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Johnson S, Dalton‐Locke C, Baker J, Hanlon C, Salisbury TT, Fossey M, Newbigging K, Carr SE, Hensel J, Carrà G, Hepp U, Caneo C, Needle JJ, Lloyd‐Evans B. Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care. World Psychiatry 2022; 21:220-236. [PMID: 35524608 PMCID: PMC9077627 DOI: 10.1002/wps.20962] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Acute services for mental health crises are very important to service users and their supporters, and consume a substantial share of mental health resources in many countries. However, acute care is often unpopular and sometimes coercive, and the evidence on which models are best for patient experience and outcomes remains surprisingly limited, in part reflecting challenges in conducting studies with people in crisis. Evidence on best ap-proaches to initial assessment and immediate management is particularly lacking, but some innovative models involving extended assessment, brief interventions, and diversifying settings and strategies for providing support are potentially helpful. Acute wards continue to be central in the intensive treatment phase following a crisis, but new approaches need to be developed, evaluated and implemented to reducing coercion, addressing trauma, diversifying treatments and the inpatient workforce, and making decision-making and care collaborative. Intensive home treatment services, acute day units, and community crisis services have supporting evidence in diverting some service users from hospital admission: a greater understanding of how best to implement them in a wide range of contexts and what works best for which service users would be valuable. Approaches to crisis management in the voluntary sector are more flexible and informal: such services have potential to complement and provide valuable learning for statutory sector services, especially for groups who tend to be underserved or disengaged. Such approaches often involve staff with personal experience of mental health crises, who have important potential roles in improving quality of acute care across sectors. Large gaps exist in many low- and middle-income countries, fuelled by poor access to quality mental health care. Responses need to build on a foundation of existing community responses and contextually relevant evidence. The necessity of moving outside formal systems in low-resource settings may lead to wider learning from locally embedded strategies.
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Affiliation(s)
- Sonia Johnson
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | | | - John Baker
- School of Healthcare, University of LeedsLeedsUK
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK,Department of PsychiatrySchool of Medicine, and Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa UniversityAddis AbabaEthiopia
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK
| | - Matt Fossey
- Faculty of Health, Education, Medicine and Social CareAnglia Ruskin UniversityChelmsfordUK
| | - Karen Newbigging
- Department of PsychiatryUniversity of OxfordOxfordUK,Institute for Mental Health, University of BirminghamBirminghamUK
| | - Sarah E. Carr
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUK
| | - Jennifer Hensel
- Department of PsychiatryUniversity of ManitobaWinnipegMBCanada
| | - Giuseppe Carrà
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur, Zürcher UnterlandWinterthurSwitzerland
| | - Constanza Caneo
- Departamento de Psiquiatría, Facultad de MedicinaPontificia Universidad Católica de ChileSantiagoChile
| | - Justin J. Needle
- Centre for Health Services Research, School of Health Sciences, City, University of LondonLondonUK
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Shukor AR, Joe R, Sincraian G, Klazinga N, Kringos DS. A Multi-sourced Data Analytics Approach to Measuring and Assessing Biopsychosocial Complexity: The Vancouver Community Analytics Tool Complexity Module (VCAT-CM). Community Ment Health J 2019; 55:1326-1343. [PMID: 31177480 PMCID: PMC6823655 DOI: 10.1007/s10597-019-00417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 05/16/2019] [Indexed: 01/09/2023]
Abstract
Operationalization of the fundamental building blocks of primary care (i.e. empanelment, team-based care and population management) within the context of Community Health Centers requires accurate and real-time measures of biopsychosocial complexity, at both client and population-levels. This article describes the conceptualization, design and development of a novel software tool (the VCAT-Complexity Module) that can calculate and report real-time person-oriented biopsychosocial complexity profiles, using multiple data sources. The tool aligns with a profile approach to conceptualizing health outcomes, and represents a potentially significant advance over disease-oriented complexity assessment tools. The results and face validity of the software's complexity score outputs are discussed, along with their practical implications on functions related to the development of primary care within Vancouver Coastal Health, a Canadian Regional Health Authority.
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Affiliation(s)
- Ali Rafik Shukor
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Ronald Joe
- Vancouver Coastal Health (VCH), 520 West 6th Ave, Vancouver, BC Canada
| | | | - Niek Klazinga
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Dionne Sofia Kringos
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Bridgett C, Polak P. Social systems intervention and crisis resolution. Part 1: Assessment. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.9.6.424] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Home treatment as an alternative to acute adult in-patient care is part of the National Health Service Plan for mental health services in the UK. As a form of crisis intervention, it benefits from an understanding of, and ways of working with, the social systems relevant to the patient in crisis. This article reviews relevant terminology and background theory, and considers the social factors associated with psychiatric admission.
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Abstract
BACKGROUND A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. OBJECTIVES To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. SEARCH METHODS We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. SELECTION CRITERIA We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. DATA COLLECTION AND ANALYSIS We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. MAIN RESULTS The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve mental state (Brief Psychiatric Rating Scale (BPRS) three months: 2 RCTs, n = 248, MD -4.03 CI -8.18 to 0.12, low quality evidence), and improve global state (Global Assessment Scale (GAS) 20 months; 1 RCT, n = 142, MD 5.70, -0.26 to 11.66, moderate quality evidence). Participants in the crisis-intervention group were more satisfied with their care 20 months after crisis (Client Satisfaction Questionnaire (CSQ-8): 1 RCT, n = 137, MD 5.40 CI 3.91 to 6.89, moderate quality evidence). However, quality of life scores at six months were similar between treatment groups (Manchester Short Assessment of quality of life (MANSA); 1 RCT, n = 226, MD -1.50 CI -5.15 to 2.15, low quality evidence). Favourable results for crisis intervention were also found for leaving the study early and family satisfaction. No differences in death rates were found. Some studies suggested crisis intervention to be more cost-effective than hospital care but all numerical data were either skewed or unusable. We identified no data on staff satisfaction, carer input, complications with medication or number of relapses. AUTHORS' CONCLUSIONS Care based on crisis-intervention principles, with or without an ongoing homecare package, appears to be a viable and acceptable way of treating people with serious mental illnesses. However only eight small studies with unclear blinding, reporting and attrition bias could be included and evidence for the main outcomes of interest is low to moderate quality. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.
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Affiliation(s)
- Suzanne M Murphy
- University of BedfordshireNIHR East of England Research Design ServicesPutteridge BuryHitchin Road,LutonBedfordshireUKLU2 8LE
| | - Claire B Irving
- The University of NottinghamCochrane Schizophrenia GroupInstitute of Mental HealthUniversity of Nottingham Innovation Park, Triumph RoadNottinghamUKNG7 2TU
| | - Clive E Adams
- The University of NottinghamCochrane Schizophrenia GroupInstitute of Mental HealthUniversity of Nottingham Innovation Park, Triumph RoadNottinghamUKNG7 2TU
| | - Muhammad Waqar
- University of BedfordshireInstitute for Health ResearchPutteridge Bury Campus, Hitchin RoadLutonBedfordshireUKLU1 1UG
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Hannigan B. 'There's a lot of tasks that can be done by any': Findings from an ethnographic study into work and organisation in UK community crisis resolution and home treatment services. Health (London) 2013; 18:406-21. [PMID: 24026359 DOI: 10.1177/1363459313501359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Across the United Kingdom, large numbers of crisis resolution and home treatment services have been established with the aim of providing intensive, short-term care to people who would otherwise be admitted to mental health hospital. Despite their widespread appearance, little is known about how crisis resolution and home treatment services are organised or how crisis work is done. This article arises from a larger ethnographic study (in which 34 interviews were conducted with practitioners, managers and service users) designed to generate data in these and related areas. Underpinned by systems thinking and sociological theories of the division of labour, the article examines the workplace contributions of mental health professionals and support staff. In a fast-moving environment, the work which was done, how and by whom, reflected wider professional jurisdictions and a recognisable patterning by organisational forces. System characteristics including variable shift-by-shift team composition and requirements to undertake assessments of new referrals while simultaneously providing home treatment shaped the work of some, but not all, professionals. Implications of these findings for larger systems of work are considered.
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Abstract
BACKGROUND A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. OBJECTIVES To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with 'standard care'. SEARCH METHODS We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group's Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. SELECTION CRITERIA We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. DATA COLLECTION AND ANALYSIS We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. MAIN RESULTS Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments.Crisis intervention appears to reduce repeat admissions to hospital after the initial 'index' crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes.Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more satisfactory form of care for both patients and families and at three months after crisis, mental state is superior to standard care. We found no differences in death outcomes. Some studies found crisis interventions to be more cost effective than hospital care but all numerical data were either skewed or unusable. No data on staff satisfaction, carer input, complications with medication or number of relapses were available. AUTHORS' CONCLUSIONS Care based on crisis intervention principles, with or without an ongoing home care package, appears to be a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.
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Affiliation(s)
- Suzanne Murphy
- NIHR East of England Research Design Services, University of Bedfordshire, Luton, Bedfordshire, UK.
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Koekkoek B, Van Meijel B, Schene A, Hutschemaekers G. Community psychiatric nursing in the Netherlands: a survey of a thriving but threatened profession. J Psychiatr Ment Health Nurs 2009; 16:822-8. [PMID: 19824976 DOI: 10.1111/j.1365-2850.2009.01461.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this paper is to describe and analyse the Dutch community psychiatric nursing profession. In spite of their large numbers, estimated at 2900, Dutch community psychiatric nurses (CPNs) have contributed little to the international literature. The history of the profession reveals a relatively isolated development, resulting in few connections with nursing and mental healthcare research. Because of various developments in these fields, CPNs appear under threat. A survey design was used to administer a 43-item electronic questionnaire, which yielded a response rate of 40%. The Dutch CPN has a mean age of 48 years, works about 32 h per week and has over 20 years of nursing experience. The Dutch CPN has a caseload of 48 patients, often participates in clinical intervision and hardly works according to evidence-based methods. Dutch community psychiatric nursing is, paradoxically, both thriving and threatened. CPNs seek to maintain a model that pays attention to both social needs and explanations, and to psychiatric diagnoses. This broad orientation may be considered essential to nursing. However, it is also a huge drawback as CPNs have not succeeded to clearly articulate what their profession adds to the care and treatment of psychiatric patients.
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Affiliation(s)
- B Koekkoek
- Altrecht Mental Health Care, Department of Outpatient Community Care, Zeist, The Netherlands.
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Abstract
BACKGROUND A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. OBJECTIVES Our objectives are to review the effects of a crisis intervention model for anyone with serious mental illness experiencing an acute episode, compared with 'standard care'. SEARCH STRATEGY We updated the 1998 and 2003 searches with a search of the Cochrane Schizophrenia Group's Register of trials (January 2006). SELECTION CRITERIA We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. DATA COLLECTION AND ANALYSIS Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated relative risk ratios (RR) and their 95% confidence intervals (CI), with the number needed to treat (NNT). We calculated Weighted Mean Differences (WMD) for continuous data. MAIN RESULTS Several home-care studies have been carried out recently but none of these met the inclusion criteria for this review. For the 2006 update we excluded four more studies (total excluded 25). Two other recent studies await assessment; we found no new studies to add to the five studies already included in this review. None of these included studies purely investigated crisis intervention; all used a form of home care for acutely ill people, which included elements of crisis intervention. Forty five percent of the crisis/home care group were unable to avoid hospital admission during their treatment period. Home care, however, may help avoid repeat admissions (n=465, 3 RCTs, RR 0.72 CI 0.54 to 0.92, NNT 11 CI 6 to 97), but these data are heterogeneous (I-squared 86%). Crisis/home care reduces the number of people leaving the study early (n=594, 4 RCTs, RR lost at 12 months 0.74 CI 0.56 to 0.98, NNT 13 CI 7 to 130), reduces family burden (n=120, 1 RCT, RR 0.34 CI 0.20 to 0.59, NNT 3 CI 2 to 4), and is a more satisfactory form of care for both patients and families. We found no differences in death or mental state outcomes. All studies found home care to be more cost effective than hospital care but all numerical data were either skewed or unusable. No data on staff satisfaction, carer input, compliance with medication or number of relapses were available. AUTHORS' CONCLUSIONS Home care crisis treatment, coupled with an ongoing home care package, is a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.
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Affiliation(s)
- C B Joy
- Cochrane Schizophrenia Group, 15 Hyde Terrace, Leeds University, Leeds, UK.
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Abstract
OBJECTIVE To assess the impact of a regional/rural crisis assessment and treatment service (CAT) on admissions into an acute adult inpatient psychiatric facility. METHODS Relevant data for admissions into an acute adult inpatient psychiatric facility in the 18 month periods before and after the establishment of a CAT were compared. Data extracted from available clinical records were transferred into an appropriately structured pro forma for statistical analysis. RESULTS There were 69 and 53 index inpatient unit admissions in the two time periods. The majority of these were for single, unemployed men aged in their 30s. Although statistically non-significant, the results appear to suggest that there were proportionately fewer readmissions and that admissions were likely to be influenced by illness severity and diagnostic considerations in the period following the establishment of the CAT. The establishment of CAT did not appear to have had much impact on the duration of psychiatric hospitalization. CONCLUSIONS Crisis assessment and treatment services operating within a regional/rural integrated mental health setting appear to have only limited impact on hospitalization for psychiatric crisis presentations. There is a need for further studies looking at a broader range of outcome variables in the assessment of the impact of CAT on psychiatric hospitalization in such settings.
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Abstract
BACKGROUND A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. OBJECTIVES To review the effects of a crisis intervention model for anyone with serious mental illness experiencing an acute episode, compared to 'standard care'. SEARCH STRATEGY Searches of 1998 were updated with a search of the Cochrane Schizophrenia Group's Register of trials (July 2003). SELECTION CRITERIA All randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. DATA COLLECTION AND ANALYSIS Working independently, reviewers selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI), with the number needed to treat (NNT). For continuous data Weighted Mean Differences (WMD) were calculated. MAIN RESULTS This 2003 update includes no new studies. Five studies, none purely investigating crisis intervention, are included and 21 excluded. All included trials used a form of home care for acutely ill people, which included elements of crisis intervention. 45% of the crisis/home care group were unable to avoid hospital admission during their treatment period. Home care, however, may help avoid repeat admissions (n = 465, 3 randomised controlled trials, RR 0.72 CI 0.54 to 0.92, NNT 11 CI 6 to 97), but these data are heterogeneous (I-squared 86%). Crisis/home care reduces the number of people leaving the study early (n = 594, 4 randomised controlled trials, RR lost at 12 months 0.74 CI 0.56 to 0.98, NNT 13 CI 7 to 130), reduces family burden (n = 120, 1 randomised controlled trial, RR 0.34 CI 0.20 to 0.59, NNT 3 CI 2 to 4), and is a more satisfactory form of care for both patients and families. We found no differences in death or mental state outcomes. All studies found home care to be more cost effective than hospital care but all data were either skewed or unusable. No data on staff satisfaction, carer input, compliance with medication and number of relapses were available. REVIEWERS' CONCLUSIONS Home care crisis treatment, coupled with an ongoing home care package, is a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are needed.
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Affiliation(s)
- C B Joy
- 15 Hyde Terrace, Leeds, West Yorkshire, UK, LS2 9LT
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Affiliation(s)
- C Adams
- Cochrane Schizophrenia Group, Oxford OX2 7LG
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Affiliation(s)
- M G Smyth
- Department of Psychiatry, Northern Birmingham Mental Health (NHS) Trust, Birmingham B23 6AL
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Gersons BP, Van de Graaf W, Rijkschroeff R, Schrameijer F. The mental health care transformation process: the Amsterdam experience. Int J Soc Psychiatry 1992; 38:50-8. [PMID: 1577571 DOI: 10.1177/002076409203800108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- B P Gersons
- Dept. of Psychiatry AZUA, Amsterdam, The Netherlands
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Abstract
As making a diagnosis in emergency psychiatry is often difficult, whether the systematic use of a diagnostic classification is worthwhile can be questioned. In the psychiatric emergency service in the Hague, The Netherlands, the use of a DSM III classification list was evaluated by comparing emergency service diagnoses during subsequent psychiatric treatments in 237 out of 300 consecutive contacts. For Organic Mental Disorders, Psychoactive Substance Use Disorders, Schizophrenia and Mood Disorders, the Kappa coefficient of agreement was found to lie between 0.5 and 0.6. The application of DSM III categories is considered to be suited to diagnostic classification in outreach emergency psychiatry.
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Affiliation(s)
- B A Blansjaar
- Municipal Health Service, Department of Mental Health Care, The Hague, The Netherlands
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Huyse FJ, Hengeveld MW. Development of consultation-liaison psychiatry in The Netherlands. Its social psychiatric heritage. Gen Hosp Psychiatry 1989; 11:9-15. [PMID: 2643541 DOI: 10.1016/0163-8343(89)90019-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Dutch consultation-liaison psychiatry (C-L psychiatry) has followed a developmental line separate from the American system. First, C-L psychiatry in the Netherlands has been less influenced by psychosomatic medicine than by social psychiatry. Second, the presence of psychiatric units in general hospitals that appear to be correlated with the growth of C-L psychiatry in the United States occurred later in the Netherlands. Third, little government support for clinical care, research, and especially for training has been available to Dutch psychiatry. Consequently, there has been little recent financial pressure on C-L psychiatry from reduced government support, as occurred in the United States. Finally, the relationship between primary and secondary health care in the Netherlands allows C-L psychiatry to have a direct impact on several inpatient and ambulatory levels in the health care chain. A nationally accepted database form for the computerized registration of the Psychiatric Consultations at the eight university hospitals and ten other general hospitals is currently in use. To facilitate standardization and recording the psychiatric consultation process, the Netherlands Consortium for C-L psychiatry (NCCP) was formed.
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Affiliation(s)
- F J Huyse
- Department of Psychiatry, Free University Hospital, Amsterdam, the Netherlands
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Van Der Veen H. Rehabilitation in Dutch Mental Health Care. INTERNATIONAL JOURNAL OF MENTAL HEALTH 1988. [DOI: 10.1080/00207411.1988.11449104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The Responsibilities of the State for the Prevention and Treatment of Mental Illness among Prisoners. J Forensic Sci 1981. [DOI: 10.1520/jfs11339j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Gittelman M. Sectorization: the quiet revolution in European mental health care. AMERICAN JOURNAL OF ORTHOPSYCHIATRY 1972; 42:159-67. [PMID: 5013503 DOI: 10.1111/j.1939-0025.1972.tb02483.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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McDowall EB. The scope of preventive psychiatry. Public Health 1970; 84:176-82. [PMID: 5432693 DOI: 10.1016/s0033-3506(70)80034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Schossberger JA. Nature, nurture or just happenings. Br J Psychiatry 1968; 114:922-3. [PMID: 5662946 DOI: 10.1192/bjp.114.512.922-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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