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Urgent psychiatric care

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114 papers 100 to 500 followers Timely ambulatory psychiatric interventions/programs for high risk individuals and people in crisis
https://www.readbyqxmd.com/read/28325505/clinical-interpretation-of-urine-drug-tests-what-clinicians-need-to-know-about-urine-drug-screens
#1
REVIEW
Karen E Moeller, Julie C Kissack, Rabia S Atayee, Kelly C Lee
Urine drug testing is frequently used in clinical, employment, educational, and legal settings and misinterpretation of test results can result in significant adverse consequences for the individual who is being tested. Advances in drug testing technology combined with a rise in the number of novel misused substances present challenges to clinicians to appropriately interpret urine drug test results. Authors searched PubMed and Google Scholar to identify published literature written in English between 1946 and 2016, using urine drug test, screen, false-positive, false-negative, abuse, and individual drugs of abuse as key words...
May 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#2
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737411/can-brief-behavioral-health-interventions-reduce-suicidal-and-self-harm-ideation-in-primary-care-patients
#3
Aubrey R Dueweke, Sasha M Rojas, Elizabeth A Anastasia, Ana J Bridges
OBJECTIVE: We examined whether brief behavioral health visits reduced suicidal and self-harm ideation among primary care patients and compared the effectiveness of interventions that targeted ideation directly (i.e., safety planning) with those that targeted ideation indirectly through management of underlying mental illness (e.g., behavioral activation). METHOD: We examined first- and last-visit data from 31 primary care patients with suicidal or self-harm ideation seen by behavioral health consultants...
September 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28364579/frequency-of-prescription-opioid-misuse-and-suicidal-ideation-planning-and-attempts
#4
Lisham Ashrafioun, Todd M Bishop, Kenneth R Conner, Wilfred R Pigeon
The goal of this study was to examine the relationship between past-year frequency of prescription opioid misuse and past-year suicidal ideation, suicide planning, and suicide attempts. Secondary data analyses were conducted using data from 41,053 participants of the 2014 National Survey of Drug Use and Health. Past-year frequency of prescription opioid misuse was grouped into 4 categories: none, less than monthly (1-11 times), monthly to weekly (12-51 times), and weekly or more (52 times or more). Binomial logistic regression analyses adjusted for demographics, overall health rating, depression, anxiety, and substance use disorders to test the associations between frequency of prescription opioid misuse and suicide-related variables...
September 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28428338/strategies-to-prevent-death-by-suicide-meta-analysis-of-randomised-controlled-trials
#5
REVIEW
Natalie B V Riblet, Brian Shiner, Yinong Young-Xu, Bradley V Watts
BackgroundFew randomised controlled trials (RCTs) have shown decreases in suicide.AimsTo identify interventions for preventing suicide.MethodWe searched EMBASE and Medline from inception until 31 December 2015. We included RCTs comparing prevention strategies with control. We pooled odds ratios (ORs) for suicide using the Peto method.ResultsAmong 8647 citations, 72 RCTs and 6 pooled analyses met inclusion criteria. Three RCTs (n = 2028) found that the World Health Organization (WHO) brief intervention and contact (BIC) was associated with significantly lower odds of suicide (OR = 0...
June 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28434871/a-brief-psychological-intervention-to-reduce-repetition-of-self-harm-in-patients-admitted-to-hospital-following-a-suicide-attempt-a-randomised-controlled-trial
#6
Rory C O'Connor, Eamonn Ferguson, Fiona Scott, Roger Smyth, David McDaid, A-La Park, Annette Beautrais, Christopher J Armitage
BACKGROUND: We investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self-harm in the 6 months following a suicide attempt. METHODS: We did a prospective, single-site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self-reported history of self-harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital...
June 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28434872/the-use-of-emergency-department-based-psychological-interventions-to-reduce-repetition-of-self-harm-behaviour
#7
Katrina Witt
No abstract text is available yet for this article.
June 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28412887/preventing-and-de-escalating-aggressive-behavior-among-adult-psychiatric-patients-a-systematic-review-of-the-evidence
#8
Bradley N Gaynes, Carrie L Brown, Linda J Lux, Kimberly A Brownley, Richard A Van Dorn, Mark J Edlund, Emmanuel Coker-Schwimmer, Rachel Palmieri Weber, Brian Sheitman, Theodore Zarzar, Meera Viswanathan, Kathleen N Lohr
OBJECTIVE: The project goal was to compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors among psychiatric patients in acute care settings, including interventions for reducing use of seclusion and restraint. METHODS: Relevant databases were systematically reviewed for comparative studies of violence prevention and de-escalation strategies involving adult psychiatric patients in acute care settings. Studies (trials and cohort studies) were required to report on aggression or seclusion or restraint outcomes...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28426367/child-and-adolescent-emergency-and-urgent-mental-health-delivery-through-telepsychiatry-12-month-prospective-study
#9
Nasreen Roberts, Tina Hu, Nicholas Axas, Leanne Repetti
BACKGROUND: The significant gap between children and adolescents presenting for emergency mental healthcare and the shortage of child and adolescent psychiatrists constitutes a major barrier to timely access for psychiatric assessment for rural and remote areas. Unlike remote areas, urban emergency departments have in-house psychiatric consultation. Telepsychiatry may be a solution to ensure the same service for remote areas. However, there is a paucity of studies on the use of telepsychiatry for child and adolescent emergency consults...
April 20, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28302702/predictive-accuracy-of-risk-scales-following-self-harm-multicentre-prospective-cohort-study
#10
Leah Quinlivan, Jayne Cooper, Declan Meehan, Damien Longson, John Potokar, Tom Hulme, Jennifer Marsden, Fiona Brand, Kezia Lange, Elena Riseborough, Lisa Page, Chris Metcalfe, Linda Davies, Rory O'Connor, Keith Hawton, David Gunnell, Nav Kapur
BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm...
June 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28320225/suicide-following-deliberate-self-harm
#11
Mark Olfson, Melanie Wall, Shuai Wang, Stephen Crystal, Tobias Gerhard, Carlos Blanco
OBJECTIVE: The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. METHOD: A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined...
August 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28248631/working-together-to-connect-care-a-metropolitan-tertiary-emergency-department-and-community-care-program
#12
Debra Harcourt, Clancy McDonald, Leonie Cartlidge-Gann, John Burke
Objective Frequent attendance by people to an emergency department (ED) is a global concern. A collaborative partnership between an ED and the primary and community healthcare sectors has the potential to improve care for the person who frequently attends the ED. The aims of the Working Together to Connect Care program are to decrease the number of presentations by providing focused community support and to integrate all healthcare services with the goal of achieving positive, patient-centred and directed outcomes...
March 2, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28193192/taking-care-of-oneself-by-regaining-control-a-key-to-continue-living-four-to-five-decades-after-a-suicide-attempt-in-severe-depression
#13
Lisa Crona, Margaretha Stenmarker, Agneta Öjehagen, Ulrika Hallberg, Louise Brådvik
BACKGROUND: Depression is a strong risk factor for suicide and suicide attempt. Several studies have examined the pathway to suicide attempt, but few studies have considered aspects important for overcoming being suicidal. The aim of the present study was to examine personal strategies to continue living after a suicide attempt. METHODS: A qualitative grounded theory approach was used. Thirteen former inpatients diagnosed with severe depression (1956-1969) participated in a follow-up 42-56 years after their last suicide attempt, which occurred between the ages of 21 and 45...
February 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/27821412/community-mental-health-care-after-self-harm-a-retrospective-cohort-study
#14
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...
July 2017: 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
#15
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...
April 1, 2017: 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
#16
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...
April 1, 2017: 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
#17
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
#18
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
#19
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
#20
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
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