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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Pathways through care of severely mentally ill individuals experiencing multiple public crisis events: a qualitative description

Authors: Mariëtte J. Hensen, Liselotte D. de Mooij, Jan Theunissen, Jack Dekker, Michael Willemsen, Jeroen Zoeteman, Jaap Peen, Matty A. S. de Wit

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Patients experiencing severe mental illnesses (SMI) need continuing support and remain vulnerable in many domains. Crisis interventions and compulsory admissions are common, causing a huge burden on police, health workers, the community and patients. The aim of this retrospective case-file study is to determine profiles of SMI-patients and their pathways through care among those experiencing multiple public crisis events.

Methods

Data from a larger study of 323 SMI-patients in Amsterdam were used. These data were linked to data of the public mental health care (PMHC) in order to identify persons that experienced crisis interventions (CI’s) between January 2004 and November 2012. The cut-off point for inclusion in the study population was set on three CI’s, resulting in a group of 47 SMI-patients. PMHC and mental health care (MHC) data were linked in order to identify profiles in patterns of care. Qualitative content analysis was used to gather and analyze chronological timelines.

Results

Three profiles were identified: SMI-patients with CI’s during continuous MHC, SMI-patients with CI’s after discharge and SMI-patients with CI’s during unstable MHC. For each profile events prior to, during and after a CI were identified.

Conclusions

PMHC and MHC can possibly identify cases with a high risk of CI’s and predict these events based on the results of this study. CI’s seem inevitable for a group of SMI-patients in care but they do not only require acute psychiatric care. The collaboration between MHC, PMHC and police could be further developed in a quick and effective triage in order to tackle the complexity of problems of the SMI-patients.
Literature
1.
Mulder CL, Ruud T, Bahler M, Kroon H, Priebe S. The availability and quality across Europe of outpatient care for difficult-to-engage patients with severe mental illness: a survey among experts. Int J Soc Psych. 2014;60(3):304–10.CrossRef
2.
Delespaul PH en de consensusgroep EPA. Consensus over de definitie van mensen met een ernstige psychische aandoening (EPA) en hun aantal in Nederland (in Dutch). Tijdschr Psychiatr. 2013;55(6):427–38.
3.
Ruggeri M, Leese M, Thornicroft G, Bisooffi G, Tansella M. Definition and prevalence of severe and persistent mental illness. Br J Psychiatry. 2000;177:149–55.CrossRefPubMed
4.
Peen J, Theunissen J, Duurkoop P, Kikkert M, Dekker J. Na de extramuralisering; een retrospectief onderzoek naar omvang en zorggebruik van de groep chronische patiënten in de Amsterdamse GGZ (in Dutch). Tijdschr Psychiatr. 2011;53(8):509–17.PubMed
5.
Dekker J, Theunissen J, Van R, Kikkert M, van der Post L, Zoeteman J, Peen J. Are long-term psychiatric patients causing more crisis consultations outside office hours in mental health care? Int J Soc Psych. 2012;59(6):555–60.
6.
Oliver JPJ, Huxley PJ, Priebe S, Kaiser W. Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Soc Psych Psychiatr Epidemiol. 1997;32:76–83.CrossRef
7.
8.
Jones K. Addressing the needs of carers during ealy psychosis. Early Interv Psychiatry. 2009;3(suppl):S22–6.CrossRefPubMed
9.
McNeil DE, Binder RL. Psychiatric emergency service use and homelessness, mental disorder, and violence. Psychiatr Serv. 2005;56(6):699–704.CrossRef
10.
Theunissen JR, Kikkert MJ, Duurkoop WRA, Peen J, Resnick S, Dekker JJM. Vermaatschappelijking van de chronische patiënt in de grote stad (in Dutch). Amsterdam; Arkin and Ingeest Mental Health Care: 2008.
11.
van de Post L. IBS admission as an outcome. Factors predicting the probability of patients qualifying for compulsory emergency admission. Amsterdam: Thesis Free University; 2012.
12.
Ngamini-Ngui A, Fleury MJ, Moisan J, Grégoire JP, Lesage A, Vanasse A. High users of Emergency Departments in Quebec among patients with both Schizophrenia and a substance use disorder. Psych Serv. 2014;65(11):1389–91.CrossRef
13.
Paradis M, Woogh C, Marcotte D, Chaput Y. Is Psychiatric Emergency Services (PES) use increasing over time? Int J Mental Hlth Systems. 2009;3:3.CrossRef
14.
Audini B, Duffett R, Lelliott P, Pearce A, Ayres C. Over-occupancy in London’s acute psychiatric units – fact or fiction. Psych Bull. 1999;23:590–4.CrossRef
15.
Bernardt C, van Oenen FJ, Dekker J, Mulder W. Spoedeisende psychiatrie in Amsterdam. De e van een psychiatrische eerstehulppost (in Dutch). Maandblad Geestelijke Volksgezondheid. 2006;61(10):827–37.
16.
van den Brink RH, Broer J, Tholen AJ, Winthorst WH, Visser E, Wiersma D. Role of the police in linking individuals experiencing mental health crises with mental health services. BMC Psychiatry. 2012;12:171.CrossRefPubMedPubMedCentral
17.
Mulder CL, Koopmans GT, Selten JP. Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to the Netherlands. Br J Psychiatry. 2006;188:386–91.CrossRefPubMed
18.
Vinkers DJ, de Vries SC, van Baars AW, et al. Ethnicity and dangerousness criteria for court ordered admission to a psychiatric hospital. Soc Psychiatry Psychiatr Epidemiol. 2010;45:221–4.CrossRefPubMed
19.
Wierdsma AI, van Baars AW, Mulder CL. Psychiatric past history and health care after compulsory admission. Care use as an indicator of the quality of care for patients in compulsory care in Rotterdam (in Dutch). Tijdschr Psychiatr. 2006;48(2):81–93.PubMed
20.
Wierdsma A, Mulder C, de Vries S, Sytema S. Reconstructing continuity of care in mental health services: a multilevel conceptual framework. J Health Serv Res Policy. 2009;14(1):52–7.CrossRefPubMed
21.
Stobbe J, Wierdsma AI, van Beest RH, et al. Drop-out from after-care following compulsory hospitalisation--how serious is the problem? (in Dutch). Tijdschr Psychiatr. 2009;51:801–12.PubMed
22.
de Vries SC, Wierdsma AI. Exploring continuity of care in patients with alcohol use disorders using time-variant measures. Eur Add Res. 2009;15:19–24.CrossRef
23.
24.
25.
26.
Dekker JJ, Theunissen J, Van R, Peen J, Duurkoop P, Kikkert M. Victimization of patients with severe psychiatric disorders: prevalence, risk factors, protective factors and consequences for mental health. A longitudinal study. BMC Public Health. 2010;10:687.CrossRefPubMedPubMedCentral
27.
Thompson EE, Nieghbors HW, Munday C, Trierweiler S. Length of stay, referral to aftercare, and rehospitalization among psychiatric inpatients. Psych Serv. 2003;54(9):1271–6.CrossRef
28.
Crawford MJ, de Jonge E, Freeman GK, Weaver T. Providing continuity of care for people with severe mental illness- a narrative review. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):265–72. 26.CrossRefPubMed
29.
Bruffaerts R, Sabbe M, Demyttenaere K. Emergency psychiatry in the 21st century: critical issues for the future. Eur J Emerg Med. 2008;15:276–8.CrossRefPubMed
Metadata
Title
Pathways through care of severely mentally ill individuals experiencing multiple public crisis events: a qualitative description
Authors
Mariëtte J. Hensen
Liselotte D. de Mooij
Jan Theunissen
Jack Dekker
Michael Willemsen
Jeroen Zoeteman
Jaap Peen
Matty A. S. de Wit
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0787-8

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