Patterns of Care in a District General Hospital Psychiatric Department

Lawrence, R E; Cumella, Stuart; Robertson, J. A.

doi:10.1192/bjp.152.2.188

Cited by 18 publications

(3 citation statements)

References 22 publications

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“…In line with other recent studies (Lawrence et al 1988;Platman ~ Booker, 1984), even taking into account the loss of beds within the East Lambeth Service over the two year study period, follow-up revealed no evidence of accumulation of medium and new long-stay patients. It may be that at present accumulation is avoided by a slow filtering of patients through the system.…”

Section: Discussionsupporting

confidence: 84%

A Two Year Follow Up of New Long-Stay Patients in an Inner City District General Hospital

Patrick

Holloway

1990

Int J Soc Psychiatry

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In 1967 Magnus described 'the new chronics', patients admitted to a psychiatric hospital who then stayed for more than one year. Since that time many studies have examined this patient group but the majority have focussed on psychiatric hospital populations. There is some doubt, however, as to whether the characteristics of new-long stay patients in District General Hospital (DGH) psychiatric in-patient units are comparable. The current paper describes a two year follow-up study of Medium and New-Long Stay patients identified within an inner-city DGH unit in 1986. Elderly patients with affective disorders and patients with organic brain syndromes were particularly highly represented. Length of stay at the time of the original survey, male sex, associated physical disability, and the presence of a secondary diagnosis were particularly associated with poor outcome. The results are discussed in relation to service provision.

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Section: Discussionsupporting

confidence: 84%

A Two Year Follow Up of New Long-Stay Patients in an Inner City District General Hospital

Patrick

Holloway

1990

Int J Soc Psychiatry

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“…They vary according to an individual's level of education and socioeconomic class. In less educated areas of the countryside, there exist a number of supernatural explanations of mental illness which include possession by spirit, black magic, or astrological misalignment [4,6,7]. Over 450 million people are estimated to be suffering from mental disorders in the world today.…”

Section: Introductionmentioning

confidence: 99%

Patterns of treatment seeking behavior for mental illnesses in Southwest Ethiopia: a hospital based study

Girma

Tesfaye

2011

BMC Psychiatry

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BackgroundEarly recognition of the signs and symptoms of mental health disorders is important because early intervention is critical to restoring the mental as well as the physical and the social health of an individual. This study sought to investigate patterns of treatment seeking behavior and associated factors for mental illness.MethodsA quantitative, institution-based cross sectional study was conducted among 384 psychiatric patients at Jimma University Specialized Hospital (JUSH) located in Jimma, Ethiopia from March to April 2010. Data was collected using a pretested WHO encounter format by trained psychiatric nurses. Data was analyzed using SPSS V.16.ResultMajor depression disorder 186 (48.4%), schizophrenia 55 (14.3%) and other psychotic disorders 47 (12.2%) were the most common diagnoses given to the respondents. The median duration of symptoms of mental illness before contact to modern mental health service was 52.1 weeks. The main sources of information for the help sought by the patients were found to be family 126 (32.8%) and other patients 75 (19.5%). Over a third of the patients 135 (35.2%), came directly to JUSH. Half of the patients sought traditional treatment from either a religious healer 116 (30.2%) or an herbalist 77 (20.1%) before they came to the hospital. The most common explanations given for the cause of the mental illness were spiritual possession 198 (51.6%) and evil eye 61 (15.9%), whereas 73 (19.0%) of the respondents said they did not know the cause of mental illnesses. Nearly all of the respondents 379 (98.7%) believed that mental illness can be cured with modern treatment. Individuals who presented with abdominal pain and headache were more likely to seek care earlier. Being in the age group 31-40 years had significant statistical association with delayed treatment seeking behavior.ConclusionsThere is significant delay in modern psychiatric treatment seeking in the majority of the cases. Traditional healers were the first place where help was sought for mental illness in this population. Most of the respondents claimed that mental illnesses were caused by supernatural factors. In contrast to their thoughts about the causes of mental illnesses however, most of the respondents believed that mental illnesses could be cured with biomedical treatment. Interventions targeted at improving public awareness about the causes and treatment of mental illness could reduce the delay in treatment seeking and improve treatment outcomes.

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“…Patients who occupy in-patient psychiatric beds for prolonged periods have attracted interest in the UK for over 25 years. They have been the focus of two national surveys (Mann & Cree, 1976; as well as local studies (Lawrence et al, 1988;O'Driscoll et al, 1990;Patrick & Holloway, 1990;Clifford et al, 1991;Thornicroft et al, 1992;Kurian et al, 1994;Rowlands et al, 1998;Holloway et al, 1999). A need for longer-term provision for this group was demonstrated by a survey of acute inpatient units, which found that 46% of new long-stay patients were considered inappropriately placed but remained as in-patients on account of their need for specialised rehabilitation places (Shepherd et al, 1997).…”

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confidence: 99%

New long-stay patients in a psychiatric admission ward setting

Cowan¹,

Walker

2005

Psychiatr. bull.

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Aims and MethodThis is a descriptive study of the admissions of new long-stay patients and their outcome in a district with minimal access to longer-stay in-patient beds. Cases were identified through an ongoing in-patient census and information was gathered by retrospective case-note review.ResultsThirty-nine new long-stay admissions were identified. High rates of living alone, early readmission following previous discharge and use of the Mental Health Act 1983 were noted. The 39 admissions occupied 12% of the unit's capacity. Four patients returned to a family residence but 27 went into residential or in-patient care. Of those discharged to settings not providing patient care, 48% were readmitted in the year after discharge.Clinical ImplicationsNew long-stay admissions continue to absorb a high proportion of the bed resources of an in-patient unit for their numbers and these patients are at risk of unsuccessful discharge.

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Patterns of Care in a District General Hospital Psychiatric Department

Cited by 18 publications

References 22 publications

A Two Year Follow Up of New Long-Stay Patients in an Inner City District General Hospital

A Two Year Follow Up of New Long-Stay Patients in an Inner City District General Hospital

Patterns of treatment seeking behavior for mental illnesses in Southwest Ethiopia: a hospital based study

New long-stay patients in a psychiatric admission ward setting

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