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Urgent psychiatric care

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92 papers 100 to 500 followers Timely ambulatory psychiatric interventions/programs for high risk individuals and people in crisis
Esther K Choo, Chantal Tapé, Kimberly M Glerum, Michael J Mello, Caron Zlotnick, Kate Morrow Guthrie
Although booster phone calls have been used to enhance the impact of brief interventions in the emergency department, there has been less number of studies describing the content of these boosters. We conducted a qualitative analysis of booster calls occurring two weeks after an initial Web-based intervention for drug use and intimate partner violence (IPV) among women presenting for emergency care, with the objective of identifying the following: progress toward goals set during the initial emergency department visit, barriers to positive change, and additional resources and services needed in order to inform improvements in future booster sessions...
2016: Substance Abuse: Research and Treatment
Roger Mulder, Giles Newton-Howes, Jeremy W Coid
Significant efforts have been made to identify risk factors associated with suicide. However, the evidence suggests that risk categorisation may be of limited value, or worse, potentially harmful, confusing clinical thinking. We argue instead for a shift in focus towards real engagement with the individual patient, their specific problems and circumstances.
October 2016: British Journal of Psychiatry: the Journal of Mental Science
Deborah Wise-Harris, Daniel Pauly, Deborah Kahan, Jason Tan de Bibiana, Stephen W Hwang, Vicky Stergiopoulos
The experiences of individuals with mental illness and addictions who frequently present to hospital emergency departments (EDs) have rarely been explored. This study reports findings from self-reported, quantitative surveys (n = 166) and in-depth, qualitative interviews (n = 20) with frequent ED users with mental health and/or substance use challenges in a large urban centre. Participants presented to hospital for mental health (35 %), alcohol/drug use (21 %), and physical health (39 %) concerns and described their ED visits as unavoidable and appropriate, despite feeling stigmatized by hospital personnel and being discharged without expected treatment...
March 9, 2016: Administration and Policy in Mental Health
Gregory Carter, Andrew Page, Matthew Large, Sarah Hetrick, Allison Joy Milner, Nick Bendit, Carla Walton, Brian Draper, Philip Hazell, Sarah Fortune, Jane Burns, George Patton, Mark Lawrence, Lawrence Dadd, Jo Robinson, Helen Christensen
OBJECTIVE: To provide guidance for the organisation and delivery of clinical services and the clinical management of patients who deliberately self-harm, based on scientific evidence supplemented by expert clinical consensus and expressed as recommendations. METHOD: Articles and information were sourced from search engines including PubMed, EMBASE, MEDLINE and PsycINFO for several systematic reviews, which were supplemented by literature known to the deliberate self-harm working group, and from published systematic reviews and guidelines for deliberate self-harm...
October 2016: Australian and New Zealand Journal of Psychiatry
Natalie C Pon, Mollie R Gordon, John Coverdale, Phuong T Nguyen
Family meetings are a critically important component of managing acutely psychiatrically ill patients, and learning how to conduct such a meeting is critically important in the training of psychiatrists. Because we found no published comprehensive tools that dealt with the biopsychosocial content areas to be covered in family meetings in acute psychiatric settings, we developed and present such a comprehensive tool that is based in part on a review of existing tools utilized by other disciplines. This article describes the specific steps involved in premeeting planning, the formal topic areas that might be canvassed during the meeting, and postmeeting documentation and debriefing...
September 2016: Journal of Psychiatric Practice
Merete Nordentoft, Annette Erlangsen, Trine Madsen
No abstract text is available yet for this article.
September 21, 2016: JAMA Psychiatry
Kevin D Shield, Paul Kurdyak, Paul A Shuper, Jürgen Rehm
OBJECTIVE: First, to compare the level of disability and functioning of patients who access psychiatric emergency services by diagnosis and service use frequency. Second, to compare patients who access psychiatric emergency services to the general population in terms of demographics and the level of disability and functioning. METHODS: Data from 420 patients were obtained by time-based sampling from August 2011 to February 2012 in the emergency department of a psychiatric hospital that provides services to adolescents and adults...
September 13, 2016: Journal of Clinical Psychiatry
Megan Moore, Lauren K Whiteside, Danae Dotolo, Jin Wang, Leyna Ho, Bonnie Conley, Mollie Forrester, Susan O Fouts, Monica S Vavilala, Douglas F Zatzick
OBJECTIVE: This study examined the role of emergency department (ED) social workers and identified predictors of receipt of social work services and length of ED stay. METHODS: Comprehensive reviews were conducted of medical records of all patients (N=49,354) treated in a level 1 trauma center ED from January 1, 2012, to March 31, 2013. Content analysis of chart notes was used to categorize the types of social work services provided. Poisson regression was used to assess associations between demographic and clinical characteristics, receipt of social work services, and length of ED stay...
July 15, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Thomas E Smith, Maria Abraham, Natalia V Bolotnikova, Sheila A Donahue, Susan M Essock, Mark Olfson, Wenjun S Shao, Melanie M Wall, Marleen Radigan
OBJECTIVE: This study examined discharge planning practices by hospital providers for 17,053 psychiatric discharges in New York's statewide Medicaid program. METHODS: Claims data were linked to information reported to New York State by managed behavioral health care organizations (MBHOs) conducting inpatient utilization reviews. MBHOs documented hospital providers' reports of the presence of three discharge planning practices for each discharge: communicating with an outpatient provider prior to discharge, scheduling an aftercare appointment, and forwarding a discharge summary...
September 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Victor Hong
Patients with borderline personality disorder (BPD) are high utilizers of psychiatric emergency services and present unique challenges in that setting. Frequently advised to visit an emergency department (ED) if safety is in question, their experiences once there often do not have beneficial effects. Issues specific to patients with BPD in the ED include volatile interactions with staff, repeat visits, concerns about safety (and liability), and disposition. Emergency department staff attitudes toward these patients are frequently negative when compared to patients with other diagnoses, and can detrimentally affect outcomes and perpetuate stigma regarding BPD...
September 2016: Harvard Review of Psychiatry
Pamela Jacobsen, Emmanuelle Peters, Paul Chadwick
BACKGROUND: Inpatient psychiatric care is a scarce and expensive resource in the National Health Service (NHS), with chronic bed shortages being partly driven by high re-admission rates. People often need to go into hospital when they have a mental health crisis due to overwhelming distressing psychotic symptoms, such as hearing voices (hallucinations) or experiencing unusual beliefs (delusions). Brief talking therapies may be helpful for people during an acute inpatient admission as an adjunct to medication in reducing re-admission rates, and despite promising findings from trials in the USA, there have not yet been any clinical trials on this kind of intervention within NHS settings...
December 2016: Pilot and Feasibility Studies
Marc A Schuckit
This article provides an overview of the current treatment of opioid-related conditions, including treatments provided by general practitioners and by specialists in substance-use disorders. The recent dramatic increase in misuse of prescription analgesics, the easy accessibility of opioids such as..
July 28, 2016: New England Journal of Medicine
Keith Hawton, Katrina G Witt, Tatiana L Taylor Salisbury, Ella Arensman, David Gunnell, Philip Hazell, Ellen Townsend, Kees van Heeringen
BACKGROUND: Self-harm (intentional acts of non-fatal self-poisoning or self-injury) is common, particularly in young adults aged 15-35 years, often repeated, and strongly associated with suicide. Effective aftercare of individuals who self-harm is therefore important. We have undertaken a Cochrane systematic review and meta-analysis of the effectiveness of psychosocial interventions for self-harm in adults. METHODS: We searched five electronic databases (CCDANCTR-Studies and References, CENTRAL, MEDLINE, Embase, and PsycINFO) between Jan 1, 1998, and April 29, 2015, for randomised controlled trials of psychosocial interventions for adults after a recent (within 6 months) episode of self-harm...
August 2016: Lancet Psychiatry
S Ryan Greysen, James D Harrison, Sunil Kripalani, Eduard Vasilevskis, Edmondo Robinson, Joshua Metlay, Jeffery L Schnipper, David Meltzer, Neil Sehgal, Gregory W Ruhnke, Mark V Williams, Andrew D Auerbach
IMPORTANCE: Patient concerns at or before discharge inform many transitional care interventions; few studies examine patients' perceptions of self-care and other factors related to readmission. OBJECTIVES: To characterise patient-reported or caregiver-reported factors contributing to readmission. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional, national study of general medicine patients readmitted within 30 days at 12 US hospitals. Interviews included multiple-choice survey and open-ended survey questions of patients or their caregivers...
January 14, 2016: BMJ Quality & Safety
Michael F Hogan, Julie Goldstein Grumet
Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings...
June 1, 2016: Health Affairs
Philip Dodd, Ailbhe Doherty, Suzanne Guerin
BACKGROUND: Suicidality in people with intellectual disability has not been extensively researched. AIM: To identify the nature of the research that has actually been conducted on this topic. METHOD: A search of research databases was conducted according to predefined criteria. Key information was extracted and rated for methodological merit. RESULTS: Twenty-four studies met the inclusion criteria for this systematic review...
May 2016: Harvard Review of Psychiatry
Deborah Kahan, Molyn Leszcz, Patricia O'Campo, Stephen W Hwang, Donald A Wasylenki, Paul Kurdyak, Deborah Wise Harris, Agnes Gozdzik, Vicky Stergiopoulos
BACKGROUND: Addressing the needs of frequent users of emergency departments (EDs) is a health system priority in many jurisdictions. This study describes stakeholder perspectives on the implementation of a multi-organizational brief intervention designed to support integration and continuity of care for frequent ED users with mental health and addictions problems, focusing on perceived barriers and facilitators to early implementation in a large urban centre. METHODS: Coordinating Access to Care from Hospital Emergency Departments (CATCH-ED) is a brief case management intervention bridging hospital, primary and community care for frequent ED users experiencing mental illness and addictions...
2016: BMC Health Services Research
Nasreen Roberts, Linda Booij, Nicholas Axas, Leanne Repetti
OBJECTIVE: (a) To describe the clinical characteristics and outcome of adolescents referred for urgent psychiatric consultation, and (b) compare suicidal with non-suicidal referrals. METHODS: This was a 2-year prospective study. Data was gathered on demographic, historical and clinical variables. Comparison of suicidal and non-suicidal patients was conducted using χ2. A hospital database was used for referral and wait times. RESULTS: Of 805 assessments, 55% were referred by emergency physicians and 28% by primary care physicians...
May 13, 2016: International Journal of Adolescent Medicine and Health
Marguerite E Burns, Haiden A Huskamp, Jessica C Smith, Jeanne M Madden, Stephen B Soumerai
BACKGROUND: The transition from Medicaid-only to dual Medicare/Medicaid coverage has the potential to reduce financial barriers to health care for patients with serious mental illness through increased coverage or expanded access to clinicians as their reimbursement increases. AIMS: To estimate the effect of dual coverage after Medicaid enrollment during the required waiting period among adults with serious mental illness on health care use, overall and related to mental health and substance use disorders (MHSUD)...
September 2016: Medical Care
Christophe Huynh, Francine Ferland, Nadine Blanchette-Martin, Jean-Marc Ménard, Marie-Josée Fleury
This study assessed the characteristics of individuals with substance use disorders (ISUDs) according to their frequency of emergency department (ED) utilization, and examined which variables were associated with an increase in ED visits using Andersen's model. Data linkage of administrative databanks from three sources [addiction rehabilitation centre registry, physician billing systems, and hospital discharge databank] for 4526 ISUDs was performed. Predisposing, enabling and need factors associated with number of ED visits were determined using a negative binomial regression model and generalised estimating equations...
February 13, 2016: Psychiatric Quarterly
2016-03-09 03:00:31
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