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InvolvE

InvolvE. Outcomes of Involuntary Admissions in Hospitals In England. Dr Diana Rose and Rajinder Sidhu. Newham Centre for Mental Health Institute of Psychiatry Liverpool University Bristol University. Department of Health Funded. MHRN. Background.

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InvolvE

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  1. InvolvE Outcomes of Involuntary Admissions in Hospitals In England Dr Diana Rose and Rajinder Sidhu Newham Centre for Mental Health Institute of Psychiatry Liverpool University Bristol University Department of Health Funded MHRN

  2. Background Psychiatry is the only medical speciality that treats significant numbers of patients against their will and many patients get admitted to hospital involuntarily. Empirical Evidence about practice, outcome and processes of coercive treatment is limited

  3. The Study • One Principle Investigator at each site • One Principle Investigator from the MHRN • One Service User Researcher/Investigator at the IOP • involved in drawing up project proposal

  4. RESEARCH QUESTIONS What is the outcome of hospitalisation for legally involuntary patients after 4 weeks of treatment, 3 months of treatment, and 12 months of treatment What patient characteristics and process variables are associated with more or less favourable outcomes? Compare findings from 11 other European Countries With different legislation (EUNOMIA) ?

  5. The Project 4 sites around the UK, IOP covers 4 Trusts LARGEST GEOGRAPHIC AREA One Service User Researcher age 18-65 able to give informed consent Questionnaires and some In depth interviews Paid Sections 2 and 3

  6. Section 2: Admission for assessment Section 3: Admission for treatment Up to 28 days. It isn't renewable. You can only be given treatment with consent unless, under extreme circumstances, it's considered necessary to save your life. Up to six months for treatment in the first place. It can then be renewed for another six months. Any renewals after this would be for one year. Section 136: Removing a mentally ill person from a public place to a place of safety Up to three days in a place of safety. In exceptional circumstances, this can include a police station. It isn't renewable.

  7. SERVICE USERS PERCEPTION OF: Respected and Understood What happens during the sectioning and Admission process Experiences of Tribunals Brief Psychiatric Assessment Scale The Consultant…… M.A. Graham, 2004 Patients own perceptions of their mental health/ability to be at ‘risk’. MANSA ? At the Zoo, Hannah Brookes, 2004

  8. SERVICE USERS PERCEPTION OF: Perceptions of treatment/medication and after care RETROSPECTIVE Level of ‘coercion’ felt and actual coercive measures used (how pressured/forced felt)

  9. Perceived Coercion Did you feel free to do what you wanted? Who suggested you go to hospital? Did you have A lot of control….? MacArther Maximum use Of Coercion 10 Minimum use of Coercion 1

  10. FOLLOW UP 10 days 4 weeks 12 weeks 12 months Community Treatment Was Sectioning Justified Pressure to Adhere to Treatment Any Coercive Measures

  11. Qualitative Interviews Process in detail from the moment the patient is sectioned What lead to this, what happened, what do they think was the reason for this Treatment and Care Retrospect – necessary? What changes need to be made? One Service User Analysing The One that got Away, Linda Hart 2004

  12. Importance,Experience and Satisfaction ( Continuity of Care and InvolvE and Partnership Working and Gendep) • Users Priorities • Scales are combined with qualitative materials and a range • of questions and measures to gain the true meaning to • experience – e.g, treatment/care/respect separated • Empowering by feedback to the participant and the service • Dissemination to user groups and other services • InvolvE: Is more than an audit of one service – looks at a process (sectioning) and its impact on the patient • Shared Experiences

  13. NOW 277 participants at the IOP Approx 870 participants nationwide Retained at 48% at One Year follow up

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