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Theme: Mental Health & Dementia
Anxiety and depression are around 3 times more common among people attending hospital than among the general population. This anxiety and depression that co-exists with other medical and surgical problems is important as it is not only associated with people experiencing greater misery, fatigue and fearfulness, but it is also associated with worse medical outcomes. For example, someone may experience more episodes of illness, which could result in greater use of emergency care services, longer stays in hosptial and worsen their quality of life.
Current medical/surgical care within the Royal Devon and Exeter Hospital and many other NHS providers focuses on the delivery of excellent physical healthcare. However, they are not well equipped to provide high quality psychological care to people attending hospital. Despite the availability of national guidance (NICE) and effective treatments for anxiety and depression, lack of staff training, increasing patient numbers and difficulty accessing psychological care pathways mean that anxiety and depression often go untreated among patients attending the hospital.
The aim of this project is to provide excellent psychological care to patients attending the Royal Devon and Exeter (RD&E) hospital by development of an Intergrated Psychological Medicine service, which will run alongside routine medical and surgical care.
This project will have 5 broad objectives that are reflected in separate work themes:
The anticipated impact of this project will be better provision for psychological support and care for patients and staff within the RD&E, that will result in reduced physical and psychological morbidity, greater engagement in self-care, improved quality of life, shorter hospital stays and reduced healthcare and work absence
In the short term, the next steps are to complete the training and introduction of routine screening for psychological problems in the key services identified and to establish and evaluate feasibility and acceptability of care pathways to patients and staff. In the medium term next steps will include extension of the training, screening and care pathways to other services.
How can we best address prolonged acute hospital stays in older inpatients with medical-psychiatric multimorbidity?: A pragmatic multicentre randomised controlled trial to compare the effectiveness and cost-effectiveness of Proactive Liaison Psychiatry with usual care.
Adrian Harris (Medical Director)