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Found 28 results
  1. News Article
    Child and adolescent eating disorder services have never achieved NHS waiting time targets, and are not able to meet significant demand, according to analysis by the Royal College of Psychiatrists. Psychiatrists can identify and address many of the root causes of eating disorders, including neurodevelopmental conditions such as autism and ADHD. However, a current lack of capacity prevents this from happening. Due to a lack of resources, even children who meet the threshold for specialist eating disorder services are often in physical and mental health crisis by the time they are seen. Delays in treatment cause children with eating disorders physical and mental harm. NHS England set a target for 95% of children and young people with an urgent eating disorder referral to be seen within a week, and for 95% of routine referrals to be seen within four weeks. These standards have not been achieved nationwide, since they were introduced in 2021. RCPsych analysis of the latest data shows that just 63.8% of children and young people needing urgent treatment from eating disorder services were seen within one week. Only 79.4% of children and young people with a routine referral were seen within four weeks. The College also warns that there is an unacceptable gap between the number of children being referred to specialist eating disorders services, and those being seen. This is driven by a shortfall in the number of trained therapists and eating disorders psychiatrists. For Eating Disorders Awareness Week, the Royal College of Psychiatrists is calling on Government and Integrated Care Boards to invest in targeted support for children and young people to reverse this eating disorders crisis. The call is backed by the UK’s eating disorder charity Beat. Read full story Source: Royal College of Psychiatrists, 29 February 2024 Further reading on the hub: For Eating Disorders Awareness Week, Patient Safety Learning has pulled together 10 useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders.
  2. Content Article
    Research clearly demonstrates that from conception onwards, rapid brain development influences the cognitive, emotional and social development of babies and young children. Pre-conception to five years is an important time in a child’s life and critical for brain and psychological development, the formation of enduring relationship patterns, and emotional, social and cognitive functioning – all of which are foundations for healthy development, but which can also confer protection against mental health conditions. The establishment of sensitive, attuned and responsive relationships is essential for positive mental health and wellbeing and underpins interventions to address problems in social and emotional development, poor mental health and mental health conditions in under 5s. This report by the Royal College of Psychiatrists (RCPsych) aims to outline the importance of mental health in babies and young children under 5 to policy makers, commissioner and healthcare practitioners.
  3. News Article
    A father whose son took his own life in July 2020 is calling for an "urgent overhaul" of the way some counsellors and therapists assess suicide risk. His son Tom had died a day after being judged "low risk", in a final counselling session, Philip Pirie said. A group of charities has written to the health secretary, saying the use of a checklist-type questionnaire to predict suicide risk is "fundamentally flawed". The government says it is now drawing up a new suicide-prevention strategy. According to the latest official data, 6,211 people in the UK killed themselves in 2020. It is the most common cause of death in 20-34-year-olds. And of the 17 people each day, on average, who kill themselves, five are in touch with mental health services and four of those five are assessed as "low" or "no risk", campaigners say. Tom Pirie, a young teacher from Fulham, west London, had been receiving help for mental-health issues. He had repeatedly told counsellors about his suicidal thoughts - but the day before he had killed himself, a psychotherapist had judged him low risk, his father said. Tom's assessment had been based on "inadequate" questionnaires widely used despite guidelines saying they should not be to predict suicidal behaviour, Philip said. The checklists, which differ depending on the clinicians and NHS trusts involved, typically ask patients questions about their mental health, such as "Do you have suicidal thoughts?" or "Do you have suicidal intentions?" At the end of the session, a score can be generated - placing the individual at low, medium or high risk of suicide, or rating the danger on a scale between 1 and 10. Read full story Source: BBC News, 20 April 2022
  4. News Article
    Many media stories about ketamine as a treatment for psychiatric disorders such as depression “go well beyond the evidence base” by exaggerating the efficacy, safety and longevity of the drug or by overstating the risks, an analysis has found. Researchers examined 119 articles about ketamine and mental illness published by major print media in Australia, the US and UK over a five-year period. They found articles peaked in 2019, when the US Food and Drug Administration approved a ketamine-derived nasal spray known as esketamine for treatment-resistant depression. Researchers found 37% of articles contained inaccurate information, largely related to efficacy, safety information and the longevity of the effect of the treatment. Ketamine treatment was portrayed in an “extremely positive light” in 69% of articles, the review found. “Overly optimistic statements from medical professionals regarding efficacy or safety may encourage patients to seek treatments that may not be clinically appropriate,” says the paper, published in the journal BJPsych Open. “Disconcertingly, some articles included strong statements about treatment efficacy that went well beyond the evidence base. Conversely, exaggeration of the risks may discourage patients from pursuing a treatment that may be suitable for them.” Read full story Source: The Guardian, 8 June 2023
  5. Content Article
    Nicole McCarthy tells us about the Royal College of Psychiatrists' Quality Network for Inpatient Working Age Mental Health Services (QNWA), how it supports and engages mental health inpatient wards in a process of quality improvement, its accreditation and developmental processes and how you can become a member.
  6. News Article
    At a time when it feels like the world’s perpetually on fire, we all need a therapist – but trying to find one in the USA is difficult. A study from the American Psychological Association (APA) found that 6 in 10 psychologists “no longer have openings for new patients” in America. The shortage comes as demand for therapy soars: since the beginning of the pandemic, about three-quarters of practitioners have seen their waiting lists expand. In the same period, almost 80% of practitioners report an increase in patients with anxiety disorders and 66% have seen an increase in those needing treatment for depression. “I started my private practice just before Covid hit, and it was certainly filling up then,” says Dr Jennifer Reid, a psychiatrist, writer and podcast host in Philadelphia. “But the numbers have exponentially risen since that time.” Reid focuses on anxiety and insomnia, which have been “major players” in the pandemic. Early on, people with anxiety, phobias or obsessive-compulsive disorder related to germs had particular trouble, she says. Then there was the isolation and the doomscrolling. And now, she says, people are struggling to re-enter the world. “People are finding they’re having anxiety trying to re-engage in social settings in situations that were previously not as safe” at Covid’s peak, she says. Often, she says, people may need to return to their primary care doctor for a period of time, “or they just end up going without and waiting on waitlists, unfortunately”. The APA study found that the average psychologist reported being contacted by 15 potential patients every month; Reid, who combines therapy and medical approaches, says she generally has space for about one new patient every few weeks. Read full story Source: The Guardian, 21 November 2022
  7. News Article
    Brain complications, including stroke and psychosis, have been linked to COVID-19 in a study that raises concerns about the potentially extensive impact of the disease in some patients. The study, published in Lancet Psychiatry, is small and based on doctors’ observations, so cannot provide a clear overall picture about the rate of such complications. However, medical experts say the findings highlight the need to investigate the possible effects of COVID-19 in the brain and studies to explore potential treatments. “There have been growing reports of an association between COVID-19 infection and possible neurological or psychiatric complications, but until now these have typically been limited to studies of 10 patients or fewer,” said Benedict Michael, the lead author of the study, from the University of Liverpool. “Ours is the first nationwide study of neurological complications associated with Covid-19, but it is important to note that it is focused on cases that are severe enough to require hospitalisation.” Scientists said the findings were an important snapshot of potential complications, but should be treated with caution as it is not possible to draw any conclusions from the data about the prevalence of such complications. Read full story Source: The Guardian, 26 June 2020
  8. Content Article
    Safety and quality of care for psychiatric patients is a relatively understudied area of patient safety research. This scoping review explores patient safety strategies used in psychiatry. The review identified seven key strategies that rely on staff performance, competence, and compliance: 1) risk management, (2) healthcare practitioners, (3) patient observation, (4) patient involvement, (5) computerised methods, (6) admission and discharge, and (7) security. These strategies primarily target reductions in suicide, self-harm, violence and falls.
  9. Content Article
    Variation in healthcare processes is widespread in mental health care and can lead to inefficient processes and unnecessarily long inpatient stays. This study in The British Journal of Healthcare Management aimed to identify sources of variation and introduce a huddle intervention to increase system efficiency on a psychiatric inpatient ward in London. The study found that huddles are a useful way to improve staff communication and increase ward efficiency without taking up a significant amount of clinicians' time.
  10. Content Article
    Stopping antidepressants commonly causes withdrawal symptoms, which can be severe and long-lasting. This paper, published in Therapeutic Advances in Psychopharmacology, outlines the themes emerging from 158 respondents to an open invitation to describe the experience of prescribed psychotropic medication withdrawal for petitions sent to British parliaments.
  11. Content Article
    This article, published in Social and Personality Psychology Compass, looks at the biopsychosocial model as a dynamic system of multiple contextual factors that influence health.
  12. Content Article
    This collection of chapters surrounding the Biopsychosocial Model covers the background to the model and it's implications in areas of medicine as diverse as gastrointestinal diseases and mental health disorders.
  13. Content Article
    This rapid response to the article 'What is a good doctor and how can we make one?', published on the BMJ website, discusses the background to the Biopsychosocial Model and it's implications in clinical practice today. The author highlights the importance of taking psychosocial factors into consideration, such as diet or loneliness, in order to improve individualised patient treatment.
  14. News Article
    Psychiatry is facing a ‘double whammy’ of chronic consultant shortages where patient care is being rationed and under-pressure doctors are working with ‘hands tied behind their backs’, a leading clinician has warned. As the Royal College of Psychiatrists’ official 2021 census reveals consultant vacancies are up by more than a third (35 per cent) since 2017 with nearly one in 10 posts going unfilled, current Dean Professor Subodh Dave told HSJ the current situation impacts “very adversely” on achieving NHS long-term plan goals. In an exclusive interview, the Derbyshire-based liaison psychiatrist told HSJ one in four (24%) of the country’s 7,782 consultant posts are not substantive and are currently dominated by locums, typically on shorter-term contracts. Professor Dave said current workforce gaps are having a knock-on effect with “inevitable rationing” of patient care to keep services running. “If you design a service that has to meet NICE standards then clearly you need the workforce to deliver that standard of care,” he added. “To do that with your hands tied behind your back is frankly impossible.” Read full story (paywalled) Source: HSJ, 6 November 2021
  15. Content Article
    Despite many investigations and inquiries into violent incidents in mental health settings, resulting in reports and guidelines, safety considerations for mental health staff continue to be an issue of serious concern. This report from the Royal College of Psychiatrists attempts to address the safety needs of psychiatrists. Psychiatrists from different disciplines are likely to be exposed to different degrees of threat to their safety, but no particular branch of psychiatry is immune. In the same vein, the context in which psychiatric practice is delivered will also have a bearing on the likelihood of violence, be it on in-patient units, in out-patient settings, in accident and emergency departments, in prisons and other custodial institutions, or in patients’ homes.
  16. Content Article
    This article examines the lasting impact of the tragic case of Daksha Emson, a 34-year old psychiatrist who took her own life and that of her baby daughter in an episode of postpartum psychosis. Daksha had a history of bipolar disorder and had attempted suicide before, and the inquiry into her death found that she received “significantly poorer standard of care than that which her own patients might have expected.” The authors highlight the impact of her story on the development in the UK of both specialist perinatal mental health services and specialised confidential services for health professionals, which remove some of the stigma attached to help-seeking.
  17. Content Article
    This report outlines the Royal College of Psychiatrists in Scotland's priorities for the Scottish Parliament. The report centres on the idea that there should be 'no wrong door' for individuals in all communities to accessing the right care, in the right place, at the right time for mental ill health. It highlights the significant effects of the Covid-19 pandemic on the mental health of the population: The number of people with high levels of psychological distress (indicating a potential psychiatric disorder) has doubled during the Covid-19 pandemic to 35.6%. Those most vulnerable to psychological distress (67%) were those with pre-existing mental ill health–the population already supported by psychiatrists. Women, young people, ethnically diverse communities and the economically disadvantaged have also been disproportionately affected.
  18. Content Article
    Despite it being 20 years since the Institute of Medicine reported poor quality and high variability in healthcare delivery, there are still significant opportunities for clinical quality improvement (QI). As frontline clinicians and future healthcare leaders tasked with driving these changes, resident physicians are an important cohort to equip with knowledge, skills, and experience in QI and patient safety.  In this article, Mitchel and Li review the barriers to resident engagement, leadership and success with QI initiatives and propose potential solutions. Several barriers are unique to psychiatric training. The barriers described are broadly categorised as either structural or process-related, a distinction derived from Donabedian who described a framework for understanding the causal relationship between structures, processes, and outcomes in QI. In addition, the authors provide an example of a resident-led QI initiative to illustrate the proposed solutions.
  19. Content Article
    Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review, published in BMJ Open, is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.
  20. Content Article
    Radio 4's Women's Hour programme discusses coronavirus and the impact the current pandemic is having on access to cervical screening services. Later in the programme, the discussion turns to the topic of dealing with addiction during the lockdown. Cervical screening (listen from the start of the recording) Speakers, Kate Sanger, Head of Public Affairs at Jo's Cervical Cancer Trust, and consultant gynaecologist Dr Christine Ekechi stress that patients should not hesitate to contact their GP if they have any concerns or symptoms. Symptoms might include: abnormal bleeding, bleeding after sex, bleeding after the menopause, bleeding in between periods, unexplained pelvic pain and in some cases increased vaginal discharge. Addiction (21:45) According to the charity Action on Addiction, one in three people are addicted to something. How difficult can it be to remain sober or clean in lockdown, and what support can you still access? Speakers include Holly Sexton, Substance Misuse Practitioner at We Are With You, and Caroline Turriff, a freelance journalist who is 15 years in recovery. They discuss whether opiate painkillers and methadone being more easily available through pharmacies creates safety issues. Caroline argues that it will reduce the risk of people obtaining opiates online or heroin via street dealers which she says could enable them to obtain life-threatening amounts. 
  21. Content Article
    The Psychological Professions Network is a membership network commissioned by Health Education England for all psychological professionals and other stakeholders in NHS commissioned psychological healthcare, whether you work with children, adults or another population, whether you are in training or qualified, a manager, commissioner, educator, or an expert by experience.
  22. Content Article
    In this BMJ opinion piece, Iona Heath reviews a new book by Penelope Campling, who worked as an NHS psychiatrist and psychotherapist for 40 years. Don't Turn Away tells the story of "an increasingly brutal turning away from the most abused and damaged people who struggle to survive within our complacent society." The article argues that over the past few decades, our society has failed to listen to and support the most vulnerable people, with mental health systems focusing on exclusion criteria and keeping people out of the system.
  23. Content Article
    Electroconvulsive therapy, or ECT, is still given to about 2,100 -2,700 people a year in England, about half of whom have not consented to it. This blog reports on a campaign for an independent review of this highly controversial procedure, and provides links to relevant articles.
  24. Content Article
    In 2020, 82 million people worldwide were forcibly displaced. In the same year, the UK received applications for asylum for over 37,500 people. Over 40% of those were women and children, and 8% were children who had arrived in the UK alone without a parent or guardian. This information produced by the Royal College of Psychiatry aims to support health and social care professionals in the UK coming into contact with displaced people. It provides information, guidance and support to ensure timely, high-quality care.
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