Predicting psychiatric inpatient costs

Sabés-Figuera, Ramón; McCrone, Paul; Csipke, Emese; Craig, Tom; Rose, Diana; Sharma, Bina; Wykes, Til

doi:10.1007/s00127-015-1152-9

Cited by 9 publications

(5 citation statements)

References 6 publications

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“…There was a lack of economic evidence available. However, if TIC is reducing rates of seclusion and restraint, reducing length of stays, as well as creating a more therapeutic environment (as reported in this review), this may have a positive impact, as conflict is costly (92), while increased patient satisfaction is associated with reduced costs (93). However, there was also a lack of data on carers, perhaps due to our focus on specific settings, and very little evidence on hospital emergency departments (where care may be experienced as traumatising (94)), and on community-based crisis assessment services, home treatment, or acute day units, which future research could investigate.…”

Section: Discussionmentioning

confidence: 98%

A scoping review of trauma informed approaches in acute, crisis, emergency and residential mental health care

Saunders

McGuinness

Barnett

et al. 2023

Preprint

Self Cite

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Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes. We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included. Most studies (n=23) were conducted in the USA and were based in acute mental health services (n=16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n=7) and the Sanctuary Model (n=6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively. TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.

show abstract

Section: Discussionmentioning

confidence: 98%

A scoping review of trauma informed approaches in acute, crisis, emergency and residential mental health care

Saunders

McGuinness

Barnett

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…There was a lack of economic evidence available, which highlights an area for future research. If TIC reduces rates of seclusion and restraint, reduces length of stays, as well as creates a more therapeutic environment (as reported in this review), this may have a positive economic impact, as conflict is costly [97] and patient satisfaction is associated with reduced costs [98]. There was also a lack of data on carers, perhaps due to our focus on specific settings, and very little evidence on hospital emergency departments (where care may be experienced as traumatising [99]), and on community-based crisis assessment services, home treatment, or acute day units, which future research could investigate.…”

Section: Key Findingsmentioning

confidence: 99%

A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care

Saunders,

McGuinness,

Barnett

et al. 2023

BMC Psychiatry

Self Cite

View full text Add to dashboard Cite

Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes.We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included.Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively.TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.

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“…This investigated care provided on seventeen inpatient wards and evaluated means of improving activities for patients. The economic analyses (described in depth by Sabes-Figuera and colleagues) 17 were a novel departure from usual studies that have examined inpatient costs in that the focus was on activities and staff contacts that patients considered to be meaningful to them. Study participants were asked what meaningful care they had received in the previous week and, from this information, costs were calculated.…”

Section: Inpatient and Residential Care Since Deinstitutionalisationmentioning

confidence: 99%

Mental Health Policy and Economics in Britain

McCrone¹

2021

Mind, State and Society

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Predicting psychiatric inpatient costs

Cited by 9 publications

References 6 publications

A scoping review of trauma informed approaches in acute, crisis, emergency and residential mental health care

A scoping review of trauma informed approaches in acute, crisis, emergency and residential mental health care

A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care

Mental Health Policy and Economics in Britain

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