‘We've got another one for you!’ Liaison psychiatry's experience of stigma towards patients with mental illness and mental health professionals

Bolton, Jim

doi:10.1192/pb.bp.112.038646

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…Stigmatising attitudes towards those working in liaison psychiatry may contribute to poor patient communication, delays in treatment and premature discharge. 3,4 Participants called for improved integration and communication within the general hospital to combat stigma. It is not usual for liaison staff to have a dedicated space to work within teams which may contribute to feeling excluded.…”

Section: Discussionmentioning

confidence: 99%

“…1 Concepts of stigma in mental health have been delineated into problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). 1 Stigma can have serious consequences including delays in medical treatment for people with mental illness [2][3][4] and service-users feeling disbelieved. 5 Up to 75% of mental health professionals working in the general hospital, encounter stigmatising attitudes; 4 however, it is not clearly explored in the literature how this affects them personally.…”

mentioning

confidence: 99%

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Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

Helingoe

Cullum

2022

Australas Psychiatry

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Objective Stigma related to mental illness can impact service-user care and clinician wellbeing. The aim of this study was to explore experiences of stigma in consultation-liaison psychiatry from the perspectives of trainee psychiatrists and suggest interventions to tackle stigma within a hospital environment. Method Ethics approval and consent were obtained for the study. In-depth interviews were conducted by telephone with six participants in four New Zealand district health boards. De-identified data was analysed using thematic analysis. An independent co-coder was employed to enhance analytic rigour. Results Participants experienced stigma during their consultation-liaison rotations. Some felt isolated and undervalued. Education, intergration and role clarification within the hospital environment were identified as ways to reduce stigma. Conclusions Stigma experienced by trainee psychiatrists completing consultation-liaison rotations may lead to them feeling devalued and perceiving service-users to experience poorer care. Multidisciplinary education may potentially combat stigma and contribute to improved integration of services.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

Helingoe

Cullum

2022

Australas Psychiatry

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“…The pathway reflected the shared understanding that patients suffering mental health problems face long waits in environments not suited to prevent crisis escalation; many self-discharge before receiving a mental health assessment. Additionally, individuals may face negative attitudes from general hospital staff toward people experiencing a mental health crisis, particularly toward those who self-harm 6 . Consequently, their needs continue unmet and their attendances persist.…”

Section: Hertfordshire Initiative To Improve Care Offered To Frequent Attendersmentioning

confidence: 99%

“…Additionally, individuals may face negative attitudes from general hospital staff toward people experiencing a mental health crisis, particularly toward those who self-harm. 6 Consequently, their needs continue unmet and their attendances persist. At the same time, resources are diverted from patients requiring medical treatment.…”

Section: Hertfordshire Initiative To Improve Care Offered To Frequent Attendersmentioning

confidence: 99%

The effect of integrated care on self-management and emergency department attendance

et al. 2019

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Aims and methodThe Frequent Attenders Programme is a joint initiative between Hertfordshire Rapid Assessment, Interface and Discharge service and the Emergency Department of the West Hertfordshire NHS Trust, which aims to divert frequent attenders from the emergency department by addressing their unmet needs. This paper describes the range of interventions put in place from the time that the service was set up in 2014 until the introduction of the new national Commissioning for Quality and Innovation 2017–2019, which tasked National Health Service trusts to improve services for people with mental health needs who present to Accident and Emergency. The terms emergency department and Accident and Emergency are used interchangeably, reflecting the practice in policy documents. A subsequent article will report on the impact of the Commissioning for Quality and Innovation in Hertfordshire.ResultsAnalysis of the interventions indicated a highly significant (P < 0.0001) mean reduction in attendances. Lower gains were made in patients whose primary presentations were alcohol-related. A failure to effect change in two patients led to a significant revision of their respective care plans, resulting in a subsequent reduction in their attendances.Clinical implicationsAn integrated approach to patients with complex presentations was associated with high levels of both patient and referrer satisfaction. It is hypothesised that dismantling the barriers between physical and mental health may lead to similar successes in frequent attenders in other in-patient and community medical and psychiatric services.Declaration of interestNone.

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“…There is still significant stigma associated with the diagnosis of mental illness, and psychiatry as a profession is stigmatized, at times by other members of the medical community. [8][9][10] There is often a sense among psychiatrists and psychiatry residents that other health professionals view psychiatry as being something different than "real medicine." 11 If distinctions between psychiatry and so-called "physical medicine" underlie at least some of the stigma directed against psychiatry, why would psychiatrists use terminology that reinforces mind-brain duality?…”

mentioning

confidence: 99%

Why We Still Use “Organic Causes”: Results From a Survey of Psychiatrists and Residents

Benrimoh

Pomerleau

Demoustier

et al. 2019

JNP

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The diagnostic category of "organic disorders" was officially removed from the psychiatric nosology in DSM-IV, published in 1994. Despite this change, physicians continue to use the term "organic causes" to refer to medical and neurological causes of psychiatric symptoms, and it remains part of the ICD-10 classification. In the context of increasing integration of psychiatric disorders within a medical and neuroscientific framework, the reasons behind the ongoing use of this term (reminiscent of mind-body dualism) have to be clarified. The authors conducted a survey of 391 Canadian psychiatrists and psychiatric residents to understand attitudes and beliefs related to this terminology and then applied qualitative and quantitative analyses. Results showed that the terminology is used by the majority (55.9%) of psychiatrists and residents for two main reasons: out of a habit that begins in residency training and because of the belief that other specialties do not fully understand alternative terminology. The authors found that some psychiatrists are concerned that their patients will not receive adequate investigation unless it is made clear through use of the "organic cause" term that other medical causes of psychiatric symptoms are suspected. Use of the "organic cause" term was predicted by being of younger age, performing emergency department calls, and finding alternative terminology difficult to use. These findings highlight the importance of reflecting on and discussing the effect of this terminology used in psychiatry.

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‘We've got another one for you!’ Liaison psychiatry's experience of stigma towards patients with mental illness and mental health professionals

Cited by 7 publications

References 8 publications

Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

The effect of integrated care on self-management and emergency department attendance

Why We Still Use “Organic Causes”: Results From a Survey of Psychiatrists and Residents

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