Slide presentations from "Improving care for people with psychosis in North West London", an event hosted by Imperial College Health Partners on 10th February, 2015.
South Region CCG Mental Health Masterclass - EIP Preparedness ProgrammeSarah Amani
The Early Intervention in Mental Health Network's mission is to improve health and social outcomes for young people with first episode psychosis, including symptom reduction and engagement with education and employment.
This document is the beginning of a programme to help people work together in preparation of the regions task to achieve the above mission.
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Sarah Amani
This document summarizes a presentation on extending early intervention services to additional mental health conditions beyond psychosis. It discusses how early intervention aims to improve outcomes by promptly starting effective treatments and providing intensive support. The network's priorities are outlined, which include identifying conditions early in adolescence/early adulthood where early intervention may be effective. Obsessive compulsive disorder is provided as an example condition that meets the priorities, as evidence demonstrates it often has onset in young people, can become severe and enduring without treatment, and responses well to early interventions. The case is also made for early intervention in anorexia nervosa based on evidence that outcomes are better when treatment is provided within the first three years.
Centre for Mental Health and Wellbeing Research: Alcohol-related violence: What works and what do we need to do?A/Prof Peter Miller
University Consortium:
1School of Psychology, Deakin University
2National Addiction Centre, Institute of Psychiatry, King's College London, UK
3NDRI, Curtin University
4Commissioning Editor, Addiction
5Centre for Addiction and Mental Health, Ontario, Canada
Funded by the National Drug Law Enforcement Research Fund:An Initiative of the National Drug Strategy
Presented at the Australian Winter School
Research studies outcome of four studies regarding alcohol related violence.
This evaluation report summarizes the Community Action on Alcohol Pilot Project, which provided training to five community task forces on alcohol-related harm and mobilizing communities. The training aimed to increase knowledge of alcohol harms, develop community action plans, and promote evidence-based approaches. The evaluation found that the high-quality training increased knowledge and supported action planning. However, limited resources, lack of stakeholder engagement in some areas, and the need for ongoing support pose challenges to sustainability. The report recommends investing in community coalitions, tailoring training delivery to groups, and maintaining long-term support.
The document outlines the process of developing a smoke-free organization at Lancashire Care NHS Foundation Trust. It discusses why the trust wants to go smoke-free, how it will implement the policy over 14 months, and the challenges it may face. These include training staff, addressing cultural issues among staff and patients, dealing with media attention, and navigating relations with neighbors. The trust will establish an implementation team, communication plan, policies and procedures, and staff training. It will also remove all smoking shelters and bins and put up signs across sites. The biggest challenges are expected to be training, addressing mixed views on smoking, and handling e-cigarettes.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
Physical Health Action at Last! by Karen Conlon, SMI Project Lead, Mike Leonard, clinical Pharmacist and Pauline Smith, Physical Healthcare Project Nurse
Evidence shows us that specialised mood disorder clinics deliver cost savings, better clinical outcomes and improved patient satisfaction. Presented to the Trent Division of the Royal College of Psychiatrists, November 2013, Sheffield.
South Region CCG Mental Health Masterclass - EIP Preparedness ProgrammeSarah Amani
The Early Intervention in Mental Health Network's mission is to improve health and social outcomes for young people with first episode psychosis, including symptom reduction and engagement with education and employment.
This document is the beginning of a programme to help people work together in preparation of the regions task to achieve the above mission.
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Sarah Amani
This document summarizes a presentation on extending early intervention services to additional mental health conditions beyond psychosis. It discusses how early intervention aims to improve outcomes by promptly starting effective treatments and providing intensive support. The network's priorities are outlined, which include identifying conditions early in adolescence/early adulthood where early intervention may be effective. Obsessive compulsive disorder is provided as an example condition that meets the priorities, as evidence demonstrates it often has onset in young people, can become severe and enduring without treatment, and responses well to early interventions. The case is also made for early intervention in anorexia nervosa based on evidence that outcomes are better when treatment is provided within the first three years.
Centre for Mental Health and Wellbeing Research: Alcohol-related violence: What works and what do we need to do?A/Prof Peter Miller
University Consortium:
1School of Psychology, Deakin University
2National Addiction Centre, Institute of Psychiatry, King's College London, UK
3NDRI, Curtin University
4Commissioning Editor, Addiction
5Centre for Addiction and Mental Health, Ontario, Canada
Funded by the National Drug Law Enforcement Research Fund:An Initiative of the National Drug Strategy
Presented at the Australian Winter School
Research studies outcome of four studies regarding alcohol related violence.
This evaluation report summarizes the Community Action on Alcohol Pilot Project, which provided training to five community task forces on alcohol-related harm and mobilizing communities. The training aimed to increase knowledge of alcohol harms, develop community action plans, and promote evidence-based approaches. The evaluation found that the high-quality training increased knowledge and supported action planning. However, limited resources, lack of stakeholder engagement in some areas, and the need for ongoing support pose challenges to sustainability. The report recommends investing in community coalitions, tailoring training delivery to groups, and maintaining long-term support.
The document outlines the process of developing a smoke-free organization at Lancashire Care NHS Foundation Trust. It discusses why the trust wants to go smoke-free, how it will implement the policy over 14 months, and the challenges it may face. These include training staff, addressing cultural issues among staff and patients, dealing with media attention, and navigating relations with neighbors. The trust will establish an implementation team, communication plan, policies and procedures, and staff training. It will also remove all smoking shelters and bins and put up signs across sites. The biggest challenges are expected to be training, addressing mixed views on smoking, and handling e-cigarettes.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
Physical Health Action at Last! by Karen Conlon, SMI Project Lead, Mike Leonard, clinical Pharmacist and Pauline Smith, Physical Healthcare Project Nurse
Evidence shows us that specialised mood disorder clinics deliver cost savings, better clinical outcomes and improved patient satisfaction. Presented to the Trent Division of the Royal College of Psychiatrists, November 2013, Sheffield.
Improving the physical health of patients with severe mental health illness ...NHS Improving Quality
Improving the physical health of patients with severe mental health illness in primary care, by Rhiannon England, GP Clinical Lead, City and Hackney CCG
Improving mental health through patient and professional partnershipAmarShahELFT
Slides from the session at the International Forum on Quality and Safety in Healthcare 2016 (Gothenburg) - Improving mental health through patient and professional partnerships
Geoff Honnor (ACON) redefines wellness in an evolving HIV epidemic, as well as discussing the context of the UN Goals for reducing HIV transmission 2010-2015 and the ACON response.
This presentation was given at the AFAO Positive Services Forum 2012.
Tele-mentoring on Integrated Mental Health and Addiction for DMHP counsellors...Prabhat Chand MD
This document summarizes a feasibility study of a tele-mentoring program on integrated mental health and addiction for counselors in Chhattisgarh, India. The program utilized Project ECHO's tele-mentoring model to provide virtual training and case discussions between counselors in 11 districts and experts at NIMHANS. Over 6 months: 1) 12 counselors from 11 districts participated in the weekly tele-mentoring clinics, with 10 presenting patient cases. 2) Counselors co-managed 17 total patient cases with NIMHANS experts. 3) The program was found to be a feasible, sustainable, and replicable way to increase counseling capacity and reduce disparities in addiction and mental health treatment in remote areas through
This document discusses developing more collaborative approaches to addressing mental health crises through integrated solutions that prevent crises and operate digitally at all times. It recommends moving towards wider collaboration using better data and building professional networks to innovate integrated solutions for preventing mental illness and crisis, reducing service demand.
(2012) The Gordian Knot for rural and remote mental health services: examinin...Dr. Chiachen Cheng
Invited presentation:
Cheng et al. 2012. Lakehead University Centre for Rural and Northern Health Research (CRaNHR). November 2012. Thunder Bay, ON, Canada.
Practical mental health commissioning explains the changing commissioning environment and how commissioners can make the most of available resources to improve the quality and outcomes of mental health and social care services in their area.
Tobacco Cessation Training for remote counsellors through “Hybrid Learning”Prabhat Chand MD
The document discusses a pilot program called the Virtual Knowledge Network NIMHANS ECHO that aims to leverage technology to provide specialist mental health and addiction care in rural districts. It does this through weekly virtual case discussions and expert lectures connecting a multi-disciplinary team at NIMHANS to remote district counselors. Early results found the program doubled the number of patients who stopped using tobacco and increased access to best practices for over 4,000 patients at a lower cost than traveling to specialist centers.
The NHS Five Year Plan-John stradling presentationmckenln
Sleep apnoea services are overwhelmed by the large number of patients requiring treatment and follow-up. New solutions are needed to manage the growing caseload. Centralized call centers using telemonitoring of CPAP machines and home sleep studies with wireless data transmission could help by allowing remote patient support and diagnosis, reducing the burden on clinic resources. These approaches aim to improve access to care for the many people affected by undiagnosed sleep apnoea.
Update on regional performance of the South West and South East Early Intervention in Psychosis (EIP) programme including the support offered to NHS England to achieve the nationally set standards.
Young people's mental health - where we have been and where we are going - Ma...NIHR CLAHRC West Midlands
Prof Max Birchwood's presentation on early interventions in youth mental health for the CLAHRC WM Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
The document describes the Mental Health Professional Online Development (MHPOD) program, which provides self-directed, online learning for mental health professionals. It has a nationally consistent curriculum across Australia organized into 13 topics areas and 45 specific courses. Evaluation of the pilot program found that over 80% of participants found the learning objectives and materials relevant and would recommend it to others.
Using Feedback and Clinical Outcome Tools to Improve Collaborative Practice a...CYP MH
CYP IAPT 2014 National Conference
This workshop will explore how the use of feedback forms and clinical outcome measures can be used to improve collaborative practice and shared decision making in CAMHS, and how the information can be used to enhance clinical supervision. The workshop will set out some of the uses and evidence base for the use of feedback and outcome forms, explore the uses of the information in clinical practice and in supervision, and draw on delegates’ own experiences and ideas of using feedback and outcome forms to improve clinical practice
Feel augmented mental health program at Open Coffee XCVOpen Coffee Greece
Augmented mental health solutions using continuous remote monitoring and real-time personalized advice can improve outcomes and lower costs compared to traditional treatment methods. By tracking physiological signals and providing 24/7 support, these solutions enable early diagnosis, prevention, and more effective treatment while increasing access and reducing fragmentation of care. This approach is well-suited for high-risk populations with behavioral health issues or mental health as a comorbidity. The startup Feel has developed wearable sensors and mobile apps to provide these augmented mental health services and aims to partner with health insurers to offer their solution.
This presentation provides an overview of the South to South quality improvement collaborative in South Africa. It describes the pilot, demonstration, and rapid scale-up phases of the program. Key achievements include establishing quality improvement teams across 112 health facilities to improve maternal and child HIV/TB outcomes. Challenges around low testing rates were addressed through collaborative learning sessions and Plan-Do-Study-Act cycles. The program aims to build individual and organizational capacity to strengthen the health system and improve health outcomes for priority populations.
The document discusses various stakeholders involved in the healthcare improvement process, including primary care physicians, nurses, dietitians, social support workers, volunteers, and patients themselves. It emphasizes the importance of effective health communication and education programs in empowering patients, improving health outcomes, and reducing healthcare costs through better disease management and prevention of complications. Ongoing evaluation of programs is needed to continuously improve quality of care.
Implementing Post-Graduate Nurse Practitioner and Clinical Psychology Residen...CHC Connecticut
In this final webinar of the Training the Next Generation series, we featured successful postgraduate nurse practitioner and psychology residency programs from around the country. Each presenter shared their unique experiences, successes, and failures of implementing these programs at their health centers.
Implementing psychosocial care into routine practice: making it easyCancer Institute NSW
1. This document discusses implementing a clinical pathway for screening and managing anxiety and depression in cancer patients. It outlines barriers to implementation and strategies to address them.
2. A key barrier is that screening alone does not improve outcomes; a clear clinical pathway and institutional support are needed. The pathway was developed through stakeholder consultation and specifies screening, assessment, referral, and treatment steps.
3. Barriers to implementing the pathway include lack of resources, responsibility issues, staff and patient reluctance. The proposed study will test intensive versus basic strategies to promote pathway uptake, including online training, automated screening/referral systems, and patient/staff educational resources. The goal is to improve psychosocial outcomes for cancer patients.
Improving the physical health of patients with severe mental health illness ...NHS Improving Quality
Improving the physical health of patients with severe mental health illness in primary care, by Rhiannon England, GP Clinical Lead, City and Hackney CCG
Improving mental health through patient and professional partnershipAmarShahELFT
Slides from the session at the International Forum on Quality and Safety in Healthcare 2016 (Gothenburg) - Improving mental health through patient and professional partnerships
Geoff Honnor (ACON) redefines wellness in an evolving HIV epidemic, as well as discussing the context of the UN Goals for reducing HIV transmission 2010-2015 and the ACON response.
This presentation was given at the AFAO Positive Services Forum 2012.
Tele-mentoring on Integrated Mental Health and Addiction for DMHP counsellors...Prabhat Chand MD
This document summarizes a feasibility study of a tele-mentoring program on integrated mental health and addiction for counselors in Chhattisgarh, India. The program utilized Project ECHO's tele-mentoring model to provide virtual training and case discussions between counselors in 11 districts and experts at NIMHANS. Over 6 months: 1) 12 counselors from 11 districts participated in the weekly tele-mentoring clinics, with 10 presenting patient cases. 2) Counselors co-managed 17 total patient cases with NIMHANS experts. 3) The program was found to be a feasible, sustainable, and replicable way to increase counseling capacity and reduce disparities in addiction and mental health treatment in remote areas through
This document discusses developing more collaborative approaches to addressing mental health crises through integrated solutions that prevent crises and operate digitally at all times. It recommends moving towards wider collaboration using better data and building professional networks to innovate integrated solutions for preventing mental illness and crisis, reducing service demand.
(2012) The Gordian Knot for rural and remote mental health services: examinin...Dr. Chiachen Cheng
Invited presentation:
Cheng et al. 2012. Lakehead University Centre for Rural and Northern Health Research (CRaNHR). November 2012. Thunder Bay, ON, Canada.
Practical mental health commissioning explains the changing commissioning environment and how commissioners can make the most of available resources to improve the quality and outcomes of mental health and social care services in their area.
Tobacco Cessation Training for remote counsellors through “Hybrid Learning”Prabhat Chand MD
The document discusses a pilot program called the Virtual Knowledge Network NIMHANS ECHO that aims to leverage technology to provide specialist mental health and addiction care in rural districts. It does this through weekly virtual case discussions and expert lectures connecting a multi-disciplinary team at NIMHANS to remote district counselors. Early results found the program doubled the number of patients who stopped using tobacco and increased access to best practices for over 4,000 patients at a lower cost than traveling to specialist centers.
The NHS Five Year Plan-John stradling presentationmckenln
Sleep apnoea services are overwhelmed by the large number of patients requiring treatment and follow-up. New solutions are needed to manage the growing caseload. Centralized call centers using telemonitoring of CPAP machines and home sleep studies with wireless data transmission could help by allowing remote patient support and diagnosis, reducing the burden on clinic resources. These approaches aim to improve access to care for the many people affected by undiagnosed sleep apnoea.
Update on regional performance of the South West and South East Early Intervention in Psychosis (EIP) programme including the support offered to NHS England to achieve the nationally set standards.
Young people's mental health - where we have been and where we are going - Ma...NIHR CLAHRC West Midlands
Prof Max Birchwood's presentation on early interventions in youth mental health for the CLAHRC WM Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
The document describes the Mental Health Professional Online Development (MHPOD) program, which provides self-directed, online learning for mental health professionals. It has a nationally consistent curriculum across Australia organized into 13 topics areas and 45 specific courses. Evaluation of the pilot program found that over 80% of participants found the learning objectives and materials relevant and would recommend it to others.
Using Feedback and Clinical Outcome Tools to Improve Collaborative Practice a...CYP MH
CYP IAPT 2014 National Conference
This workshop will explore how the use of feedback forms and clinical outcome measures can be used to improve collaborative practice and shared decision making in CAMHS, and how the information can be used to enhance clinical supervision. The workshop will set out some of the uses and evidence base for the use of feedback and outcome forms, explore the uses of the information in clinical practice and in supervision, and draw on delegates’ own experiences and ideas of using feedback and outcome forms to improve clinical practice
Feel augmented mental health program at Open Coffee XCVOpen Coffee Greece
Augmented mental health solutions using continuous remote monitoring and real-time personalized advice can improve outcomes and lower costs compared to traditional treatment methods. By tracking physiological signals and providing 24/7 support, these solutions enable early diagnosis, prevention, and more effective treatment while increasing access and reducing fragmentation of care. This approach is well-suited for high-risk populations with behavioral health issues or mental health as a comorbidity. The startup Feel has developed wearable sensors and mobile apps to provide these augmented mental health services and aims to partner with health insurers to offer their solution.
This presentation provides an overview of the South to South quality improvement collaborative in South Africa. It describes the pilot, demonstration, and rapid scale-up phases of the program. Key achievements include establishing quality improvement teams across 112 health facilities to improve maternal and child HIV/TB outcomes. Challenges around low testing rates were addressed through collaborative learning sessions and Plan-Do-Study-Act cycles. The program aims to build individual and organizational capacity to strengthen the health system and improve health outcomes for priority populations.
The document discusses various stakeholders involved in the healthcare improvement process, including primary care physicians, nurses, dietitians, social support workers, volunteers, and patients themselves. It emphasizes the importance of effective health communication and education programs in empowering patients, improving health outcomes, and reducing healthcare costs through better disease management and prevention of complications. Ongoing evaluation of programs is needed to continuously improve quality of care.
Implementing Post-Graduate Nurse Practitioner and Clinical Psychology Residen...CHC Connecticut
In this final webinar of the Training the Next Generation series, we featured successful postgraduate nurse practitioner and psychology residency programs from around the country. Each presenter shared their unique experiences, successes, and failures of implementing these programs at their health centers.
Implementing psychosocial care into routine practice: making it easyCancer Institute NSW
1. This document discusses implementing a clinical pathway for screening and managing anxiety and depression in cancer patients. It outlines barriers to implementation and strategies to address them.
2. A key barrier is that screening alone does not improve outcomes; a clear clinical pathway and institutional support are needed. The pathway was developed through stakeholder consultation and specifies screening, assessment, referral, and treatment steps.
3. Barriers to implementing the pathway include lack of resources, responsibility issues, staff and patient reluctance. The proposed study will test intensive versus basic strategies to promote pathway uptake, including online training, automated screening/referral systems, and patient/staff educational resources. The goal is to improve psychosocial outcomes for cancer patients.
Perinatal mental health, pop up uni, 9am, 3 september 2015NHS England
This document provides an overview of perinatal mental health issues and services. It discusses:
- Depression is the most common major complication of maternity. Postpartum psychosis has a more rapid and severe onset during pregnancy and the postpartum period compared to other times.
- Suicide is always among the top three causes of maternal death up to 12 months postpartum. Maternal anxiety during pregnancy is linked to increased risk of child mental health problems.
- Only a minority of women with perinatal depression are recognized and receive adequate treatment. Specialist perinatal community services and inpatient mother and baby units are needed.
- National campaigns call for accountability, community perinatal
Geraldine Strathdee and Jen Hyatt: Technology innovation for supporting patie...Nuffield Trust
Geraldine Strathdee, Oxleas NHS Foundation Trust,and Jen Hyatt, Big White Wall, present in a breakout session on using technology to support people with mental health issues at home.
CYP IAPT: Children and Young People's Mental Health Conference 2017NHSECYPMH
The document discusses the long-term benefits of early intervention for children and families. It provides evidence from several long-term studies showing that early intervention programs aimed at improving social-emotional skills, parenting support, and treating childhood mental health disorders can lead to positive outcomes lasting into adulthood, including reduced mental illness, antisocial behavior, substance abuse, and criminal activity as well as increased well-being and life success. The studies find early intervention can generate high cost savings to society through reductions in later public expenditures.
OPTCARE Neuro - Palliative care in patients with Multiple Sclerosis (MS)MS Trust
1) The document discusses a clinical trial called OPTCARE Neuro that is evaluating the effectiveness of short-term integrated palliative care (SIPC) services for people with advanced neurological conditions.
2) Previous research found SIPC improved symptom control, reduced caregiver burden, and saved costs for MS patients. However, more research is needed on how best to deliver palliative care for neurological patients.
3) OPTCARE Neuro aims to determine if SIPC is clinically and cost-effective for a broader range of neurological conditions when provided in multiple centers. The trial has recruited over 200 patients so far from sites across England and Wales.
Risk profiling, multiple long term conditions & complex patients, integrated ...Dr Bruce Pollington
Dr Bruce Pollington web-ex presentation to LTC QIPP programme
Utilising risk profiling, and risk stratification to identify patients with multiple long term conditions requiring complex care through integrated care teams.
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
This document summarizes the key priorities and recommendations from the Five Year Forward View for Mental Health (5YFV MH) report in the UK. The 5YFV MH aims to transform mental health services by 2020 through four priorities: 1) Improving 24/7 crisis care, 2) Integrating physical and mental health care, 3) Promoting good mental health, and 4) Reforming the mental health system. Some recommendations include expanding 24/7 crisis services, increasing access to psychological therapies, and developing children's crisis models. The 5YFV MH dashboard will monitor progress through key metrics on areas like crisis care, perinatal services, and outcomes for people with mental health problems.
The document describes efforts to improve psychosis care through the Treatment and Recovery In PsycHosis (TRIumPH) program. The key points are:
1) A working group was established between Southern Health NHS Foundation Trust and Wessex Academic Health Science Network to improve assessment and treatment for people experiencing psychosis based on understanding gaps in existing care.
2) The program developed and implemented a standardized care pathway across four Early Intervention in Psychosis teams, improving access to assessment and treatment.
3) Feedback from service users, carers, and clinicians informed the work, which aimed to provide more compassionate, holistic, and recovery-focused care.
David Behan, Chief Executive of the Care Quality Commission (CQC), presents findings from 'Cracks in the pathway', CQC's report looking at people's experiences of dementia care as they move between care homes and hospitals.
Rachel Bowes, Inspector, and Ann Macfarlane, Expert by Experience, members of the inspection teams that took part in this programme, went on to share their perspectives on the work of CQC in inspecting health and care services used by people living with dementia.
This presentation was given at the UK Dementia Congress in Brighton on 12 November 2014.
A experiência do Reino Unido sobre as Práticas Avançadas em Enfermagem foi tema da última reunião virtual, que aconteceu nesta quarta (24/11), do ciclo de intercâmbio promovido pela Organização Pan-Americana da Saúde no Brasil, pelo Conselho Federal de Enfermagem (Cofen) e pelo Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem da Universidade de São Paulo/Ribeirão. As palestrantes foram a diretora e a presidente do International Council of Nurses (ICN) do Reino Unido, Melaine Roger e Daniela Lehwaldt, respectivamente. Elas abordaram os avanços globais nas práticas em enfermagem, trouxeram casos do que acontece no Reino Unido e o porquê da importância dos enfermeiros e enfermeiras em práticas avançadas para os sistemas universais de saúde.
Advancing Team-Based Care: Achieving Full Integration of Behavioral Health an...CHC Connecticut
This webinar highlighted ways to fully integrate behavioral health care into primary care. The role of nurses, medical assistants, behaviorists, lay health workers, and primary care providers was discussed along with the use of clinical dashboards and warm hand-offs.
This webinar was presented May 19, 2016 3:00 p.m. Eastern Time
The document discusses a telepsychiatry program implemented in rural nursing homes to improve access to mental healthcare. The program saw success in increasing psychiatric consultations, reducing anti-psychotic drug usage, and gaining acceptance from residents, staff, and psychiatrists. Key benefits included improved quality of care, reduced hospitalizations and transportation costs, and increased psychiatrist productivity through telemedicine. Some technical, administrative, and acceptance challenges were encountered but addressed over time.
The document discusses a webinar series from the Patient Experience Network (PEN) focusing on what is working well in patient experience. The webinars will cover various initiatives and case studies from the UK that have improved patient experience. They will discuss topics like initiatives driven by passion, the importance of organizational support, measuring impact, and partnership working. The webinars are part of promoting the PEN National Awards which recognize excellence in patient experience.
Primary care staff are often not fully trained to provide mental health care. The document discusses improving training for GPs and practice nurses to screen for and treat mental health issues according to clinical guidelines. It also describes new models of integrated primary and community care being piloted, including incorporating mental health support into care for physical health conditions. People with mental health problems often receive poorer physical healthcare and die younger. The models aim to improve care coordination and support mental health alongside other needs.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
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Improving care for people with psychosis in North West London - 10th February, 2015
1. 10th February, 2015
Improving Care for People with
Psychosis in North West London
Phase 2 Launch event
#nwlmentalhealth
2. Dr Geraldine Strathdee
National Clinical Director for Mental Health, NHS England
Setting the national context
#nwlmentalhealth
3. Psychosis care in England :dawn of
a new era
• Major new thinking and scientific discovery
• The 5 year Forward View
• New access standards to evidence based treatments
• We have the information to commission & plan for local areas
• We have the best quality standards in the world
• We have ‘what good looks like; services we can emulate
• We have new learning on how to fast track implementation
• We know how to develop leaders
• Lets get going ……
3
4. England is not alone: this is an international movement
4
5. The British Psychological
Society’s summary of what
we know about the
psychology of psychosis,
and how services need to
change as a result
Downloadable free from
www.understandingpsychosis.net
6. THE CONVERGENCE OF VIEWS ON PSYCHOSIS
• Childhood adversity
• Cultural communities lived
experience & discrimination
• Urbanicity
• Social isolation and alienation
• Intrusive life events
• Institutionalisation
• Cannabis & Kat
• PET studies show that excess striatal
dopamine appears to be a reflection of
risk factors - it is a mechanism, not a
cause
• Molecular genetics demonstrates a
continuum of vulnerability with much
overlap between disorders
High impact factors The gene & brain findings
7. New explanations for how the brain, biology and Social adversity interact in
the causes and impacts in psychosis
child abuse adverse life events sensitise the dopamine system & cause excessive salience
But if the cycle can be broken there should be recovery.
Howes & Murray. Schizophrenia: An integrated socio developmental cognitive model Lancet Dec 2013
Belinda Lennox, EIP lead, Oxford
• Smaller amygdala volumes found for children exposed to different forms of ELS.
• Smaller hippocampal volumes in children who were physically abused or from low
socioeconomic status households.
• Smaller amygdala and hippocampal volumes were associated with greater cumulative
stress exposure and behavioral problems. Hippocampal volumes partially mediated the
relationship between ELS and greater behavioral problems.
8. The most frequent complaint about
mental health professionals was that
they were too pessimistic about the
likely outcome
Schizophrenia Commission, 2014
9. • 65% had no psychotic symptoms at 10 years
• 46% had had none for >2 years (40% of those diagnosed as having Schizophrenia)
Of these who had no symptoms 56% had received medication
in previous two years
AESOP Study -387 patients followed-up ten years
after a first presentation with psychosis
Morgan et al. Psychol Med 2014;44:407–419
10. No-one can tell for sure what has
caused a particular person’s
problems. The only way is to sit down
with them and try and work it out.
The opportunity to talk things through
in this way is vital, but surprisingly rare.
Psychological therapy is very helpful for many people.
NICE recommends that it should be offered to everyone
with a diagnosis of psychosis or schizophrenia.
However currently most people are unable to access it.
Services need to change radically. We also need to invest
much more in prevention by attending to inequality and
child maltreatment. Concentrating resources only on
treating existing problems is like mopping the floor while the
tap is still running.
11. 11
5 Year Forward view Lifespan mental health
Being Born well Best early years Living and working well Growing older well Dying well
Building positive
mental health in
individuals and
communities
through raising
political & public
awareness and
reduced stigma
Prevention of
mental ill
health
through
addressing the
fundamental
causes
Improving
access to
timely, effective
services for the 16
mental health
conditions
maximizing the
potential of the digital
revolution
Transformation
of services to deliver
value, better outcomes,
quality & personalized
Right Care
Building a
sustainable
future
Of
Leaders,
intelligence & and
improvement
programmes
2015-2020
12. The 15/16 Access & Waiting Time Standards
12
By April 2016:
• 75% of people referred to the Improved Access to Psychological Therapies
programme will be treated within 6 weeks of referral, and 95% will be
treated within 18 weeks of referral.
• More than 50% of people experiencing a first episode of psychosis will be
treated with a NICE approved care package within two weeks of referral.
And there will be:
• £30m targeted investment on effective models of liaison psychiatry in a
greater number of acute hospitals. Availability of liaison psychiatry will
inform CQC inspection and therefore contribute to ratings.
13. Psychosis care in England :dawn of a new era
• Increasing access to evidence based treatments (early) and
transforming our current system
• We have the information to commission & plan for local areas
• We have the best quality standards in the world
• We have ‘what good looks like; services we can emulate
• We have new learning on how to fast track implementation
• We know how to develop leaders
• We have services that are delivering excellent care, BUT the
variation is
13
14. What do the mental health NICE guidelines say
There are 7 core effective care interventions
1. Right information
2. Right Physical health care
3. Right Medication
4. Right Psychological therapies
5. Right Rehabilitation/ training for employment
6. Right Care plan addressing housing, healthcare, self management
7. Right crisis care
In the Right least restrictive setting by the Right trained, supervised team
1
Mental health : Is the problem that we have no evidence or value based guidance?
Mental health has over 100 NICE Health Technology appraisals, NICE
guidelines, Public health related guidelines and Quality standards…..
The problem is not lack of guidance
The problem is that we have not focused on how we learn and disseminate from
those that can and have implemented
We have not communicated this to our Boards
The standard of Care has unacceptable major variation across England
16. Have you ever been offered Cognitive Behavioural
Therapy (CBT)?
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
41
42
39
21
24
50
65
09
20
17
25
33
49
45
48
06
08
44
02
07
67
12
27
31
59
51
60
05
04
36
01
16
TNS
69
54
61
29
72
71
10
03
13
19
56
53
11
28
46
15
52
74
73
47
64
43
70
66
38
35
37
30
34
63
26
68
Source: Audit of practice
Yes No, but was available No, as CBT was not available Not known Yes, was taken up
17. Mental health system of care:
what can be done to build personalized, recovery orientated care & reduce suicide at every
level
High
secure
beds
Medium
secure beds
Low secure beds
Intensive rehabilitation
closed unit
for complex dual diagnosis
Open rehabilitation units
Locally authority Residential rehabilitation
Supported accommodation with care package
Own tenancy plus personalized budget
24/7 Assertive outreach/ community forensic team
multi agency teams
24/7 Assertive outreach /rehabilitation & recovery,
multiagency teams
24/7 Assertive outreach /rehabilitation &
recovery multi agency teams
Rehabilitation / recovery team:
multi agency
Rehabilitation / recovery team
CMHT/ Enhanced primary care SMI
with 3rd sector outreach
CMHT/ Enhanced primary care SMI
with 3rd sector outreach
Design Principle :It is vital to understand that in mental health our ‘technology’ and ‘care model design principle’ is that in
order to provide safe, NICE concordant , efficient services, we need proven effective care teams to link with beds
In mental health we are expert at using case managers to triage all admissions & work early on the discharge plans
The beds The teams
18. Another way to say communities are what
makes the world a place we want for
ourselves and our children work
18
19. The top 8 key implementation fast track
success techniques
1. Board to floor commitment
2. Clinical leadership by top medics and nurses
3. Proper sophisticated programme management
4. Feed back progress to each clinical team so they can own need to
improve
5. Commission and employ GPs to come on to wards to help immediate
actions but also to train and supervise MH staff ( mega fast improvement
and smoke free wards with this technique)
6. Use of templates for both primary and secondary care : like any QOF
activity …clinicians decision support tools
7. Work force training , preferably practice nurses and ward nurses and con
together
8. CQC & Monitor regulatory emphasis
20. Phoebe Robinson
Programme Manager, Imperial College Health Partners
Beverley
Expert by experience and Imperial College Health Partners steering group
(Phoebe and Beverley’s Prezi presentation is available online to view at
http://prezi.com/duh75qzcnolz/?utm_campaign=share&utm_medium=copy&rc=
ex0share)
(The next seven slides are the source data for the Prezi presentation delivered at
the event)
Improving the psychosis
pathway in North West
London – our journey
#nwlmentalhealth
21. We used a rigorous method to identify
psychosis patients in health system data
Identify by
ICD-10
Diagnostic
Codes
Identify by
MH PbR
Clusters
Identify by
Lived
Experience
(HONOS)
HES
MHMDS
Anonymised data
across 3 years
Apr 2011 - Mar 2013
Mental Health Care
Secondary and
Community
Physical Health Care
A&E, Inpatient
and Outpatient
Identify
users with
psychosis*
Raw data licensed by Janssen Healthcare Innovation from the Health
and Social Care Information Centre, 2013
21
*Approach validated by clinicians in multiple AHSNs
22. 22
Combining the 3 approaches gives us a
“user-by-user” count of those with psychosis
Source: MHMDS 2010-2013 (3 years)
Psychosis using defined criteria*
Other
mental
health
23,937
(29%)
3 years*
Unknown*
81,643
35,067
22,639
Psychosis
Source: ICHP user data contained in HES and MHMDS datasets licensed from
HSCIC, 2014
*These service users belong to ICHP Lower Super Output Areas but have no valid diagnostic,
cluster or HONOS codes; It is difficult to differentiate among errors, transient users or “not
yet classified” patients
2,520
(29%)
2,996
(38%)
Hillingdon
6,495
8,616
7,839
Hounslow
2,948
(45%)
4,314
(44%) 2,698
(38%)
Hammersmith
and Fulham
6,232
Harrow
7,1017,259
Central
London
2,678
(43%)
Brent
5,589
Ealing
9,873
3,492
(48%)
2,291
(41%)
West
London
CCGs: Latest recorded across 2010-11 to 2012-13
23. This allows us to look for patterns in user
demographics…
23
0
500
1,000
1,500
2,000
2,500
3,000
3,500
20-
24
35-
39
25-
29
40-
44
15-
19
45-
49
30-
34
50-
54
60-
64
55-
59
90+85-
89
80-
84
75-
79
70-
74
65-
69
Service users in
NW London CCGs
Psychosis
Other mental health
*Age in 2012-13
24. … and identify areas with highest need
24
Top 25 GP practices
by number of
service users with
psychosis
(over 100 users
each)
25. We are able to build a picture of demand for
mental health care in our region…
25
Users with psychosis need 4 times as
many HCP contacts (healthcare
professional contacts) as users with
other mental health conditions
Users with psychosis need over 50%
more inpatient bed days per user
per year as users with other mental
health conditions
29%
72%
89%
100%
Inpatient Ward
bed days
994,729
Healthcare Professional
contacts
1,406,530
Service users 81,643
Other mental health
Psychosis
Unknown
67
23
39
6
Inpatient bed days
per user per year
HCP contacts
per user per year
Charts cover activity across 2 years;
they do not include all activity at Mental Health Trusts
26. … and measure the impact of our service
users on the rest of the health care system
26
8,966
Psychosis users needing
A&E (anytime in 3 years)
Psychosis users needing
Acute Trust Emergency admissions
(anytime in 3 years)
16,243
23,937Psychosis service users (3 years)
5
8,875
A&E attendances by
users with psychosis per year (3 yr avg)
28,447
Inpatient emergency admissions
by users with psychosis per year (3 yr avg)
47,692
Inpatient emergency bed days
by users with psychosis per year (3 yr avg)
Average length of stay per admission (days)
67% of Psychosis users visit
A&E and 37% get emergency
admissions to Acute Trusts
With unit cost assumptions of
£108 per A&E attendance and
£255 per Acute Trust bed day,
we estimate NW London
spends over
£3 million on A&E
attendances and nearly
£12 million on Acute Trust
beds (emergency only) for
psychosis patients
27. 27
Identifying psychosis users within MHMDS
ADD Based on ICD: Select all those with ICD-10 codes F20 to F29 in the Primary or
Secondary Diagnosis fields, using all relevant Events (PDIAG or SDIAG Events) in 2 years
ADD Based on Clustering: Select all those with Cluster values from 10 to 17 in the Cluster
field, using the highest PbR Cluster value across all relevant Events (MHCT Events) in 2
years
ADD Based on Honos: Select all those with a Honos Question 6 (hallucinations and
delusions) score between 1 and 4 in the “original” Honos questionnaire (working age
adults), using all relevant Events (HNS Events) in 2 yrs; Also select those with these scores
for Honos CA (children/adolescents) Question 7 or Honos 65+ (elderly) Question 6.
REMOVE For those selected based on ICD-10 alone (and not by any other method):
Remove those with ICD-10 codes F21, F23-24, F26-29 (leaving only F20, F22 and F25)
REMOVE For those selected based on PbR Cluster alone (and not by any other method):
Remove PbR Cluster 15 (severe psychotic depression)
REMOVE For those selected based on Honos Q6 score alone (and not by any other
method): Find the ICD-10 codes and remove those with ICD-10 codes F31 (bipolar
disorders) /F60 (personality disorders)
… with a similar approach for 2010-11 data (without Clusters)
REVISED Selection criteria using Events in 2011-12/2012-13 data…
28. Professor David Kingdon
Professor of Mental Health Care Delivery, University of
Southampton
Taking the pathway forwards
#nwlmentalhealth
30. Preventative
strategies
Collaborative
assessment of
needs
Effective
intervention
Intelligent
guidance
Responsive
funding
Psychosis &
complex trauma
(‘BPD’)
programmes
Systematic
regular &
responsive to
service user
‘What’ & ‘when’
condition-based
care pathways
Outcome-focused
reliable and
relevant
information
Effective
interventions &
community care
rewarded
Integration of
psychosis (EIP) &
complex trauma
initiatives
HoNOS,
WEMWBS
DIALOG F&F
Specific scales
Imperial &
Wessex Pathways
& intervention
coding
National Mental
Health Intelligence
Network (incl.
MDLDS+)
Individual and
stratified
personal
budgets
31. Pre-psychosis Early psychosis Persistent psychosis Recovery
Acute care pathway
EIP pathway Assertive outreach pathway
Community mental health pathway
Collette’s journey
Social
services
care
Early
intervention:
care
coordination &
medication
Safety &
rehabilitation:
hospital
medication&
DBT
Independence:
support, reduced
medication &
CBTP
Recovery-
self-
manageme
nt
32. 'More than 80% of patients with their
first episode of psychosis will recover
…. less than 20% will never have
another episode.
Quoted by Marco M Picchioni, Clinical Lecturer in
psychiatry and Robin M Murray, Professor of Psychiatry (2004)
Robinson D, Woerner MG, Alvir JMJ, Bilder R, Goldman R, Geisler S, et al.
Predictors of relapse following response from a first episode of schizophrenia
or schizoaffective disorder. Arch Gen Psychiatry 1999;56:241-7.
36. We can also benchmark general outcomes
and care standards against peer CCGs
Sources: Commissioning for Value Datapack, NHS Rightcare, Nov 2014
Figures show
performance on a
few key indicators,
when compared to
10 “similar” CCGs
37. 37
Basic Data
Incidence and prevalence of people with psychotic disorder
Number of people in services with diagnosis of psychosis with co-existing substance
misuse &/or complex trauma (BPD) (from diagnostic coding & HONOS/MCHT)
Access to interventions
Timeliness – to CBT, FI, ISP
Duration of untreated psychosis
Delayed discharge
Early access to services
Timeliness
EIP referrals/predicted incidence
No and % who access Acute Care Team
(CRHT compared to admissions)
Length of stay with ACT
MHA detention rates
A&E attendances
Section 136 assessments
Contact with Criminal Justice System
Emergency admissions to hospital
Physical health
% patients who have a health
passport at 6 month review
Admissions to general hospital
Physical health checks (QOF) &
intervention (CQC) (MHLDDS)
Outcomes
Change in symptoms: HoNOS, DIALOG +/- DRAKE, PHQ9, GAD7, Mania scale
Changes in Hope Agency and Opportunity (PROM): Accommodation & Employment
Carer and family support
Recovery & relapse rates at 6 months, 1 & 2 years
Self-harm/ suicide /premature mortality
39. Psychosis Pathways
– can efficiently address service user need
– support staff implementing evidence-based
interventions through local ownership
– provide incentives for prevention and least
restrictive care
– produce persistently positive outcomes and
recovery
40. Dr Bill Tiplady - Acute Services Lead Psychologist, Central And North West
London NHS Foundation Trust
Professor Thomas Barnes - Professor of Clinical Psychiatry, Imperial College
Professor David Kingdon - Professor of Mental Health Care Delivery, University of
Southampton
Beverley – Expert by experience, Imperial College Health Partners steering group
Phoebe Robinson – Programme Manager, Imperial College Health Partners
Panel discussion: North West
London pathway development
#nwlmentalhealth
41. Panel 1 – Developing the Psychosis Pathway
1. How can we continue to iterate and develop the pathway and make it a living
document?
2. Are there any parts of the pathway that are more or less developed and why?
3. What are the key ways in which ICHP can use this pathway to support
improved outcomes for people with psychosis?
4. What have been the key learnings from the project process?
#nwlmentalhealth
42. Steve Shrubb
Chief Executive, West London Mental Health NHS Trust
Collaborating across North
West London and beyond
#nwlmentalhealth
43. Steve Shrubb - Chief Executive, West London Mental Health NHS
Trust
Dr Shanaya Rathod – Mental Health Clinical Lead, Wessex AHSN
Dr Geraldine Strathdee – National Clinical Director for Mental
Health, NHS England
Phoebe Robinson – Head of Project Development and
Performance, Imperial College Health Partners
Panel discussion:
Collaboration across North
West London and beyond
#nwlmentalhealth
44. Panel 2 – Collaborating to embed and spread
our work
1. What have been the main benefits of working together the Imperial College
Health Partners to deliver this work?
2. How can we look to spread this innovative work more widely?
3. What can AHSNs learn from this mental health project that could be used to
drive change in other parts of their work programme?
#nwlmentalhealth
46. Session 1: What does a shared journey to delivery of the North
West London psychosis pathway look like? (Dawson Room)
Session 2: Collaborative working across AHSNs on Mental Health
(Seacole Room)
Session 3: Early intervention in psychosis – next steps for North
West London (Wild and Hindle Rooms)
Workshops
#nwlmentalhealth
The data for Figure 25 are taken from Q42 and Q44 of the audit of practice tool.
The number of cases included in this analysis is 5,608.
There were no cases where Q42 was not answered and 102 cases where Q44 was not answered.
Prevalence – for estimates of SMI, Liverpool is at the top end – 4th line is an actual count based on GP QoF it is near the top