Determinants of decision‐making in the screening procedure of a community psychiatric service

Abstract

This study is a predictor analysis of the screening procedure followed by a psychiatric service for a period of 1 year preceding and a period of 1 year following the introduction of community psychiatry. Throughout this period, the psychiatric service consisted of a local service within the catchment area and a central service at a psychiatric hospital outside the area. At the time of the reorganization, the responsibility for the psychiatric service was transferred from the public health authorities to the social services. Before the reorganization, screenings were conducted on the basis of referral papers or simply as a result of telephone communication. After the reorganization, the screening procedure was intensified by means of a pre-examination. One aim of the reorganization was to ensure that the severely mentally ill take priority over patients characterized predominantly by social strain. Patients with manic-depressive psychosis and other psychoses showed a significantly increased probability of being accepted for treatment, whereas those with schizophrenia showed no significant increase, irrespective of the service reorganization. Similarly, manic-depressive psychosis and other psychoses (not schizophrenia) were significant predictors of hospitalization at the mental hospital outside the catchment area as well as hospitalization in the local facilities, irrespective of the service reorganization. Indicators of social strain were not given higher priority following the service reorganization.

Community learning disability teams: the need for objective methods of prioritization and discharge planning

“…Sùgaard and Sùndergaard, 1996). Although this may serve to reduce the caseload, it may actually increase the workload because of the time taken to conduct the pre-examination procedures.…”

“…An advance on rating clients' priority according to referral information would be to introduce a screening process (e.g. Sùgaard and Sùndergaard, 1996). Although this may serve to reduce the caseload, it may actually increase the workload because of the time taken to conduct the pre-examination procedures.…”

Constructie en validatie van de Gewaarwordingenlijst: een hulpmiddel bij het signaleren van een verhoogde kans op psychosen*

“…Om andere psychotische stoornissen op te sporen is het voldoende alleen op positieve symptomen te letten (Van den Bosch, 1994). Tot op heden bestaan er weinig vragenlijsten die specifiek deze symptomen meten (Bebbington & Nayani, 1995 ;Dingemans, Van den Bosch, Kahn, & Schene, 1995 ;Søgaard & Søndergaard, 1996).…”

Emergency psychiatric assessments: do outcomes match priorities?

“…While the``public risk'' aspect of mental illness occupies the top of the media agenda (Philo et al, 1994), clinicians and health service professionals are equally concerned to offer treatment to patients suffering severe mental illness and those at risk of suicide. The importance of these three patient characteristics is consistently cited for deciding on level of priority and/or hospitalisation (Spencer and Mattson, 1983;Prunier and Buorgiorno, 1989;White et al, 1995;Sogaard and Sondergaards, 1996;Atakan and Davies, 1997;Sullivan ., 1997), and is stressed in the Health of the Nation document (Department of Health, 1993).…”