The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Marguerite E Ohaire - One of the best experts on this subject based on the ideXlab platform.
-
a part of our family effects of Psychiatric Service dogs on quality of life and relationship functioning in military connected couples
Military behavioral health, 2020Co-Authors: Christine E Mccall, Kerri E Rodriguez, Shelley Macdermid Wadsworth, Laura A Meis, Marguerite E OhaireAbstract:Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and individual functioning. Emerging evidence has shown that Psychiatric Service dogs may be an effective com...
-
Service dogs for veterans and military members with posttraumatic stress disorder replication with the ptsd checklist for dsm 5
Journal of Traumatic Stress, 2020Co-Authors: Clare L Jensen, Kerri E Rodriguez, Marguerite E OhaireAbstract:Psychiatric Service dogs are an emerging complementary intervention for veterans and military members with posttraumatic stress disorder (PTSD). Recent cross-sectional studies have documented significant, clinically relevant effects regarding Service dogs and PTSD symptom severity. However, these studies were conducted using the PTSD Checklist (PCL) for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The present study aimed to replicate and advance these findings using the latest version of the PCL for the fifth edition of the DSM (PCL-5). Participants included 186 military members and veterans who had received a PTSD Service dog (n = 112) or who were on the waitlist to receive one in the future (n = 74). A cross-sectional design was used to investigate the association between having a Service dog and PCL-5 total and symptom cluster scores. After controlling for demographic variables, there was a significant association between having a Service dog and lower PTSD symptom severity both in total, B = -14.52, p < .001, d = -0.96, and with regard to each symptom cluster, ps < .001, ds = -0.78 to -0.94. The results replicated existing findings using the largest sample size to date and the most recent version of the PCL. These findings provide additional preliminary evidence for the efficacy of Service dogs as a complementary intervention for military members and veterans with PTSD and add to a growing body of foundational research serving to rationalize investment in the further clinical evaluation of this emerging practice.
-
defining the ptsd Service dog intervention perceived importance usage and symptom specificity of Psychiatric Service dogs for military veterans
Frontiers in Psychology, 2020Co-Authors: Kerri E Rodriguez, Megan R Lafollette, Karin Hediger, Niwako Ogata, Marguerite E OhaireAbstract:Research suggests that Psychiatric Service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD Service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of Service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the Service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with Service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national Service dog provider, including n = 134 with a Service dog and n = 83 on the waitlist. Results showed that the Service dog's trained tasks of calming and interrupting anxiety were perceived as the most important for veterans' PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the Service dog's untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran's PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their Service dogs reported using trained tasks more often, and veterans who had their Service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a Service dog. In conclusion, findings describe the core components of the PTSD Service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD Service dog's clinically relevant value while contributing to the scientific understanding of this emerging practice.
-
the effect of a Service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder ptsd
Psychoneuroendocrinology, 2018Co-Authors: Kerri E Rodriguez, Crystal I Bryce, Douglas A Granger, Marguerite E OhaireAbstract:Abstract Recent studies suggest a therapeutic effect of Psychiatric Service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD Service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a Service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a Service dog on both the CAR and the AUCi, with individuals with a Service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a Service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a Service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD Service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a Service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.
-
preliminary efficacy of Service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Marguerite E Ohaire, Kerri E RodriguezAbstract:OBJECTIVE: Psychiatric Service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. METHOD: A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained Service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. RESULTS: Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a Service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with Service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. CONCLUSION: The addition of trained Service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record
Kerri E Rodriguez - One of the best experts on this subject based on the ideXlab platform.
-
a part of our family effects of Psychiatric Service dogs on quality of life and relationship functioning in military connected couples
Military behavioral health, 2020Co-Authors: Christine E Mccall, Kerri E Rodriguez, Shelley Macdermid Wadsworth, Laura A Meis, Marguerite E OhaireAbstract:Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and individual functioning. Emerging evidence has shown that Psychiatric Service dogs may be an effective com...
-
Service dogs for veterans and military members with posttraumatic stress disorder replication with the ptsd checklist for dsm 5
Journal of Traumatic Stress, 2020Co-Authors: Clare L Jensen, Kerri E Rodriguez, Marguerite E OhaireAbstract:Psychiatric Service dogs are an emerging complementary intervention for veterans and military members with posttraumatic stress disorder (PTSD). Recent cross-sectional studies have documented significant, clinically relevant effects regarding Service dogs and PTSD symptom severity. However, these studies were conducted using the PTSD Checklist (PCL) for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The present study aimed to replicate and advance these findings using the latest version of the PCL for the fifth edition of the DSM (PCL-5). Participants included 186 military members and veterans who had received a PTSD Service dog (n = 112) or who were on the waitlist to receive one in the future (n = 74). A cross-sectional design was used to investigate the association between having a Service dog and PCL-5 total and symptom cluster scores. After controlling for demographic variables, there was a significant association between having a Service dog and lower PTSD symptom severity both in total, B = -14.52, p < .001, d = -0.96, and with regard to each symptom cluster, ps < .001, ds = -0.78 to -0.94. The results replicated existing findings using the largest sample size to date and the most recent version of the PCL. These findings provide additional preliminary evidence for the efficacy of Service dogs as a complementary intervention for military members and veterans with PTSD and add to a growing body of foundational research serving to rationalize investment in the further clinical evaluation of this emerging practice.
-
defining the ptsd Service dog intervention perceived importance usage and symptom specificity of Psychiatric Service dogs for military veterans
Frontiers in Psychology, 2020Co-Authors: Kerri E Rodriguez, Megan R Lafollette, Karin Hediger, Niwako Ogata, Marguerite E OhaireAbstract:Research suggests that Psychiatric Service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD Service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of Service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the Service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with Service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national Service dog provider, including n = 134 with a Service dog and n = 83 on the waitlist. Results showed that the Service dog's trained tasks of calming and interrupting anxiety were perceived as the most important for veterans' PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the Service dog's untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran's PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their Service dogs reported using trained tasks more often, and veterans who had their Service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a Service dog. In conclusion, findings describe the core components of the PTSD Service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD Service dog's clinically relevant value while contributing to the scientific understanding of this emerging practice.
-
the effect of a Service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder ptsd
Psychoneuroendocrinology, 2018Co-Authors: Kerri E Rodriguez, Crystal I Bryce, Douglas A Granger, Marguerite E OhaireAbstract:Abstract Recent studies suggest a therapeutic effect of Psychiatric Service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD Service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a Service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a Service dog on both the CAR and the AUCi, with individuals with a Service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a Service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a Service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD Service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a Service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.
-
preliminary efficacy of Service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Marguerite E Ohaire, Kerri E RodriguezAbstract:OBJECTIVE: Psychiatric Service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. METHOD: A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained Service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. RESULTS: Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a Service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with Service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. CONCLUSION: The addition of trained Service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record
Michele Tansella - One of the best experts on this subject based on the ideXlab platform.
-
a census based socio economic status ses index as a tool to examine the relationship between mental health Services use and deprivation
Social Science & Medicine, 2005Co-Authors: Juan Eduardo Tello, Paola Bonizzato, Julia Jones, Francesco Amaddeo, Mariangela Mazzi, Michele TansellaAbstract:This paper discusses the development and application of a socio-economic status (SES) index, created to explore the relationship between socio-economic variables and Psychiatric Service use. The study was conducted in a community-based mental health Service (CMHS) in Verona, Northern Italy, utilising Service use data from 1996. An ecological SES index was constructed through a factor analysis from 1991 Census data, at census block level. Three factors reflected the following domains: the educational-employment sector (with four components), the relational network (with three components) and the material conditions (with three components). All Service users were assigned a SES value, according to their place of residence in 1996. When these data were explored spatially, using ArcView 8.3, an association was observed between socio-economic deprivation and Psychiatric Service use. The SES index was then successfully validated using occupational status at the individual level. This study confirms the usefulness of developing and validating an ecological census-based SES index, for Service planning and resource allocation in an area with a community-based system of mental health care.
-
does socioeconomic status affect the use of community based Psychiatric Services a south verona case register study
Acta Psychiatrica Scandinavica, 2005Co-Authors: J E Tello, Paola Bonizzato, Michele Tansella, Maria Angela Mazzi, Julia Jones, Francesco AmaddeoAbstract:Objective: To assess the effect of socioeconomic status (SES) on Psychiatric Service use in an Italian area with a well-developed community-based Psychiatric Service. Method: An index of SES was calculated from nine census variables and grouped into four categories, ranging from SES-I-affluent to SES-IV-deprived, for each of 328 census blocks (CB). Fifteen indicators of Psychiatric Service use were collected using the Psychiatric case register. All patients resident in the catchment area, who had at least one Psychiatric contact in 1996 (n = 989), were included in the study. Results: Indicators of in-patient, day-patient, out-patient and community Service use showed an inverse association with SES. Only first-ever and long-term psychotic patients were equally distributed in the four SES groups. Conclusion: The inverse association between SES and most indicators of Psychiatric Service use suggests that the planning of community-based Services and resource allocation should take into account the SES of residents.
-
demographic clinical social and Service variables associated with higher needs for care in community Psychiatric Service patients the south verona outcome project 8
Social Psychiatry and Psychiatric Epidemiology, 2004Co-Authors: Mirella Ruggeri, Morven Leese, Mike Slade, Paola Bonizzato, Laura Fontecedro, Michele TansellaAbstract:Mental health Services should be provided on the basis of need. This study investigated a representative sample of patients attending a community-based Psychiatric Service. The aim was to identify the profile of patients with higher needs for care, by considering a full range of potential demographic, clinical, social and Service correlates. A total of 268 patients using mental health Services in South Verona, Italy, had cross-sectional assessments of their needs (using the Camberwell Assessment of Need), symptomatology, disability, functioning, quality of life, Service use and satisfaction with care analysed using linear regression. A model comprising being male, being unemployed, having high symptomatology and disability, having low functioning and self-reported quality of life, and a high number of outpatient and community contacts accounted for 67% of the variance in total level of need. Patients who meet any of these criteria may be more likely to have higher needs, which has implications for clinical practice and audit. Assessment of needs for care by using the CAN provides a good overall measure of the number and the severity of a patient’s problems in several key areas of everyday life.
-
community based psychiatry long term patterns of care in south verona
1993Co-Authors: Michele TansellaAbstract:Community-based psychiatry has stimulated widespread interest and controversy over the past 20 years. Analyzing the results of evaluative studies of the South-Verona Community Psychiatric Service over a 10-year period, this book explores the implications of the Verona experience.
Graham Thornicroft - One of the best experts on this subject based on the ideXlab platform.
-
discrimination in relation to parenthood reported by community Psychiatric Service users in the uk a framework analysis
BMC Psychiatry, 2013Co-Authors: Debra Jeffery, Sarah Clement, Elizabeth Corker, Louise M Howard, Joanna Murray, Graham ThornicroftAbstract:Experienced discrimination refers to an individual’s perception that they have been treated unfairly due to an attribute and is an important recent focus within stigma research. A significant proportion of mental health Service users report experiencing mental illness-based discrimination in relation to parenthood. Existing studies in this area have not gone beyond prevalence, therefore little is known about the nature of experienced discrimination in relation to parenthood, and how is it constituted. This study aims to generate a typology of community Psychiatric Service users’ reports of mental illness-based discrimination in relation to becoming or being a parent. A secondary aim is to assess the prevalence of these types of experienced discrimination. In a telephone survey 2026 community Psychiatric Service users in ten UK Mental Health Service provider organisations (Trusts) were asked about discrimination experienced in the previous 12 months using the Discrimination and Stigma Scale (DISC). The sample were asked if, due to their mental health problem, they had been treated unfairly in starting a family, or in their role as a parent, and gave examples of this. Prevalence is reported and the examples of experienced discrimination in relation to parenthood were analysed using the framework method of qualitative analysis. Three hundred and four participants (73% female) reported experienced discrimination, with prevalences of 22.5% and 28.3% for starting a family and for the parenting role respectively. Participants gave 89 examples of discrimination about starting a family and 228 about parenting, and these occurred in social and professional contexts. Ten themes were identified. These related to being seen as an unfit parent; people not being understanding; being stopped from having children; not being allowed to see their children; not getting the support needed; children being affected; children avoiding their parents; children’s difficulties being blamed on the parent’s mental health problem; not being listened to; and being undermined as a parent. This research highlights the need for: greater support for parents with mental illness, those wishing to have children, and those who lose access or custody; Services to better meet the needs of children with a mentally ill parent; training about discrimination for professionals; and parenting issues to be included in anti-stigma programmes.
-
a study of crisis cards in a community Psychiatric Service
Acta Psychiatrica Scandinavica, 1999Co-Authors: Kim Sutherby, Graham Thornicroft, George Szmukler, A Halpern, M Alexander, C Johnson, S WrightAbstract:Sutherby K, Szmukler GI, Halpern A, Alexander M, Thornicroft G, Johnson C, Wright S. A study of ‘crisis cards’ in a community Psychiatric Service. Acta Psychiatr Scand 1999: 100: 56–61. © Munksgaard 1999. Objective: ‘Crisis cards’ state patients' treatment details and preferences in anticipation of a later occasion when the patient might be too ill to express them directly. We assessed the feasibility of introducing ‘crisis cards’, or a collaborative form of them, ‘joint crisis plans’, into a sectorized community Psychiatric Service. Method All patients with a psychosis and at high risk of crisis were invited to participate. Follow-up examined patients' satisfaction and how the cards were used. Results: In total, 106 eligible patients were identified and offered a card, and 40% agreed to participate. Patients with an affective psychosis, past suicide attempts and less frequent admissions were over-represented among those who agreed to take part. Patients chose to include a wide range of information. For participants, admissions fell by 30% in the follow-up year. Conclusion: Crisis cards serve both a ‘manifest’, practical function (to provide important information when the patient is too ill to do so) and a ‘latent’ psychological one (positive effects on the patient's attitude to self, their illness and treatment, and their relationship with the clinical team).
-
drug and alcohol problems among individuals with severe mental illness in south london
British Journal of Psychiatry, 1996Co-Authors: Paulo Rossi Menezes, Graham Thornicroft, Sonia Johnson, Jane Marshall, David Prosser, Paul Bebbington, Elizabeth KuipersAbstract:BACKGROUND High rates of comorbid alcohol and drug disorders have previously been found among individuals with severe mental illnesses such as schizophrenia and bipolar affective disorders. Clinical and social outcomes have been reported to be worse in this group and Service costs greater than in individuals with severe mental illness only. These 'dual diagnosis' patients have mainly been investigated in the USA, and there has been very little research in Europe, where patterns of substance abuse may be different. METHOD All patients with psychotic illnesses who had any contact with the mental health Services in a geographically defined sector in South London over a specified period were studied. Individuals with problems related to alcohol or drugs were identified using standardised interviews with subjects and their keyworkers. Data on Psychiatric Service use during the previous 2 years were also obtained. RESULTS One hundred and seventy-one subjects with psychotic illnesses were interviewed (response rate: 78.4%). The one-year prevalence rate for any substance problem was 36.3% (95% CI = 29.1-43.5), for alcohol problems it was 31.6% (95% CI = 24.6-38.5), and for drug problems 15.8% (95% CI = 10.3-21.3). Young male subjects were at higher risk of having substance problems. Patients with substance problems had spent almost twice as many days in hospital as those without such problems over the previous two years (difference = 26.3 days, 95% CI = 3.8-48.7). CONCLUSIONS The prevalence of substance problems among people suffering from severe mental disorders is high, and seems to be associated with greater use of in-patient Services. This is a significant clinical problem, with cost implications. Further investigation is needed for adequate Service provision.
-
social deprivation and rates of treated mental disorder developing statistical models to predict Psychiatric Service utilisation
British Journal of Psychiatry, 1991Co-Authors: Graham ThornicroftAbstract:A review of the literature shows that there are strong associations of treated prevalence rates of Psychiatric disorder with social class, sex, marital status, ethnic group and living alone; and moderate associations with living in inner-city areas and a high degree of residential mobility. The Jarman-8 index of social deprivation correlates with Psychiatric admission rates for patients aged less than 65 years (R2 = 0.38). Individual census variables can themselves account for up to 0.71 of the variance in the admission rates, while combined in a stepwise multiple regression the census variables will account for over 0.95 of this variation. Multiple regression models using individual census variables and derived indices should be applied next on a wider geographical basis, and to narrower age, sex and diagnosis-specific Psychiatric morbidity rates.
Paola Bonizzato - One of the best experts on this subject based on the ideXlab platform.
-
a census based socio economic status ses index as a tool to examine the relationship between mental health Services use and deprivation
Social Science & Medicine, 2005Co-Authors: Juan Eduardo Tello, Paola Bonizzato, Julia Jones, Francesco Amaddeo, Mariangela Mazzi, Michele TansellaAbstract:This paper discusses the development and application of a socio-economic status (SES) index, created to explore the relationship between socio-economic variables and Psychiatric Service use. The study was conducted in a community-based mental health Service (CMHS) in Verona, Northern Italy, utilising Service use data from 1996. An ecological SES index was constructed through a factor analysis from 1991 Census data, at census block level. Three factors reflected the following domains: the educational-employment sector (with four components), the relational network (with three components) and the material conditions (with three components). All Service users were assigned a SES value, according to their place of residence in 1996. When these data were explored spatially, using ArcView 8.3, an association was observed between socio-economic deprivation and Psychiatric Service use. The SES index was then successfully validated using occupational status at the individual level. This study confirms the usefulness of developing and validating an ecological census-based SES index, for Service planning and resource allocation in an area with a community-based system of mental health care.
-
does socioeconomic status affect the use of community based Psychiatric Services a south verona case register study
Acta Psychiatrica Scandinavica, 2005Co-Authors: J E Tello, Paola Bonizzato, Michele Tansella, Maria Angela Mazzi, Julia Jones, Francesco AmaddeoAbstract:Objective: To assess the effect of socioeconomic status (SES) on Psychiatric Service use in an Italian area with a well-developed community-based Psychiatric Service. Method: An index of SES was calculated from nine census variables and grouped into four categories, ranging from SES-I-affluent to SES-IV-deprived, for each of 328 census blocks (CB). Fifteen indicators of Psychiatric Service use were collected using the Psychiatric case register. All patients resident in the catchment area, who had at least one Psychiatric contact in 1996 (n = 989), were included in the study. Results: Indicators of in-patient, day-patient, out-patient and community Service use showed an inverse association with SES. Only first-ever and long-term psychotic patients were equally distributed in the four SES groups. Conclusion: The inverse association between SES and most indicators of Psychiatric Service use suggests that the planning of community-based Services and resource allocation should take into account the SES of residents.
-
demographic clinical social and Service variables associated with higher needs for care in community Psychiatric Service patients the south verona outcome project 8
Social Psychiatry and Psychiatric Epidemiology, 2004Co-Authors: Mirella Ruggeri, Morven Leese, Mike Slade, Paola Bonizzato, Laura Fontecedro, Michele TansellaAbstract:Mental health Services should be provided on the basis of need. This study investigated a representative sample of patients attending a community-based Psychiatric Service. The aim was to identify the profile of patients with higher needs for care, by considering a full range of potential demographic, clinical, social and Service correlates. A total of 268 patients using mental health Services in South Verona, Italy, had cross-sectional assessments of their needs (using the Camberwell Assessment of Need), symptomatology, disability, functioning, quality of life, Service use and satisfaction with care analysed using linear regression. A model comprising being male, being unemployed, having high symptomatology and disability, having low functioning and self-reported quality of life, and a high number of outpatient and community contacts accounted for 67% of the variance in total level of need. Patients who meet any of these criteria may be more likely to have higher needs, which has implications for clinical practice and audit. Assessment of needs for care by using the CAN provides a good overall measure of the number and the severity of a patient’s problems in several key areas of everyday life.
