Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.234
Filtrar
1.
MMWR Morb Mortal Wkly Rep ; 70(13): 490-494, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33793459

RESUMO

The spread of disease and increase in deaths during large outbreaks of transmissible diseases is often associated with fear and grief (1). Social restrictions, limits on operating nonessential businesses, and other measures to reduce pandemic-related mortality and morbidity can lead to isolation and unemployment or underemployment, further increasing the risk for mental health problems (2). To rapidly monitor changes in mental health status and access to care during the COVID-19 pandemic, CDC partnered with the U.S. Census Bureau to conduct the Household Pulse Survey (HPS). This report describes trends in the percentage of adults with symptoms of an anxiety disorder or a depressive disorder and those who sought mental health services. During August 19, 2020-February 1, 2021, the percentage of adults with symptoms of an anxiety or a depressive disorder during the past 7 days increased significantly (from 36.4% to 41.5%), as did the percentage reporting that they needed but did not receive mental health counseling or therapy during the past 4 weeks (from 9.2% to 11.7%). Increases were largest among adults aged 18-29 years and among those with less than a high school education. HPS data can be used in near real time to evaluate the impact of strategies that address mental health status and care of adults during the COVID-19 pandemic and to guide interventions for groups that are disproportionately affected.


Assuntos
Ansiedade/epidemiologia , Ansiedade/terapia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
2.
Global Health ; 17(1): 51, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902638

RESUMO

BACKGROUND: Due to the implementation of social distancing and quarantine measures, loneliness has been a major public health concern during the COVID-19 pandemic. However, few studies have examined loneliness in Chinese residents during the COVID-19 epidemic, as well as its associations with mental health needs and services utilization. METHODS: The present study was a cross-sectional survey during the COVID-19 outbreak in China. A total of 7741 adults were invited and completed an online self-administered questionnaire. The Chinese 12-item General Health Questionnaire was used to screen for common mental health problems, loneliness was measured with a single-item self-report question ("How often do you feel lonely in recent days?"), and two standardized questions were used to assess perceived needs for and use of mental health services. RESULTS: In total, 24.2 % of the participants felt lonely in recent days. Age of 16-29 years (OR = 1.36, P = 0.020), marital status of never-married (OR = 1.47, P < 0.001), marital status of "others" (re-married, co-habiting, separated, divorced, and widowed) (OR = 1.72, P < 0.001), having infected family members or close relatives (OR = 1.64, P = 0.026), and having infected colleagues, friends, or classmates (OR = 1.62, P < 0.001) were significant correlates of loneliness. Rates of mental health needs (17.4 % vs. 4.9 %, P < 0.001) and services utilization (2.7 % vs. 1.0 %, P < 0.001) were significantly higher in lonely than not lonely participants. After adjusting for socio-demographic and epidemic characteristics and common mental health problems, loneliness was still significantly associated with mental health needs (OR = 2.50, P < 0.001) and services utilization (OR = 1.62, P = 0.020). CONCLUSIONS: Feelings of loneliness are prevalent among Chinese residents affected by the COVID-19 epidemic and the presence of loneliness is associated with high levels of mental health needs and greater services utilization. Effective measures aiming at preventing or reducing loneliness are potentially beneficial for the mental wellbeing of COVID-19-affected population and reducing the use of the limited mental health service resources during the COVID-19 pandemic.


Assuntos
/epidemiologia , Epidemias , Utilização de Instalações e Serviços/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Solidão/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
3.
Psychiatry Res ; 299: 113848, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33725578

RESUMO

Whilst telehealth may overcome some traditional barriers to care, successful implementation into service settings is scarce, particularly within youth mental health care. This study aimed to leverage the rapid implementation of telehealth due to COVID-19 to understand the perspectives of young people and clinicians on how telehealth impacts service delivery, service quality, and to develop pathways for future uses. Youth mental health service users (aged 12-25) and clinicians took part in an online survey exploring service provision, use, and quality following the adoption of telehealth. Service use data from the period were also examined. Ninety-two clinicians and 308 young people responded to the survey. Service use was reduced compared to the same period in 2019, however, attendance rates were higher. Across eight domains of service quality, the majority of young people reported that telehealth positively impacted service quality, and were significantly more likely to rate telehealth as having a positive impact on service quality than clinicians. There was high interest in continuing to use telehealth as part of care beyond the pandemic, supporting its permanent role in youth mental health care for a segment of service users. Future work should explore how best to support its long-term implementation.


Assuntos
/psicologia , Assistência à Saúde/métodos , Serviços de Saúde Mental/estatística & dados numéricos , Qualidade da Assistência à Saúde , Telemedicina/estatística & dados numéricos , Adolescente , Adulto , Criança , Difusão de Inovações , Feminino , Humanos , Masculino , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/tendências , Pandemias , Inquéritos e Questionários , Telemedicina/organização & administração , Adulto Jovem
4.
BMJ Open ; 11(3): e046365, 2021 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-33785494

RESUMO

OBJECTIVES: The recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in-person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications. DESIGN AND SETTING: The Clinical Record Interactive Search tool was used to examine deidentified electronic health records of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing. PARTICIPANTS: All patients receiving care from SLaM between 7 January 2019 and 20 September 2020 (around 37 500 patients per week). OUTCOME MEASURES: (i) The number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week.(ii) Prescribing of antipsychotic and mood stabiliser medications per week. RESULTS: Following the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared with that in the previous year (ß coefficient: -5829.6 contacts, 95% CI -6919.5 to -4739.6, p<0.001), while the frequency of remote contacts significantly increased (ß coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels. CONCLUSIONS: The COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.


Assuntos
/psicologia , Prescrições de Medicamentos , Serviços de Saúde Mental/estatística & dados numéricos , Padrões de Prática Médica , Telemedicina , Adolescente , Idoso , Criança , Assistência à Saúde , Registros Eletrônicos de Saúde , Humanos , Londres , Pandemias , Psiquiatria/tendências
5.
J Ment Health Policy Econ ; 24(1): 31-41, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739934

RESUMO

BACKGROUND: Unemployment is associated with a high risk of experiencing mental illness. This can lead to stigmatisation, reduced quality of life, and long-term costs like increased healthcare expenditure and productivity losses for society as a whole. Previous research indicates evidence for an association between unemployment and higher mental health service costs, but there is insufficient information available for the German healthcare system. AIM OF THE STUDY: This study aims to identify costs and cost drivers for health and social service use among unemployed people with mental health problems in Germany. METHODS: A sample of 270 persons participated at baseline and six-month-follow-up. Healthcare and social service use was assessed using the Client Socio-Demographic and Service Receipt Inventory. Descriptive cost analysis was performed. Associations between costs and potential cost drivers were tested using structural equation modelling. RESULTS: Direct mean costs for 12 months range from EUR 1265.13 (somatic costs) to EUR 2206.38 (psychiatric costs) to EUR 3020.70 (total costs) per person. Path coefficients indicate direct positive effects from the latent variable mental health burden (MHB) on stigma stress, somatic symptoms, and sick leave. DISCUSSION: The hypothesis that unemployed people with mental health problems seek help for somatic symptoms rather than psychiatric symptoms was not supported. Associations between MHB and costs strongly mediated by sick leave indicate a central function of healthcare provision as being confirmation of the inability to work. IMPLICATIONS FOR HEALTH POLICIES: Targeted interventions to ensure early help-seeking and reduce stigma remain of key importance in reducing long-term societal costs. IMPLICATIONS FOR FURTHER RESEARCH: Future research should explore attitudes regarding effective treatment for the target group.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Transtornos Mentais/economia , Transtornos Mentais/terapia , Serviços de Saúde Mental/economia , Licença Médica/economia , Desemprego/estatística & dados numéricos , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Qualidade de Vida , Estigma Social , Desemprego/psicologia , Adulto Jovem
7.
South Med J ; 114(2): 81-85, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33537788

RESUMO

OBJECTIVES: This pilot study explores the additional psychiatric problems and their associated professional mental health utilization by students in recovery from addiction in collegiate recovery communities (CRCs) across the US South. The article has three goals: introduce CRCs to a broad medical audience; identify coexisting psychiatric concerns among students in CRC programs; and determine these students' type, rate, and location of professional mental health services. METHODS: During the 2014-2015 academic year, this study recruited participants through e-mail to all known CRC directors, who had the option of forwarding a survey link to its participants. RESULTS: Fourteen percent of students in 13 known southern CRCs completed the survey. Seventy-four percent of them reported at least one coexisting psychiatric issue. The most common issue was depression, followed by anxiety. Other reported disorders included attention-deficit/hyperactivity disorder, eating disorder, bipolar disorder, posttraumatic stress disorder, psychotic disorder, and obsessive-compulsive disorder. Most of the students in southern CRCs worked with psychiatrists and other therapists off-campus on their psychiatric problems. CONCLUSIONS: This pilot study suggests that a significant number of students in southern CRCs have additional psychiatric problems that require professional mental health services.


Assuntos
Comportamento Compulsivo/epidemiologia , Transtornos Mentais/epidemiologia , Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudantes/psicologia , Adulto , Comorbidade , Comportamento Compulsivo/terapia , Feminino , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários , Universidades/organização & administração , Adulto Jovem
9.
Epidemiol Psychiatr Sci ; 30: e12, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33543688

RESUMO

AIMS: Persistent inequalities exist in how individuals from minority ethnic groups access mental health care. A failure to investigate how these inequalities are experienced and what they mean to people with psychosis has privileged professional narratives and hindered our understanding of how they are sustained and what could be done to reduce them. The aim of this study was to investigate the long-term experience of living with psychosis and navigating mental health services within different ethnic groups. METHOD: Our approach was informed by work on narrative analysis and prioritised the meaning that mental health services held for participants. In-depth interviews with 17 black Caribbean, 15 white British and 3 non-British white people with psychosis as part of AESOP-10, a 10-year follow-up of an ethnically diverse cohort of individuals with first-episode psychosis in the UK. Thematic narrative analysis was used to examine experiences at the personal level within and then across the individual accounts. RESULTS: Service users shared many defining experiences and narratives frequently returned to individuals' first contact with mental health services, first hospital admission, the experience of impatient wards, and the meaning of medication and diagnosis in their lives. We found that experiences of powerlessness punctuated the journey through mental health services and this appeared to dominate the accounts of black Caribbean, and to a lesser extent, white British participants. The findings reveal how negative expectations and experiences of mental health services are compounded over time, creating a vicious cycle of disempowerment and mistrust that manifests for many in resistance to - or at the best passive acceptance of - intervention by mental health services. High levels of need, coupled with alienation from services, contributed to negative patterns of service use among black Caribbean participants. White participants recounted substantial, though fewer, experiences of disempowerment and more instances of shared decision making that for some helped protect positive aspects of their lives. CONCLUSIONS: Against a background of entrenched social and economic disempowerment, services were experienced as disempowering by many black Caribbean people, compounding and perpetuating a sense of alienation. Concerted efforts by services to more systematically target social needs and to share power through partnership working may reduce the mistrust that many with psychosis feel when entering services and in turn reduce persistent inequalities across ethnic groups.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Transtornos Psicóticos/etnologia , Adulto , Região do Caribe , Progressão da Doença , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Navegação de Pacientes , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Pesquisa Qualitativa , Classe Social , Reino Unido
12.
Med Care ; 59(4): 319-323, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480660

RESUMO

BACKGROUND: Since coronavirus disease 2019 (COVID-19) has caused dramatic changes in everyday life, a major concern is whether patients have adequate access to mental health care despite shelter-in-place ordinances, school closures, and social distancing practices. OBJECTIVES: The aim was to examine the availability of telehealth services at outpatient mental health treatment facilities in the United States at the outset of the COVID-19 pandemic, and to identify facility-level characteristics and state-level policies associated with the availability. RESEARCH DESIGN: Observational cross-sectional study. SUBJECTS: All outpatient mental health treatment facilities (N=8860) listed in the Behavioral Health Treatment Services Locator of the Substance Abuse and Mental Health Services Administration on April 16, 2020. MEASURES: Primary outcome is whether an outpatient mental health treatment facility reported offering telehealth services. RESULTS: Approximately 43% of outpatient mental health facilities in the United States reported telehealth availability at the outset of the pandemic. Facilities located in the United States South and nonmetropolitan counties were more likely to offer services, as were facilities with public sector ownership, those providing care for both children and adults, and those accepting Medicaid as a form of payment. Outpatient mental health treatment facilities located in states with state-wide shelter-in-place laws were less likely to offer telehealth, as well as facilities in counties with more COVID-19 cases per 10,000 population. CONCLUSIONS: At the onset of the COVID-19 pandemic, fewer than half of outpatient mental health treatment facilities were providing telehealth services. Our results suggest that additional policies to promote telehealth may be warranted to increase availability over the course of the COVID-19 pandemic.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Assistência Ambulatorial/organização & administração , /transmissão , Estudos Transversais , Geografia , Acesso aos Serviços de Saúde/organização & administração , Humanos , Serviços de Saúde Mental/organização & administração , Pandemias/prevenção & controle , Telemedicina/organização & administração , Estados Unidos/epidemiologia
13.
J Psychiatr Res ; 135: 289-293, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33516081

RESUMO

OBJECTIVE: Mental health professionals are often exposed to workplace violence (WPV) in China. This study examined the prevalence of WPV and the associated factors and quality of life (QOL) among frontline mental health professionals during the COVID-19 pandemic. METHODS: This national survey was carried out between March 15 and March 20, 2020. WPV and QOL were assessed with standardized measures. RESULTS: A total of 10,516 participants were included. The prevalence of overall WPV was 18.5% (95% CI: 17.9%-19.3%), while verbal abuse/threats was 15.8% and physical violence was 8.4%. Multiple logistic regression analysis revealed that male gender (OR = 1.42, p < 0.01), higher educational level (OR = 1.40, p < 0.01), working in tertiary hospitals (OR = 1.33, p < 0.01), caring for COVID-19 patients (OR = 3.10, p < 0.01) and having more severe anxiety symptom (OR = 1.21, p < 0.01) were positively associated with WPV. In contrast, working in inpatient departments (OR = 0.74, p < 0.01), having longer work experience (OR = 0.99, p = 0.03), and being a junior nurse (OR = 0.73, p < 0.01) were negatively associated with WPV. After controlling for the covariates, mental health professionals who experienced WPV had a lower overall QOL compared to those without WPV (F(1, 10515) = 68.28, p < 0.01). CONCLUSION: This study found that WPV was common among mental health professionals in China during the COVID-19 pandemic. Considering the negative impact of WPV on QOL and quality of patient care, appropriate measures to prevent WPV should be developed.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Qualidade de Vida , Violência no Trabalho/estatística & dados numéricos , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Prevalência
14.
Am J Public Health ; 111(2): 277-285, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33351663

RESUMO

Objectives. To examine the dual disproportionality that individuals with serious mental illness and people of color (PoC) occupy in the criminal-legal system.Methods. This study follows a cohort of 623 individuals who screened positive for mental health issues at booking in 8 Midwestern jails in 2017. We followed individuals through the jails' practices of jail-based mental health treatment, and we used Medicaid billing data to assess community-based behavioral health treatment engagement in the postyear period after jail release. The aim was to examine if an individual's race/ethnicity was associated with their access to jail- and community-based mental health treatment.Results. We did not find any racial disparities in jail-based treatment, although 3 community-based outcomes significantly differed. Compared with PoC, White people had 1.9 times greater odds of receiving community-based mental health and substance use treatment and 4.5 times greater odds of receiving co-occurring disorder treatment.Conclusions. Barriers that individuals released from jail face adversely affect PoC, resulting in reduced access to treatment. Critical race theory can expose the assumptions and functions of systems of care and the possible reproduction of implicit bias in potential solutions.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Racismo/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Medicaid , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Prisioneiros/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos , Adulto Jovem
15.
Am J Surg ; 221(1): 233-239, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690211

RESUMO

BACKGROUND: Violent trauma has lasting psychological impacts. Our institution's Community Violence Response Team (CVRT) offers mental health services to trauma victims. We characterized implementation and determined factors associated with utilization by pediatric survivors of interpersonal violence-related penetrating trauma. METHODS: Analysis included survivors (0-21 years) of violent penetrating injury at our institution (2011-2017). Injury and demographic data were collected. Nonparametric regression models determined factors associated with utilization. RESULTS: There was initial rapid uptake of CVRT (2011-2013) after which it plateaued, serving >80% of eligible patients (2017). White race and higher injury severity were associated with receipt and duration of services. In post-hoc analysis, race was found to be associated with continued treatment but not with initial consultation. CONCLUSION: Successful implementation required three years, aiding >80% of patients. CVRT is a blueprint to strengthen existing violence intervention programs. Efforts should be made to ensure that barriers to providing care, including those related to race, are overcome.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Violência , Ferimentos Penetrantes/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Estudos Retrospectivos , Ferimentos Penetrantes/complicações , Adulto Jovem
17.
AIDS Patient Care STDS ; 35(1): 9-14, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33347344

RESUMO

Young Black gay, bisexual, and other men who have sex with men (YB-GBMSM) face multiple psychosocial stressors, and are disproportionately impacted by HIV. Mental health care engagement is a promising avenue for addressing these disparities. To date, rates of mental health service utilization have not been examined specifically in this population. We conducted a retrospective cohort study among YB-GBMSM receiving care in a Ryan White-funded HIV care center that includes co-located HIV and mental health services. Of 435 unique YB-GBMSM patients, mental health concerns were identified in n = 191 (43.9%). Depressive symptoms were the most common concerns identified, followed by substance use, anxiety, and trauma. Among patients with identified mental health concerns who were not previously in mental health care, 79.1% were referred to mental health care, 56.3% set an appointment with a mental health provider, 40.5% were linked to mental health care (attended an initial visit), and 19.6% remained engaged in mental health care. Younger YB-GBMSM (age 18-24 years), who received care in a more integrated pediatric/adolescent part of the center, were more likely to have an appointment set once a concern was identified (χ2 = 7.17; p = 0.007). Even in a setting with co-located HIV and mental health care services, we found significant gaps in engagement at each stage of a newly described mental health care continuum. Implications for intervention at the provider and systems levels are discussed.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Bissexualidade/psicologia , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina/psicologia , Seguro Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/psicologia , Idoso , Bissexualidade/etnologia , Criança , Infecções por HIV/etnologia , Homossexualidade Masculina/etnologia , Humanos , Masculino , Estudos Retrospectivos , Minorias Sexuais e de Gênero , Estados Unidos , Adulto Jovem
18.
Pediatrics ; 147(1)2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33376211

RESUMO

BACKGROUND: Health administrative data offer a vital source of data on maternal prenatal opioid exposure (POE). The impact of different methods to estimate POE, especially combining maternal and newborn records, is not known. METHODS: This population-based cross-sectional study included 454 746 hospital births with linked administrative data in Ontario, Canada, in 2014-2017. POE ascertainment included 3 sources: (1) prenatal opioid prescriptions, (2) maternal opioid-related hospital records, and (3) newborn hospital records with neonatal abstinence syndrome (NAS). Positive percent agreement was calculated comparing cases identified by source, and a comprehensive method was developed combining all 3 sources. We replicated common definitions of POE and NAS from existing literature and compared both number of cases ascertained and maternal socio-demographics and medical history using the comprehensive method. RESULTS: Using all 3 data sources, there were 9624 cases with POE (21.2 per 1000 births). Among these, positive percent agreement (95% confidence interval) was 79.0% (78.2-79.8) for prenatal opioid prescriptions, 19.0% (18.2-19.8) for maternal opioid-related hospital records, and 44.7% (43.7-45.7) for newborn NAS. Compared with other definitions, our comprehensive method identified up to 523% additional cases. Contrasting ascertainment with maternal opioid-related hospital records, newborn NAS, and prenatal opioid prescriptions respective rates of maternal low income were 57%, 48%, and 39%; mental health hospitalization history was 33%, 28%, and 17%; and infant discharge to social services was 8%, 13%, and 5%. CONCLUSIONS: Combining prenatal opioid prescriptions and maternal and newborn opioid-related hospital codes improves identification of a broader population of mothers and infants with POE.


Assuntos
Analgésicos Opioides/efeitos adversos , Exposição Materna/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Serviços de Proteção Infantil/estatística & dados numéricos , Estudos Transversais , Bases de Dados Factuais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Serviços de Saúde Mental/estatística & dados numéricos , Síndrome de Abstinência Neonatal/epidemiologia , Ontário/epidemiologia , Pobreza , Gravidez , Adulto Jovem
19.
Clin Med (Lond) ; 21(1): e77-e79, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33355199

RESUMO

During COVID-19 there has been increased pressure on mental health services internationally. In this report, we compare admissions to one acute medical unit (AMU) for patients with mental health problems during the COVID-19 pandemic (April, May and June 2020) to the same period of time in 2019. We found an increase in this cohort of patients in 2020, both as an absolute number and as a proportion of the medical take. We outline some strategies which we have adopted locally to improve care for this patient group.


Assuntos
/epidemiologia , Pessoal de Saúde/psicologia , Transtornos Mentais/epidemiologia , Serviços de Saúde Mental/estatística & dados numéricos , Saúde Mental , Pandemias , Admissão do Paciente/estatística & dados numéricos , /complicações , Seguimentos , Humanos , Incidência , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Estudos Retrospectivos
20.
Artigo em Inglês | MEDLINE | ID: mdl-33322095

RESUMO

Public safety personnel (PSP) experience unique occupational stressors and suffer from high rates of mental health problems. The COVID-19 pandemic has impacted virtually all aspects of human life around the world and has introduced additional occupational stressors for PSP. The objective of this study was to explore how PSP, especially those seeking digital mental health services, have been affected by the pandemic. Our research unit, PSPNET, provides internet-delivered cognitive behavioral therapy to PSP in the Canadian province of Saskatchewan. When the pandemic spread to Saskatchewan, PSPNET began inquiring about the impact of the pandemic on prospective clients during the eligibility screening process. We used content analysis to analyze data from telephone screening interviews (n = 56) and descriptive statistics to analyze data from a questionnaire concerning the impacts of COVID-19 (n = 41). The results showed that most PSP reported facing several novel emotional challenges (e.g., social isolation, boredom, anger, and fear) and logistical challenges (e.g., related to childcare, finances, work, and access to mental healthcare). Most participants indicated they felt at least somewhat afraid of contracting COVID-19 but felt more afraid of their families contracting the virus than themselves. However, few participants reported severe challenges of any kind, and many (40%) indicated that they had not been significantly negatively impacted by the pandemic. Overall, the results suggest that PSP are not expressing significant concern at this time in meeting the novel challenges posed by COVID-19. Continued research will be required to monitor how diverse PSP populations and treatment outcomes are affected by the pandemic as the situation evolves.


Assuntos
/psicologia , Socorristas/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Saskatchewan
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...