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Urgent psychiatric care

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101 papers 100 to 500 followers Timely ambulatory psychiatric interventions/programs for high risk individuals and people in crisis
https://www.readbyqxmd.com/read/27821412/community-mental-health-care-after-self-harm-a-retrospective-cohort-study
#1
Matthew J Spittal, Fiona Shand, Helen Christensen, Lisa Brophy, Jane Pirkis
OBJECTIVE: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). METHODS: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011...
November 7, 2016: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/27903135/support-for-relatives-bereaved-by-psychiatric-patient-suicide-national-confidential-inquiry-into-suicide-and-homicide-findings
#2
Alexandra L Pitman, Isabelle M Hunt, Sharon J McDonnell, Louis Appleby, Navneet Kapur
OBJECTIVES: International suicide prevention strategies recommend providing support to families bereaved by suicide. The study objectives were to measure the proportion of cases in which psychiatric professionals contact next of kin after a patient's suicide and to investigate whether specific, potentially stigmatizing patient characteristics influence whether the family is contacted. METHODS: Annual survey data from England and Wales (2003-2012) were used to identify 11,572 suicide cases among psychiatric patients...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27974000/characteristics-of-hospital-emergency-room-visits-for-mental-and-substance-use-disorders
#3
Toluwalope Ayangbayi, Albert Okunade, Mustafa Karakus, Thierry Nianogo
OBJECTIVE: This study compared characteristics of visits to emergency rooms (ERs) for mental and substance use disorders and for physical health conditions to establish a baseline against which to measure changes after full implementation of the Affordable Care Act (ACA) and parity legislation. METHODS: The retrospective, cross-sectional analysis fit a logistic regression model to pooled data comprising 193,526 observations from National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005 to 2011...
December 15, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/25606742/lessons-from-washington-state-s-medical-home-payment-pilot-what-it-will-take-to-change-american-health-care
#4
Reena A Koshy, Douglas A Conrad, David Grembowski
The Washington State Multi-Payer Medical Home Reimbursement Pilot (Pilot) tested a payment method for the patient-centered medical home (PCMH) model intended to reduce avoidable emergency department (ED) and hospitalization rates. Very little is known about the primary care clinic (clinic) experience with various payment methods designed for the medical home model. The objective was to elicit and describe the primary care clinic experience among various medical groups in Washington State's payment Pilot. This was a qualitative analysis of semi-structured interviews conducted in January 2014 to identify enabling features (or "facilitators") as well as barriers to successful implementation of PCMH in this multi-payer pilot...
August 2015: Population Health Management
https://www.readbyqxmd.com/read/25651603/care-coordination-measures-of-a-family-medicine-residency-as-a-model-for-hospital-readmission-reduction
#5
Wayne A Mathews
The processes of care coordination of patient transition from hospital to outpatient settings are an integral part of the Patient-Centered Medical Home. We report a cooperative initiative between our admission hospital and family medicine residency to analyze the discharge process using the Agency for Healthcare Research and Quality's Re-engineering Discharge initiative, focusing on efficient information transfer and communication with discharged patients to insure rapid follow-up in the clinic. Our project yielded markedly reduced readmission rates compared with both local hospital and national rates...
November 2014: American Journal of Managed Care
https://www.readbyqxmd.com/read/27702961/rethinking-thirty-day-hospital-readmissions-shorter-intervals-might-be-better-indicators-of-quality-of-care
#6
David L Chin, Heejung Bang, Raj N Manickam, Patrick S Romano
Public reporting and payment programs in the United States have embraced thirty-day readmissions as an indicator of between-hospital variation in the quality of care, despite limited evidence supporting this interval. We examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient...
October 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27724889/roles-of-disease-severity-and-post-discharge-outpatient-visits-as-predictors-of-hospital-readmissions
#7
Hao Wang, Carol Johnson, Richard D Robinson, Vicki A Nejtek, Chet D Schrader, JoAnna Leuck, Johnbosco Umejiego, Allison Trop, Kathleen A Delaney, Nestor R Zenarosa
BACKGROUND: Risks prediction models of 30-day all-cause hospital readmissions are multi-factorial. Severity of illness (SOI) and risk of mortality (ROM) categorized by All Patient Refined Diagnosis Related Groups (APR-DRG) seem to predict hospital readmission but lack large sample validation. Effects of risk reduction interventions including providing post-discharge outpatient visits remain uncertain. We aim to determine the accuracy of using SOI and ROM to predict readmission and further investigate the role of outpatient visits in association with hospital readmission...
October 10, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27738261/factors-associated-with-timely-physician-follow-up-after-a-first-diagnosis-of-psychotic-disorder
#8
Kelly K Anderson, Paul Kurdyak
OBJECTIVE: Physician follow-up after a first diagnosis of psychotic disorder is crucial for improving treatment engagement. We examined the factors associated with physician follow-up within 30 days of a first diagnosis of schizophrenia. METHOD: We conducted a retrospective cohort study using linked health administrative data to identify incident cases of schizophrenia between 1999 and 2008 among people aged 14 to 35 years in Ontario. We estimated the proportion of patients who had physician follow-up within 30 days of the index diagnosis...
October 13, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/27798483/recent-advances-in-differentiating-suicide-attempters-from-suicide-ideators
#9
E David Klonsky, Tianyou Qiu, Boaz Y Saffer
PURPOSE OF REVIEW: This article summarizes findings from recent studies (published since 2015) examining differences between suicide attempters and suicide ideators. RECENT FINDINGS: Converging evidence suggests that the capability to attempt suicide (e.g., acquired capability, painful and provocative experiences, high tolerance for pain and distress) is higher in suicide attempters than suicide ideators. Other psychosocial and biological differences have also been identified but require replication...
January 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/27660459/-that-s-where-the-arguments-come-in-a-qualitative-analysis-of-booster-sessions-following-a-brief-intervention-for-drug-use-and-intimate-partner-violence-in-the-emergency-department
#10
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
https://www.readbyqxmd.com/read/27698212/the-futility-of-risk-prediction-in-psychiatry
#11
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
https://www.readbyqxmd.com/read/26961781/-hospital-was-the-only-option-experiences-of-frequent-emergency-department-users-in-mental-health
#12
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
https://www.readbyqxmd.com/read/27650687/royal-australian-and-new-zealand-college-of-psychiatrists-clinical-practice-guideline-for-the-management-of-deliberate-self-harm
#13
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
https://www.readbyqxmd.com/read/27648507/content-area-framework-for-conducting-family-meetings-for-acutely-ill-psychiatric-patients
#14
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
https://www.readbyqxmd.com/read/27653829/postdischarge-suicides-nightmare-and-disgrace
#15
Merete Nordentoft, Annette Erlangsen, Trine Madsen
No abstract text is available yet for this article.
September 21, 2016: JAMA Psychiatry
https://www.readbyqxmd.com/read/27631147/disability-and-functioning-of-patients-who-use-psychiatric-hospital-emergency-services
#16
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
https://www.readbyqxmd.com/read/27417898/the-role-of-social-work-in-providing-mental-health-services-and-care-coordination-in-an-urban-trauma-center-emergency-department
#17
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...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27582241/psychiatric-inpatient-discharge-planning-practices-and-attendance-at-aftercare-appointments
#18
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...
January 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27603743/borderline-personality-disorder-in-the-emergency-department-good-psychiatric-management
#19
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
https://www.readbyqxmd.com/read/27516897/mindfulness-based-crisis-interventions-for-patients-with-psychotic-symptoms-on-acute-psychiatric-wards-ambition-study-protocol-for-a-feasibility-randomised-controlled-trial
#20
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
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