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Complex Mental Health Problems (complex + mental_health_problem)

Distribution by Scientific Domains

Psychology	75%

Selected Abstracts

Children with Complex Mental Health Problems: Needs, Costs and Predictors over One Year

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2005
Andrew F. Clark
Background:, Little is known regarding children of greatest concern with complex mental health problems. Method:, A one-year prospective study of psychiatric diagnosis, psychosocial functioning, need status and service receipt in 60 children identified as most concerning. Results:, Thirty-two (53%) had two or more disorders. The mean number of needs per child was five. One year later mean needs were unchanged but with considerable individual variation. Mean weekly costs were £1017 (,1627) (SD = £957 (,1531)). Higher costs related to social factors rather than diagnosis or need. Conclusions:, The mean annual cost of services to children with complex mental health problems is ten times that in other studies of children with mental health problems. [source]

Evidence-based care and the case for intuition and tacit knowledge in clinical assessment and decision making in mental health nursing practice: an empirical contribution to the debate

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2001
I. Welsh BEd (Hons) RGN ONC RNTDipN (London)
This paper provides empirical evidence that challenges the view that methods of clinical assessment and decision making should not rely solely on logical positivist approaches. Whilst the National Health Service (NHS) Executive currently takes a hard positivist line on what constitutes evidence-based practice, data reveal that it is not always appropriate to disregard the tacit knowledge and intuition of experienced practitioners when making assessment decisions in mental health nursing practice. Data support the case for a holistic approach which may draw on intuition and tacit knowledge, as well as traditional approaches, to meet the requirements of clients with complex mental health problems. A model based on Schon's notion of reflection in and reflection on practice is proposed which demonstrates the value of intuition and tacit knowledge. This model allows the generation of insights which may ultimately be demonstrated to be acceptable and empirically testable. It is accepted that an element of risk taking is inevitable, but the inclusion of a formal analytical process into the model reduces the likelihood of inappropriate care interventions. The cognitive processes which experienced nurses use to make clinical decisions and their implications for practice will be explored. [source]

Inpatient treatment in child and adolescent psychiatry , a prospective study of health gain and costs

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 12 2007
Jonathan Green
Background:, Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods:, A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results:, We found a significant (p < .001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size .92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size .27). Health needs assessment showed similar gain (p < .001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was £24,100; pre-admission and post-discharge support costs were similar. Conclusions:, Inpatient treatment is associated with substantive sustained health gain across a range of diagnoses. Lack of intensive outpatient-treatment alternatives limits any unqualified inference about causal effects, but the rigour of measurement here gives the strongest indication to date of the positive impact of admission for complex mental health problems in young people. [source]