The Mental Health Network (MHN) has published the fourth edition of key statistics and trends in mental health. This updated edition, reflects new figures, statistics and resources, giving an overview of the major trends and challenges facing mental health services.
This factsheet sets out available data relating to:
investment in services
trends in morbidity
suicide and homicide rates
use of mental health legislation
mental health of children and young people
service user experience
inequalities experienced by people with mental health problems
Good practice in prescribing opioid medicines for pain should reflect fundamental principles in prescribing generally. The decision to prescribe is underpinned by applying best professional practice; understanding the condition, the patient and their context and understanding the clinical use of the drug. This resource, developed by UK healthcare professionals and policymakers, provides the information to support a safe and effective prescribing decision.
Howe, C. J. & Close, S. Journal of Pediatric Nursing. Available online: 8 March 2016
Image shows the different levels of evidence:
Evidence-based practice (EBP) is a problem-solving approach to clinical decision-making that integrates the best available evidence with one’s own clinical expertise. As well, it incorporates patient values and preferences to improve health outcomes (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). The Institute of Medicine Roundtable on Evidence-Based Medicine (2009) set a goal that by the year 2020, 90% of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, reflecting the best available evidence. Melnyk et al. (2014) established nursing competencies for EBP, highlighting the importance of EBP skills for practicing nurses.
Despite these directives, the use of EBP remains inconsistent in the practice setting. Significant obstacles to EBP include lack of time, lack of knowledge and skills, the inability to access research evidence, and the lack of support from colleagues and administration (Dogherty, Harrison, Graham, Vandyk, & Keeping-Burke, 2013). Many nurses, however, wish to learn and refine their EBP skills to optimize health care for their patients (Melnyk et al., 2012).
This column focuses on four essential EBP skills: 1) asking a practice question using the PICO method, 2) retrieving evidence from the literature, 3) appraising the evidence, and 4) synthesizing the evidence. Although there are several models of EBP in the literature (Schaffer, Sandau, & Diedrick, 2013), the Johns Hopkins Nursing EBP (JHNEBP) model offers a practical guide to the EBP process. The JHNEBP textbook by Dearholt and Dang (2012) proves easy to read and many of their EBP tools are available online.
The King’s Fund. Published online: 8th March 2016.
The King’s Fund publishes a new report today which shows that the psychological problems associated with physical health conditions, and vice versa, are costing the NHS more than £11 billion a year and care is less effective than it could be. The report argues that by integrating physical and mental health care the NHS can improve health outcomes and save money.
The £11 billion a year is the collective cost of:
high rates of mental health issues among those with long-term conditions such as cancer, diabetes or heart disease
limited support for the psychological aspects of physical health, for example during and after pregnancy
poor management of ‘medically unexplained symptoms’ such as persistent pain or tiredness.
The separation between physical and mental health has a high human cost: the life expectancy for people with severe mental illness (such as bipolar disorder or schizophrenia) is 15 to 20 years below that of the general population, largely as a result of physical health conditions.
Lintern, S. HSJ. Published online: 9th March 2016.
Medical examiners to review all deaths in England and Wales from April 2018
Jeremy Hunt to implement recommendation of Dame Janet Smith after 7 year delay
Medical examiner pilots found one in four hospital death certificates were inaccurate
All deaths in England and Wales will be investigated by independent medical examiners from April 2018 in an effort to improve patient safety and tackle inaccurate death certification.
Health secretary Jeremy Hunt is set to announce plans for a nationwide medical examiner service at a patient safety summit in London tomorrow.
The new role will see approximately 300 senior doctors appointed to review the causes of all deaths from April 2018. These examiners will have the ability to refer deaths to a coroner for investigation and it is hoped their work will make it easier to spot trends in deaths and tackle clinical governance problems.
Medical examiners will also be able to liaise with relatives and potentially investigate any concerns they may have about the care their loved one received.
The idea of medical examiners was first recommended by Dame Janet Smith following her public inquiry into serial killer GP Harold Shipman. Legislation was passed via the Coroners and Justice Act 2009 but the role was never implemented. It was also supported by recommendations from Sir Robert Francis QC after the Mid Staffordshire public inquiry and Dr Bill Kirkup’s investigation into failures at Morecambe Bay.
Objective: To assess the effects of using health social media on web activity.
Design: Individually randomised controlled parallel group superiority trial.
Setting: Twitter and Weibo.
Participants: 170 Cochrane Schizophrenia Group full reviews with an abstract and plain language summary web page.
Interventions: Three randomly ordered slightly different 140 character or less messages, each containing a short URL to the freely accessible summary page sent on specific times on one single day. This was compared with no messaging.
Outcome: The primary outcome was web page visits at 1 week. Secondary outcomes were other metrics of web activity at 1 week.
Results: 85 reviews were randomised to each of the intervention and control arms. Google Analytics allowed 100% follow-up within 1 week of completion. Intervention and control reviews received a total of 1162 and 449 visits, respectively (IRR 2.7, 95% CI 2.2 to 3.3). Fewer intervention reviews had single page only visits (16% vs 31%, OR 0.41, 0.19 to 0.88) and users spent more time viewing intervention reviews (geometric mean 76 vs 31 s, ratio 2.5, 1.3 to 4.6). Other secondary metrics of web activity all showed strong evidence in favour of the intervention.
Conclusions: Tweeting in this limited area of healthcare increases ‘product placement’ of evidence with the potential for that to influence care.
Megan A. Moreno. JAMA Pediatrics. 2016;170(3):304.
Water is essential for human life. It prevents dehydration and is an important source of a nutritious diet. Research scientists have been studying how drinking water compared with sugar-sweetened beverages, such as soda or juice, affects children’s health.
A new study in this month’s JAMA Pediatrics describes an intervention in New York City public elementary and middle schools. This quasi-experimental study included more than 1 000 000 students in these schools. It was performed after New York City schools banned artificial flavors, colors, or sweeteners in all beverage vending machines and limited beverages to those that had less than 10 cal per 8 oz. As part of this new program, the school installed water jets in school cafeterias.
Water jets are electrically cooled, large clear jugs that can provide a fast stream of cool water. The schools provided plastic cups for students to use with the water jets. The researchers wanted to know whether the change from sugar-sweetened beverages in vending machines to water jets would affect the students’ weight. They found that the adoption of water jets was associated with a reduction in the average weight of students as measured by body mass index (calculated as weight in kilograms divided by height in meters squared). The researchers also found that there was a decrease in the likelihood of being overweight. These changes happened after the sugar-sweetened beverages were removed from the schools and the water jets were placed in the school cafeterias.