Evaluation of the Efficacy of Involuntary Outpatient Treatment in Reducing the Use of Mental Health Services in Hospital

Hernández-Viadel, Miguel; Nicolás, Carlos Cañete; Prieto, Juan Francisco; Calatayud, Guillem Lera; Beneyto, Manuel Gómez

doi:10.1016/s2173-5050(10)70009-1

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…In 2019, 2265 psychiatric pathology emergencies were treated at the Arnau de Vilanova Hospital emergency department, and 433 of these, were referred to Santa María Hospital, which represents 19.11% of the total. This means that about 80% of psychiatric pathology that visits the emergency department is solved by the Emergency Service (ES) professionals, and the patients who were derived, most were sent home, which shows the importance of carrying out a correct ambulatory follow-up, from primary care professionals and mental health centers [6].…”

Section: Discussionmentioning

confidence: 99%

Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

Gómez¹,

Guzmán²,

Torres³

2021

Arch Psychiatr Ment Health

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Introduction: Psychiatric emergencies constitute between 1% - 10% of general emergencies in Spain, of which a quarter will end up being hospital admissions. There is little literature on patients who are referred from general to specialized hospitals. Methods: Cross-Sectional study of all the patients referred in 2018. Sociodemographic variables and clinical variables, such as diagnosis and discharge destination, were analyzed. An analysis was performed by comparing means with the Chi Square test. Results: 433 derived emergencies were analyzed. Most of the patients were women. The main reason for derivation were suicide attempts. Of those patients, 40% required hospitalizations. More than 50% of the derived emergencies were referred to the home and followed up on an outpatient basis. Conclusion: Most derived emergencies are referred to the home after evaluation. This implies that most are not life-threatening and that with adequate tools for evaluating suicide risk, we could avoid transfers and improve the resolution of these cases.

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Section: Discussionmentioning

confidence: 99%

Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

Gómez¹,

Guzmán²,

Torres³

2021

Arch Psychiatr Ment Health

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Compulsory community treatment to reduce readmission to hospital and increase engagement with community care in people with mental illness: a systematic review and meta-analysis

Barnett

Matthews

Lloyd‐Evans

et al. 2018

The Lancet Psychiatry

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SummaryBackgroundCompulsory community treatment (CCT) aims to reduce hospital readmissions among people with mental illness. However, research examining the usefulness of CCT is inconclusive. We aimed to assess the effectiveness of CCT in reducing readmission and length of stay in hospital and increasing community service use and treatment adherence.MethodsFor this systematic review and meta-analysis, we searched three databases (PsycINFO, MEDLINE and Embase) for quantitative studies on CCT published in English between Jan 1, 1806, and Jan 4, 2018. We included both randomised and non-randomised designs that compared CCT with no CCT, and pre-post designs that compared patients before and after CCT. Studies were eligible if they had been peer-reviewed, if 50% or more of patients had severe mental illness, and if CCT was the intervention. Trials in which CCT was used in response to a criminal offence were excluded. We extracted data on study characteristics and length of follow-up, patient-level data on diagnosis, age, sex, race, and admission history, and outcomes of interest (readmission to hospital, inpatient bed-days, community service use, and treatment adherence) for meta-analysis, for which we extracted summary estimates. We used a random-effects model to compare disparate outcome measures and convert effect size statistics into standardised mean differences. This systematic review is registered with PROSPERO, number CRD42018086232.FindingsOf 1931 studies identified, 41 (2%) met inclusion criteria and had sufficient data for analysis. Before and after CCT comparisons showed significant large effects on readmission to hospital (standardised mean difference 0·80, 95% CI 0·53–1·08; I2=94·74), use of community services (0·83, 0·46–1·21; I2=87·26), and treatment adherence (2·12, 1·69–2·55; I2=0), and a medium effect on inpatient bed-days (0·66, 0·46–0·85; I2=94·12). Contemporaneous controlled comparison studies (randomised and non-randomised) showed no significant effect on readmission, inpatient bed-days, or treatment adherence, but a moderate effect on use of community services (0·38, 0·19–0·58; I2=96·92). A high degree of variability in study quality was found, with observational study ratings ranging from three to nine. Bias most frequently centred on poor comparability between CCT and control participants.InterpretationWe found no consistent evidence that CCT reduces readmission or length of inpatient stay, although it might have some benefit in enforcing use of outpatient treatment or increasing service provision, or both. Future research should focus on why some people do not engage with treatment offered and on enhancing quality of the community care available. Shortcomings of this study include high levels of variability between studies and variation in study quality.FundingNational Institute for Health Research.

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Evaluation of the Efficacy of Involuntary Outpatient Treatment in Reducing the Use of Mental Health Services in Hospital

Cited by 2 publications

References 12 publications

Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

Compulsory community treatment to reduce readmission to hospital and increase engagement with community care in people with mental illness: a systematic review and meta-analysis

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