Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes

被引:10
作者
Bidargaddi, Niranjan [1 ,2 ]
Bastiampillai, Tarun [3 ]
Allison, Stephen [4 ]
Jones, Gabrielle M. [5 ,6 ]
Furber, Gareth [7 ]
Battersby, Malcolm [8 ]
Richards, David [9 ]
机构
[1] Flinders Univ S Australia, Country Hlth SA LHN, Mental Hlth Informat Res Unit, Bedford Pk, SA, Australia
[2] Flinders Univ S Australia, Sch Med, Bedford Pk, SA, Australia
[3] Director Mental Hlth Strategy SA Hlth, Tomsk, Russia
[4] Flinders Univ S Australia, Sch Med, Psychiat & Gen Practice, Bedford Pk, SA, Australia
[5] Univ Adelaide, Country Hlth SA LHN, Mental Hlth Informat Res Unit, Adelaide, SA 5005, Australia
[6] Univ Adelaide, Discipline Med, Adelaide, SA 5005, Australia
[7] Univ S Australia, Sch Populat Hlth, Sansom Inst Hlth Res, Hlth Econ & Social Policy Grp, Adelaide, SA 5001, Australia
[8] Flinders Univ S Australia, Flinders Human Behav & Hlth Serv Unit, Adelaide, SA 5001, Australia
[9] Univ Exeter, Sch Med, Exeter, Devon, England
关键词
Cost-utility; telecare; telehealth; telepsychiatry; health economics; RANDOMIZED CONTROLLED-TRIAL; PSYCHOLOGICAL THERAPIES; SUICIDE ATTEMPTS; SELF-HARM; INTERVENTION; DEPRESSION; MANAGEMENT; AUSTRALIA; CONTACT; PEOPLE;
D O I
10.1177/1357633X15579785
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction In Australia there is an overwhelming need to provide effective treatment to patients presenting to the Emergency Department (ED) in mental health crisis. We adapted Improving Access to Psychological Therapies service model (IAPT) from the National Health Service (NHS) method for the large scale delivery of psychological therapies throughout the United Kingdom to an Australian ED setting. This telephone-based low intensity therapy was provided to people presenting in crisis to the EDs with combinations of anxiety, depression, substance use, and suicidal thinking. Methods This uncontrolled study utilised session-by-session, before-and-after measures of anxiety and depression via Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Results Of 347 eligible post-crisis ED referred patients, 291 (83.9%) engaged with the IAPT team. Most patients (65%) had attended the ED previously on an average of 3.9 (SD=6.0) occasions. Two hundred and forty one patients received an average of 4.1 (SD=2.3) contacts of low-intensity psychological therapies including 1.2 (SD=1.7) community outreach visits between 20th Oct 2011 and 31st Dec 2012. Treated patients reported clinically significant improvements in anxiety, depression and suicidal ideation. Uncontrolled effect sizes were moderate for anxiety (0.6) and depression (0.6). Discussion The Australian ED IAPT program demonstrated that the UK IAPT program could be adapted for emergency mental health patients and be associated with similar clinical benefits as the original program. Funding The Flinders Medical Centre IAPT program received Emergency Department project funding from the Australian Commonwealth Government through the Council of Australian Governments (COAG) and the South Australian Government initiative, Every Patient Every Service (EPES).
引用
收藏
页码:385 / 391
页数:7
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