Mental Health Care Delivery Research Articles

Advancing behavioral health and social justice: A century of global interdisciplinary progress in psychiatric mental health nursing.

This article explores the century-long history of psychiatric nursing through the dual lens of behavioral health and social justice, emphasizing the pivotal role of psychiatric nurses in mental health. Focused on the contributions of nurse members and leaders from the American Orthopsychiatric Association (later known as the Global Alliance for Behavioral Health and Social Justice), the article will provide a comprehensive timeline that showcases the evolution of the field. It will discuss diverse aspects of psychiatric nursing, including role development, work with children and families, minority populations, integrated care, mental illness prevention, mental health promotion, community mental health, and global mental health nursing. Moreover, the article will identify and examine barriers that have historically hindered, and continue to impact, the practice of psychiatric nursing and the delivery of quality mental health care universally. The influence of culture and stigma on mental health and the profession will be discussed, shedding light on how these factors have shaped psychiatric nursing. The article will delve into the future direction of the field, emphasizing the growing importance of global mental health, integrated care, workforce development, and the continued need for interdisciplinary collaboration. Through this exploration, the article aims to offer insights into the significant progress and enduring challenges faced by psychiatric nursing, ultimately underscoring its indispensable role in advancing mental health and social justice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Risk factors and strategies for relapse prevention among individuals living with serious mental illness in South Africa: Qualitative inquiry from patients' and caregivers' perspectives.

Relapse among individuals with serious mental illnesses in resource-limited contexts, including South Africa, is a significant concern. To date, the risks for relapse among this population is well documented, but little is known about prevention strategies to reduce its occurrence in these resource-limited settings. Therefore, this qualitative study explores the risk factors and strategies for relapse prevention from the patients' and caregivers' perspectives. We conducted audio-recorded face-to-face in-depth interviews to capture the lived experience of relapse of inpatient study participants with serious mental illness (N = 24) at a public specialized psychiatry hospital in South Africa and their caregivers (N = 6). We conducted an inductive thematic analysis with two pre-specified themes (risk factors for relapse and strategies for prevention), with the codes devised from the data. Six sub-themes were identified from the analysis within the two pre-specified themes(Risk factors and strategies for relapse prevention): personal-related, family-related, and health system-related risk factors and strategies for preventing relapse, respectively. To highlight some essential findings, the importance of motivation for drug adherence, family involvement, and availability of anti-psychotic drugs in public health care were noted. More importantly, this study identified important cultural complexities where traditional healers play a significant role in some cultural understanding and treatment of mental illness, affecting medication adherence. This study calls for people-centered mental health care delivery in a public health system that listens to the voice of concern, including cultural challenges, and implements meaningful support that matters most to the patient and their family/caregivers.

TikTok and the changing landscape of therapeutic digital spaces of care

The COVID-19 pandemic increased the prevalence of mental health issues across the U.S. While therapists have been able to shift to telehealth delivery of mental healthcare, there has been a recent increase in the number of therapists on social media. Social media as a site of engagement has been feared by systems of power which regulate the ethics of therapists, and despite the influx of therapists online, these ethical guidelines remain under researched. Feminist geographers have explored theories and practices of care within different spaces, and especially in the wake of the pandemic, there is a need to conceptualize how therapists provide care within digital spaces and how this affects the delivery of mental healthcare. This study sampled 100 videos on the social media site, TikTok, for a content analysis using the hashtag #therapistsoftiktok. The videos were analyzed to uncover themes relating to how therapists provided care to the viewer. Four themes emerged in the analysis and showed that therapists provided care both directly and indirectly to the viewers. Direct care included providing psychoeducation to the viewers and offering validations/affirmations. Indirect care included normalizing therapy and humanizing the therapist, and these videos were interpreted to focus more on relationship building and addressing viewers' anxieties about therapy and therapists, which may allow viewers to engage in therapy in the future. This study identified ways that therapists are engaging in care work digitally, despite the admonishments and warnings from professional therapy boards. Ethical concerns still abound, as intimacy and relationship-building can occur across digital spaces. However, rather than simply abstaining from social media, therapists are engaging in resistant and creative ways to provide care and destigmatize mental health issues to a global audience.

Cancer care for people with significant mental health difficulties (SMHD) - patient perspectives

Objectives People with significant mental health difficulties (SMHD) experience inequities in cancer care. This study aims to deepen understanding of cancer care for individuals with SMHD. Method We conducted semi-structured interviews with seven individuals with SMHD regarding their experiences accessing and engaging with cancer care from August 2021 to February 2022. Data were analyzed using thematic analysis where both inductive and deductive coding was adopted through the lens of the socio-ecological model (SEM) as a theoretical framework. Results The main themes included intrapersonal, interpersonal and organizational barriers and facilitators to care with a specific focus on modifiable factors related to cancer care delivery. Conclusion This study provides further evidence for promoting collaborative mental health and cancer care delivery to prevent inequalities in cancer care for patients with SMHD. Practice implications Adopting an interdisciplinary, team-based approach to cancer care and help with patient navigation across services are potential factors in improving cancer care for individuals with SMHD.

Primary care provider perspectives on virtual and in-person depression management during the COVID-19 pandemic.

During the COVID-19 pandemic, primary care providers (PCPs), nurses, and integrated mental health specialists continued to collaboratively manage depression among patients using both in-person and virtual (i.e., hybrid) modalities. Few studies have characterized how hybrid services are currently delivered within interdisciplinary primary care teams. This study aimed to understand frontline PCPs' perspectives on providing hybrid virtual and in-person depression care during the pandemic. From September to November 2020, 12 semistructured individual interviews focused on depression management were conducted with PCPs in two Veterans Health Administration (VA) clinics in Los Angeles, which resumed in-person services while balancing rising COVID-19 cases. Interviews were audio-recorded, transcribed, and coded for depression management patterns. Themes were derived using a team-based constant comparative analytic approach. The pandemic and subsequent expanded use of virtual care necessitated clinic adaptations to depression assessments and procedures. PCPs perceived increased depression and anxiety among patients with existing psychiatric conditions, attributed to social distancing and isolation restrictions. They expressed acceptance of virtual care modalities for patients' depression management. PCPs did not perceive a delay in mental health care delivery in the shift to virtual care but noted the possibility of patients being lost to follow-up. During the pandemic, there has been heightened PCP concern for patients' emotional well-being and adaptations of clinic processes to meet needs for depression care. While PCPs were optimistic about new virtual care options for depression management, virtual care transfers remained poorly defined and the extent to which patient care experiences and health outcomes have been disrupted remains unknown. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Introduction to Generative Artificial Intelligence in Mental Health Care: Considerations and Guidance.

This paper provides an overview of generative artificial intelligence (AI) and the possible implications in the delivery of mental health care. Generative AI is a powerful technology that is changing rapidly. As psychiatrists, it is important for us to understand generative AI technology and how it may impact our patients and our practice of medicine. This paper aims to build this understanding by focusing on GPT-4 and its potential impact on mental health care delivery. We first introduce key concepts and terminology describing how the technology works and various novel uses of it. We then dive into key considerations for GPT-4 and other large language models (LLMs) and wrap up with suggested future directions and initial guidance to the field.

Prenatal and postpartum depression diagnosis in a large health system: prevalence and disparities

Background/objectives/introduction Depression during pregnancy or postpartum carries the same risks as general depression as well as additional risks specific to pregnancy, infant health and maternal well-being. The purpose of this study is to document the prevalence of depression symptoms and diagnosis during pregnancy and in the first 3 months postpartum among a cohort of women receiving prenatal care in a large health system. Secondarily, we examine variability in screening results and diagnosis by race, ethnicity, language, economic status and other maternal characteristics during pregnancy and postpartum. Patients/materials and methods A retrospective study with two cohorts of patients screened for depression during pregnancy and postpartum. Out of 7807 patients with at least three prenatal care visits and a delivery in 2016, 6725 were screened for depression (87%) at least once during pregnancy or postpartum. Another 259 were excluded because of missing race data. The final sample consisted of 6523 prenatal care patients who were screened for depression; 4914 were screened for depression in pregnancy, 4619 were screened postpartum (0–3 months). There were 3010 screened during both periods who are present in both the pregnancy and postpartum cohorts. Depression screening results are from the Patient Health Questionnaire (PHQ-9) and diagnosis of depression was measured using ICD codes. For patients screened more than once during either time period, the highest score is used for analysis. Results Approximately, 11% of women had a positive depression screen as indicated by an elevated PHQ-9 score (>10) during pregnancy (11.3%) or postpartum (10.7%). Prevalence of depression diagnosis was similar in the two periods: 12.6% during pregnancy and 13.0% postpartum. A diagnosis of depression during pregnancy was most prevalent among women who were age 24 and younger (19.7%), single (20.5%), publicly insured (17.8%), multiracial (24.1%) or Native American (23.8%), and among women with a history of depression in the past year (58.9%). Among women with a positive depression screen, Black women were less than half as likely as White women to receive a diagnosis in adjusted models (AOR 0.40, CI: 0.23–0.71, p = .002). This difference was not present postpartum. Conclusions Depression symptoms and diagnoses differ by maternal characteristics during pregnancy with some groups at substantially higher risk. Efforts to examine disparities in screening and diagnosis are needed to identify reasons for variability in prenatal depression diagnosis between Black and White women. Key messages Women who were young, single, have public insurance, and women who identify as multiracial or non-Hispanic (NH) Native American were most likely to have a positive depression screen or a diagnosis for depression. After adjustment for confounders, NH Black women with a positive depression screen were about half as likely to have a diagnosis of depression during pregnancy as NH White women. Awareness of the differing prevalence of depression risk screening results, diagnoses and potential for variation in diagnosis may identify opportunities to improve equity in the delivery of essential mental health care to all patients.

Knowledge, awareness, and practices of telehealth: A cross-sectional study on psychiatric nurses in Jeddah City

The emergence of telehealth stands at the forefront of healthcare evolution, particularly in mental healthcare delivery. The efficacy and adoption of this modality, however, are largely contingent upon the awareness and competence of professionals in the field. This study sought to investigate the awareness, attitudes, and proficiency of psychiatric nurses in Jeddah City regarding telehealth, providing insights into its applicability and potential challenges in the region. Findings indicated that a significant 81% of psychiatric nurses in Jeddah City are familiar with telehealth. Attitudinally, the majority viewed telehealth favorably, with an overall mean attitude score of 3.7 ± 0.91 on a 5-point scale. Proficiency-wise, foundational digital skills were robust, with 72.4% showcasing medium to professional competence in basic computing tasks. However, more specialized telehealth-specific tasks identified areas for enhancement, such as installing software where only 40.4% demonstrated professional or medium competency. Psychiatric nurses in Jeddah exhibit a strong foundational readiness for the integration of telehealth, underscored by their considerable awareness and largely positive attitudes. Targeted training, especially in niche digital areas, is paramount to ensure telehealth's seamless integration and efficacy in mental healthcare delivery.

The Impact of COVID-19 on Psychiatric Acuity in a Community Psychiatric Hospital.

The COVID-19 pandemic has had extensive impacts on mental health care delivery. Anecdotal observations of inpatient care teams at Pennsylvania Psychiatric Institute suggested increased patient acuity during the pandemic. The authors found no consensus definition for measuring psychiatric acuity in the literature. We performed an interrupted time series analysis to identify whether COVID-19 was associated with changes in several hospital parameters that might reflect our patients' access to psychiatric services and acuity. We found increases in inpatient parameters for length of stay, rates of involuntary admissions, and the incidence of restraints, seclusion, and 1:1 observation orders. Observing these increasing trends can inform mitigation efforts to improve the quality of mental health care treatment and care delivery. We suggest the use of these metrics for objective measurements of psychiatric acuity.

A mixed-methods pilot examination of Montana, North Dakota nurse practitioner telepresence behaviors through web-camera eye-tracking and qualitative descriptive interviews.

The use of telehealth for mental health-related encounters has increased exponentially since the COVID-19 pandemic. However, little is known how nurse practitioners (NPs) in rural areas establish connection and presence with patients through telehealth. To leverage web-camera eye-tracking technology coupled with qualitative interviews to better understand rural NPs' perceptions, beliefs, experiences, and visual cues of connection and presence during mental health-related telehealth encounters. This mixed-methods study employed web-camera eye-tracking technology to measure eye contact, facial/body movements with microexpressions, and auditory expressions during a simulated mental health-related telehealth visit. A qualitative descriptive methodology was used to conduct semistructured interviews with participants regarding utilization of telehealth in rural mental health care delivery. Sticky software, R, and STATA were used for the quantitative eye-tracking and demographic data analyses. Qualitative findings were analyzed using inductive thematic analysis. Ten NPs participated in the eye-tracking aspect of the study; among them, three completed semistructured interviews. Eye-tracking areas of interest were significant for the number of fixations ( p = .005); number of visits ( p < .001); time until notice ( p < .001); and time viewed ( p < .001). The category Workflow had the greatest number of thematic units ( n = 21) derived from semistructured interviews. Although an accessible means of obtaining data, web-camera eye tracking poses challenges with data usability. This prompts further attention to research, optimizing the telehealth milieu to lessen patient and provider frustrations with technological or environmental issues. Nurse practitioners provide a key voice in the design and deployment of telehealth platforms congruent with the comprehensive assessment and presence of remote care delivery.

Trustworthy Data and AI Environments for Clinical Prediction: Application to Crisis-Risk in People with Depression.

Depression is a common mental health condition that often occurs in association with other chronic illnesses, and varies considerably in severity. Electronic Health Records (EHRs) contain rich information about a patient's medical history and can be used to train, test and maintain predictive models to support and improve patient care. This work evaluated the feasibility of implementing an environment for predicting mental health crisis among people living with depression based on both structured and unstructured EHRs. A large EHR from a mental health provider, Mersey Care, was pseudonymised and ingested into the Natural Language Processing (NLP) platform CogStack, allowing text content in binary clinical notes to be extracted. All unstructured clinical notes and summaries were semantically annotated by MedCAT and BioYODIE NLP services. Cases of crisis in patients with depression were then identified. Random forest models, gradient boosting trees, and Long Short-Term Memory (LSTM) networks, with varying feature arrangement, were trained to predict the occurrence of crisis. The results showed that all the prediction models can use a combination of structured and unstructured EHR information to predict crisis in patients with depression with good and useful accuracy. The LSTM network that was trained on a modified dataset with only 1000 most-important features from the random forest model with temporality showed the best performance with a mean AUC of 0.901 and a standard deviation of 0.006 using a training dataset and a mean AUC of 0.810 and 0.01 using a hold-out test dataset. Comparing the results from the technical evaluation with the views of psychiatrists shows that there are now opportunities to refine and integrate such prediction models into pragmatic point-of-care clinical decision support tools for supporting mental healthcare delivery.

Integrated Behavioral Healthcare: Paving the Future of Mental Health in India

This research paper explores the concept of integrated behavioral healthcare (IBHC) and its potential as a transformative approach to the future of mental health services in India. This paper explores how integrated care can bridge the gap between physical and mental health, enhance access to services, and improve outcomes by recognizing the unique challenges and opportunities in the Indian healthcare landscape. This paper presents a comprehensive overview of the subject and discusses policy implications for the Indian context towards improving mental health outcomes and healthcare delivery.

A retrospective comparison of pharmacist and psychiatrist‐led medication management clinics in an outpatient setting

AbstractIntroductionThe need for mental health care continues to outpace available providers in the United States. Clinical pharmacists trained in mental health are an available resource for mental health care delivery. To our knowledge, studies have not compared patient outcomes between pharmacist and psychiatrist medication management clinics. The aim of this study is to assess if a significant difference exists between pharmacist and psychiatrist medication management clinics with regard to escalation of care, evidence‐based medication prescribing, and medication adherence.MethodsThis study was a retrospective chart review of patients who received an outpatient prescription from a mental health provider between January 1, 2017 to July 1, 2018 at an urban Veterans Affairs (VA) medical center. The primary outcome was a composite of hospital admissions and emergency department visits due to a psychiatric or substance use condition. Secondary outcomes assessed in this study included treatment aspects related to escalation of care, medication prescribing, and adherence to treatment.ResultsIn this study, 111 patients were included in the pharmacist group and 110 patients in the psychiatrist group with patients matched based on diagnoses. The primary outcome was similar between groups (p = 0.646). The pharmacist clinic had a significantly higher medication possession ratio (p &lt; 0.00001) and laboratory monitoring (p = 0.0015). The psychiatrist clinic had a significantly higher ratio of clinic appointments attended (p = 0.0025).DiscussionPsychiatric pharmacists may serve as an additional resource to provide evidence‐based medication management and improve medication adherence without the need for escalation of care. Increased utilization of psychiatric pharmacists can help improve access to quality care with the psychiatrist shortage.

The Role of Health Systems in Black Maternal Mental Health Care Delivery: a Socio-Ecological Framework

The Role of Health Systems in Black Maternal Mental Health Care Delivery: a Socio-Ecological Framework

Patterns of mental health service utilisation in people with cancer compared with people without cancer: analysis of the Australian National Study of Mental Health and Wellbeing.

To compare the patterns of mental health service utilisation between people with and without cancer. We performed a cross-sectional study using data of all respondents aged ≥ 25 years from the Australian National Study of Mental Health and Wellbeing 2020-2021 conducted during the COVID-19 pandemic. Comparisons were made between the two groups (cancer versus non-cancer) using logistic regression models. The study comprised 318 people with cancer (55% female) and 4628 people without cancer (54% female). Cancer survivors had a higher prevalence of reporting poor health (38% versus 16%) and mental distress (18% versus 14%) than people without cancer. There were no significant differences between people with and without cancer in the odds of consulting general practitioner, psychiatrist and other health professionals for mental health, although people with cancer were significantly more likely to consult a psychologist than people without cancer (adjusted odds ratio (aOR) = 1.64, 95%CI = 1.05-2.48). While the odds of being hospitalised for physical health was significantly higher in cancer survivors than people without cancer (aOR = 2.32, 95%CI = 1.78-3.01), there was only a negligible number of people reported being hospitalised for mental health between the two groups. Several factors were associated with higher odds of mental health service utilisation including younger age, unpartnered marital status and presence of a current mental condition. Alarmingly, despite experiencing higher prevalence of poor health status and mental distress, cancer survivors did not utilise more mental health services than the general population. That is, there is a higher degree of untreated, or undertreated, distress in cancer than in the general population. Further research to identify optimal approaches of mental health care delivery for cancer survivors are urgently needed.

Reframing Mental Health Ethics.

Mental health ethics has been classically focused on ethical concepts and problems in clinical mental health spaces. Psychiatric and psychotherapeutic ethics are main threads of analysis in this subfield of bioethics. However, ethical issues emerge around mental health and illness both within and beyond clinical settings. In particular, ethical quandaries arise in employment, education, family caregiving, and incarceration of people with mental health conditions outside of the clinical setting. Likewise, ethics are an important consideration within alternative care systems where mentally ill people seek support beyond biomedicine, psychotherapy, and case management. In this article, we argue that our understanding of "mental health ethics" should expand to be more inclusive of value questions and conflicts that arise in all areas of the lives of people with mental health conditions, rather than focusing more narrowly on how clinical practitioners and researchers should best respond to ethical quandaries in the delivery of mental healthcare. Community mental health is an ideal space in which to think about such ethical issues, as scholars and practitioners in the field strive to meet not only medical needs but the broader social needs of people with mental health conditions. We begin by providing an overview of psychiatric and psychotherapeutic ethics, and then describe broader applications of ethics in the lives of people experiencing mental illness. We encourage community mental health practitioners and researchers to reconceptualize disciplinary boundaries to consider the vast scope of ethical issues related to mental health in and out of the clinic.

Development of an Integrated Telehealth Primary Care and Mental Health Training Program for Nurse Practitioner Students: Review of the Literature

Nurse practitioners (NPs) are well equipped to meet the growing mental and primary health care needs of patients through telehealth. Training programs that integrate primary care and mental health care delivery through telehealth for NPs are needed in advanced practice education. A review of the literature was completed to guide the development and determine the best education practices for an integrated telehealth primary care and mental health training program for NP students. This review highlights 4 themes: confidence and competency, collaboration and consultation, applicability to practice, and technology use.

52 An Evaluation of Satisfaction with Emergency Department Care in Children and Adolescents with Mental Health Concerns

Abstract Background Increasingly, the emergency department (ED) is a vital safety net for children and adolescents with mental health concerns seeking crisis care. Evaluating patient and parent/caregiver experience and satisfaction with care is essential to improve the quality of mental health services provided. Objectives The primary objective was to evaluate total satisfaction with the delivery of ED mental health care in two paediatric EDs in Alberta, Canada (Stollery Children's Hospital and Alberta Children's Hospital). Secondary objectives included exploring aspects of ED mental health care (staff interpersonal skills, confidentiality/privacy, and patient-reported outcomes of care) associations with general satisfaction, patient and ED visit characteristic associations with total satisfaction score, and care experience themes. Design/Methods We enrolled patients &amp;lt;18 years of age presenting with a mental health concern—e.g., anxiety, disruptive behaviour, self-harm, depression, situational crisis—over a 12-month period (February 1, 2020—January 31, 2021). Satisfaction data were collected using the Service Satisfaction Scale, which includes quantitative and qualitative data on aspects of ED mental health care. ED visit (length of stay, mental health and psychiatry consultations, hospital admission) and patient (discharge diagnoses, age, sex) data were collected. We evaluated associations of general satisfaction with ED mental health care using Pearson’s correlation coefficient tests, and associations between total satisfaction score with patient and ED visit characteristics using multivariable regression analyses. Inductive thematic analysis of qualitative feedback identified satisfaction and patient experience themes. Results 646 participants were enrolled with most being Caucasian (71.2%; 460/646) and female (56.3%; 364/646); the median age was 13 years (IQR, 11-15 years). The most common discharge diagnosis was anxiety or stress-related disorders (39.5%; 245/620). Parents/caregivers and adolescents were most satisfied with confidentiality and respect in the ED and least satisfied with how the ED services helped reduce symptoms and/or problems. Greater satisfaction was reported for parents/caregivers whose child received care at Alberta Children’s Hospital (p=0.003). General satisfaction was strongly associated with the perceived amount of help received in the ED (r=0.85). ED visit characteristics associated with total satisfaction score included an evaluation by a mental health team member (p=0.004) and psychiatrist consultation (p=0.05). Written comments demonstrated satisfaction with ED provider attitudes and interpersonal skills and dissatisfaction with access to mental health and addictions care, wait time, and COVID-19. Conclusion The results reflect the need to improve the satisfaction with ED mental health care delivery, with a particular focus on enhancing access to care by appropriate mental health providers.

1 Youth Experiencing Homelessness Presenting to an Urban Paediatric Emergency Department: A Descriptive Study

Abstract Background Youth experiencing homelessness (YEH) have high rates of both mental and physical health concerns. This population faces multiple barriers in accessing care, resulting in unaddressed needs and reliance on Emergency Departments (ED). In Canada, the use of the paediatric ED by YEH has not been well described, and there is no data exploring the effects of the COVID-19 pandemic lockdown on ED attendance by this population. Objectives This study aims: 1) To review the frequency/nature of the presentations to the paediatric ED by YEH; 2) To compare pre- and post-COVID-19 data. Design/Methods Medical records were searched for ED encounters where a patient identified a youth shelter as their address and/or had terms documented such as “homeless”, during two time periods: pre-COVID-19 (May 1, 2018–March 15, 2020) and post-COVID-19 lockdown (March 16, 2021–Jan 31, 2022). Pertinent details of the encounters were documented, including chief complaint (CC). Descriptive statistics were used, as well as comparative analysis of the two time periods. Results A total of 1103 encounters were included. Over the total 45-month study time period, CCs were split between mental health-related (n=562, 50.9%) and physical health-related presentations (n=541, 49%). Of the mental health CCs, 396 (70.4%) were documented as “depression/overdose/suicidal/self-harm”. The most common CCs related to physical health were injuries (n=127, 23.4%), and pain (n=126, 23.2%). YEH most commonly attended the paediatric ED between 17:00-00:00 (n=504, 45%), and were triaged as CTAS 3/urgent (n = 676, 61.2%). Of those who completed an Ask Suicide-Screening Questionnaire (ASQ) (n=303), 45.8% (n=139) had an acute positive screen/imminent risk identified. The most common principal diagnoses documented at disposition were related to injuries/assault/pain (n= 224, 20%), and suicide attempt/self-harm (n=196, 17.7%). Of the 166 outpatient referrals made at discharge from ED, 105 (63%) were to mental health/psychiatry. While overall there were fewer ED encounters for this population “post COVID-lockdown” (n=465) as compared to “pre-COVID” (n=638) (p-value &amp;lt;0.05), there was a significant reduction in mental health-related CCs (pre-COVID n=365, post-COVID n=197; p-value &amp;lt;0.05), with no significant reduction in physical-related CCs after the pandemic lockdown (pre-COVID, n=273, n=268). Conclusion YEH utilize the paediatric ED for both their mental and physical healthcare and frequently report suicide risk. The findings that lower attendance to the paediatric ED for mental health-related concerns followed the pandemic lockdown, while physical health encounters remained steady, may reflect increased barriers to care or novel methods of mental health care delivery post-pandemic.

Cohort profile: Working age adults accessing secondary mental healthcare services in South London (UK) and benefits – A data linkage of electronic mental healthcare records and benefits data

ObjectivesTo present an overview of a cohort of working age adults accessing secondary mental healthcare services and benefits related to unemployment, sickness, disability, or income support and describe the different benefit types received across diagnostic and sociodemographic groups.&#x0D; MethodsUsing a novel data linkage containing electronic secondary mental health care records from the South London and Maudsley (SLaM) NHS Foundation Trust and benefits data from the Department for Work and Pensions (DWP), we present descriptive statistics on a cohort of working age adults. The data window covers the period January 2007-June 2020.&#x0D; ResultsWe identified n=150,348 patients of working age (18-65 years), who had attended SLaM secondary mental health care services, 78.3% of which had received a benefit relating to unemployment, sickness, disability, or income support. Of this group, 68% had a recorded primary psychiatric diagnosis. We found that a much higher percentage of those with a primary psychiatric diagnosis received more than one benefit (69.4%) compared to those who had not received a primary psychiatric diagnosis (30.6%).&#x0D; ConclusionsWe showed types of benefits received among working age adults accessing secondary mental health care services. This cohort will be further examined to explore trajectories of mental health care and benefit receipt and provide evidence that will help to inform both DWP policies and mental health care delivery.