Review article: Interventions for people presenting to emergency departments with a mental health problem: A systematic scoping review

Johnston, Amy N.B.; Spencer, Melinda; Wallis, Marianne; Kinner, Stuart A; Broadbent, Marc; Young, Jesse T; Heffernan, Ed; FitzGerald, Gerry; Bosley, Emma; Keijzers, Gerben; Scuffham, Paul Anthony; Zhang, Ping; Martin‐Khan, Melinda; Crilly, Julia

doi:10.1111/1742-6723.13335

Cited by 21 publications

(21 citation statements)

References 25 publications

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“…36 Previous reviews have evaluated the clinical effectiveness of suicide prevention interventions, but they have yet to investigate interventions that target clinicians' behavior change. [37][38][39][40][41][42] Clinicians' behavior change is complex to understand because many factors influence human behavior. 43 Therefore, it is helpful to use behavioral frameworks such as the Behaviour Change Wheel (BCW) 44 when attempting to understand a behavior.…”

Section: Introductionmentioning

confidence: 99%

Interventions to change clinicians’ behavior related to suicide prevention care in the emergency department: a scoping review

Shin

Cassidy²,

Weeks³

et al. 2021

JBI Evidence Synthesis

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The objective of this scoping review was to explore, characterize, and map the literature on interventions and intervention components implemented to change emergency department clinicians' behavior related to suicide prevention using the Behaviour Change Wheel as a guiding theoretical framework.Introduction: An emergency department is a critical place for suicide prevention, yet patients are often discharged without proper suicide risk assessments or referrals. In response, we must support emergency department clinicians' behavior change to follow evidence-based suicide prevention strategies. However, reviews to date have yet to systematically and theoretically examine the functional mechanisms of interventions and how these characteristics can influence emergency department clinicians' behaviors related to suicide prevention care. Inclusion criteria: This review considered interventions that targeted emergency department clinicians' behavior change related to suicide prevention. Behavior change referred to observable practice changes as well as proxy measures of behavior change, including changes in knowledge and attitude.Methods: This review followed JBI methodology for scoping reviews. Searches included PubMed, PsycINFO, CINAHL, Embase, and gray literature, including targeted Google searches for relevant organizations/websites, ProQuest Dissertations and Theses Global, and Scopus conference papers (using a specific filter). This review did not apply any date limits, but our search was limited to the English language. Data extraction was undertaken using a charting table developed specifically for the review objective. Narrative descriptions of interventions were coded using the Behaviour Change Wheel's intervention functions. Reported outcome measures were categorized. Findings were tabulated and synthesized narratively.Results: This review included a total of 70 sources, describing 66 different interventions. Forty-one studies were included from the database searches, representing a mixture of experimental (n ¼ 2), quasi-experimental (n ¼ 24), non-experimental (n ¼ 12), qualitative (n ¼ 1), and mixed methods (n ¼ 2) approaches. An additional 29 citations were included from gray literature searches. One was a pilot mixed methods study, and the rest were interventions. Identified interventions comprised a wide range of Behaviour Change Wheel intervention functions to change clinicians' behavior: education (n ¼ 48), training (n ¼ 40), enablement (n ¼ 36), persuasion (n ¼ 21), environmental restructuring (n ¼ 18), modeling (n ¼ 7), and incentivization (n ¼ 2). Based on the Behaviour Change Wheel analysis, many interventions targeted more than one determinant of behavior change, often employing education and training to improve clinicians' knowledge and skills simultaneously. Among the 42 studies that reported outcome measures, effectiveness was measured at clinician (n ¼ 38), patient (n ¼ 4), or organization levels (n ¼ 6). Few studies reported implementation outcomes, such as measures of reach (n ¼ 4), adoption...

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Section: Introductionmentioning

confidence: 99%

Interventions to change clinicians’ behavior related to suicide prevention care in the emergency department: a scoping review

Shin

Cassidy²,

Weeks³

et al. 2021

JBI Evidence Synthesis

View full text Add to dashboard Cite

show abstract

“…A variety of models of using psychiatric liaison staff within hospital emergency departments have been trialled with varying levels of success (Evans et al , 2019). However, there is an overall lack of rigorously evaluated, multi-disciplinary and multi-faceted interventions available for assisting people with mental health issues presenting at hospital emergency departments (Johnston et al , 2019).…”

Section: Addressing the Complexity Of Violence In Health Carementioning

confidence: 99%

The “disease” of violence against health-care workers is a wicked problem. Managing and preventing violence in health-care

Jacob

McCann

Buykx

et al. 2021

JACPR

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Purpose This paper aims to illustrate the complexity of understanding and managing violent behaviour in health care. The authors will show how different perceptions of the reasons for violent behaviour, and linkages between violent behaviour and illness have contributed to the creation of a wicked problem and added significant complexity to the management of violence towards staff within health-care settings. This paper will conclude with a call for strong multi-disciplinary action to address this ongoing issue. Design/methodology/approach A narrative review was undertaken to explore the ways that violence has been perceived in health care and the ways in which the concept of violence has moved from being seen as a criminal issue to being within the realms of disease. This paper will show the importance of understanding who is perpetrating violence in health care, why and in what settings. It will expound on the idea that considering violence as a consequence of disease necessarily adds a layer of complexity to both individual and organisational responses to violence towards health-care staff. Findings Understanding the complexity in preventing and managing violence against health-care staff can assist policymakers and managers to develop multi-faceted approaches to violence prevention, including better recognition and understanding of perpetrators of violence. Originality/value This paper provides a unique perspective on thinking about violence in health care and the implications of its complexity.

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“…CM is dedicated to people, who have severe illness, social problems, higher overall mortality rates, psychiatric illness, and incur higher healthcare costs [31]. Several studies showed that CM is a good intervention and can be beneficial not only to patients but also to the healthcare system because of cost reduction [8,9,31]. It is a very promising program for ED frequent users, which reduces the frequency of visits and costs [7,8].…”

Section: Case Management (Cm) and Individualized Care Planmentioning

confidence: 99%

“…Additionally, it is associated with frequent use of medical services and increased costs [6,7]. Complexity is widely observed in patients with mental disorders, chronic diseases, systemic diseases, multimorbidity, age-related conditions, addictions, and also in the case of frequent emergency users [4,[8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Clinical complexity – where to find it and how to use it

Kobyłko¹,

Rymaszewska²,

Rymaszewska³

et al. 2021

Psychiatr Pol

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Kompleksowość kliniczna pacjenta oznacza wieloaspektowość problemów jednostki w podejściu biopsychospołecznym, w którym ocenia się, czy pacjent doświadcza trudności w sferze biologicznej, w życiu psychicznym, społecznym i w zakresie opieki zdrowotnej. Skuteczna, całościowa ocena pacjenta podczas procesu leczenia ma kluczowe znaczenie dla efektywnej pracy publicznej ochrony zdrowia i zapewnia pacjentom indywidualną, holistyczną i kompleksową opiekę zdrowotną. Pacjenci, którzy nie zawsze są w stanie samodzielnie szukać pomocy, wymagają zapewnienia kompleksowej opieki, skutecznej diagnostyki we wczesnych stadiach choroby oraz pomocy w koordynacji i kontynuacji leczenia. Kompleksowość kliniczna dotyczy pacjentów wielu dziedzin medycyny, ale przede wszystkim medycyny ratunkowej, chorób wewnętrznych, geriatrii, psychiatrii i podstawowej opieki zdrowotnej. Brak dostępu do kompleksowej opieki zdrowotnej z podejściem biopsychospołecznym ogranicza dobór najodpowiedniejszych opcji terapeutycznych, ich jakość oraz satysfakcję chorego. Istnieje kilka narzędzi do badań przesiewowych pod kątem kompleksowości klinicznej, takich jak: platforma INTERMED, INTERMED Self-Assessment, INTERMED dla osób starszych, INTERMED dla osób starszych Self-Assessment i Kwestionariusz prawdopodobieństwa ponownego przyjęcia (Probability of Repeated Admission). Co ważniejsze, istnieją również interwencje, które można wykorzystać do zarządzania kompleksową i skuteczną opieką nad pacjentem, takie jak: Zarządzenie przypadkiem (Case Management), Udostępnianie informacji (Information Sharing) oraz Samozarządzanie (Self-Management). Badania przesiewowe i interwencje razem mogą być bardzo efektywne w pomocy pacjentom, wymagającym kompleksowej opieki oraz w zapewnieniu dobrze zorganizowanej, wysokiej jakości opieki zdrowotnej z ukierunkowanym na pacjenta biopsychospołecznym podejściem.

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Review article: Interventions for people presenting to emergency departments with a mental health problem: A systematic scoping review

Cited by 21 publications

References 25 publications

Interventions to change clinicians’ behavior related to suicide prevention care in the emergency department: a scoping review

Interventions to change clinicians’ behavior related to suicide prevention care in the emergency department: a scoping review

The “disease” of violence against health-care workers is a wicked problem. Managing and preventing violence in health-care

Clinical complexity – where to find it and how to use it

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