Mental health care in hospitals and primary care: an unsustainable balance

Green, Ben; Gowans, Bill W J

doi:10.3399/bjgp15x683365

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The mental health system in the UK operates under large demand pressures and often operates at or over 100% operational capacity 11 . This has implications for working with complex patients who require repeated access to multiple services.…”

Section: Complexity Of Uk Mental Health Systemsmentioning

confidence: 99%

An analysis of how people with a personality disorder in Devon United Kingdom use mental health services

Manzi¹,

Pearn²,

Winterton³

2023

Preprint

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Mental health service clients with a personality disorder have been identified as high service users and there is disagreement about the effectiveness of current treatments. This study provides a description of personality disorder client service use in Devon, United Kingdom. Descriptive analysis, probabilities of escalation from community to inpatient services and a novel application of network analysis were conducted. In Devon, people with a personality disorder use a median value of four community services and a median value of one inpatient service within the three years of data (January 2015 to February 2018) used in this study. Personality disorder clients use a wide range of community and inpatient services persistently over time. Network analysis showed that they most commonly rely on psychiatric liaison services and Crisis Resolution and Home Treatment teams. Suggested changes include the provision of alternative services to avoid clients repeatedly seeking high intensity emergency mental health care.

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Section: Complexity Of Uk Mental Health Systemsmentioning

confidence: 99%

An analysis of how people with a personality disorder in Devon United Kingdom use mental health services

Manzi¹,

Pearn²,

Winterton³

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Increases in admissions, particularly for alcohol related issues, have seen adult psychiatric facilities continuing to operate at or above 100% capacity (B. Green & Gowans, 2015). Capacity planning and system design for effective functioning is a difficult task especially when the systems are as large and complicated as the UK mental health system, even at a local level these systems are often opaque even to those working in them.…”

Section: Introductionmentioning

confidence: 99%

Balancing improvements to avoid out-of-area placements in acute psychiatric inpatient care

Manzi¹,

Pitt²

2023

Preprint

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BackgroundIncreasing pressures on acute adult NHS mental health services have led to the practice of sending patients out of their home county when there is insufficient local capacity to provide them with an acute psychiatric inpatient bed. AimsThis study sought to determine how rates of referrals, bed capacity and length of stay could be improved to avoid sending people out of their local area for care.MethodA discrete event simulation approach was applied to a mental health trust in the South West of England.ResultsThe model demonstrated that to achieve zero out-of-area placements the rate of referrals would have to be halved, bed capacity would have to be increased from 78 to 123 beds or length of stay would have to halve. If changes were made to all three elements of the system between 85 and 93 beds would be required in combination with between a 22% and 44% reduction in the rate of referrals and between a 11% and 21% reduction in length of stay.ConclusionsDue to non-linear effects in the system, avoiding the need to send patients out-of-area for care can best be achieved by improving multiple elements of the system in combination.

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Boring but important: the community mental health team

Forrest¹

2015

Br J Gen Pract

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Mental health care in hospitals and primary care: an unsustainable balance

Cited by 4 publications

References 3 publications

An analysis of how people with a personality disorder in Devon United Kingdom use mental health services

An analysis of how people with a personality disorder in Devon United Kingdom use mental health services

Balancing improvements to avoid out-of-area placements in acute psychiatric inpatient care

Boring but important: the community mental health team

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