Mental health clustering and diagnosis in psychiatric in-patients

Abstract

Aims and method This paper investigates the relationship between cluster (Mental Health Clustering Tool, MHCT) and diagnosis in an in-patient population. We analysed the diagnostic make-up of each cluster and the clinical utility of the diagnostic advice in the Department of Health’s Mental Health Clustering Booklet. In-patients discharged from working-age adult and older people’s services of a National Health Service trust over 1 year were included. Cluster on admission was compared with primary diagnosis on discharge.Results Organic, schizophreniform, anxiety disorder and personality disorders aligned to one superclass cluster. Alcohol and substance misuse, and mood disorders distributed evenly across psychosis and non-psychosis superclass clusters. Two-thirds of diagnoses fell within the MHCT ‘likely’ group and a tenth into the ‘unlikely’ group.Clinical implications Cluster and diagnosis are best viewed as complimentary systems to describe an individual’s needs. Improvements are suggested to the MHCT diagnostic advice in in-patient settings. Substance misuse and affective disorders have a more complex distribution between superclass clusters than all other broad diagnostic groups.

The extension of a set of needs-led mental health clusters to accommodate people accessing UK intellectual disability health services

“…The validity of both approaches can be challenged but it is also important to avoid conflating issues of validity with utility (Kendell & Jablensky, 2003). In this way, the two systems should be viewed as complimentary (Trevithick, Painter, & Keown, 2015).…”

Patient-reported outcome measures in community mental health teams: pragmatic evaluation of PHQ-9, GAD-7 and SWEMWBS

“…4,5 Although CTOs have been recommended as a method for improving adherence and patient safety, patients treated under CTOs feel more coerced. 6 The use of CTOs has been much higher than was initially anticipated, 7,8 and has increased considerably since they were first introduced. 8,9 Concerns have been raised about greater use of compulsion amongst people from ethnic minority communities.…”

“…6 The use of CTOs has been much higher than was initially anticipated, 7,8 and has increased considerably since they were first introduced. 8,9 Concerns have been raised about greater use of compulsion amongst people from ethnic minority communities. [10][11][12] Data submitted to NHS Digital in 2016 indicated that Black or Black British patients were almost nine times more likely to be treated on a CTO than White British patients.…”

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