Psychiatric services : a journal of the American Psychiatric Association
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Recovery has emerged over the past decade as a dominant theme in public mental health care. ⋯ The recommendations identify areas for change that can be accomplished through individual psychiatrist action and organized group efforts.
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Information about mental health systems is essential for mental health planning to reduce the burden of neuropsychiatric disorders. Unfortunately, many low- and middle-income countries lack systematic information on their mental health systems. The objectives, scope, structure, and contents of mental health assessment and monitoring instruments commonly used in high-income countries may not be appropriate for use in middle- and low-income countries. ⋯ Countries will be able to develop information-based mental health policy and plans with clear baseline information and targets. Moreover, they will be able to monitor progress in implementing reform policies, providing community services, and involving consumers, families, and other stakeholders in mental health promotion, prevention, care and rehabilitation. This article provides an overview of the rationale, development process, and potential uses and benefits of WHO-AIMS.
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A retrospective study of inmates with severe mental illness in a large, urban county jail aimed to obtain information about their psychiatric and criminal histories and status, the psychiatric services they used while incarcerated, and the challenges they might present in psychiatric treatment after release. ⋯ A large percentage of persons with severe mental illness received their acute psychiatric inpatient treatment in the criminal justice system rather than in the mental health system. The persons with severe mental illness in this study would present a major challenge in treatment in any setting given their psychiatric and criminal histories. The resources of the mental health system need to be greatly expanded, with priority given to treating persons who are criminalized or who are in danger of becoming criminalized.
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Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom. ⋯ There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.
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There appear to be links between psychiatric disorders and work-related stress as well as between psychiatric disorders and physical conditions. This study explores the relationships between chronic work stress, psychiatric disorders, and chronic physical conditions and disability among workers. By doing so, this study sought to understand how these factors are associated with worker disability when they are experienced alone versus in combination with one another. ⋯ The presence of chronic work stress seems to amplify effects of psychiatric disorders and chronic physical conditions on disability. In addition, psychiatric disorders co-occurring with physical illness seem to be associated with significantly higher odds of disability.