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5 results

  • Evaluating mental health service use during and after emergency department visits in a multisite cohort of Canadian children and youth

  • Mario Cappelli, Paula Cloutier, Amanda S. Newton, Eleanor Fitzpatrick, Samina Ali, Kathryn A. Dong, Clare Gray, Allison Kennedy, John S. Lyons, Christine Polihronis, Rhonda J. Rosychuk
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 21 / Issue 1 / January 2019
    Published online by Cambridge University Press:
    04 December 2017, pp. 75-86
    Print publication:
    January 2019
    • Article
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  • Objectives

    The goal of this study was to examine the mental health needs of children and youth who present to the emergency department (ED) for mental health care and to describe the type of, and satisfaction with, follow-up mental health services accessed.

    Methods

    A 6-month to 1.5-year prospective cohort study was conducted in three Canadian pediatric EDs and one general ED, with a 1-month follow-up post-ED discharge. Measures included 1) clinician rating of mental health needs, 2) patient and caregiver self-reports of follow-up services, and 3) interviews regarding follow-up satisfaction. Data analysis included descriptive statistics and the Fisher’s exact test to compare sites.

    Results

    The cohort consisted of 373 children and youth (61.1% female; mean age 15.1 years, 1.5 standard deviation). The main reason for ED presentations was a mental health crisis. The three most frequent areas of need requiring action were mood (43.8%), suicide risk (37.4%), and parent-child relational problems (34.6%). During the ED visit, 21.6% of patients received medical clearance, 40.9% received a psychiatric consult, and 19.4% were admitted to inpatient psychiatric care. At the 1-month post-ED visit, 84.3% of patients/caregivers received mental health follow-up. Ratings of service recommendations were generally positive, as 60.9% of patients obtained the recommended follow-up care and 13.9% were wait-listed.

    Conclusions

    Children and youth and their families presenting to the ED with mental health needs had substantial clinical morbidity, were connected with services, were satisfied with their ED visit, and accessed follow-up care within 1-month with some variability.

  • Chapter 4 - Planning for elective and emergency problems

  • from Section 1 - General non-medical considerations
  • Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
  • Book:
    Maternal Critical Care
    Published online:
    05 July 2013
    Print publication:
    04 July 2013, pp 26-42

  • Summary

    This chapter presents an overview on the current recommendations and guidelines that may be implemented to improve the management of planned and unplanned urgent high-risk obstetric patients and prevent fatal outcomes for both mothers and their babies. Reviewing morbidity and mortality data over the 10 years from 2000 reveals an increase in the proportion of indirect causes of maternal deaths and demonstrates that many of the case-fatalities were women who did not receive pre-pregnancy counseling or any specific medical management. The chapter discusses two examples of multidisciplinary care planning: for women who have placenta previa with acreta and have had a previous cesarean section and for women with a serious comorbidity. The goal of rapid response teams (RRTs) is to bring critical expertise and equipment to the patient without delay, in a timely manner, and to provide a solution to the problem in a standardized manner.

  • Alcohol dependence and mood state in a population receiving methadone maintenance treatment

  • Edward MacManus, Clare Fitzpatrick
  • Journal:
    Irish Journal of Psychological Medicine / Volume 24 / Issue 1 / March 2007
    Published online by Cambridge University Press:
    13 June 2014, pp. 19-22
    Print publication:
    March 2007

  • Objectives: The aim of this study was to assess the prevalence of alcohol dependence and anxiety and depressive disorder symptomatology among heroin users in drug treatment.

    Method: Fifty-five clients on methadone maintenance treatment programmes in Dublin were interviewed.

    Results: Prevalence rates were found to be 56% [n = 31] for alcohol dependence, 56% [n = 31] for anxiety disorder symptomatology, and 42% [n = 23] for depressive disorder symptomatology. This finding of comorbid alcohol dependence and psychopathology among methadone maintenance treatment clients suggests that both clients' health and methadone maintenance treatment participation and completion rates may be compromised.

    Conclusions: Alcohol dependence and psychopathology among methadone maintenance treatment clients should be considered when providing effectively targeted services to the drug using population.

  • A Follow-up Study on Alcoholics with and without Co-existing Affective Disorder

  • K. O'Sullivan, C. Rynne, J. Miller, S. O'Sullivan, V. Fitzpatrick, M. Hux, J. Cooney, A. Clare
  • Journal:
    The British Journal of Psychiatry / Volume 152 / Issue 6 / June 1988
    Published online by Cambridge University Press:
    02 January 2018, pp. 813-819
    Print publication:
    June 1988

  • Three-hundred male alcoholics were selected from consecutive admissions to hospital. They were divided into three diagnostic sub-groups: primary alcoholics; alcoholics with unipolar affective disorder; and alcoholics with bipolar affective disorder. After three follow-up interviews over a 2-year period after hospital discharge, the three sub-groups reported differences in frequency of mood change, amount of treatment received, and hospital attendance, although there were no clear-cut differences in items associated with their alcoholism. There were, however, some indications that bipolar patients functioned at a better level during the follow-up period, particularly those who were older, had a previous history of longer periods of abstinence, and maintained more frequent contact with Alcoholics Anonymous (AA) and their family doctor.