Improving community services for serious mental disorders

Patmore, Charles; Weaver, Tim

doi:10.3109/09638239209034522

Cited by 29 publications

(17 citation statements)

References 3 publications

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“…titioners is underestimated, and asks that psychiatrists do not refer to such patients as having 'minor' or 'neurotic' The severity criteria used by Patmore & Weaver (1992) and by the Audit Commission (1994) contain a similar par-conditions. He asserts that the quality of life that these patients lose is anything but minor, a conclusion which is tial misjudgement.…”

Section: Risk Managementmentioning

confidence: 99%

Community psychiatric nurse caseloads and the ‘worried well’: misspent time or vital work?

Bowers

1997

Journal of Advanced Nursing

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Community psychiatric nurses (CPNs) in the United Kingdom are being repeatedly urged to focus their attention upon those with serious and enduring psychotic illnesses, and to withdraw from working with the 'worried well' in the primary health care setting. In view of this pressure, it is important to discover the nature of community psychiatric nurses' non-psychotic caseloads. The aim of this study was to describe these cases, what precipitated their referral, what problems they suffered from, what effects these problems had upon their lives and what kinds of therapeutic interventions they were receiving. A random sample was drawn of non-psychotic CPN patients. The community psychiatric nurses then received a structured interview about the history, care and treatment of these patients. These patients did not, in general, suffer from minor, self-limiting conditions. They typically had had 5 years of contact with psychiatric services, and their psychiatric symptoms blighted their occupational, social and personal lives. Their condition caused significant carer burden, and there was frequently a risk of suicide. The CPNs case-managed a complex combination of interventions for these patients, of which psychotherapeutic methods were only one part. The findings show that community psychiatric nurses have a valid role to play in the care of those with non-psychotic mental disorders, and should continue to receive the opportunity, and appropriate training, to do so.

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Section: Risk Managementmentioning

confidence: 99%

Community psychiatric nurse caseloads and the ‘worried well’: misspent time or vital work?

Bowers

1997

Journal of Advanced Nursing

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“…The present paper follows Dempster (1974) and Spiegelhalter et al (1995) in monitoring the posterior distribution of the usual deviance statistic as a measure of overall ® t; goodness of ® t is measured by the mean of this distribution since the minimum deviance (analogous to the conventional deviance) is likely to be poorly estimated by the sample minimum.…”

Section: Empirical Bayes Methods For Data Analysismentioning

confidence: 99%

“…For example, the original Metropolis sampling scheme samples parameter values from a symmetrical candidate density (for example, the uniform or normal) and compares the posterior density using the newly sampled parameter value with the current density. The results presented here are based on the BUGS implementation of the Gibbs sampler (Spiegelhalter et al, 1994).…”

Section: Empirical Bayes Methods For Data Analysismentioning

confidence: 99%

Assessing Psychiatric Morbidity from Community Registers: Methods for Bayesian Adjustment

1998

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This paper considers Bayesian approaches to adjusting small area prevalence estimates derived from a community register of the seriously mentally ill, by taking account of underlying variability in latent prevalence between areas. Adjustment of individual prevalence rates to take account of the entire spatial distribution has implications both for epidemiological inference and resource rankings for localities. The more commonly adopted empirical Bayes approaches are here compared with fully Bayes approaches. Fully Bayes methods allow for uncertainty in the prevalence parameters and also permit the inclusion of information from other sources (for example, hospital admissions for mental illness) or from previous studies. The impact of socioeconomic indices on morbidity and its relevance for adjusted prevalence estimates is also considered. A case study is applied to an East London Health Authority, Barking and Havering.

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“…Som eone within the team needs to exercise clear operational m anagement responsibility if CM HTs are to rem ain focused on work with people with severe and long term m ental health problems (Patmore & W eaver, 1992;. However, they will not be the only influence on practitioners.…”

Section: Clear Aims and Enhanced Strategic And Operational M Anagementmentioning

confidence: 99%

Multidisciplinary community teams: Where is the wreckage?

Ford

1996

Journal of Mental Health

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Galvin and M cCarthy' s (1994) recent critique of com munity m ental health team s (CM HTs) overemphasized process issues rather than the outcomes of m ulti-disciplinary provision. W hen examining the outcome literature it is clear that, when focused on providing intensive and proactive support to people with severe and long term mental health problems, multi-disciplinary CM HTs can be a costeffective option that is positively evaluated by users, carers and referrers. In addition, interdisciplinary team work and support from colleagues is often cited as an important source of reward for team members and may be critical to effective provision. Far from providing a fundamental critique of the need for CM HTs, Galvin & M cCarthy highlight a range of implementation issues. Responsibility for failing to effectively implement the CM HTs lies with all levels of purchasing and providing agencies, not with the concept of comm unity multidisciplinary teamworking itself. Recom mendations for improving the functioning of CM HTs are made.J Ment Health Downloaded from informahealthcare.com by Chulalongkorn University on 12/27/14For personal use only.

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Improving community services for serious mental disorders

Cited by 29 publications

References 3 publications

Community psychiatric nurse caseloads and the ‘worried well’: misspent time or vital work?

Community psychiatric nurse caseloads and the ‘worried well’: misspent time or vital work?

Assessing Psychiatric Morbidity from Community Registers: Methods for Bayesian Adjustment

Multidisciplinary community teams: Where is the wreckage?

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