Understanding liaison psychiatry commissioning: an observational study

Abstract

Purpose The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals. Design/methodology/approach Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98). Findings Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern. Research limitations/implications There were a small number of survey respondents (n = 98). The sampling used an opportunistic framework that targeted commissioner and clinician forums. Using an opportunistic framework, the sample may not be representative. Additionally, multiple pairwise comparisons were conducted during the analysis of the survey responses, increasing the risk that significant results were found by chance. Practical implications A number of steps were identified that could be applied in practice. These mainly related to the importance of collecting and communicating data and co-production with commissioners in the design, development and monitoring of liaison psychiatry services. Originality/value This is the first study that has specifically considered the challenges associated with the commissioning of liaison psychiatry services.

Experiences of people seen in an acute hospital setting by a liaison mental health service: responses from an online survey

“…Our previous work on commissioning of liaison services has shown there is agreement across all NHS staff groups (commissioners, psychiatrists and hospital managers) that patients in mental health crises are currently being signposted to emergency departments, despite the concerns raised about the appropriateness of using EDs for this purpose [27]. A recent report by the Royal College of Emergency Medicine has recommended that all people presenting to EDs in a mental health crisis should undergo immediate mental health triage at the time of their arrival and that parallel physical and mental assessments should be the norm to improve patient experience and limit time in the emergency setting [28].…”

Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care

“…For many people experiencing an acute mental health problem, attending the emer­gency department (ED) of a local general hospital is the default option in a crisis 3 , and in some mental health systems primary care referrals may be directed to this setting. Despite efforts to develop alternatives, mental health presentations to the ED have been reported to be on the rise across the US 4 , Australia 5 and England 6 .…”

Theoretical and practical significance of scientific research by The Institute of Public Health of the NAMS of Ukraine

“…населення), а кількість амбулаторно-поліклінічних закладів збільшилась вдвічі -6,9/13,8% (на 10 тис. населення) [20].…”

“…Кількість медичних сестер соціальної допомоги у 12,4-23,7 рази менше порівняно з медичними сестрами лікарень. Загалом за останні роки реєструється менша кількість лікарів-психологів, соціальних працівників, медичних сестер соціальної допомоги на 10 тисяч населення порівняно з країнами ЄС [18,20].…”

“…Одноразове пероральне введення препарату лабораторним безпородним щурам у дозах від 250 мг/кг до 8000 мг/кг викликало розвиток отруєння, у клінічній картині якого спостерігалися симптоми ураження центральної нервової системи: короткочасне збудження (тварини безладно пересувалися кліткою, тер-ли лапками мордочки), після чого рухома активність тварин знижувалась, за [20][21][22][23][24][25][26][27][28][29][30] Отримані нами дані узгоджуються з результатами 28денних та 90-денних досліджень інгаляційної токсичності ізопропілового спирту у максимальній концентрації 5200 ppm на самцях і самицях мишей, проведених відповідно до рекомендацій GLP та OECD [9]. Автори публікації зазначають, що не виявили жодного впливу ізопропілового спирту на споживання їжі, масу тіла, масу органів, не викликали клінічних проявів інтоксикації, змін гематологічних та біохімічних показників або гістології тканин.…”