Vulnerable patients going to court: a psychiatrist's guide to special measures [Current Practice]
There have been significant changes to how vulnerable people are treated in the court system, including the introduction of special measures to support people both as witness and as accused. This paper summarises the use of special measures and their application to people with mental health diagnoses or cognitive impairment. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Cooper, P., Grace, J. Tags: Current Practice Source Type: research
Psychiatrists' use of formulation: Commentary on ... Psychiatrists' understanding and use of psychological formulation [Special articles]
Both psychologists and psychiatrists are trained to write formulations of their patients' illnesses, with some differences in how they do this. Psychologists focus on psychological understanding, while psychiatrists' formulation brings together aetiology, functioning and a management plan. Mohtashemi et al's study records how some psychiatrists understand formulation and its usefulness. Time pressure was an important barrier to making a full formulation, and some believed the medical role of the psychiatrist was a priority. The study illustrates some of the challenges facing psychiatrists working in the NHS in terms of mai...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Hughes, P. M. Tags: Special articles Source Type: research
Psychiatrists' understanding and use of psychological formulation: a qualitative exploration [Special articles]
Aims and method To establish an initial conceptualisation of how psychiatrists understand and use formulation within adult psychiatry practice. Twelve psychiatrists took part in semi-structured interviews. Transcripts were analysed using a constructivist grounded theory methodology.
Results Formulation was conceptualised as an addition to diagnosis, triggered by risk, complexity and a need for an enhanced understanding. Participants valued collaborative formulation with psychologists. Multiple contextual factors were perceived to either facilitate or inhibit the process. Barriers to formulation led to a disjointed way of w...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Mohtashemi, R., Stevens, J., Jackson, P. G., Weatherhead, S. Tags: Special articles Source Type: research
Lessons to be learned from the oldest community psychiatric service in the world: Geel in Belgium [Special articles]
This article reviews the family foster care model practised in the small Belgian town of Geel. A historical introduction is followed by a description of a family foster care project in its current form. Issues are raised as to whether the current culture of care pathways, managed care, payment by results and an emphasis on ‘cure’ are conducive to recovery as promoted by the recovery model. Finally, the lessons from Geel are summarised and it is argued that there is much that can be learned from this way of working to support the recovery movement. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: van Bilsen, H. P. J. G. Tags: Special articles Source Type: research
It is time to bring borderline intellectual functioning back into the main fold of classification systems [Special articles]
Borderline intellectual functioning is an important and frequently unrecognised comorbid condition relevant to the diagnosis and treatment of any and all psychiatric disorders. In the DSM-IV-TR, it is defined by IQ in the 71–84 range. In DSM-5, IQ boundaries are no longer part of the classification, leaving the concept without a clear definition. This modification is one of the least highlighted changes in DSM-5. In this article we describe the history of the classification of borderline intellectual functioning. We provide information about it and on the importance of placing it in the right context and in the right...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Wieland, J., Zitman, F. G. Tags: Special articles Source Type: research
A history of liaison psychiatry in the UK [Special articles]
We describe the development of training guidelines, the publication of joint documents with other Royal Colleges, establishing international collaborations and defining service specifications. We emphasise the importance of collaboration with other medical organisations, and describe successes and pitfalls.
Clinical implications Much has been achieved but challenges remain. Liaison psychiatry has a potentially important role in improving patient care. It needs to adapt to the requirements of the current National Health Service, marshal evidence for cost-effectiveness and persuade healthcare commissioners to fund services t...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Aitken, P., Lloyd, G., Mayou, R., Bass, C., Sharpe, M. Tags: Special articles Source Type: research
Intelligent outcome measures in liaison psychiatry: essential even if not desirable: Commentary on ... a multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) [Special articles]
Service development is guided by outcome measures that inform service commissioners and providers. Those in liaison psychiatry should be encouraged to develop a positive approach that integrates the collection of outcome measures into everyday clinical practice. The Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) is a very useful tool to measure service quality and clinical effectiveness, using a combination of clinician-rated and patient-rated outcome measures and patient-rated experience measures. However, it does not include measures of cost-effectiveness or training activities. The FROM-LP is ...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Tadros, G. Tags: Special articles Source Type: research
A multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) [Special articles]
In the field of liaison psychiatry, as in all areas of healthcare, there is an essential need for well-organised and consistent collection of information on outcomes, from a range of perspectives. This special article introduces, and describes the development of, the multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP). This was challenging owing to the variety of service settings and types of intervention which characterise liaison psychiatry. Similar challenges may be faced by other specialties and this, along with the direct relevance of much of the eventual content of the framework...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Trigwell, P., Kustow, J. Tags: Special articles Source Type: research
Talking therapy groups on acute psychiatric wards: patients' experience of two structured group formats [Original papers]
We report the results of a clinical audit of patients' reactions to two types of talking therapy groups facilitated by assistant psychologists and psychology graduates on three acute wards. Patients' experiences of problem-solving and interpersonal group formats were explored via focus groups and structured interviews with 29 group participants.
Results Both group formats generated high satisfaction ratings, with benefits related mostly to generic factors.
Clinical implications Adequately trained and supported assistant psychologists and psychology graduates can provide supportive talking groups that patients find helpful....
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Radcliffe, J., Bird, L. Tags: Original papers Source Type: research
Service and treatment engagement of people with very late-onset schizophrenia-like psychosis [Original papers]
Aims and method Electronic patient records were used to investigate the level of engagement and treatment that patients with very late-onset schizophrenia-like psychosis (VLOSLP) had with mental health services.
Results Of 131 patients assessed and diagnosed, 63 (48%) were taking antipsychotic treatment at 3 months, 46 (35%) at 6 months and 36 (27%) at 12 months. At discharge from mental health services, 54% of patients had failed to engage with services or became lost to follow-up, 18% had engaged with services but were not taking antipsychotic medication and only 28% were taking treatment.
Clinical implications Results s...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Sin Fai Lam, C. C., Reeves, S. J., Stewart, R., Howard, R. Tags: Original papers Source Type: research
Colleague and patient appraisal of consultant psychiatrists and the effects of patient detention on appraisal scores [Original papers]
Aims and method This paper aims to review colleague and patient feedback from the 10-year period of the operation of the Royal College of Psychiatrists' 360-degree appraisal system, specifically: (1) examine the overall distribution of ratings; (2) examine the effect of working primarily with detained patients on patient feedback, represented by forensic psychiatrists; and (3) look for a relationship between colleague and patient ratings.
Results Data were analysed for 977 participating psychiatrists. Both colleagues and patients rated psychiatrists overall with high scores. Less than 1% were identified as low scorers, alt...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Heneghan, M., Chaplin, R. Tags: Original papers Source Type: research
Opening the 'black box: liaison psychiatry services and what they actually do [Original papers]
Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service.
Results Three hundred and forty-four patients were referred to the service over a 12-month period. Ten different types of liaison interventions were identified, with the most common interventions being diagnosis (112 patients, 32.6%), medication management (57 patients, 16.6%), risk assessment and treatment (56 patients, 16.3% each). M...
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Guthrie, E., McMeekin, A., Thomasson, R., Khan, S., Makin, S., Shaw, B., Longson, D. Tags: Original papers Source Type: research
Suicide under crisis resolution home treatment - a key setting for patient safety [Editorials]
Recent years have seen a substantial increase in the use of crisis resolution home treatment (CRHT) teams as an alternative to psychiatric in-patient admission. We discuss the functions of these services and their effectiveness. Our research suggests high rates of suicide in patients under CRHT. Specific strategies need to be developed to improve patient safety in this setting. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Hunt, I. M., Appleby, L., Kapur, N. Tags: Editorials Source Type: research
Patients or prisoners? Time to reconsider the voting rights of mentally disordered offenders [Editorials]
This article clarifies the voting rights of individuals receiving in-patient psychiatric care and contends that the selective disenfranchisement of some mentally disordered offenders is problematic, discriminatory and may breach international human rights law. There are therefore strong arguments for the UK government to address this long-standing inequality before the next general election. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - July 31, 2016 Category: Psychiatry Authors: Rees, G., Reed, J. Tags: Editorials Source Type: research
Sad Dad: An Exploration of Postnatal Depression in Fathers [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - May 31, 2016 Category: Psychiatry Authors: Coccia, F. Tags: Reviews Source Type: research
