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Psychiatric emergency services

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https://www.readbyqxmd.com/read/29447412/service-models-for-urgent-and-emergency-psychiatric-care-an-overview
#1
Dominiek Coates
There is variation in the way mental health services respond to urgent and emergency presentations, with few evidence-based models reported in the literature, and no agreed on best practice models. To inform the development of urgent and emergency psychiatric care models, a literature review was performed. The review sought to identify strengths and critiques of varying models, evidence gaps, and areas for future research. After review, significant variation was found in the design and scope of urgent and emergency care models...
February 15, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29438124/friendly-faces-characteristics-of-children-and-adolescents-with-repeat-visits-to-a-specialized-child-psychiatric-emergency-program
#2
Mollie Marr, Sarah M Horwitz, Ruth Gerson, Amy Storfer-Isser, Jennifer F Havens
OBJECTIVES: Pediatric mental health emergency department (ED) visits continue to rise with 19% to 62% of youth presenting to the ED ultimately returning for a mental health-related complaint. To better understand the needs of children returning to the ED, this study examines the clinical, demographic, and environmental factors associated with revisits to a dedicated child psychiatric ED. METHODS: Clinical factors, home environment, and mental health service utilization of 885 children presenting to a dedicated child psychiatric ED over a 1-year period were abstracted by retrospective chart review...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29436881/psychiatric-nurses-attitudes-towards-violent-behaviour-a-brazilian-study
#3
Maraína Gomes Pires Fernandes Dias, Divane de Vargas
This study examines nurses' attitudes towards violent behaviour and the management of aggressiveness. A convenience sample of 185 nurses working in psychiatric urgent care and emergency services in Brazil responded to the MAVAS-BR. The results show that nurses' attitudes are more reflective of the external and situational models of violent behaviour and the use of control methods to manage aggressiveness. The mapping of this phenomenon using the same tools in a different context from those traditionally studied while observing similar results suggests a pattern of attitudes towards violent behaviour and the management of aggressiveness among nurses around the world...
February 13, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29431144/paradigm-shift-purity-progress-and-the-origins-of-first-episode-psychosis
#4
Suze G Berkhout
First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying concepts, ideologies and imagery embedded within the early intervention paradigm. In this paper, I offer a sociohistorical analysis of the emergence of first-episode psychosis and early intervention as entities in psychiatry, drawing on contemporary philosophical thought to explore various concepts embedded in them...
February 3, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29429425/association-between-alcohol-and-substance-use-disorders-and-psychiatric-service-use-in-patients-with-severe-mental-illness-a-nationwide-danish-register-based-cohort-study
#5
Kirstine Bro Jørgensen, Merete Nordentoft, Carsten Hjorthøj
BACKGROUND: Substance use disorder is highly prevalent in people with psychiatric disorders, and known to impede the psychiatric treatment. Some studies show increased rates of service use, while others show a decrease. These conflicting results are further hampered by a lack of large-scale studies. The aim of this study was to investigate the association between substance use disorder and psychiatric service use in psychiatric patients. METHODS: The study was a prospective registry-based cohort study including patients with severe mental illness...
February 12, 2018: Psychological Medicine
https://www.readbyqxmd.com/read/29412043/acute-crisis-care-for-patients-with-mental-health-crises-initial-assessment-of-an-innovative-prehospital-alternative-destination-program-in-north-carolina
#6
Jamie O Creed, Julianne M Cyr, Hillary Owino, Shannen E Box, Mia Ives-Rublee, Brian B Sheitman, Beat D Steiner, Jefferson G Williams, Michael W Bachman, Jose G Cabanas, J Brent Myers, Seth W Glickman
OBJECTIVE: Emergency Departments (ED) are overburdened with patients experiencing acute mental health crises. Pre-hospital transport by Emergency Medical Services (EMS) to community mental health and substance abuse treatment facilities could reduce ED utilization and costs. Our objective was to describe characteristics, treatment, and outcomes of acute mental health crises patients who were transported by EMS to an acute crisis unit at WakeBrook, a North Carolina community mental health center...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29401055/on-becoming-trauma-informed-role-of-the-adverse-childhood-experiences-survey-in-tertiary-child-and-adolescent-mental-health-services-and-the-association-with-standard-measures-of-impairment-and-severity
#7
Abdul Rahman, Andrea Perri, Avril Deegan, Jennifer Kuntz, David Cawthorpe
CONTEXT: There is a movement toward trauma-informed, trauma-focused psychiatric treatment. OBJECTIVE: To examine Adverse Childhood Experiences (ACE) survey items by sex and by total scores by sex vs clinical measures of impairment to examine the clinical utility of the ACE survey as an index of trauma in a child and adolescent mental health care setting. DESIGN: Descriptive, polychoric factor analysis and regression analyses were employed to analyze cross-sectional ACE surveys (N = 2833) and registration-linked data using past admissions (N = 10,400) collected from November 2016 to March 2017 related to clinical data (28 independent variables), taking into account multicollinearity...
2018: Permanente Journal
https://www.readbyqxmd.com/read/29388524/weekday-and-seasonal-patterns-in-psychiatric-referrals-in-three-major-london-a-e-departments-2012-2014
#8
James Dove, Amit Mistry, Nomi Werbeloff, David Osborn, Nora Turjanski
Aims and method To identify temporal and demographic trends in referrals made to psychiatric liaison services. Routine clinical data from 16 105 individual referrals from three central London accident and emergency (A&E) departments to psychiatric liaison services from 2012 to 2014 were obtained and analysed using the Clinical Record Interactive Search (CRIS). RESULTS: Referrals from A&E to psychiatric liaison services increased 16% over the 3-year study period. There were fewer referrals to psychiatric liaison services in winter months compared with other seasons...
February 2018: BJPsych Bulletin
https://www.readbyqxmd.com/read/29385959/reducing-frequent-utilization-of-psychiatric-emergency-services-among-veterans-while-maintaining-quality-of-care
#9
Daniel M Blonigen, Luisa Manfredi, Adrienne Heinz, Xiaoyu Bi, Paola Suarez, Andrea L Nevedal, Anita A Vashi, Christine Timko, Todd Wagner
OBJECTIVE: Use of psychiatric emergency services in emergency departments (EDs) and inpatient psychiatry units contributes substantially to the cost of mental health care. Among patients who utilize psychiatric emergency services, a small percentage ("high utilizers") contributes a disproportionate share of the total cost, yet little is known about the context of care for these patients. This study employed qualitative methods to identify barriers to and facilitators of reducing use of psychiatric emergency services among high utilizers...
February 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29385820/characteristics-of-psychiatric-emergency-department-use-among-privately-insured-adolescents-with-autism-spectrum-disorder
#10
Luther G Kalb, Elizabeth A Stuart, Roma A Vasa
This study examined differences in the rates of psychiatric-related emergency department visits among adolescents with autism spectrum disorder, adolescents with attention deficit hyperactivity disorder, and adolescents without autism spectrum disorder or attention deficit hyperactivity disorder. Additional outcomes included emergency department recidivism, probability of psychiatric hospitalization after the emergency department visit, and receipt of outpatient mental health services before and after the emergency department visit...
January 1, 2018: Autism: the International Journal of Research and Practice
https://www.readbyqxmd.com/read/29385053/prevalence-of-mental-disorders-and-addictions-among-homeless-people-in-the-greater-paris-area-france
#11
Anne Laporte, Stéphanie Vandentorren, Marc-Antoine Détrez, Caroline Douay, Yann Le Strat, Erwan Le Méner, Pierre Chauvin
The Samenta study was conducted in 2009 in the Greater Paris area to estimate the prevalence of psychiatric disorders in homeless people. A cross-sectional survey was performed with a three-stage random sample of homeless people (n = 859), including users of day services, emergency shelters, hot meal distribution, long-term rehabilitation centres, and social hotels. Information was collected by a lay interviewer, using the Mini International Neuropsychiatric Interview, and completed by a psychologist through an open clinical interview...
January 31, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29383464/patient-centered-values-and-experiences-with-emergency-department-and-mental-health-crisis-care
#12
Kathleen C Thomas, Hillary Owino, Sana Ansari, Leslie Adams, Julianne M Cyr, Bradley N Gaynes, Seth W Glickman
Little is known about what patients value in psychiatric crisis services or how they compare community-based services with those received in the emergency department. Three focus groups (n = 27) were held of participants who had received psychiatric crisis services in emergency departments or a community mental health center. Participants described care experiences and preferences. Focus groups were audio recorded, transcribed, and coded using a value-based lens. Themes included appreciation for feeling respected, basic comforts, and shared decision-making as foundations of quality care...
January 30, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29375631/emergency-department-referrals-for-adolescent-urgent-psychiatric-consultation-comparison-of-clinical-characteristics-of-repeat-presentations-and-single-presentation
#13
Nasreen Roberts, Robert Nesdole, Tina Hu
Objective: a) to examine the demographic and clinical characteristics of repeat-presentations to an adolescent urgent psychiatric clinic, and b) to compare them with single-time presentation. Method: This 18-month retrospective study compared repeat-presenters to age and gender matched single-time presenters. Demographic variables included age gender and ethnicity. Clinical variables included reason for referral, family history, diagnosis, recommendations and compliance...
January 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29369663/preliminary-efficacy-of-service-dogs-as-a-complementary-treatment-for-posttraumatic-stress-disorder-in-military-members-and-veterans
#14
Marguerite E O'Haire, Kerri E Rodriguez
OBJECTIVE: Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. METHOD: A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75)...
February 2018: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/29369662/on-the-potential-for-iatrogenic-effects-of-psychiatric-crisis-services-the-example-of-dialectical-behavior-therapy-for-adult-women-with-borderline-personality-disorder
#15
Trevor N Coyle, Jennifer A Shaver, Marsha M Linehan
OBJECTIVE: Although previous research has suggested that people with a history of using psychiatric crisis services are at higher risk for suicide, it is unclear whether this link is attributable to individual risk factors or iatrogenic effects of service utilization. We examined this question by analyzing data from a randomized controlled trial of dialectical behavior therapy (DBT), a treatment for highly suicidal individuals in which patients took advantage of crisis services less than those in the comparison condition...
February 2018: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/29329038/hallucinations-as-a-presenting-complaint-in-emergency-departments-prevalence-diagnosis-and-costs
#16
Flavie Waters, Milan Dragovic
Hallucinations occur in the context of many disorders. When experienced as distressing, they are a likely cause of presentation to emergency departments. Knowledge about the rates, diagnoses, and associated costs of hallucinations in emergency departments however is currently lacking. In this study, we analysed patients' presenting complaints in Western Australia's Emergency Department Data Collection dataset during a two year period (n = 1,798,754). Visits to emergency departments because of distressing hallucinations were more common than previously assumed...
January 2, 2018: Psychiatry Research
https://www.readbyqxmd.com/read/29327358/opioid-medication-use-in-patients-with-gastrointestinal-diagnoses-vs-unexplained-gastrointestinal-symptoms-in-the-us-veterans-health-administration
#17
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29321126/toward-mhealth-brief-contact-interventions-in-suicide-prevention-case-series-from-the-suicide-intervention-assisted-by-messages-siam-randomized-controlled-trial
#18
Sofian Berrouiguet, Mark Erik Larsen, Catherine Mesmeur, Michel Gravey, Romain Billot, Michel Walter, Christophe Lemey, Philippe Lenca
BACKGROUND: Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. OBJECTIVE: The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up...
January 10, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#19
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29320381/a-brief-interview-to-detect-panic-attacks-and-panic-disorder-in-emergency-department-patients-with-cardiopulmonary-complaints
#20
Sharon C Sung, A John Rush, Arul Earnest, Leslie E C Lim, Maeve P P Pek, Joen M F Choi, Magdalene P K Ng, Marcus E H Ong
OBJECTIVES: Patients with panic-related anxiety often initially present to the emergency department (ED) complaining of respiratory or cardiac symptoms, but rates of detection of panic symptoms by ED physicians remain low. This study was undertaken to evaluate the relevance of panic attacks and panic disorder in ED patients who present with cardiopulmonary symptoms and to determine whether a brief symptom-based tool could be constructed to assist in rapid recognition of panic-related anxiety in the ED setting...
January 2018: Journal of Psychiatric Practice
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