The Experts below are selected from a list of 216 Experts worldwide ranked by ideXlab platform
Graham Thornicroft - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic Overshadowing and other challenges involved in the Diagnostic process of patients with mental illness who present in emergency departments with physical symptoms a qualitative study
PLOS ONE, 2014Co-Authors: Guy Shefer, Claire Henderson, Joanna Murray, Louise M Howard, Graham ThornicroftAbstract:We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of ‘Diagnostic Overshadowing’ – the misattribution of physical symptoms to mental illness – and other challenges involved in the Diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the Diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing. Language: en
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing.
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discrimination in health care against people with mental illness
International Review of Psychiatry, 2007Co-Authors: Graham Thornicroft, Diana Rose, Aliya KassamAbstract:This paper discusses factors associated with low rates of help-seeking and poorer quality of physical healthcare among people with mental illnesses. Evidence is reviewed on the associations between low rates of mental health literacy, negative attitudes towards people with mental illness, and reluctance to seek help by people who consider that they may have a mental disorder. People with mental illness often report encountering negative attitudes among mental health staff about their prognosis, associated in part with 'physician bias'. 'Diagnostic Overshadowing' appears to be common in general health care settings, meaning the misattribution of physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions.
Claire Henderson - One of the best experts on this subject based on the ideXlab platform.
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liaison psychiatry professionals views of general hospital care for patients with mental illness the care of patients with mental illness in the general hospital setting
Journal of Psychosomatic Research, 2017Co-Authors: J Noblett, A Caffrey, A Khan, E Lagunescordoba, O Galegrant, Claire HendersonAbstract:Abstract Objective Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. Methods A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Results Areas of concern in the quality of care of patients with co-morbid mental illness included ‘Diagnostic Overshadowing’, ‘poor communication with patient’, ‘patient dignity not respected’ and ‘delay in investigation or treatment’. Eleven contributing factors were identified, the two most frequently mentioned were ‘stigmatising attitudes of staff towards patients with co-morbid mental illness’ and ‘complex diagnosis’. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included ‘formal education’ and ‘changing the liaison psychiatry team’. Conclusion The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care.
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Diagnostic Overshadowing and other challenges involved in the Diagnostic process of patients with mental illness who present in emergency departments with physical symptoms a qualitative study
PLOS ONE, 2014Co-Authors: Guy Shefer, Claire Henderson, Joanna Murray, Louise M Howard, Graham ThornicroftAbstract:We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of ‘Diagnostic Overshadowing’ – the misattribution of physical symptoms to mental illness – and other challenges involved in the Diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the Diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing. Language: en
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing.
Aliya Kassam - One of the best experts on this subject based on the ideXlab platform.
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing. Language: en
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing.
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discrimination in health care against people with mental illness
International Review of Psychiatry, 2007Co-Authors: Graham Thornicroft, Diana Rose, Aliya KassamAbstract:This paper discusses factors associated with low rates of help-seeking and poorer quality of physical healthcare among people with mental illnesses. Evidence is reviewed on the associations between low rates of mental health literacy, negative attitudes towards people with mental illness, and reluctance to seek help by people who consider that they may have a mental disorder. People with mental illness often report encountering negative attitudes among mental health staff about their prognosis, associated in part with 'physician bias'. 'Diagnostic Overshadowing' appears to be common in general health care settings, meaning the misattribution of physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions.
Joanna Murray - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic Overshadowing and other challenges involved in the Diagnostic process of patients with mental illness who present in emergency departments with physical symptoms a qualitative study
PLOS ONE, 2014Co-Authors: Guy Shefer, Claire Henderson, Joanna Murray, Louise M Howard, Graham ThornicroftAbstract:We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of ‘Diagnostic Overshadowing’ – the misattribution of physical symptoms to mental illness – and other challenges involved in the Diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the Diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing. Language: en
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing.
Louise M Howard - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic Overshadowing and other challenges involved in the Diagnostic process of patients with mental illness who present in emergency departments with physical symptoms a qualitative study
PLOS ONE, 2014Co-Authors: Guy Shefer, Claire Henderson, Joanna Murray, Louise M Howard, Graham ThornicroftAbstract:We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of ‘Diagnostic Overshadowing’ – the misattribution of physical symptoms to mental illness – and other challenges involved in the Diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the Diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing. Language: en
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emergency department staff views and experiences on Diagnostic Overshadowing related to people with mental illness
Epidemiology and Psychiatric Sciences, 2013Co-Authors: A Van Nieuwenhuizen, Claire Henderson, Joanna Murray, Louise M Howard, Aliya Kassam, Tanya Graham, Graham ThornicroftAbstract:Aims. To investigate recognition of Diagnostic Overshadowing, i.e., misattribution of physical symptoms to mental illness, among emergency medicine professionals; further, to identify contributory and mitigating factors to Diagnostic Overshadowing. Methods. In-depth individual interviews of 25 emergency department clinicians and qualitative analysis using thematic analysis. Results. Diagnostic Overshadowing was described as a significant issue. Contributing factors included: (1) problems of knowledge and information gathering; (2) clinicians' attitudes toward people with mental illness, substance misuse and frequent attenders; and (3) difficulties in working with mental health services in the context of a 4-h target for discharge from the emergency department. Avoidance of patients with a psychiatric diagnosis was also described, due to fear of violence. Conclusion. The physical health care of people with mental illness in emergency departments may be adversely affected by Diagnostic Overshadowing and avoidance by clinical staff, along with difficulties created by the illness, medication and the emergency department environment. Greater joint working between psychiatric and emergency department staff is suggested as one way to reduce Diagnostic Overshadowing.