A systems analysis of an area mental health service
type: CreativeWork
description: The mental health services existing in a defined geographic area in New Zealand were studied in an effort to establish priorities for service development. It was clear from a preliminary review of the services that while community based services were operating in the area, they were under-resourced and very poorly monitored. They did not provide care that was comprehensive and the population they were intended to service was not clearly specified. Information about who used the services, where they came from and why, was difficult to obtain. There were no psychiatric beds in the general hospital in the area which served a population of approximately 300,000. Acute inpatient care was provided in a 300 bed psychiatric hospital remote from the main centres of population. The acute area of this hospital provided 50 beds and appeared to be under strain most of the time. No standardised criteria for admission and discharge to and from the service were in place. The aims of the acute service, the boundaries of clinical responsibility between assessment, symptom control, treatment and continuing care were vague. To begin the study, a scale was developed and used to assess the feasibility of evaluating individual psychiatric services. A one day census of patients registered with the services was then carried out. The services included inpatient services, general hospital and court liaison services, community mental health centres, day hospital programmes, domicilliary nursing services, a substance abuse service, a rapid assessment service and a child and family service. The census uncovered a lack of adequate record systems for both patient and management information. As a consequence, a patient case register, based on a minimum data set of patient information, was developed. Meantime, a preliminary review of the acute services in the psychiatric hospital revealed a service under stress. Major sources of this stress were identified as inadequacies in the physical environment…
abstract: The mental health services existing in a defined geographic area in New Zealand were studied in an effort to establish priorities for service development. It was clear from a preliminary review of the services that while community based services were operating in the area, they were under-resourced and very poorly monitored. They did not provide care that was comprehensive and the population they were intended to service was not clearly specified. Information about who used the services, where they came from and why, was difficult to obtain. There were no psychiatric beds in the general hospital in the area which served a population of approximately 300,000. Acute inpatient care was provided in a 300 bed psychiatric hospital remote from the main centres of population. The acute area of this hospital provided 50 beds and appeared to be under strain most of the time. No standardised criteria for admission and discharge to and from the service were in place. The aims of the acute service, the boundaries of clinical responsibility between assessment, symptom control, treatment and continuing care were vague. To begin the study, a scale was developed and used to assess the feasibility of evaluating individual psychiatric services. A one day census of patients registered with the services was then carried out. The services included inpatient services, general hospital and court liaison services, community mental health centres, day hospital programmes, domicilliary nursing services, a substance abuse service, a rapid assessment service and a child and family service. The census uncovered a lack of adequate record systems for both patient and management information. As a consequence, a patient case register, based on a minimum data set of patient information, was developed. Meantime, a preliminary review of the acute services in the psychiatric hospital revealed a service under stress. Major sources of this stress were identified as inadequacies in the physical environment…
author: Keith, Catherine B.
license: https://researchcommons.waikato.ac.nz/bitstreams/91dc3a66-7c21-46cb-bb67-c238fba471da/download
date published: 1992
date modified: 2026-07-24T05:57:49Z
provider: University Waikato
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: The University of Waikato