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1.
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
3.
Australas Psychiatry ; 29(2): 194-199, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33626304

RESUMO

OBJECTIVE: The Australian federal government introduced new COVID-19 psychiatrist Medicare Benefits Schedule (MBS) telehealth items to assist with providing private specialist care. We investigate private psychiatrists' uptake of video and telephone telehealth, as well as total (telehealth and face-to-face) consultations for Quarter 3 (July-September), 2020. We compare these to the same quarter in 2019. METHOD: MBS-item service data were extracted for COVID-19-psychiatrist video and telephone telehealth item numbers and compared with Quarter 3 (July-September), 2019, of face-to-face consultations for the whole of Australia. RESULTS: The number of psychiatry consultations (telehealth and face-to-face) rose during the first wave of the pandemic in Quarter 3, 2020, by 14% compared to Quarter 3, 2019, with telehealth 43% of this total. Face-to-face consultations in Quarter 3, 2020 were only 64% of the comparative number of Quarter 3, 2019 consultations. Most telehealth involved short telephone consultations of ⩽15-30 min. Video consultations comprised 42% of total telehealth provision: these were for new patient assessments and longer consultations. These figures represent increased face-to-face consultation compared to Quarter 2, 2020, with substantial maintenance of telehealth consultations. CONCLUSIONS: Private psychiatrists continued using the new COVID-19 MBS telehealth items for Quarter 3, 2020 to increase the number of patient care contacts in the context of decreased face-to-face consultations compared to 2019, but increased face-to-face consultations compared to Quarter 2, 2020.


Assuntos
/prevenção & controle , Transtornos Mentais/terapia , Serviços de Saúde Mental/tendências , Padrões de Prática Médica/tendências , Prática Privada/tendências , Psiquiatria/tendências , Telemedicina/tendências , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/tendências , Austrália , Utilização de Instalações e Serviços/tendências , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Serviços de Saúde Mental/organização & administração , Programas Nacionais de Saúde , Pandemias , Padrões de Prática Médica/organização & administração , Prática Privada/organização & administração , Psiquiatria/organização & administração , Telemedicina/métodos , Telemedicina/organização & administração , Telefone/tendências , Comunicação por Videoconferência/tendências
6.
J Nerv Ment Dis ; 209(1): 85-87, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323794

RESUMO

In the last half of the 20th century, psychiatry lost many of the conditions needed for unhindered practice. I compiled from searches of the literature the 20th century changes in the arenas of psychiatric practice and the sources of these changes. I determined how these changes are shaping 21st century health and well-being. The neglect of the severely mentally ill, first in Bedlams and now on Boulevards, reflects a wide loss of resources. Psychiatry's patients have lost a past of community-based mental health services, interdisciplinary care teams, preventive consultation with social agencies, and, with reimbursements targeted for 15-minute visits, time adequate with the physician to individualize diagnosis and treatment. With the Covid-19 and other epidemics, economic inequalities, an economic crisis, unrest over police violence, and racism, psychiatry can find in its past the resources to engage 21st century psychiatric and other problems.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/história , Psiquiatria/história , /história , História do Século XX , História do Século XXI , Humanos , Transtornos Mentais/economia , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/tendências , Psiquiatria/economia , Psiquiatria/tendências
7.
Recurso na Internet em Inglês, Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-47922

RESUMO

La pandemia de COVID-19 ha perturbado o paralizado los servicios de salud mental esenciales del 93% de los ‎países del mundo, en tanto que aumenta la demanda de atención de salud mental, según un nuevo estudio de ‎la OMS. El estudio, que abarca 130 países, aporta los primeros datos mundiales acerca de los efectos ‎devastadores de la COVID-19 sobre el acceso a los servicios de salud mental y pone de relieve la necesidad ‎urgente de incrementar la financiación


Assuntos
Infecções por Coronavirus , Saúde Mental/tendências , Serviços de Saúde Mental/tendências
8.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006815
9.
Australas Psychiatry ; 28(6): 639-643, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33016772

RESUMO

OBJECTIVE: To analyse the smaller Australian state/territory service impact of the introduction of new COVID-19 psychiatrist video and telephone telehealth Medicare Benefits Schedule (MBS) items. METHOD: MBS item service data were extracted for COVID-19 psychiatrist video and telephone telehealth item numbers corresponding to the pre-existing in-person consultations for the Australian Capital Territory (ACT), Northern Territory (NT), South Australia (SA) and Tasmania. RESULTS: The overall rate of consultations (face-to-face and telehealth) increased during March and April 2020, compared to the monthly face-to-face consultation average, excepting Tasmania. Compared to an annual monthly average of in-person consultations for July 2018-June 2019, total telepsychiatry consultations were higher for April than May. For total video and telephone telehealth consultations combined, video consultations were lower in April and higher in May. As a percentage of combined telehealth and in-person consultations, telehealth was greater for April and lower for May compared to the monthly face-to-face consultation average. CONCLUSIONS: In the smaller states/territories, the private practice workforce rapidly adopted COVID-19 MBS telehealth items, with the majority of psychiatric consultation shifting to telehealth initially, and then returning to face-to-face. With a second wave of COVID-19 in Australia, telehealth is likely to remain a vital part of the national mental health strategy.


Assuntos
Infecções por Coronavirus , Serviços de Saúde Mental , Pandemias , Pneumonia Viral , Padrões de Prática Médica , Prática Privada , Consulta Remota/métodos , Comunicação por Videoconferência , Adulto , Austrália/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Revisão da Utilização de Seguros , Masculino , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/tendências , Inovação Organizacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/tendências , Prática Privada/organização & administração , Prática Privada/tendências , Telemedicina/métodos
10.
Psychiatry Res ; 293: 113429, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32882598

RESUMO

BACKGROUND: COVID-19 pandemic and lockdown has brought about a sense of fear and anxiety around the globe. This phenomenon has led to short term as well as long term psychosocial and mental health implications for children and adolescents. The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection. AIMS: This paper is aimed at narratively reviewing various articles related to mental-health aspects of children and adolescents impacted by COVID-19 pandemic and enforcement of nationwide or regional lockdowns to prevent further spread of infection. METHODOLOGY: We conducted a review and collected articles and advisories on mental health aspects of children and adolescents during the COVID-19 pandemic. We selected articles and thematically organized them. We put up their major findings under the thematic areas of impact on young children, school and college going students, children and adolescents with mental health challenges, economically underprivileged children, impact due to quarantine and separation from parents and the advisories of international organizations. We have also provided recommendations to the above. CONCLUSION: There is a pressing need for planning longitudinal and developmental studies, and implementing evidence based elaborative plan of action to cater to the psycho social and mental health needs of the vulnerable children and adolescents during pandemic as well as post pandemic. There is a need to ameliorate children and adolescents' access to mental health support services geared towards providing measures for developing healthy coping mechanisms during the current crisis. For this innovative child and adolescent mental health policies policies with direct and digital collaborative networks of psychiatrists, psychologists, paediatricians, and community volunteers are deemed necessary.


Assuntos
Adaptação Psicológica , Betacoronavirus , Infecções por Coronavirus/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Quarentena/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/prevenção & controle , Transtornos Mentais/psicologia , Saúde Mental/tendências , Serviços de Saúde Mental/tendências , Pandemias/prevenção & controle , Pais/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Psiquiatria/métodos , Psiquiatria/tendências , Fatores de Risco
18.
J Child Adolesc Psychopharmacol ; 30(7): 404-413, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32639849

RESUMO

Objective: Telemental health (TMH) is not well described for mental health service delivery during crises. Most child and adolescent psychiatry training programs have not integrated TMH into their curricula and are ill equipped to respond during crises to their patients' needs. In this study, we present the implementation of a home-based TMH (HB-TMH) service during the COVID-19 pandemic. Methods: We describe the technological, administrative, training, and clinical implementation components involved in transitioning a comprehensive outpatient child and adolescent psychiatry program to a HB-TMH virtual clinic. Results: The transition was accomplished in 6 weeks. Most in-clinic services were rapidly moved off campus to the home. Owing to challenges encountered with each implementation component, phone sessions bridged the transition from in-clinic to reliable virtual appointments. Within 3 weeks (March 20, 2020) of planning for HB-TMH, 67% of all appointments were conducted at home, and within 4 weeks (March 27, 2020), 90% were conducted at home. By week 6 (April 3, 2020), reliable HB-TMH appointments were implemented. Conclusions: The COVID-19 pandemic crisis created the opportunity to innovate a solution to disrupted care for our established patients and to create a resource for youth who developed problems during the crisis. Our department was experienced in providing TMH services that facilitated the transition to HB-TMH, yet still had to overcome known and unanticipated challenges. Our experience provides a roadmap for establishing a HB-TMH service with focus on rapid implementation. It also demonstrates a role for TMH during (rather than after) future crises when usual community resources are not available.


Assuntos
Infecções por Coronavirus , Serviços de Assistência Domiciliar , Transtornos Mentais/terapia , Serviços de Saúde Mental , Pandemias , Pneumonia Viral , Telemedicina , Adolescente , Betacoronavirus , Criança , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Serviços de Assistência Domiciliar/organização & administração , Serviços de Assistência Domiciliar/tendências , Humanos , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/tendências , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Telemedicina/organização & administração , Washington/epidemiologia
19.
PLoS One ; 15(7): e0234876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645017

RESUMO

BACKGROUND: Access to neurology specialty care can influence outcomes in individuals with multiple sclerosis (MS), but may vary based on patient sociodemographic characteristics, including immigration status. OBJECTIVE: To compare health services utilization in the year of MS diagnosis, one year before diagnosis and two years after diagnosis in immigrants versus long-term residents in Ontario, Canada. METHODS: We identified incident cases of MS among adults aged 20-65 years by applying a validated algorithm to health administrative data in Ontario, Canada, a region with universal health insurance and comprehensive coverage. We separately assessed hospitalizations, emergency department (ED) visits, outpatient neurology visits, other outpatient specialty visits, and primary care visits. We compared rates of health service use in immigrants versus long-term residents using negative binomial regression models with generalized estimating equations adjusted for age, sex, socioeconomic status, urban/rural residence, MS diagnosis calendar year, and comorbidity burden. RESULTS: From 2003 to 2014, there were 13,028 incident MS cases in Ontario, of whom 1,070 (8.2%) were immigrants. As compared to long-term residents, rates of hospitalization were similar (Adjusted rate ratio (ARR) 0.86; 95% CI: 0.73-1.01) in immigrants the year before MS diagnosis, but outpatient neurology visits (ARR 0.93; 95% CI: 0.87-0.99) were slightly less frequent. However, immigrants had higher rates of hospitalization during the diagnosis year (ARR 1.20, 95% CI: 1.04-1.39), and had greater use of outpatient neurology (ARR 1.17, 95% CI: 1.12-1.23) but fewer ED visits (ARR 0.86; 95% CI: 0.78-0.96). In the first post-diagnosis year, immigrants continued to have greater numbers of outpatient neurology visits (ARR 1.16; 95% CI: 1.10-1.23), but had fewer hospitalizations (ARR 0.79; 95% CI: 0.67-0.94). CONCLUSIONS: Overall, our findings were reassuring concerning health services access for immigrants with MS in Ontario, a publicly funded health care system. However, immigrants were more likely to be hospitalized despite greater use of outpatient neurology care in the year of MS diagnosis. Reasons for this may include more severe disease presentation or lack of social support among immigrants and warrant further investigation.


Assuntos
Emigrantes e Imigrantes/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Assistência Ambulatorial/tendências , Canadá/etnologia , Estudos de Coortes , Serviço Hospitalar de Emergência/tendências , Feminino , Hospitalização/tendências , Humanos , Masculino , Transtornos Mentais/terapia , Serviços de Saúde Mental/tendências , Pessoa de Meia-Idade , Esclerose Múltipla/psicologia , Ontário/etnologia , Atenção Primária à Saúde/tendências , Estudos Retrospectivos , Classe Social
20.
Int Psychogeriatr ; 32(10): 1239-1243, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32609082
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