Articles de revues : « Emergency Service Mental Health »

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Upadhyaya, Kapil Dev. « Mental Health & ; Community Mental Health in Nepal : Major Milestones in the development of Modern Mental Health Care ». Journal of Psychiatrists' Association of Nepal 4, n^o 1 (21 février 2017) : 60–67. http://dx.doi.org/10.3126/jpan.v4i1.16746.

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Bir Hospital, the first general hospital with specialist services was established in the country in 1889 A.D. When I came back to Nepal after MBBS in 1971, most of the specialties like Medicine, Surgery, Gynae & Obs, Opthalmology, ENT, Psychiatry, Anesthesiology, Radiology, Emergency department with 24 hours service were there. Paediatric OPD service was available, and children were admitted in Kanti children hospital Kathmandu. So mental health service in Nepal was started in a general hospital with different specialties.

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Lewis, Jen, Scott Weich, Colin O’Keeffe, Tony Stone, Joe Hulin, Nicholas Bell, Mike Doyle, Mike Lucock et Suzanne Mason. « Use of urgent, emergency and acute care by mental health service users : A record-level cohort study ». PLOS ONE 18, n^o 2 (13 février 2023) : e0281667. http://dx.doi.org/10.1371/journal.pone.0281667.

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Background People with serious mental illness experience worse physical health and greater mortality than the general population. Crude rates of A&E attendance and acute hospital admission are higher in people with serious mental illness than other hospital users. We aimed to further these findings by undertaking a standardised comparison of urgent and emergency care pathway use among users of mental health services and the general population. Methods Retrospective cohort analysis using routine data from 2013–2016 from the CUREd dataset for urgent and emergency care contacts (NHS 111, ambulance, A&E and acute admissions) and linked mental health trust data for Sheffield, England. We compared annual age- and sex-standardised usage rates for each urgent and emergency care service between users of mental health services and those without a recent history of mental health service use. Results We found marked differences in usage rates for all four urgent and emergency care services between the general population and users of mental health services. Usage rates and the proportion of users were 5–6 times and 3–4 times higher in users of mental health services, respectively, for all urgent and emergency care services. Users of mental health services were often more likely to experience the highest or lowest acuity usage characteristics. Conclusions Current users of mental health services were heavily over-represented among urgent and emergency care users, and they made more contacts per-person. Higher service use among users of mental health services could be addressed by improved community care, more integrated physical and mental health support, and more proactive primary care. A complex pattern of service use among users of mental health services suggests this will need careful targeting to reduce avoidable contacts and optimise patient outcomes.

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Ledek, Veronica, Frank P. Deane, Gordon Lambert et Catherine McKeehan. « Description of a Rural Australian Free Call Telephone Mental Health Information and Support Service ». Australasian Psychiatry 10, n^o 4 (août 2002) : 365–70. http://dx.doi.org/10.1046/j.1440-1665.2002.00496.x.

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Objective: To describe the activity of a rural-based free call 1800-Mental Health Information and Support Service (1800-MHISS) which provides a 24-hour single point of contact for people experiencing a mental health problem. Method: Routine data collected during a 15 month period concerning service utilisation, caller characteristics, service provision, triage assessment and the impact of the service on after-hours services are described. Qualitative data from a survey of emergency department and community mental health is discussed. Results: The service received an average of 1117 calls per month. While a majority of calls were for information and support, 13% required a triage assessment and, of these, 13% resulted in an emergency response. Analysis of pre and post study data demonstrated a 43% reduction in the activation of after-hours services. Conclusions: Overall, the study suggests the 1800-MHISS provides a safe and efficient response to psychiatric emergencies and is valued by Emergency Department and community mental health staff.

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Wand, Timothy, et Kathryn White. « Examining Models of Mental Health Service Delivery in the Emergency Department ». Australian & ; New Zealand Journal of Psychiatry 41, n^o 10 (octobre 2007) : 784–91. http://dx.doi.org/10.1080/00048670701579033.

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The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

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Westwood, Barbara, et Geoffrey Westwood. « Multi-presenter mental health patientsin emergency departments -a review of models of care ». Australian Health Review 24, n^o 4 (2001) : 202. http://dx.doi.org/10.1071/ah010202a.

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Only a small proportion of the treatment of mental illness occurs in an institution or hospital. By far the most significant treatment happens in the community and in the patient's own social and family environment. However, de-institutionalisation of mental health services has brought increasing numbers of patients to the emergency department in need of psychiatric assistance. The traditional service model of emergency departments, focusing on physical illness and injury, is being challenged. The literature review identified numerous psychiatric service models inplace but dramatically highlighted the lack of a specific service model addressing psychiatric patients who present on multiple occasions [multi-presenters] in emergency departments. At present, accurate data on the effects of multi-presentation of psychiatric disorders are not available. Recent international and local research into models of service delivery management and best practice is examined.

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Phillips, Joel Simon. « Paramedic role in emergency mental healthcare ». Journal of Paramedic Practice 16, n^o 5 (2 mai 2024) : 204–11. http://dx.doi.org/10.12968/jpar.2024.16.5.204.

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Background: Paramedics are increasingly involved in providing emergency mental healthcare through specialist mental health paramedic roles or expanded responsibilities within generalist roles. Methods: This article reviews the relevant academic literature to critically evaluate the opportunities and challenges of greater paramedic involvement in mental health. Findings: Potential benefits include prompt crisis response, improved service integration, and enhanced accessibility. However, challenges exist around limited mental health training, role ambiguity, care continuity, and stakeholder concerns. Conclusion: Realising the benefits of paramedics in mental healthcare requires investment in education, clear protocols, strong governance, and collaboration with mental health professionals and service users to ensure safety and quality.

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Tacchi, Mary Jane, Suresh Joseph et Jan Scott. « Evaluation of an emergency response service ». Psychiatric Bulletin 27, n^o 4 (avril 2003) : 130–33. http://dx.doi.org/10.1192/pb.27.4.130.

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Aims and MethodAn emergency response service (ERS) was introduced to streamline the assessment of individuals presenting in a crisis in one sector of a large provincial city. Data on service activity, clinical details and outcome were recorded on consecutive referrals to the service over the first 6 months of operation, and all patients were offered the opportunity to complete the Client Satisfaction Questionnaire.ResultsSeventy-five per cent of those referred accepted the offer of assessment, and the majority were seen in their own home within 2 hours. One in ten individuals were not offered any further mental health input and 17% were hospitalised. The number of admissions via primary care fell by 60% after the introduction of this service. However, at its peak of activity the service received an average of only two referrals per day and three each weekend. Only 30% of referrals were received outside of normal office hours. Service users and general practitioners were found to be more satisfied with the service than the staff that provided it.Clinical ImplicationsThe introduction of the ERS led to a faster, more consistent process of assessment of crisis referrals and assessment undertakings in the community, and appeared to increase the use of alternative treatments for individuals in crisis before resorting to admission. Funding opportunities are restricted for the development of crisis services. The development of emergency response services for the use of current staff from a number of community mental health teams is an option worth considering.

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GUTTERMAN, ELANE M., JEFFREY S. MARKOWITZ, JOHN S. LOCONTE et JULIET BEIER. « Determinants for Hospitalization from an Emergency Mental Health Service ». Journal of the American Academy of Child & ; Adolescent Psychiatry 32, n^o 1 (janvier 1993) : 114–22. http://dx.doi.org/10.1097/00004583-199301000-00017.

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Deady, M., D. Peters, H. Lang, R. Calvo, N. Glozier, H. Christensen et S. B. Harvey. « Designing smartphone mental health applications for emergency service workers ». Occupational Medicine 67, n^o 6 (23 mai 2017) : 425–28. http://dx.doi.org/10.1093/occmed/kqx056.

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Gairin, Isaura, Allan House et David Owens. « Attendance at the accident and emergency department in the year before suicide : Retrospective study ». British Journal of Psychiatry 183, n^o 1 (juillet 2003) : 28–33. http://dx.doi.org/10.1192/bjp.183.1.28.

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BackgroundThe National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact.AimsTo determine the proportion of suicides preceded by accident and emergency attendance in the previous year.MethodWe obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from thecity's accident and emergency departments for a year before each death.ResultsEighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits dueto self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as‘not in contact’ with local mental health services.ConclusionsAlthough many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.

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Frank, Rowena, Lisa Fawcett et Brett Emmerson. « Development of Australia's First Psychiatric Emergency Centre ». Australasian Psychiatry 13, n^o 3 (septembre 2005) : 266–72. http://dx.doi.org/10.1080/j.1440-1665.2005.02200.x.

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Objectives: To describe the development of the first Australian psychiatric emergency centre co-located with the Emergency Department at the Royal Brisbane and Women's Hospital. This paper covers the current operational model, significant partnerships and benefits of this service, which assesses and treats over 7200 presentations per year. Conclusions: The co-location of the Psychiatric Emergency Centre and Emergency Department has created a unique model of service delivery and effective working relationships between the two services. The model improves clinical care providing multiple benefits for patients and the Emergency Department by means of direct access to specialized mental health staff, early mental health responsibility for patients and reduced access block.

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Lynch, Carly. « Developing the emergency response for mental health patients ». British Journal of Nursing 33, n^o 20 (7 novembre 2024) : 964–66. http://dx.doi.org/10.12968/bjon.2024.0404.

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Carly Lynch, Consultant Nurse for Mental Health, London Ambulance Service ( carly.lynch@nhs.net ), was the winner of the Gold Award in the Mental Health Nurse of the Year category of the BJN Awards 2024

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Lawrence, David. « MENTAL HEALTH AND WELLBEING IN THE POLICE AND EMERGENCY SERVICES SECTOR ». Journal of Intelligence, Conflict, and Warfare 5, n^o 3 (31 janvier 2023) : 204–8. http://dx.doi.org/10.21810/jicw.v5i3.5199.

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On November 23, 2022, David Lawrence, Professor of Mental Health in the School of Population Health at Curtin University & Adjunct Professor in the School of Population and Global Health at the University of Western Australia, presented on Mental Health and Wellbeing in the Police and Emergency Services Sector. Following the presentation, a question-and-answer period ensued with questions from the audience and CASIS Vancouver executives. The key points discussed were experiences by retired service personnel, and generational attitudes among police and Emergency Medical Services (EMS) towards mental health conditions. Received: 2023-01-14Revised: 2023-01-25

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de Winter, Remco F. P., Mirjam C. Hazewinkel, Roland van de Sande, Derek P. de Beurs et Marieke H. de Groot. « Outreach Psychiatric Emergency Service ». Crisis 41, n^o 5 (septembre 2020) : 375–82. http://dx.doi.org/10.1027/0227-5910/a000651.

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Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

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Bagchi, Dhruba, George Tadros et Opeyemi Odejimi. « A narrative literature review of the typology of psychiatric emergency services in the UK ». BJPsych Open 7, S1 (juin 2021) : S235. http://dx.doi.org/10.1192/bjo.2021.629.

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AimsThis study aims to provide a detailed literature review of the different forms of Psychiatric Emergency Services currently available within the UK.Background1 in 6 individuals have one form of mental health disorders. Mental health crisis resulting in an individual requiring access to Psychiatric Emergency Service (PES) can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 hours. Presently, several PESs are available in the UK with the aim of providing prompt and effective assessment, management and in some cases treatment and/or referral. Over the years, economic and political influences have greatly determined the service delivery models of PES. Indeed, these services vary in name, accessibility, structure, professionals involved, outcomes and many more.MethodElectronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was carried out to identify various models of PES in the UK. Various combinations of search terms were used and studies which met the inclusion criteria were selected. Studies were included if they were written in English, conducted within the United Kingdom, and described a form of PES. Search was not limited by years and this is to help have a comprehensive overview as well as show changes over time of the various models of psychiatric emergency services. Studies which did not meet any of the criteria detailed above were excluded.ResultIn total, 59 relevant studies were found which identified nine type of PES-Crisis resolution home treatment, police officer intervention, street triage, mental health liaison services in the Emergency Department, psychiatric assessment unit, integrated services, voluntary services and crisis house. There were more papers describing Crisis resolution home treatment services than the others. Furthermore, majority of the papers reported services within England than other countries within the UK.ConclusionAll forms of PES are beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of all models of PES. This will inform researchers, educationist, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PES meet the needs as well as aid recovery of mental health service users.

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Ojo, Jumoke, et Dharmesh Rai. « Review of Improvement in Enhanced Access Services for Mental Health Emergencies in NHS Grampian ». BJPsych Open 10, S1 (juin 2024) : S156—S157. http://dx.doi.org/10.1192/bjo.2024.406.

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Aims1.Identify changes in the services rendered in the Enhanced access/emergency service following the previously suggested modifications.2.Identify areas of possible improvement within the service to provide seamless emergency and out-of-hours mental health support to patients.3.Evaluate adherence to current guidelines for the Enhanced access/emergency service.MethodsAn audit of a total of 100 patients on the list was selected in chronological order. Patient documentation was reviewed against the current criteria for patients on the list, which included having a documented care plan in place, remaining open to a community mental health team, and having been reviewed at least within the last 6 months.The data was then analysed and compared with the previous year's results to see if there was any significant change year over year.ResultsYear on Year improvement: 1.Total number of patients on the list had increased by 16.7%.2.The number of patients without a care plan on the list reduced by 6.3.The number of discharged patients on the list was also reduced by 1.4.The number of patients who had not been reviewed in six months reduced by 9.ConclusionWhile there had been some improvement in the service provision and adherence to the guidelines, there was still ample room for improvement, which would be achieved by adherence to the guidelines and protocols, to ensure better service improvement for enhanced access and out-of-hours emergency services to patients.

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Zandy, Moe, Sylvia El Kurdi, Hasina Samji, Geoff McKee, Reka Gustafson et Kate Smolina. « Mental health-related healthcare service utilisation and psychotropic drug dispensation trends in British Columbia during COVID-19 pandemic : a population-based study ». General Psychiatry 36, n^o 1 (février 2023) : e100941. http://dx.doi.org/10.1136/gpsych-2022-100941.

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BackgroundThe impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making. However, information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited.AimsWe examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared with the prepandemic period.MethodsWe conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits, emergency department visits, hospital admissions and psychotropic drug dispensations. We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). In addition, we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic, stratified by year, sex, age and condition.ResultsBy late 2020, except for emergency department visits, utilisation of healthcare services recovered to prepandemic levels. Between 2019 and 2021, the monthly average rate for overall mental health-related outpatient physician visits, emergency department visits and psychotropic drug dispensations increased significantly by 24%, 5% and 8%, respectively. Notable and statistically significant increases were observed among 10–14 year-olds (44% in outpatient physician visits, 30% in emergency department visits, 55% in hospital admissions and 35% in psychotropic drug dispensations) and 15–19 year-olds (45% in outpatient physician visits, 14% in emergency department visits, 18% in hospital admissions and 34% in psychotropic drug dispensations). Additionally, these increases were more prominent among females than males, with some variation for specific mental health-related conditions.ConclusionsThe increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures. Recovery efforts in British Columbia should consider these findings, especially among the most affected subpopulations, such as adolescents.

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Saurman, Emily, David Lyle, David Perkins et Russell Roberts. « Successful provision of emergency mental health care to rural and remote New South Wales : an evaluation of the Mental Health Emergency Care–Rural Access Program ». Australian Health Review 38, n^o 1 (2014) : 58. http://dx.doi.org/10.1071/ah13050.

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Objective To evaluate a rural emergency telepsychiatry program, the Mental Health Emergency Care–Rural Access Program (MHEC-RAP), which aims to improve access to emergency mental health care for communities throughout western New South Wales (NSW). Methods A descriptive analysis of service activity data from the introduction of the MHEC-RAP in 2008 to 2011 using Chi-squared tests and linear regression modelling to assess change and trends over time. Result There were 55 959 calls to the MHEC-RAP, 9678 (17%) of these calls initiated an MHEC-RAP service (~2500 each year). The use of video assessment increased over 18 months, then levelled off to an average of 65 each month. Health care provider use increased from 54% to 75% of all contacts, and 49% of MHEC-RAP patients were triaged ‘urgent’. Most (71%) were referred from the MHEC-RAP for outpatient care with a local provider. The proportion of MHEC-RAP patients admitted to hospital initially increased by 12%, then declined over the next 2 years by 7% (by 28% for admissions to a mental health inpatient unit (MHIPU)). Conclusion The MHEC-RAP is well established. It has achieved acceptable levels of service activity and continues to be as used as intended. Further research is required to confirm how the MHEC-RAP works in terms of process and capacity, how it has changed access to mental health care and to document its costs and benefits. What is known about the topic? Rural and remote communities have poorer access to and use of mental health services. Telehealth care is a reliable and accepted means for providing non-urgent mental health care. What does this paper add? The MHEC-RAP is a practical and transferable solution to providing specialist emergency mental health care, and support for local providers, in rural and remote areas via telehealth. There is a possible impact upon the problem of recruiting and retaining a mental health workforce in rural and remote areas. What are the implications for practitioners? Providing reliable remote access to specialist mental health assessment and advice while supporting providers in rural communities can result in better outcomes for patients and services alike.

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Cordell, Katharan D., et Lonnie R. Snowden. « Reducing Mental Health Emergency Services for Children Served Through California’s Full Service Partnerships ». Medical Care 55, n^o 3 (mars 2017) : 299–305. http://dx.doi.org/10.1097/mlr.0000000000000641.

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Wurlitzer, Katherine C. « Reducing Mental Health Emergency Services for Children Served Through California’s Full Service Partnership ». Journal of Emergency Medicine 52, n^o 5 (mai 2017) : 788. http://dx.doi.org/10.1016/j.jemermed.2017.03.040.

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Tacchi, Mary Jane, Suresh Joseph et Jan Scott. « Evaluation of an emergency response service ». Psychiatric Bulletin 27, n^o 04 (avril 2003) : 130–33. http://dx.doi.org/10.1192/s0955603600001811.

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Aims and Method An emergency response service (ERS) was introduced to streamline the assessment of individuals presenting in a crisis in one sector of a large provincial city. Data on service activity, clinical details and outcome were recorded on consecutive referrals to the service over the first 6 months of operation, and all patients were offered the opportunity to complete the Client Satisfaction Questionnaire. Results Seventy-five per cent of those referred accepted the offer of assessment, and the majority were seen in their own home within 2 hours. One in ten individuals were not offered any further mental health input and 17% were hospitalised. The number of admissions via primary care fell by 60% after the introduction of this service. However, at its peak of activity the service received an average of only two referrals per day and three each weekend. Only 30% of referrals were received outside of normal office hours. Service users and general practitioners were found to be more satisfied with the service than the staff that provided it. Clinical Implications The introduction of the ERS led to a faster, more consistent process of assessment of crisis referrals and assessment undertakings in the community, and appeared to increase the use of alternative treatments for individuals in crisis before resorting to admission. Funding opportunities are restricted for the development of crisis services. The development of emergency response services for the use of current staff from a number of community mental health teams is an option worth considering.

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Wynaden, Dianne, Rose Chapman, Sunita McGowan, Stuart McDonough, Michael Finn et Sean Hood. « Emergency department mental health triage consultancy service : a qualitative evaluation ». Accident and Emergency Nursing 11, n^o 3 (juillet 2003) : 158–65. http://dx.doi.org/10.1016/s0965-2302(02)00237-0.

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Stainsby, Matt, et Susie White. « Psychology in Accident and Emergency : Mental health liaison psychology ». Clinical Psychology Forum 1, n^o 259 (juillet 2014) : 38–43. http://dx.doi.org/10.53841/bpscpf.2014.1.259.38.

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Cook, Amy. « Taking a holistic approach to acute mental health crisis ». Journal of Paramedic Practice 11, n^o 10 (2 octobre 2019) : 426–32. http://dx.doi.org/10.12968/jpar.2019.11.10.426.

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An innovative, collaborative model implemented by a UK ambulance service allows patients presenting with a mental health condition to be promptly assisted by a specialist team comprising a paramedic, mental health nurse and police officer. Initial evidence suggests that greater collaboration between emergency services and mental health trusts benefits patients and services: leading to timely assessments, reductions in patient distress levels, and decreasing emergency department overcrowding while providing substantial savings for the NHS. This article explores existing care pathways for patients experiencing acute mental health crisis. Current research from the UK is discussed, and compared with working practices of paramedics internationally. Through reflection of a case study, common difficulties faced in paramedic practice are identified. A multi-agency response to ensure the right care is provided in the right place at the right time is proposed.

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Douglas, Kathryn, et Sonya MacVicar. « Non-medical prescribing considerations in emergency mental health services ». Journal of Prescribing Practice 4, n^o 7 (2 juillet 2022) : 312–16. http://dx.doi.org/10.12968/jprp.2022.4.7.312.

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The emergency mental health practitioner's job involves providing immediate care to patients who are suffering a mental health crisis. Independent nurse prescribing supports this service through timely access to pharmacological and non-pharmacological measures or cognitive behavioural strategies. This case study involves a service user diagnosed with bipolar type II disorder who presents with suicidal ideation, and outlines the prescribing options available for short-term crises and long-term risk management. There is a complex balance of appraising physical and mental health including capacity, assessment of risk of self-harm and harm to others, and working in consultation to optimise adherence and concordance. The authors highlight the importance of using a person-centred approach, which includes family, carers and their wider support network, to develop a therapeutic relationship which promotes positive outcomes. This is further supported by utilising the most recent and up-to-date policy, guidelines and legislation, including local and national policies.

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Gray, Nicola, et Emad Salib. « Asylum seekers : self-referrals to a large psychiatric hospital ». Psychiatric Bulletin 21, n^o 12 (décembre 1997) : 751–53. http://dx.doi.org/10.1192/pb.21.12.751.

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We reviewed, prospectively, all patients who presented themselves at the reception of a large psychiatric hospital, which had no casualty department, to assess the extent and value of a long standing ‘unofficial emergency service’ that has been provided for decades. We found no evidence that the service was abused or that it led to unwarranted admissions. The service could provide a useful point of entry to mental health services for certain patients. The ‘ad hoc’ emergency service described here is hoping to become a recognised ‘Emergency Clinic’ in the reprovided service, after the closure of this 100 year old psychiatric institution in the very near future.

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Mahato, Preeti, et Ursula Rolfe. « Mental Health Care Experiences in Prehospital and Community Settings : A Scoping Review ». Europasian Journal of Medical Sciences 5, n^o 1 (27 juin 2023) : 11–22. http://dx.doi.org/10.46405/ejms.v5i1.457.

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Background Mental health issues are among the top ten causes of disease burden worldwide. Many people waiting for mental health treatment are being resorted to emergency or crisis services and evidence points to low levels of satisfaction with these services. The purpose of this scoping review is therefore to explore the experiences of mental health patients accessing prehospital settings, for example emergency care through ambulance use and emergency medical services, and community care.Data and Methods To identify a knowledge gap and sources of evidence, a scoping review was conducted that examined research about the experiences of people accessing prehospital and community care. A scoping review using a systematic and comprehensive literature search of databases resulted in the inclusion of 10 articles. These articles were synthesised using thematic analysis and resulted in five different themes related to access of community and prehospital based sources.Results The themes identified were: (i) communication; (ii) relationship with patients and family members; (iii) attitude of providers and trust established; (iv) care and support; and (iv) satisfaction. Some themes overlap and were interrelated. For example, attitudes of healthcare staff determined the type of communication with patients: either positive or negative. In turn, communication by healthcare staff also affected the relationship formed with the patients and the trust established with them. In addition, results of quantitative studies were presented separately.Conclusion The review identified that mental health service users accessing prehospital and community-based services are seeking support because of dissatisfaction with immediacy of responses elsewhere. To meet this increased demand, paramedics need further education and support on mental health to ensure the appropriate care of these service users. Keywords prehospital, community mental health services, mental health, paramedics

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Briggs, Hannah, Stephen Clarke et Nigel Rees. « Mental health assessment and triage in an ambulance clinical contact centre ». Journal of Paramedic Practice 13, n^o 5 (2 mai 2021) : 196–203. http://dx.doi.org/10.12968/jpar.2021.13.5.196.

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Background: With increasing numbers of emergency calls to ambulance services, exploration of the triage and management of mental health calls is valuable, given their volume and duration. Studies have explored these calls from patient and practitioner perspectives, but few have considered the perspective of the practitioners assessing patients over the phone in terms of clinical capability. Aim: This study aimed to explore the thoughts, feelings and educational requirements of paramedics and nurses working on emergency medical services clinical desks, focusing on mental health-related calls and the triage tools used. Methods: A service evaluation was conducted. A questionnaire was developed and distributed to 41 staff on clinical desks at the Welsh Ambulance Service Trust's (WAST) clinical contact centres in June 2019. Quantitative data was analysed using descriptive statistics and qualitative data by thematic analysis. Findings: Out of the 41 employees, 26 (63%) responded. Low levels of confidence were reported in managing mental health calls, along with inadequate detail in the mental health elements of their triage algorithm and deficiencies in referral pathways. Conclusion: Given the volume and complexity of mental health calls to ambulance services, more attention should be paid to the education and training of clinical desk professionals and the decision support tools available in WAST and other ambulance services. Further research is required with a larger sample size over multiple ambulance services.

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Gourdie, Alison, et Vivienne Schnieden. « Emergency and liaison psychiatry ». Psychiatric Bulletin 14, n^o 9 (septembre 1990) : 548–49. http://dx.doi.org/10.1192/pb.14.9.548.

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The post of Emergency and Liaison Registrar in the Bloomsbury Rotation was created in 1988 to provide a psychiatric service at University College Hospital, London, in the Accident and Emergency (A&E) Department and to the A&E Ward for assessment of deliberate self harm (DSH) cases. It incorporated existing commitments of liaison to the UCH wards and provision of urgent psychiatric assessments. The service had previously been shared among a number of psychiatric staff. The registrar can thus be seen as a ‘central pivot’ within the District Psychiatric Services.

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Huxley, Peter, et Michael Kerfoot. « Social services response to psychiatric emergencies ». Psychiatric Bulletin 17, n^o 5 (mai 1993) : 282–85. http://dx.doi.org/10.1192/pb.17.5.282.

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This paper reports the results of a nationwide survey of social services responses to psychiatric emergencies. The survey is a companion to that by Johnson & Thornicroft (1991) (J&T) who reviewed the emergency service options available in psychiatry, including the emergency clinic, general hospital services, the emergency ward, acute day hospital and crisis intervention and residential services, as well as considering the role of sectorised services, and community mental health centres (CMHCs). For the purposes of our respective surveys of health and social services in England and Wales, we have defined a psychiatric emergency as “occurring when someone (patient, friend, relative or professional) requests urgent intervention on behalf of someone in the community who is suffering from a mental disorder”.

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Fontão, Mayara Cristine, Jeferson Rodrigues, Monica Motta Lino, Murielk Motta Lino et Silvana Silveira Kempfer. « Nursing care to people admitted in emergency for attempted suicide ». Revista Brasileira de Enfermagem 71, suppl 5 (2018) : 2199–205. http://dx.doi.org/10.1590/0034-7167-2017-0219.

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ABSTRACT Objective: to analyze the nursing care to people admitted in emergency for attempted suicide in the perception of the nursing staff. Method: descriptive and exploratory study, of qualitative approach, developed from semi-structured interviews with eight nurses and eight nursing technicians of the emergency service of a University Hospital in south Brazil. Data analysis was performed through content analysis. Results: three categories emerged: nursing care to the person who attempted suicide; the adult emergency service as a scenario of mental health practices; and permanent education-related needs in mental health Final considerations: initiatives capable to potentialize good practices in mental health care are still incipient and lack encouragement in the health service. There is an urgent need to think about changes in the care culture of the emergency service, especially to ensure the scope of psychosocial care actions.

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Gaddini, A., M. Ascoli et L. Biscaglia. « Mental health care in Rome ». European Psychiatry 20, S2 (octobre 2005) : s294—s297. http://dx.doi.org/10.1016/s0924-9338(05)80177-4.

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AbstractAimTo describe principles and characteristics of mental health care in Rome.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways tocare, user/carer involvement and specific issues are reported.ResultsAfter the Italian psychiatric reform of 1978, an extensive network of community-based services has been set up in Romeproviding prevention, care and rehabilitation in mental health. A number of small public acute/emergency inpatient units inside general hospitals was created (median length of stay in 2002 = 8 days) to accomplish the shift from a hospital-based to a community-based psychiatric system of care. Some private structures provide inpatient assistance for less acute conditions (median length of stay in 2002 = 28 days), whilst the large Roman psychiatric hospital was closed in 1999.DiscussionWhilst various issues of mental health care in Rome overlap with those in other European capitals, there also are some specific problems and features. During the last two decades, the mental health system in Rome has been successfully converted to a community-based one. Present issues concern a qualitative approach, with an increasing need to foresee adequate evaluation, especially considering mental health patients' satisfaction with services and economic outcomes.

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Islam, Md Irteja, Shumona Sharmin Salam, Enamul Kabir et Rasheda Khanam. « Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13–17 Years : Results from a Nationwide Study ». Healthcare 11, n^o 18 (14 septembre 2023) : 2537. http://dx.doi.org/10.3390/healthcare11182537.

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Aim: In this study, we aimed to identify the determinants of four different forms of mental health service usage (general health services, school counselling, telephone, and online services), and the number of mental health services accessed (single and multiple) by Australian adolescents aged 13–17 years. We also measured socioeconomic inequality in mental health services’ usage following the concentration index approach within the same sample. Subject and Methods: The data came from the nationwide cross-sectional survey, Young Minds Matter (YMM): the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Random effect models were used to identify the factors associated with four different mental health services and the number of services accessed. Further, the Erreygers’ corrected concentration indices for binary variables were used to quantify the socioeconomic inequality in each mental health service. The four services were the general health service (GP, specialist, psychiatrist, psychologist, hospital including emergency), school services, telephone counselling and online services. Results: Overall, 31.9% of the total analytical sample (n = 2268) aged 13–17 years old visited at least one service, with 21.9% accessing a single service and 10% accessing multiple services. The highest percentage of adolescents used online services (20.1%), followed by general mental health services (18.3%), while school services (2.4%) were the least used service. Age, gender, family type and family cohesion statistically significantly increased the use of general health and multiple mental health service usage (p < 0.05). Area of residence was also found to be a significant factor for online service use. The concentration indices (CIs) were −0.073 (p < 0.001) and −0.032 (p < 0.001) for health and telephone services, respectively, which implies pro-rich socio-economic inequality. Conclusion: Adolescents from low-income families frequently used general mental health services and telephone services compared to those who belonged to high-income families. The study concluded that if we want to increase adolescents’ usage of mental health services, we need to tailor our approaches to their socioeconomic backgrounds. In addition, from a policy standpoint, a multi-sectoral strategy is needed to address the factors related to mental health services to reduce inequity in service utilisation.

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Doey, Tamison, Pamela Hines, Bonnie Myslik, JoAnn Elizabeth Leavey et Jamie A. Seabrook. « Creating Primary Care Access for Mental Health Care Clients in A Community Mental Health Setting ». Canadian Journal of Community Mental Health 27, n^o 2 (1 septembre 2008) : 129–38. http://dx.doi.org/10.7870/cjcmh-2008-0023.

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Successful support of persons living with a mental illness in the community is challenged by the lack of primary care accessible to this population. The Canadian Mental Health Association–Windsor Essex County Branch explored options to provide mental and physical health care, initially creating an integrated primary care clinic and later a larger community health clinic co-located with its mental health care services and staffed by a multidisciplinary team. A retrospective review of 805 charts and a client satisfaction survey were conducted in 2001 to evaluate this service. Findings indicate that access to primary care and mental health care co-located at a community-based clinic has reduced the number of emergency room visits and admissions, and length of stay in hospital, for individuals with moderate to serious mental illness. A client survey in January 2008 supports these preliminary findings.

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Cherner, Rebecca, Alexia Polillo, Jonathan Samosh, John Sylvestre, Jennifer Rae, Donna Pettey et Tim Aubry. « Bridging the Gap Between Hospital and Community Mental Health Services for Frequent Emergency Department Visitors ». Canadian Journal of Community Mental Health 41, n^o 1 (1 janvier 2022) : 1–17. http://dx.doi.org/10.7870/cjcmh-2022-001.

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Inappropriate emergency department (ED) use is costly. A system navigation service was developed to connect individuals with repeated ED presentations due to mental health or substance use to community services. Management, staff, and clients (n = 37) participated in interviews or focus groups to identify implementation challenges and associated solutions. Referrals were improved through ED staff support and automating the process. The outreach process, decreased service duration, and prompt support with connection to services facilitated program delivery. Two newly funded programs addressed the limited capacity of other services, and technology facilitated communication. Attention to partnerships and flexibility in the design were essential.

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McDonough, Stuart, Dianne Wynaden, Michael Finn, Sunita McGowan, Rose Chapman et Shirilee Gray. « Emergency Department Mental Health Triage and Consultancy Service : An advanced practice role for mental health nurses ». Contemporary Nurse 14, n^o 2 (avril 2003) : 138–44. http://dx.doi.org/10.5172/conu.14.2.138.

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Jennings, Paul, et Catherine B. Matheson-Monnet. « Multi-agency mentoring pilot intervention for high intensity service users of emergency public services : the Isle of Wight Integrated Recovery Programme ». Journal of Criminological Research, Policy and Practice 3, n^o 2 (12 juin 2017) : 105–18. http://dx.doi.org/10.1108/jcrpp-01-2017-0007.

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Purpose The purpose of this paper is to describe the design, implementation and evaluation of a small UK case study of a mentoring style pilot intervention integrating a specially trained police officer alongside mental health professionals to support highly intensive service users of emergency services. Design/methodology/approach The development of the conceptual framework informing the mentoring intervention is described and its implementation evaluated using a range of qualitative and quantitative outcome measures. Findings The four high intensity service users involved in the pilot had internalised the need to participate in recommended recovery pathways. Mental health nurses reported improved compliance with treatment. Although the sample was small, the number of police mental health crisis detentions was reduced by 66 per cent after one year and by 100 per cent after 18 months. Usage of other emergency public services had also drastically reduced, or been eliminated altogether. Research limitations/implications Limited time and resources and the need for a solution that could be implemented as soon as possible meant a pragmatic design, implementation and evaluation. Practical implications The study indicated that a wider roll out of the new multi-agency mentoring model would be beneficial. Originality/value This is the first intervention to integrate mental health professionals and a trained police officer directly into the care pathway of repeated users of emergency public services with complex mental health needs.

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Smith, Susan M., Linda Peoples et Peggy Johnson. « Disaster response : community mental health service capacity in the USA ». International Journal of Emergency Management 5, n^o 3/4 (2008) : 311. http://dx.doi.org/10.1504/ijem.2008.025100.

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Chaput, Yves, Marie Josée Lebel, Edith Labonté et Lucie Beaulieu. « The Psychiatric Emergency Service Patient ». Canadian Journal of Psychiatry 50, n^o 5 (avril 2005) : 303–4. http://dx.doi.org/10.1177/070674370505000520.

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Tyavokina, E. Y., et I. M. Barsukova. « Emergency Medical Service to Psychiatric Patients ». Russian Sklifosovsky Journal "Emergency Medical Care" 9, n^o 2 (22 octobre 2020) : 215–20. http://dx.doi.org/10.23934/2223-9022-2020-9-2-215-220.

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Abstract The issues of providing medical care to patients with mental disorders are of exceptional medical and social importance. The aim of the study was to analyze the current state of medical care for psychiatric patients under emergency medical care (EMC) conditions. We used regulatory, statistical and analytical methods. The gaps of the normative legal support of the activities of the teams in the provision of ambulance care for patients with mental disorders and behavioral disorders are considered. In order to improve legislation in the field of ambulance care, it was proposed to amend the Procedure for the provision of emergency, including specialized medical care, approved by the Order of the Ministry of Health of Russian Federation dated 06.06.2013 No. 388n “On the Approval of the Procedure for the Provision of Emergency Care, Including Specialized Medical Care”.

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Meiliana, Riesa, Bambang Kusbandrijo et Achluddin Ibnu Rochim. « PENGARUH PELAYANAN DAN KEPERCAYAAN TERHADAP KEPUASAN PASIEN GAWAT DARURAT BADAN LAYANAN UMUM DAERAH RSUD BALANGAN PROVINSI KALIMANTAN SELATAN ». SENTRI : Jurnal Riset Ilmiah 3, n^o 4 (5 avril 2024) : 2113–25. http://dx.doi.org/10.55681/sentri.v3i4.2607.

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Health services are one of the many important needs for the community and are one of the basic rights of the community whose provision must be provided by the government as mandated in the 1945 Constitution Article 28 paragraph (1) "Everyone has the right to live in physical and mental prosperity. mentally, have a place to live, and have a good and healthy living environment and are entitled to health services” and Article 34 paragraph (3) “The state is responsible for the provision of proper public service facilities”. The purpose of this study was to determine the effect of service, trust, product quality and service quality on patient satisfaction in the emergency department of the Balangan Regional Public Service Agency. This study uses a quantitative approach. The number of samples used in this study were 93 samples of patients.Based on the results obtained, it is stated that the trust variable has a positive and significant effect on patient satisfaction in the emergency department of the Regional Public Service Agency of Balangan Hospital. (2) The service quality variable has a positive and significant effect on patient satisfaction in the emergency department of the Regional Public Service Agency of Balangan Hospital. (3) The variables of trust and service quality have a positive and significant effect on patient satisfaction in the emergency department of the Regional Public Service Agency of Balangan Hospital

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Saini, Pooja, Jason McIntyre, Rhiannon Corcoran, Konstantinos Daras, Clarissa Giebel, Elizabeth Fuller, Jane Shelton et al. « Predictors of emergency department and GP use among patients with mental health conditions : a public health survey ». British Journal of General Practice 70, n^o 690 (17 décembre 2019) : e1-e8. http://dx.doi.org/10.3399/bjgp19x707093.

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BackgroundHigh demand for health services is an issue of current importance in England, in part because of the rapidly increasing use of emergency departments (EDs) and GP practices for mental health conditions and the high cost of these services.AimTo examine the social determinants of health service use in people with mental health issues.Design and settingTwenty-eight neighbourhoods, each with a population of 5000–10 000 people, in the north west coast of England with differing levels of deprivation.MethodA comprehensive public health survey was conducted, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work, and finances. Poisson regression models assessed the effect of mental health comorbidity, mental and physical health comorbidity, and individual mental health symptoms on ED and general practice attendances, adjusting for relevant socioeconomic and lifestyle factors.ResultsParticipants who had both a physical and mental health condition reported attending the ED (rate ratio [RR] = 4.63, 95% confidence interval [CI] = 2.86 to 7.51) and general practice (RR = 3.82, 95% CI = 3.16 to 4.62) more frequently than all other groups. Having a higher number of mental health condition symptoms was associated with higher general practice and ED service use. Depression was the only mental health condition symptom that was significantly associated with ED attendance (RR = 1.41, 95% CI = 1.05 to 1.90), and anxiety was the only symptom significantly associated with GP attendance (RR = 1.19, 95% CI = 1.03 to 1.38).ConclusionMental health comorbidities increase the risk of attendances to both EDs and general practice. Further research into the social attributes that contribute to reduced ED and general practice attendance rates is needed.

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Nishi, D. « Mental health service requirements in a Japanese medical centre emergency department ». Emergency Medicine Journal 23, n^o 6 (1 juin 2006) : 468–69. http://dx.doi.org/10.1136/emj.2005.029769.

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Frosch, Emily, Jill McCulloch, Yesel Yoon et Susan dosReis. « Pediatric Emergency Consultations : Prior Mental Health Service Use in Suicide Attempters ». Journal of Behavioral Health Services & ; Research 38, n^o 1 (19 septembre 2009) : 68–79. http://dx.doi.org/10.1007/s11414-009-9192-0.

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JADOON, H., ES SIDDIQUI, R. MOHSIN, A. BATOOL, N. JABEEN et F. MUH. « THE PREVALENCE AND PREDICTORS OF DEPRESSION AND ANXIETY AMONG EMERGENCY MEDICAL SERVICES PERSONNEL ». Biological and Clinical Sciences Research Journal 2023, n^o 1 (27 juin 2023) : 334. http://dx.doi.org/10.54112/bcsrj.v2023i1.334.

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This study aimed to determine the prevalence and predictors of depression and anxiety among emergency medical services personnel at the Liaquat University of Medical & Health Sciences (LUMHS). The study was conducted over the course of one year, from December 2021 to December 2022, and involved a sample size of 120 participants. The study used a cross-sectional design, and data was collected using a self-administered questionnaire that assessed depression and anxiety symptoms, as well as demographic and job-related factors. The questionnaire was distributed to all emergency medical services personnel working in LUMHS, and participation in the study was voluntary. Data collected was analyzed using descriptive statistics to determine the prevalence of depression and anxiety among emergency medical services personnel in LUMHS. Logistic regression analysis was used to identify predictors of depression and anxiety, including demographic and job-related factors such as age, gender, years of service, and job stressors. The results showed that the prevalence of depression and anxiety among emergency medical services personnel in LUMHS was 45% and 50%, respectively. Logistic regression analysis revealed that older age, female gender, long years of service, and higher job stressors were significant predictors of depression and anxiety. These findings provided valuable information about the mental health status of emergency medical services personnel in LUMHS, highlighting the need for interventions and support services to address the high prevalence of depression and anxiety in this population. The study contributed to the growing body of research on mental health in the workplace, particularly in high-stress occupations such as emergency medical services and underscored the importance of addressing the mental health needs of this vulnerable population.

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Kalb, Luther G., Joan Beasley, Andrea Caoili et Ann Klein. « Improvement in Mental Health Outcomes and Caregiver Service Experiences Associated With the START Program ». American Journal on Intellectual and Developmental Disabilities 124, n^o 1 (1 janvier 2019) : 25–34. http://dx.doi.org/10.1352/1944-7558-124.1.25.

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Abstract This study examined outcomes from the Systemic, Therapeutic, Assessment, Resources, and Treatment (START) program, a community-based tertiary care model for individuals with intellectual and developmental disabilities and mental health needs. The sample included 111 START service users and their family caregivers, who were receiving START Clinical Team services, located in the Northeast and Southwest regions of the United States. Results from the analyses found a significant 1-year pre-post improvement in caregiver service experiences and mental health symptoms of the service user. A significant decrease in psychiatric hospitalizations and emergency department visits was also found (all p < .01). These data suggest that START holds promise in improving outcomes, for both the caregiver and service user, while reducing dependence on costly and restrictive hospital-based services.

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Smith-MacDonald, Lorraine, Chelsea Jones, Phillip Sevigny, Allison White, Alexa Laidlaw, Melissa Voth, Cynthia Mikolas, Alexandra Heber, Andrew J. Greenshaw et Suzette Brémault-Phillips. « The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel : Qualitative Thematic Analysis ». JMIR Formative Research 5, n^o 8 (12 août 2021) : e26369. http://dx.doi.org/10.2196/26369.

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Background Exposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery. Objective This paper aims to explore the experience of mental health service providers regarding digital health service delivery, including the current state of digital mental health service delivery, barriers to and facilitators of the use of digital health for mental health service delivery experienced during the pandemic, and recommendations for implementing and integrating digital health into regular mental health service delivery. Methods This embedded mixed-methods study included questionnaires and focus groups with key stakeholders (N=31) with knowledge and experience in providing mental health services. Data analysis included descriptive, quantitative, and qualitative thematic analyses. Results The following three themes emerged: being forced into change, daring to deliver mental health services using digital health, and future possibilities offered by digital health. In each theme, participants’ responses reflected their perceptions of service providers, organizations, and clients. The findings offer considerations regarding for whom and at what point in treatment digital health delivery is appropriate; recommendations for training, support, resources, and guidelines for digitally delivering trauma therapy; and a better understanding of factors influencing mental health service providers’ perceptions and acceptance of digital health for mental health service delivery. Conclusions The results indicate the implementation of digital health for mental health service delivery to military members, public safety personnel, and veterans. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy are urgently needed to support the well-being of those who have served and continue to serve.

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Buckley, Ciara, Robert Malcolm et Jo Hanlon. « Economic impact of a vision-based patient monitoring system across five NHS mental health trusts ». PLOS Digital Health 3, n^o 9 (11 septembre 2024) : e0000559. http://dx.doi.org/10.1371/journal.pdig.0000559.

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A vision-based patient monitoring system (VBPMS), Oxevision, has been introduced in approximately half of National Health Service (NHS) mental health trusts in England. A VBPMS is an assistive tool that supports patient safety by enabling non-contact physiological and physical monitoring. The system aims to help staff deliver safer, higher-quality and more efficient care. This paper summarises the potential health economic impact of using a VBPMS to support clinical practice in two inpatient settings: acute mental health and older adult mental health services. The economic model used a cost calculator approach to evaluate the potential impact of introducing a VBPMS into clinical practice, compared with clinical practice without a VBPMS. The analysis captured the cost differences in night-time observations, one-to-one continuous observations, self-harm incidents, and bedroom falls at night, including those resulting in A&E visits and emergency service callouts. The analysis is based on before and after studies conducted at five mental health NHS trusts, including acute mental health and older adult mental health services. Our findings indicate that the use of a VBPMS results in more efficient night-time observations and reductions in one-to-one observations, self-harm incidents, bedroom falls at night, and A&E visits and emergency service callouts from night-time falls. Substantial staff time in acute mental health and older adult mental health services is spent performing night-time observations, one-to-one observations, and managing incidents. The use of a VBPMS could lead to cost savings and a positive return on investment for NHS mental health trusts. The results do not incorporate all of the potential benefits associated with the use of a VBPMS, such as reductions in medication and length of hospital stay, plus the potential to avoid adverse events which would otherwise have a detrimental impact on a patient’s quality of life.

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Cammell, Paul. « Emergency psychiatry : a product of circumstance or a growing sub-speciality field ? » Australasian Psychiatry 25, n^o 1 (26 septembre 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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Hugo, Malcolm, Matthew Smout et John Bannister. « A Comparison in Hospitalization Rates Between a Community-Based Mobile Emergency Service and a Hospital-Based Emergency Service ». Australian & ; New Zealand Journal of Psychiatry 36, n^o 4 (août 2002) : 504–8. http://dx.doi.org/10.1046/j.1440-1614.2002.01042.x.

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Objectives: The aims of this study were to compare the rates of inpatient admission between a mobile community-based psychiatric emergency service and a hospital-based psychiatric emergency service, and to identify the clinical characteristics of consumers more likely to be admitted to hospital. Methods: A retrospective, quasi-experimental design was used with a 3-month cohort of all face-to-face emergency service contacts presenting at the mobile and hospital-based sites. The Health of the Nation Outcome Scales and details of the outcome following initial assessment were completed for all contacts, and each group was compared for differences in clinical characteristics and outcome. Results: Hospital-based emergency service contacts were found to be more than three times as likely to be admitted to a psychiatric inpatient unit when compared with those using a mobile community-based emergency service, regardless of their clinical characteristics. Those with severe mental health disorders such as schizophrenia and major affective disorder, and experiencing problems with aggression, non-accidental self-injury, hallucinations and delusions, problems with occupation, activities of daily living, and living conditions were more likely to be admitted to hospital. Nevertheless, after controlling for clinical characteristics, site of initial assessment accounted for a substantial proportion of the variance in decisions to admit to hospital. Conclusions: Emergency psychiatric services which include a mobile component and provide a specialized multidisciplinary team approach appear to be most effective in providing services in the least restrictive environment and avoiding hospitalization.

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