Psychiatric Community Crisis Services for Youth

Sowar, Kristina; Thurber, Deborah; Vanderploeg, Jeffrey J.; Haldane, Eva C.

doi:10.1016/j.chc.2018.03.002

Cited by 9 publications

(16 citation statements)

References 6 publications

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“…This is the reason for which the societal perspective was chosen in this economic evaluation and broader outcomes of the direct and indirect costs were taken into account since the effects of any mental intervention strongly rely on social outcomes. Nonetheless, the operation of Mobile Health Units (MHUs) has already been shown as a cost-effective and cost saving option by other researchers and its use in the field of mental health is suggested [36] [37] [38] [39]. In addition, the findings of this study are in accordance with the results of a study conducted in New Hampshire which estimated the operational cost of the MMHUs to be €495,858 in 2015 [40].…”

Section: Discussionsupporting

confidence: 85%

Economic Evaluation of Mobile Mental Health Units in Greece: The Case of Cyclades Islands

Lykomitrou¹,

Geitona²,

Stylianidis³

et al. 2020

Health

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Background: In Greece, the provision of mental health services is limited to people residing in rural and remote areas. The operation of Mobile Mental Health Units (MMHUs) has been introduced in the Cyclades islands. It is an innovative policy intervention that has been shown to be effective and efficient internationally. Objective: The aim was to evaluate the operation of MMHUs in the Cyclades islands based on real-world evidence (RWE), from a societal perspective. Methods: A cost-effectiveness analysis was performed where outcomes and costs were elaborated and classified based on two comparators, 1) with MMHUs' operation and 2) without MMHUs' operation. Clinical primary outcomes were based on RWE data and were elaborated for the Disability-Adjusted Life Years (DALYs) values calculation, for a 12 months' time horizon. Data descriptive statistics were performed with SPSS Statistics 22.0. Direct medical, non-medical and indirect costs were incorporated. Unit costs and monetary values were extracted from published data. Sensitivity analysis was undertaken to test the robustness of the results. Results: The operation of MMHUs in the Cyclades islands led to an incremental cost of €12,250.78 per DALY averted. A substantial higher increase is observed in the direct non-medical costs of the non-MMHUs' operation where patients had to pay approximately €2,602 per capita annually for their transportation and accommodation due to hospitalization and outpatient care. Informal care expenses are 3 fold increasing in the non-MMHUs' operation arm. Both direct non-medical and informal care costs correspond to high out of pocket payments totally covered by the patients. The sensitivity analyses demonstrated that the decision does not change when we varied the unit costs by ±10%.

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Section: Discussionsupporting

confidence: 85%

Economic Evaluation of Mobile Mental Health Units in Greece: The Case of Cyclades Islands

Lykomitrou¹,

Geitona²,

Stylianidis³

et al. 2020

Health

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“…Autism Speaks hosts multiple online resources designed to improve maladaptive behaviors and alleviate caregiver strain 35,36 . Outpatient crisis services to rapidly follow-up with families should be used where available 37 . Medication management is generally performed in the outpatient setting, but families and outpatient providers can be directed to psychiatric support resources, including specialty consultation 38,39 .…”

Section: Common Behavioral Health Concernsmentioning

confidence: 99%

“…35,36 Outpatient crisis services to rapidly follow-up with families should be used where available. 37 Medication management is generally performed in the outpatient setting, but families and outpatient providers can be directed to psychiatric support resources, including specialty consultation. 38,39 Clear return to care guidelines should be offered to families so they feel comfortable seeking further care if symptoms escalate.…”

Section: Externalizing Behaviors/aggressionmentioning

confidence: 99%

Behavioral Management of Children With Autism in the Emergency Department

Wolpert

Kodish

Kim³

et al. 2023

Pediatr Emer Care

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Autism spectrum disorder (ASD) is characterized by impaired social communication in conjunction with patterned behaviors. Often associated with emotional dysregulation, irritability, aggression, depression, and suicidality, ASD youth frequently present to the emergency department for behavioral and mental health evaluation. Psychiatric comorbidities, agitation, and depression are commonly encountered. During these visits, practitioners must thoughtfully consider organic etiologies for presenting symptoms, formulate plans to address risk of agitation, and understand how to effectively formulate disposition options in this patient population.

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“…Existen múltiples tipos de servicios de crisis en otros países, que van desde líneas telefónicas de triaje hasta equipos móviles de crisis y unidades de ingresos breves para la estabilización y observación de jóvenes. El objetivo de estas unidades es intentar evitar la asistencia de niños y adolescentes a urgencias, ofrecer una evaluación y tratamiento más adecuado y conseguir una buena coordinación con los servicios ambulatorios (9). Otros programas revisados ofrecían una atención ambulatoria intensiva, en el que gran parte de la población infantil y adolescente que les era derivada, lo hacía por ideación o tentativas autolíticas y en el que obtuvieron menores tasas de hospitalización y visitas posteriores al servicio de urgencias (10).…”

Section: Introductionunclassified

Desarrollo y evaluación del programa de atención preferente a población infantil y adolescente en situación de crisis de salud mental

Díaz¹,

Muñoz²,

Farré³

et al. 2022

Rev Psiquiatr Infanto-Juv

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Introducción: Se presenta la implantación de un nuevo programa de atención preferente en población infantil y adolescente en el Hospital Clínic de Barcelona. Este programa surge tras el incremento de menores atendidos en urgencias de psiquiatría y el aumento de demanda de ingreso para esta población. El objetivo es atender a estos pacientes de forma prioritaria, favorecer la estabilización de su patología y tratar de evitar el ingreso hospitalario. Método: Se estudian los pacientes atendidos durante los 6 meses de funcionamiento del programa (entre el 13 de septiembre de 2021 y el 13 de marzo de 2022). Resultados: Se atendieron un total de 124 pacientes, 44 derivados para ingreso y 80 derivados desde el servicio de urgencias. Se han realizado 378 visitas y 402 coordinaciones con otros dispositivos asistenciales, servicios sociales y escolares. Desde su derivación a la primera intervención transcurrió una media de 1,5 días laborables. Un elevado porcentaje de pacientes presentaban ideación o tentativas autolíticas (54%). En un 59,6% de los pacientes se realizaba seguimiento psicosocial. Se evitó el ingreso hospitalario en 58,3% de los pacientes. Conclusión: Este programa se muestra como una respuesta útil y eficaz para ayudar en las situaciones de psicopatología aguda asociada a complejidad psicosocial de esta población. Los factores de riesgo psicosocial estuvieron presentes en gran parte de los pacientes, por lo que es importante una intervención multidisciplinar. Gracias a la intervención realizada, se recondujo la situación en gran parte de los pacientes, priorizando un tratamiento ambulatorio en colaboración con la red comunitaria.

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Psychiatric Community Crisis Services for Youth

Cited by 9 publications

References 6 publications

Economic Evaluation of Mobile Mental Health Units in Greece: The Case of Cyclades Islands

Economic Evaluation of Mobile Mental Health Units in Greece: The Case of Cyclades Islands

Behavioral Management of Children With Autism in the Emergency Department

Desarrollo y evaluación del programa de atención preferente a población infantil y adolescente en situación de crisis de salud mental

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