques Bradwejn. "Mental Health Reform and Evolution of General Psychiatry in Ontario." Canadian Journal of Psychiatry 47, no. 7 (September 2002): 644–51. http://dx.doi.org/10.1177/070674370204700706.
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Objectives: To discuss developments in Ontario mental health reform, describe general psychiatric services in contrast to tertiary services, describe guidelines for the training of general psychiatrists, and suggest what changes may be required to develop an integrated mental health system (IMHS). Method: We review the Ontario government's recent blueprint for mental health reform and the Canadian federal government's document on best practices in psychiatry, in the context of defining general psychiatric services and their relation to tertiary services. From this, we consider the education of general psychiatrists and make suggestions for their training. Results: General psychiatric services correspond to first-line and intensive psychiatric services delivered by community mental health agencies, community psychiatrists, and general hospitals for patients with moderate or serious mental illness. Many suggest that psychiatrists are not being trained to meet the needs of a reformed mental health system. An education program for general psychiatrists should include training in a wide range of community and general hospital settings, work within a multidisciplinary mental health team, and experience working in a shared care model with family physicians. Conclusions: Along with training general psychiatrists better, we must also develop recruitment and payment incentives, which would allow general psychiatrists who are based in the community and general hospitals to work within an IMHS.
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Briscoe, Jane, Rosemarie McCabe, Stefan Priebe, and Thomas Kallert. "A national survey of psychiatric day hospitals." Psychiatric Bulletin 28, no. 5 (May 2004): 160–63. http://dx.doi.org/10.1192/pb.28.5.160.
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Aims and MethodWe conducted a postal questionnaire survey of all psychiatric day hospitals in England to identify the range of aims, organisational structure and content of service provision.ResultsOf 102 identified day hospitals, 77% responded to the questionnaire. The findings confirmed that there is great heterogeneity in English day hospital service provision. The function or aim with the highest mean rating was ‘providing an alternative to in-patient care’, with 66% of day hospitals giving this a rating of great or greatest importance. However, the majority of respondents prioritised multiple roles, with many day hospitals aiming to provide acute and chronic care concurrently.Clinical ImplicationsThe label ‘day hospital’ covers a considerable range of community psychiatric services. The heterogeneity of service provision in existing day hospitals could lead to difficulties in generalising research findings on day hospital efficacy.
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Suzuki, Akihito. "Psychiatric hospital, domestic strategies and gender issues in Tokyo, c. 1920–45." History of Psychiatry 33, no. 3 (August 18, 2022): 308–18. http://dx.doi.org/10.1177/0957154x221090630.
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This paper explores domestic dynamics in the complex making of institutional psychiatry in Japan in c. 1920–45. It mainly examines gender issues between the relatively long-lasting system of the family care of mentally ill members and the use of freshly introduced systems of psychiatric hospitals. I shall look at the record of Ohji Brain Hospital (1901–45) in Tokyo, which has several thousands of case histories mainly in Tokyo c. 1920–45. From the analysis of the cases of male and female patients, as well as the complex situations of their households and kin groups, I shall look at the gender issues in the making of the psychiatric hospital regime.
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Lesage, Alain D. "Evaluating the closure or downsizing of psychiatric hospitals: social or clinical event?" Epidemiologia e Psichiatria Sociale 9, no. 3 (September 2000): 163–70. http://dx.doi.org/10.1017/s1121189x00007855.
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SummaryObjectives – The evaluation matrix recently proposed by Tansella and Thornicroft suggests that the field of social and epidemiological psychiatry has focussed more on the individual/patient level of mental health care services than the system level. Moreover, phenomena such as deinstitutionalisation have been examined more as clinical events than as social ones. The aims here are to deepen our understanding of deinstitutionalisation, particularly as regards the downsizing/closure and role of psychiatric hospitals. Methods – I begin by reviewing the manifest and latent functions of psychiatric hospitals. This is followed by a discussion of how these functions must be met by any comprehensive community-oriented system of mental health care for severely mentally ill patients. Also, in order to reframe the downsizing/closure of psychiatric hospitals as a social event for the field of social psychiatry and psychiatric epidemiology, I posit that the process of deinstitutionalisation is driven today by the same forces that were present at the outset of the movement. Results – I review four recent series of studies addressing primarily the outcomes, but also other aspects, of the downsizing/closure of psychiatric hospitals, with a view to illustrating the methods used, the results obtained and the blind angles missed in this research. Conclusions – Lessons are drawn on how to fill certain vacant cells of the matrix.
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Castro, L. C. "Consultation Liason Issues in the Training of Psychiatry Residents in Portugal." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70450-x.
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Background:It is widely recognized the importance of Consultation Liaison (C-L) training for general psychiatry residents. The present International and European panorama is diverse among countries which reflect different cultural, historical and political backgrounds.Aim:To present the postgraduate training in C-L Psychiatry during Psychiatry Residency in Portugal and discuss it in a trans-european perspective.Methods:Review of the literature. MEDLINE and PubMed databases searches, using combinations of the Medline Subject Heading terms consultation-liaison psychiatry and training, residency, internship.Results:In Portugal, during postgraduate training, rotation to a C-L psychiatry service is mandatory, with a minimal duration of three months. It is possible to prolong the duration of the stage for several months as an optional rotation training. National psychiatric directives define generally the core competencies and skills to acquire during the C-L Psychiatry training. There are no specific national guidelines for C-L Psychiatry training. There is no C-L Psychiatry speciality or sub-speciality. Liaison Psychiatry is practised in general hospitals where there is a psychiatric unit.Conclusions:Portuguese psychiatry residents are exposed to C-L work as part of their clinical experience in general psychiatry as the national psychiatry residency training program include three months minimum of compulsory training in C-L Psychiatry in a general hospital. It is crucial to reflect on training issues in C-L Psychiatry in Portugal and Europe, since it is a step to a common path of higher quality and homogeneity of training across european countries.
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Akiyama, Tsuyoshi. "Profile of psychiatry in Japan." International Psychiatry 4, no. 2 (April 2007): 35–37. http://dx.doi.org/10.1192/s1749367600001752.
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During the Edo period in Japan (1603–1867), people with mental illness were not excluded from society. Upon the introduction of European psychiatry around the 1870s, Japanese society became more discriminatory, however. In 1900 a primary law was introduced to regulate the custody of patients. In 1919 another law was approved to facilitate the establishment of public psychiatric hospitals. In 1950 the Mental Hygiene Law was enacted to prohibit home custody. However, these regulations did not assure quality of care or protect service users' rights. Also, after the Second World War, many private psychiatric hospitals were built, but this expansion of the sector was not well thought out or well coordinated. In Japan, the government regulates the private health sector only insofar as it sets standardised fees for treatments and carries out basic quality assurance.
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Barun, I., S. Vuk Pisk, D. Šago, T. Zadravec, and I. Filipcic. "Art therapy and psychosis – experiences from the University psychiatric hospital „Sveti Ivan“." European Psychiatry 65, S1 (June 2022): S324. http://dx.doi.org/10.1192/j.eurpsy.2022.824.
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Introduction The language of visual arts speaks to us in a way that words cannot. Acknowledging the therapeutic effects of artistic expression, art therapy – a psychotherapeutic approach that integrates expressive characteristics of art and explorative characteristics of psychotherapy – has developed. From its beginnings, it has been used with people with psychotic disorders and is enlisted in NICE guidelines as psychological therapy for psychosis and schizophrenia. Objectives To understand and to activate the potential of artistic expression in people with psychotic disorders treated on acute ward, in day hospitals and as a form of long-term therapy in the Patients club of the University psychiatric hospital „Sveti Ivan“. Methods Art therapy programme is conducted separately on acute ward (Ward for integrative psychiatry), day hospitals (Day hospital for integrative psychiatry and Day hospital for psychotic disorders) and in the Patients club with patients with psychotic disorders. The workshops are adjusted for people with psychotic disorders to enable them to strengthen their sense of self, to empower them and to express their authentic feelings in a safe environment. Results The artwork of people who have taken part in the art therapy programmes for psychosis of the University psychiatric hospital „Sveti Ivan“ will be presented and will serve as an example of an art therapy process, therapeutic goals, as well as the significance of this method for psychotic disorders. Conclusions Art therapy can be of great benefit for people with psychosis both on acute wards and as a long-term therapy. Disclosure No significant relationships.