Mental Health Division Research Articles

Implementation of Prescriptive Practice: A Course to Facilitate Transition from Theory into Practice

In April 1995, Wisconsin’s law initiating independent prescriptive authority for advanced practice nurses went into effect. At the Milwaukee County Mental Health Division, state-licensed advanced practice psychiatric nurse prescribers were now eligible to prescribe medication, but they had no experience in doing so. Advanced practice psychiatric nurse prescribers needed the opportunity to synthesize previous learning and prescribing principles. This article will discuss the development of an innovative course that prepares learners for their new role through case presentations and clinical mentorship experiences.

White Pages misses important population segments

Australian and New Zealand Journal of Public HealthVolume 25, Issue 5 p. 472-472 Free to Read White Pages misses important population segments Sharon Lawn, Corresponding Author Sharon Lawn Division of Mental Health, Flinders Medical Centre, South Australia*Division of Mental Health, Flinders Medical Centre, Marion Community Care Team, 820 Marion Road, Marion, South Australia 5043. E-mail:Sharon.lawn@fmc.sa.gov.auSearch for more papers by this author Sharon Lawn, Corresponding Author Sharon Lawn Division of Mental Health, Flinders Medical Centre, South Australia*Division of Mental Health, Flinders Medical Centre, Marion Community Care Team, 820 Marion Road, Marion, South Australia 5043. E-mail:Sharon.lawn@fmc.sa.gov.auSearch for more papers by this author First published: 27 June 2009 https://doi.org/10.1111/j.1467-842X.2001.tb00299.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume25, Issue5October 2001Pages 472-472 RelatedInformation

State mental health authority oversight of clubhouse programs

Abstract Utah has adopted clubhouse as a preferred practice of psychosocial rehabilitation for persons with serious mental illnesses. For practical reasons as well as superior monitoring and technical assistance, the state mental health authority (Utah Division of Mental Health) has subcontracted oversight of clubhouses through certification by the International Center for Clubhouse Development. The result has had benefits for both clubhouses and the Division.

Risk adjustment in the hoosier assurance plan: Impact on providers

The Indiana Division of Mental Health designed a method for developing risk-adjusted case rates built on multidimensional assessment instruments that identified a consumer's level of need. An algorithm was developed sorting consumers within each of three target populations (adults with serious mental illness, adults with a chronic addiction, and children/adolescents with serious emotional disorders) into groups based on the relationship between their level of need and their similarity with regard to service cost. Actuarially determined risk-adjusted case rates were assigned to each group and applied to the case mix served by each provider in Indiana's public behavioral health system. This article describes four studies through which a determination was made as to the applicability of the risk-adjustment methodology. The results of the four studies supported using the adjusted case rates for adult consumers, but not for children/adolescents.

Implementation of Prescriptive Practice: Resolution of Institutional Issues and Evolution of Community Standards

Wisconsin’s prescriptive authority for advanced practice nurses went into effect April 1, 1995. Initiating prescriptive practice into the largest mental health division in the state presented some unique obstacles, including diverse preparation in psychopharmacology among advanced practice nurses, the political climate of the institution, and risk management concerns. This article discusses how addressing these issues led to the establishment of a community standard for advanced practice psychiatric nurse prescribers.

Book review: Dementia Care in Victoria: Building a Pathway to Excellence, Final Report, Ministerial Task Force on Dementia Services in Victoria. Aged, Community and Mental Health Division, Victorian Government Department of Human Services, Australia.

Book review: Dementia Care in Victoria: Building a Pathway to Excellence, Final Report, Ministerial Task Force on Dementia Services in Victoria. Aged, Community and Mental Health Division, Victorian Government Department of Human Services, Australia.

Through the wall: An address to practitioners at a forum on the Working Together Strategy

This address was given at a forum in November J999 for practitioners in the juvenile justice, alcohol and drug, mental health and child protection services in Victoria as part of the Department of Human Services’ Working Together Strategy’ (WTS). The WTS is a quality improvement initiative of the DHS in partnership with adolescent mental health and drug treatment service providers.WTS provides an organisational framework for the Community Care Division, the Aged, Community and Mental Health Division and the Public Health Division (specifically in reference to the mental health, child protection and care, juvenile justice and drug treatment services programs) to achieve better outcomes for shared clients. WTS is a response to perceived deficits in cross-program collaboration and communication in cases involving high need adolescent clients.

Diagnostic reliability in mental disorders of the International Classification of Diseases in primary care

The objective is to evaluate the test version of Chapter V - "Mental and Behavioral Disorders reliability", of the 10th revision of the International Classification of Diseases, Version for Primary Care (ICD -10 PC), prepared by the Division of Mental Health of the World Health Organization (WHO). During September and October of 1994, Community General Physicians (CGP) from the Health and Environment Department of the State of Rio Grande do Sul were trained in the use of this version, prepared for the field trial, according to the design proposed by WHO. The results refer to a study about reliability of diagnosis attributed by 9 pairs of CGP to 460 patients in their first appointments. Cohen's Kappa for Mental Health Disorder, present or absent, was 0,79 (CI 95%: 0,69 - 0,88). The use of ICD-10 CP will give more specificity to the information and will allow a better communication between health workers at the level of primary care

Dementia Care in Victoria: Building a Pathway to Excellence Final Report, Ministerial Taskforce on Dementia Services in Victoria. Melbourne, Australia: Aged, Community & Mental Health Division, Victorian Government Department of Human Services, 1997, 398 pp., No charge.

<b>Dementia Care in Victoria: Building a Pathway to Excellence</b> Final Report, Ministerial Taskforce on Dementia Services in Victoria. Melbourne, Australia: Aged, Community &amp; Mental Health Division, Victorian Government Department of Human Services, 1997, 398 pp., No charge.

Shifts in case mix and locus of mental health care for Washington State adults with severe mental illness.

The author describes outcomes of interventions that were aimed at decreasing high use of state hospitals. Research focused on changes in state hospital case mix and dynamics of use by individuals identified as "high utilizers" before and after the Washington State Mental Health Division (MHD) implemented a series of interventions designed to reduce use. A set of recommendations are offered for policymakers who plan interventions that shift the locus of care for severely and persistently mentally ill adults.

Antipsychotics: Past and Future: National Institute of Mental Health Division of Services and Intervention Research Workshop, July 14, 1998.

A workshop on "Antipsychotics: Past and Future" was convened by the National Institute of Mental Health (NIMH), Division of Services and Intervention Research (DSIR), on July 14, 1998, to review the results of recent antipsychotic drug research, discuss current standards of treatment, and identify areas needing further study. There has been a proliferation of new antipsychotic medications and a rapid increase in their clinical utilization. The new atypicals are beginning to supplant the older typical neuroleptic antipsychotics, and the scientific and ethical issues raised by this transition prompted the workshop. Given the apparent, albeit not fully defined, advantages of atypical drugs, particularly their safety profiles, the question is whether more comparisons with typical antipsychotics are warranted and whether clinical trial designs warrant (or would be justified in) the inclusion of typical drugs as standard active comparators. Workshop participants--including clinical researchers, patient advocates, bioethicists, and NIMH staff--discussed the conclusions drawn from current data, ethical issues for subjects in clinical trials, funding for ongoing studies using typical agents, and appropriate comparators for trials using atypical agents.

The financial incentives in a shift to capitation for state mental health services

The State of Washington’s Mental Health Division (MHD) is the State agency responsible for providing state sponsored mental health services. In 1993, the MHD received a Health Care Financing Administration (HCFA) waiver to implement a statewide system of managed care for outpatient mental health rehabilitation services. Payments were to be prepaid and capitated and based on the numbers of clients in each of at least 3 payment tiers. This paper describes financial findings from a HCFA-mandated evaluation of the waiver. It looks at payment rates for children and adults, by tier, and for separately rated groups such as the categorically needy, medically needy, and disabled clients. Three types of State expenditures are compared in this paper: predicted expenditures based on actuarial projections, expenditures made on the basis of service utilization, and expenditures made after being adjusted for over payment controls. Expenditure predictions were consistently lower than actual expenditures, even after adjustments for over payment.

Images in psychiatry. World Health Organization. Division of Mental Health and Prevention of Substance Abuse.

Images in psychiatry. World Health Organization. Division of Mental Health and Prevention of Substance Abuse.

Mental health and general practice: improving linkages using a total quality management approach.

This paper reports on a project to implement total quality management strategies to improve the linkages between general practitioners and specialist mental health services. The project implemented a process of change and objectively assessed the success of the process. The project involved all mental health staff (n = 100) in the St George Division of Psychiatry and Mental Health. General practitioners registered with the St George Division of General Practice were invited to participate in the change process. The project showed that the attempts to engage general practitioners in the ongoing care of patients with chronic mental illness is unlikely to be successful until mental health services promote general practitioner linkages as an ongoing service goal, relevant at all levels of delivery.

Psychiatry of the Elderly

J. Wertheimer, Professor for psychogeriatrics at the University of Lausanne and Chairman, Geriatric Psychiatry Section, World Psychiatric Association (WPA) and Dr. J. A. Costa e Silva, Director, Division of Mental Health and Prevention of Substance Abuse (WHO) organized a Consensus Meeting which took place in Lausanne from 05.–07.02. 1996. The meeting aimed at the elaboration of recommendations on psychogeriatrics. The meeting was attended by the above mentioned WHO and WPA representatives and also by representatives from the following organisations: International Psychogeriatric Association, International Association of Gerontology, International Union of Psychological Science, Alzheimer's Disease International, International Council of Nurses, International Federation of Social Workers, International Federation of Ageing, World Federation of Occupational Therapists. Further attendants were various experts who participated at the meeting on invitation of Prof. Wertheimer and Dr. Costa e Silva. The discussion was chaired by Prof. H. Hafner (Mannheim). Dr. N. Graham (London) and Prof. C. Katona (Harlow/Essex) acted as co-rapporteurs. The Consensus Statement was unamnimously accepted by all participants. It contains recommendations for the development within a field of great future importance with regard to the current and expected global demographic structure and the increasing knowledge about agespecific diseases and general health, social and personal problems of the elderly.

Progress toward achieving a common language in psychiatry, II: Results from the international field trials of the ICD-10 diagnostic criteria for research for mental and behavioral disorders.

In preparing for the publication of ICD-10, the Division of Mental Health of the World Health Organization developed several versions of chapter V, which deals with mental and behavioral disorders. The version for research purposes is called the Diagnostic Criteria for Research (ICD-10 DCR) and gives operational criteria for the diagnosis of mental disorders. This article describes the results of international field trials undertaken to evaluate the draft criteria and refine them further. Data were obtained to assess interrater agreement, the confidence with which diagnoses could be made, and the ease of use of the criteria. Additional substudies examined the concordance between ICD-10 DCR, ICD-10 Clinical Descriptions and Diagnostic Guidelines, and other national classification systems (e.g., DSM-IV). The field trials were carried out at 151 clinical centers in 32 countries by 942 clinician/researchers who conducted 11,491 individual assessments of patients. Results for cases assessed by at least two raters are reported here. Most clinician/researchers found the criteria to be explicit and easy to apply. Interrater agreement was high for most diagnostic categories. For some categories, such as those dealing with certain polymorphic psychotic disorders or milder forms of affective disorders, the criteria were rated as somewhat difficult to use, and reliability was lower. Comparison of the results of these field trials with those of the ICD-10 Clinical Descriptions and Diagnostic Guidelines demonstrated that there are increases in interrater agreement when the operational criteria are used. The use of internationally accepted research criteria enhances the reliability of diagnosis of mental disorders made in research settings worldwide.

Japan needs more forensic psychiatrists

In recent years increased consideration has been given to the human rights of Japanese psychiatric patients and there have been significant improvements in the care afforded to them. It is argued that mentally disordered offenders have not yet benefited to the same extent as general psychiatric patients and further improvements could be achieved. This paper describes the forensic mental health system in Japan and institutions which provide services for mentally disordered offenders. At present there are no hospital units specifically designed to care for mentally ill offenders and most are detained within general psychiatric facilities. There is no equivalent to Part III of the English Mental Health Act 1983 enabling courts and prisons to transfer people to hospital, so that offender patients are detained by the use of civil sections as defined in the Japanese ‘Mental Health Law’ of 1987 (translated by the Mental Health Division of the Health Service Bureau of the Ministry of Health and Welfare of Japan,1988). Some mentally abnormal offenders are incarcerated in prison or medical prisons where they can be treated against their will and where they do not have effective access to an independent appeal system. It is the author’s view that the development of forensic psychiatry would be an important stimulus to improving the care given to mentally disordered offenders both within institutions and in the community.

Mental illness: a major public healthcare burden

Mental health services should be an integral part of primary healthcare, according to Dr Jorge Alberto Costa e Silva, Director of the WHO Mental Health Division. He was commenting on WHO research * that showed that just under one-quarter of all patients contacting primary care physicians were experiencing mental distress such as depression or anxiety. The major highlights of the international collaborative study were discussed at a WHO press conference [ Paris, France; March 1995 ]

World Health Organisation: Division of Mental Health

This article provides informations about the work of the World Health Organization - informations on projects, developments and documents produced by the Division of Mental Health

Revision of the ICIDH: mental health aspects. WHO/MNH Disability Working Group.

This article reviews the key issues arising in the revision of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) from a mental health perspective, and describes the work of the Disability Working Group of the WHO's Division of Mental Health. The ICIDH, which describes the consequences of disorders at three levels as impairments, disabilities, and handicaps, is generally applicable and useful for mental health purposes. While some impairments are mainly a consequence of 'mental' disorders (e.g. cognitive impairment), there should be no differences between mental and physical disorders in the classification scheme, to avoid a dichotomy between mind and body. There is also a need to improve the ways in which interference with the performance of social roles is described, since this is often the most obvious consequence of mental disorders. This article presents the potentials of the ICIDH in the field of mental health, and gives recommendations for the development of the revision process of the ICIDH. To stimulate the process of producing a 'common language' in the ICIDH related to mental health issues, former and potential users of the ICIDH are invited to give comments and suggestions.