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  • Wiley  (2)
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  • Wiley  (2)
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  • 1
    Online-Ressource
    Online-Ressource
    Wiley ; 2017
    In:  Journal of Applied Research in Intellectual Disabilities Vol. 30, No. 2 ( 2017-03), p. 316-325
    In: Journal of Applied Research in Intellectual Disabilities, Wiley, Vol. 30, No. 2 ( 2017-03), p. 316-325
    Kurzfassung: In the UK , people with intellectual disabilities who exhibit aggressive behaviour often receive community‐based specialist health services from a community learning disability team ( CLDT ). Our aim was to estimate costs associated with this provision and to identify predictors of higher costs. Method Costs were estimated for 60 adults with intellectual disabilities and aggressive behaviour who attended specialist psychiatric outpatient clinics in the West Midlands region of the UK , including contact time with members of the CLDT and use of psychotropic medication over a 12‐month period. Results Mean total cost of 12‐month service provision was £418 (95% confidence interval [ CI ] £299–557). Mean total cost of 12‐month psychotropic medication was £369 (95% CI £256–492). Amongst individual members of the CLDT , mean costs were highest for psychiatrists (£181) and relatively lower for community nurses (£70) and clinical psychologists (£30), and lowest for physiotherapists (£13). Male sex, presence of expressive verbal communication and presence of epilepsy were independently associated with 12‐month medication and service use costs, accounting for 23% of the variance in cost. Conclusions It seems that in terms of costs, there is an overreliance on medication and psychiatrists and a relatively lesser reliance on other CLDT members such as community nurses and clinical psychologists for the management of aggressive behaviour in adults with intellectual disabilities within community settings. Health commissioners may wish to explore this relative cost discrepancy further and try to redress the balance where appropriate.
    Materialart: Online-Ressource
    ISSN: 1360-2322 , 1468-3148
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2017
    ZDB Id: 2030830-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Wiley ; 2016
    In:  World Psychiatry Vol. 15, No. 3 ( 2016-10), p. 276-286
    In: World Psychiatry, Wiley, Vol. 15, No. 3 ( 2016-10), p. 276-286
    Kurzfassung: This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness.
    Materialart: Online-Ressource
    ISSN: 1723-8617 , 2051-5545
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2016
    ZDB Id: 2236130-3
    Standort Signatur Einschränkungen Verfügbarkeit
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