The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Feb 1996
ReviewAssisted suicide and euthanasia: what about the clinical issues?
This paper aims to address the clinical issues involved in a patient's request for assisted suicide. The psychiatric and broader psychosocial issues for the dying patient, their family and their treating doctor have been largely unaddressed in the debate concerning euthanasia to date. A range of the clinical issues that need to be incorporated in the ethical and legal considerations are reviewed. ⋯ The dynamics of family interactions and doctor-patient relationships in this setting are factors that may impinge upon a request for assistance to die. These factors may be more important than the severity of a person's illness or their quality of life, and are less likely to be recognised and addressed in situations of professional isolation. There are critical issues facing psychiatry in new legislative developments.
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This study examined the availability and staffing of acute psychiatry beds in NSW and ACT. "Gazetted" acute psychiatry hospitals (which take compulsory admissions under mental health law) were polled directly for bed numbers, occupancy and staffing for the year 1990-1991. The NSW Department of Health provided beds numbers for non-gazetted and private hospitals. Four analyses sequentially reallocated beds according to the origin of patients to estimate acute bed availability and use by regional populations. ⋯ Referral of patients to remote hospitals is not related to actual bed provision in the regions, but appears to reflect attitudes to ensuring local care. Recommendations about current de facto standards are made. Current average nursing and medical staffing standards are reported.
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Aust N Z J Psychiatry · Jun 1995
Queensland's geographical maldistribution of psychiatrists and Queensland Health's response.
There is a major geographical maldistribution and shortage of psychiatrists throughout Queensland. In June 1992, 48 psychiatrists worked outside of Brisbane where 66% of the population reside, while 172 psychiatrists worked in the metropolitan area. The reasons for and the effects of the maldistribution are discussed. ⋯ These strategies are outlined. Between July 1992 and December 1993, 14 new full time psychiatrists were recruited. The results of these strategies are encouraging.
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Aust N Z J Psychiatry · Mar 1995
Comparative StudyEating disorder patients at a NSW teaching hospital: a comparison with state-wide data.
The aim of the study was to present data which may be useful in deciding the type of services needed for eating disorder (ED) patients in New South Wales (NSW). The demographic and clinical characteristics of 155 patients consecutively admitted to a special ED unit at a major Sydney teaching hospital during the triennium 1989-1991 were documented and compared with relevant data from the State as a whole (709 admissions for ED to public facilities and 938 admissions for ED to private facilities during the same period). The findings are discussed in the light of information from overseas studies. ⋯ Most referrals are tertiary, and there is a high prevalence of physical morbidity indicating a need for access to general medical facilities. Most serious physical complications occur in patients who can be identified by their chronicity and by the pattern of their behavioural disturbance. These various factors are considered in the formulation of recommendations for rationalizing the service.
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Aust N Z J Psychiatry · Jun 1994
Police referrals to a psychiatric hospital: indicators for referral and psychiatric outcome.
Studies of police psychiatric referrals in the USA and the UK generally show these patients to be ill and in need of care. There are, however, no published Australian studies and such findings may not be validly generalised. This prospective study of consecutive police psychiatric referrals in Adelaide reports psychiatric assessment in 92 cases and observations by police in 69 of these, with no evidence of selection bias. ⋯ There were 14 cases where possible charges were not being pursued: of these 7 were regarded as ill and 4 were regarded as inappropriate referrals. The rates of major disorders are lower than in other published work. It is proposed that this can be explained by relative ease of referral by police to psychiatry and flexible acceptance criteria.