nach oben

Administration and Policy in Mental Health and Mental Health Services Research

Erschienen in:

30.01.2018 | Original Article

Patient-Centered Values and Experiences with Emergency Department and Mental Health Crisis Care

verfasst von: Kathleen C. Thomas, Hillary Owino, Sana Ansari, Leslie Adams, Julianne M. Cyr, Bradley N. Gaynes, Seth W. Glickman

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Little is known about what patients value in psychiatric crisis services or how they compare community-based services with those received in the emergency department. Three focus groups (n = 27) were held of participants who had received psychiatric crisis services in emergency departments or a community mental health center. Participants described care experiences and preferences. Focus groups were audio recorded, transcribed, and coded using a value-based lens. Themes included appreciation for feeling respected, basic comforts, and shared decision-making as foundations of quality care. Participants preferred the community mental health center. Research should address long-term outcomes to motivate change in psychiatric crisis care.

Nur mit Berechtigung zugänglich

Alston, C., Berger, Z., Brownlee, S., Elwyn, G., Fowler, F. J. Jr., Hall, L. K., … Henderson, D. (2014). Shared decision-making strategies for best care: Patient decision aids. Institute of Medicine Roundtable on Value and Science-driven Health Care.

An, M., Colarelli, S. M., O’Brien, K., & Boyajian, M. E. (2016). Why we need more nature at work: Effects of natural elements and sunlight on employee mental health and work attitudes. PLoS ONE, 11(5). https://doi.org/10.1371/journal.pone.0155614.CrossRef

Appelbaum, P. S. (2015). “Boarding” psychiatric patients in emergency rooms: One court says “No more”. Psychiatric Services, 66(7), 668–670. https://doi.org/10.1176/appi.ps.660707.CrossRefPubMed

Beute, F., & de Kort, Y. (2014). Salutogenic effects of the environment: Review of health protective effects of nature and daylight. Applied Psychology: Health and Well-Being, 6(1), 67–95. https://doi.org/10.1111/aphw.12019.CrossRef

Broadbent, M., Moxham, L., & Dwyer, T. (2014). Implications of the emergency department triage environment on triage practice for clients with a mental illness at triage in an Australian context. Australasian Emergency Nursing Journal, 17(1), 23–29. https://doi.org/10.1016/j.aenj.2013.11.002.CrossRefPubMed

Centers for Disease Control and Prevention (CDC). (2013). Emergency department visits by patients with mental health disorders–North Carolina, 2008–2010. MMWR Morbidity and Mortality Weekly Report, 62(23), 469–472.

Chapman, R., Ogle, K. R., Martin, C., Rahman, A., McKenna, B., & Barnfield, J. (2016). Australian nurses’ perceptions of the use of manual restraint in the emergency department: A qualitative perspective. Journal of Clinical Nursing, 25(9–10), 1273–1281. https://doi.org/10.1111/jocn.13159.CrossRefPubMed

Creed, J. O., Cyr, J. M., Owino, H., Box, S. E., Ives-Rublee, M., Sheitman, B. … Glickman, S. W. (2018). Prehospital diversion and subsequent treatment of patients with acute behavioral health disorders at a community mental health center. Academic Emergency Medicine, 22, S199–S200.

Cunningham, R. M., Carter, P. M., Ranney, M., Zimmerman, M. A., Blow, F. C., Booth, B. M., … Walton, M. A. (2015). Violent reinjury and mortality among youth seeking emergency department care for assault-related injury: A 2-year prospective cohort study. JAMA Pediatrics, 169(1), 63–70. https://doi.org/10.1001/jamapediatrics.2014.1900.CrossRefPubMedPubMedCentral

Dahlqvist Jönsson, P., Schön, U. K., Rosenberg, D., Sandlund, M., & Svedberg, P. (2015). Service users’ experiences of participation in decision making in mental health services. Journal of Psychiatric and Mental Health Nursing, 22(9), 688–697. https://doi.org/10.1111/jpm.12246.CrossRefPubMed

deBruyn, J. (2017). Opioid epidemic strains hospital emergency departments, WUNC 91.5 North Carolina Public Radio. Retrieved January 26, 2018 from http://wunc.org/post/opioid-epidemic-strains-hospital-emergency-departments#stream/0.

Dixon, L. B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness: Review and update. World Psychiatry, 15(1), 13–20. https://doi.org/10.1002/wps.20306.CrossRefPubMedPubMedCentral

Dunnion, M. E., & Griffin, M. (2010). Care planning in the emergency department. International Emergency Nursing, 18(2), 67–75. https://doi.org/10.1016/j.ienj.2009.10.002.CrossRefPubMed

Elbogen, E. B., Van Dorn, R., Swanson, J. W., Swartz, M. S., Ferron, J., Wagner, H. R., & Wilder, C. (2007). Effectively implementing psychiatric advance directives to promote self-determination of treatment among people with mental illness. Psychology, Public Policy, and Law. https://doi.org/10.1037/1076-8971.13.4.273.PubMedPubMedCentralCrossRef

Fenton, W. S., Hoch, J. S., Herrell, J. M., Mosher, L., & Dixon, L. (2002). Cost and cost-effectiveness of hospital vs residential crisis care for patients who have serious mental illness. Archives of General Psychiatry, 59(4), 357–364.CrossRefPubMed

Garcia-Toro, M., Roca, M., Monzón, S., Vives, M., Oliván, B., Vicens, E., … Gili, M. (2012). Hygienic-dietary recommendations for major depression treatment: Study protocol of a randomized controlled trial. BMC Psychiatry. https://doi.org/10.1186/1471-244X-12-201.CrossRefPubMedPubMedCentral

Griswold, K. S., Zayas, L. E., Pastore, P. A., Smith, S. J., Wagner, C. M., & Servoss, T. J. (2008). Primary care after psychiatric crisis: A qualitative analysis. The Annals of Family Medicine, 6(1), 38–43. https://doi.org/10.1370/afm.760.CrossRefPubMed

Hackman, A. L., Goldberg, R. W., Brown, C. H., Fang, L. J., Dickerson, F. B., Wohlheiter, K., … Dixon, L. (2006). Use of emergency department services for somatic reasons by people with serious mental illness. Psychiatric Services, 57(4), 563–566.CrossRefPubMed

Hahn, I. H., Grynderup, M. B., Dalsgaard, S. B., Thomsen, J. F., Hansen, A. M., Kærgaard, A., … Kolstad, H. A. (2011). Does outdoor work during the winter season protect against depression and mood difficulties? Scandinavian Journal of Work, Environment & Health, 37(5), 446–449. https://doi.org/10.5271/sjweh.3155.CrossRef

Halmer, T. C., Beall, R. C., Shah, A. A., & Dark, C. (2015). Health policy considerations in treating mental and behavioral health emergencies in the United States. Emergency Medicine Clinics of North America, 33(4), 875–891.CrossRefPubMed

Hamilton, J. E., Desai, P. V., Hoot, N. R., Gearing, R. E., Jeong, S., Meyer, T. D., … Begley, C. E. (2016). Factors associated with the likelihood of hospitalization following emergency department visits for behavioral health conditions. Academic Emergency Medicine, 23(11), 1257–1266. https://doi.org/10.1111/acem.13044.CrossRef

Hendrie, H. C., Lindgren, D., Hay, D. P., Lane, K. A., Gao, S., Purnell, C., … Callahan, C. M. (2013). Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses. The American Journal of Geriatric Psychiatry, 21(12), 1267–1276. https://doi.org/10.1016/j.jagp.2013.01.056.CrossRefPubMed

Hoban, R. (2016). ED wait times not budging for mental health patients. North Carolina Health News. Retrieved from http://northcarolinahealthnews.org/2016/05/24/ed-wait-times-not-budging-for-mental-health-patients/.

Institute of Medicine (US) Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. (2006). Improving the quality of health care for mental and substance-use conditions: Quality chasm series. Washington, D.C.: National Academies Press.

Jelinek, G. A., Weiland, T. J., Mackinlay, C., Gerdtz, M., & Hill, N. (2013). Knowledge and confidence of Australian emergency department clinicians in managing patients with mental health-related presentations: Findings from a national qualitative study. International Journal of Emergency Medicine, 6(1), 2. https://doi.org/10.1186/1865-1380-6-2.CrossRefPubMedPubMedCentral

Kaufmann, C. N., Spira, A. P., Rae, D. S., West, J. C., & Mojtabai, R. (2011). Sleep problems, psychiatric hospitalization, and emergency department use among psychiatric patients with Medicaid. Psychiatric Services, 62(9), 1101–1105. https://doi.org/10.1176/appi.ps.62.9.1101.CrossRefPubMedPubMedCentral

Kessler, R. C., Berglund, P. A., Bruce, M. L., Koch, J. R., Laska, E. M., Leaf, P. J., … Wang, P. S. (2001). The prevalence and correlates of untreated serious mental illness. Health Services Research, 36(6 Pt 1), 987–1007.PubMedPubMedCentral

La, E. M., Lich, K. H., Wells, R., Ellis, A. R., Swartz, M. S., Zhu, R., & Morrissey, J. P. (2016). Increasing access to state psychiatric hospital beds: Exploring supply-side solutions. Psychiatric Services, 67(5), 523–528. https://doi.org/10.1176/appi.ps.201400570.CrossRefPubMed

Lunsky, Y., Lin, E., Balogh, R., Klein-Geltink, J., Wilton, A. S., & Kurdyak, P. (2012). Emergency department visits and use of outpatient physician services by adults with developmental disability and psychiatric disorder. The Canadian Journal of Psychiatry, 57(10), 601–607.CrossRefPubMed

Luthra, S. (2016). How gaps in mental health care play out in emergency rooms, Kaiser health news. Retrieved January 26, 2018 from http://www.npr.org/sections/health-shots/2016/10/17/498270772/how-gaps-in-mental-health-care-play-out-in-emergency-rooms?utm_source=Tuesday+Newsday+October+18%2C+2016&utm_campaign=Tuesday+Newsday+10%2F18%2F16&utm_medium=email.

McKenna, B., Fernbacher, S., Furness, T., & Hannon, M. (2015a). “Cultural brokerage” and beyond: Piloting the role of an urban Aboriginal Mental Health Liaison Officer. BMC Public Health. https://doi.org/10.1186/s12889-015-2221-4.CrossRefPubMedPubMedCentral

McKenna, B., Furness, T., Oakes, J., & Brown, S. (2015b). Police and mental health clinician partnership in response to mental health crisis: A qualitative study. International Journal of Mental Health Nursing, 24(5), 386–393. https://doi.org/10.1111/inm.12140.CrossRefPubMed

McPherson, S., Barbosa-Leiker, C., Daratha, K., Short, R., McDonell, M. G., Alicic, R., … Tuttle, K. (2014). Association of co-occurring serious mental illness with emergency hospitalization in people with chronic kidney disease. American Journal of Nephrology, 39(3), 260–267. https://doi.org/10.1159/000360095.CrossRefPubMed

Mental Health America. (2016). You’re on the team: Shared decision-making. Retrieved January 26, 2018 from http://www.mentalhealthamerica.net/youre-team-shared-decision-making.

Misek, R. K., DeBarba, A. E., & Brill, A. (2015). Predictors of psychiatric boarding in the emergency department. Western Journal of Emergency Medicine, 16(1), 71–75. https://doi.org/10.5811/westjem.2014.10.23011.CrossRefPubMed

Montreuil, M., Butler, K. J., Stachura, M., & Pugnaire Gros, C. (2015). Exploring helpful nursing care in pediatric mental health settings: The perceptions of children with suicide risk factors and their parents. Issues in Mental Health Nursing, 36(11), 849–859. https://doi.org/10.3109/01612840.2015.1075235.CrossRefPubMed

National Institutes of Health. (2009). Research involving individuals with questionable capacity to consent: Points to consider. Retrieved January 26, 2018 from https://grants.nih.gov/grants/policy/questionablecapacity.htm.

Nguyen, N., Davis, K., Counts, N., & Fritze, D. (2017). Prevention and early intervention B4Stage4: The State of Mental Health in America 2016. Retrieved January 26, 2018 from http://www.mentalhealthamerica.net/issues/2016-state-mental-health-america-report-overview-historical-data.

Nolan, J. M., Fee, C., Cooper, B. A., Rankin, S. H., & Blegen, M. A. (2015). Psychiatric boarding incidence, duration, and associated factors in United States emergency departments. Journal of Emergency Nursing, 41(1), 57–64. https://doi.org/10.1016/j.jen.2014.05.004.CrossRefPubMed

Nossel, I. R., Calmes, C. A., Brown, C. H., Kreyenbuhl, J., Goldberg, R. W., Fang, L., & Dixon, L. B. (2010). Patterns of emergency department use for medical conditions among persons with serious mental illness. Psychiatric Services, 61(12), 1251–1254. https://doi.org/10.1176/appi.ps.61.12.1251.CrossRefPubMed

O’Malley, A. S., Gerland, A. M., Pham, H. H., & Berenson, R. A. (2005). Rising pressure: Hospital emergency departments as barometers of the health care system. Issue Brief Center for Studying Health System Change, 101, 1–4.

O’Regan, C., & Ryan, M. (2009). Patient satisfaction with an emergency department psychiatric service. International Journal of Health Care Quality Assurance, 22(5), 525–534.CrossRefPubMed

Olive, P. (2016). First contact: Acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.13311.PubMedCrossRef

Olsø, T. M., Gudde, C. B., Moljord, I. E., Evensen, G. H., Antonsen, D., & Eriksen, L. (2016). More than just a bed: Mental health service users’ experiences of self-referral admission. International Journal of Mental Health Systems. https://doi.org/10.1186/s13033-016-0045-y.PubMedPubMedCentralCrossRef

Owens, C., Hansford, L., Sharkey, S., & Ford, T. (2016). Needs and fears of young people presenting at accident and emergency department following an act of self-harm: Secondary analysis of qualitative data. The British Journal of Psychiatry, 208(3), 286–291. https://doi.org/10.1192/bjp.bp.113.141242.CrossRefPubMedPubMedCentral

Palmer, B. W., Dunn, L. B., Appelbaum, P. S., Mudaliar, S., Thal, L., Henry, R., … Jeste, D. V. (2005). Assessment of capacity to consent to research among older persons with Schizophrenia, Alzheimer disease, or diabetes mellitus. Archives of General Psychiatry, 62(7), 726–733. https://doi.org/10.1001/archpsyc.62.7.726.CrossRefPubMed

Park, J. M., Park, L. T., Siefert, C. J., Abraham, M. E., Fry, C. R., & Silvert, M. S. (2009). Factors associated with extended length of stay for patients presenting to an urban psychiatric emergency service: A case-control study. Journal of Behavioral Health Services Resesarch, 36(3), 300–308. https://doi.org/10.1007/s11414-008-9160-0.CrossRef

Park, S. G., Derman, M., Dixon, L. B., Brown, C. H., Klingaman, E. A., Fang, L. J., … Kreyenbuhl, J. (2014). Factors associated with shared decision-making preferences among veterans with serious mental illness. Psychiatric Services, 65(12), 1409–1413. https://doi.org/10.1176/appi.ps.201400131.CrossRefPubMed

Patel, S. R., & Bakken, S. (2010). Preferences for participation in decision making among ethnically diverse patients with anxiety and depression. Community Mental Health Journal, 46(5), 466–473. https://doi.org/10.1007/s10597-010-9323-3.CrossRefPubMedPubMedCentral

Pearlmutter, M. D., Dwyer, K. H., Burke, L. G., Rathlev, N., Maranda, L., & Volturo, G. (2017). Analysis of emergency department length of stay for mental health patients at ten Massachusetts Emergency Departments. Annals of Emergency Medicine, 70(2), 193–202.e16. https://doi.org/10.1016/j.annemergmed.2016.10.005.CrossRefPubMed

Reavley, N. J., Yap, M. B., Wright, A., & Jorm, A. F. (2011). Actions taken by young people to deal with mental disorders: Findings from an Australian national survey of youth. Early Intervention Psychiatry, 5(4), 335–342.CrossRef

Sajatovic, M., Gunzler, D., Einstadter, D., Thomas, C., McCormick, R., Perzynski, A. T., … Blixen, C. (2016). A preliminary analysis of individuals with serious mental illness and comorbid diabetes. Archives of Psychiatric Nursing, 30(2), 226–229. https://doi.org/10.1016/j.apnu.2015.11.004.CrossRefPubMed

Saldana, J. (2009). First cycle coding methods. In J. Saldana (Ed.) The coding manual for qualitative researchers, (1st edn., pp. 89–93). London: Sage.

Saurman, E., Kirby, S. E., & Lyle, D. (2015). No longer ‘flying blind’: How access has changed emergency mental health care in rural and remote emergency departments, a qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-015-0839-7.PubMedPubMedCentralCrossRef

Sharieff, G. Q., Burnell, L., Cantonis, M., Norton, V., Tovar, J., Roberts, K., VanWyk, C., Saucier, J., & Russe, J. (2013) Improving emergency department time to provider, left-without-treatment rates, and average length of stay. Journal of Emergency Medicine, 45(3), 426–432. https://doi.org/10.1016/j.jemermed.2013.03.014.CrossRefPubMed

Shern, D. L., Blanch, A. K., & Steverman, S. M. (2016). Toxic stress, behavioral health, and the next major era in public health. American Journal of Orthopsychiatry, 86(2), 109–123. https://doi.org/10.1037/ort0000120.CrossRefPubMed

Slade, E. P., Dixon, L. B., & Semmel, S. (2010). Trends in the duration of emergency department visits, 2001–2006. Psychiatric Services, 61(9), 878–884. https://doi.org/10.1176/appi.ps.61.9.878.CrossRefPubMed

Smith, J. L., De Nadai, A. S., Storch, E. A., Langland-Orban, B., Pracht, E., & Petrila, J. (2016). Correlates of length of stay and boarding in Florida Emergency Departments for patients with psychiatric diagnoses. Psychiatric Services, 67(11), 1169–1174.CrossRefPubMed

Solberg, R. G., Edwards, B. L., Chidester, J. P., Perina, D. G., Brady, W. J., Williams, M. D. (2016). The prehospital and hospital costs of emergency care for frequent ED patients. American Journal of Emergency Medicine, 34(3), 459–463. https://doi.org/10.1016/j.ajem.2015.11.066.CrossRefPubMed

Stephens, R. J., White, S. E., Cudnik, M., & Patterson, E. S. (2014). Factors associated with longer length of stay for mental health emergency department patients. Journal of Emergency Medicine, 47(4), 412–419. https://doi.org/10.1016/j.jemermed.2014.04.040.CrossRefPubMed

Swanson, J. W., Swartz, M. S., Elbogen, E. B., Van Dorn, R. A., Ferron, J., Wagner, H. R., … Kim, M. (2006). Facilitated psychiatric advance directives: A randomized trial of an intervention to foster advance treatment planning among persons with severe mental illness. American Journal of Psychiatry, 163(11), 1943–1951.CrossRefPubMedPubMedCentral

Swartz, M., & Morrissey, J. (2003). Mental health care in North Carolina: Challenges on the road to reform. North Carolina Medical Journal, 64(5), 205–211.PubMed

Swartz, M. S. (2016). Emergency department boarding: Nowhere else to go. Psychiatric Services, 67(11), 1163.CrossRefPubMed

Thomas, K. C., Ellis, A. R., Konrad, T. R., Holzer, C. E., & Morrissey, J. P. (2009). County-level estimates of mental health professional shortage in the United States. Psychiatric Services, 60(10), 1323–1328. https://doi.org/10.1176/appi.ps.60.10.1323.CrossRefPubMed

Thomas, K. C., Ellis, A. R., Konrad, T. R., & Morrissey, J. P. (2012). North Carolina’s mental health workforce: Unmet need, maldistribution, and no quick fixes. North Carolina Medical Journal, 73(3), 161–168.PubMed

Velligan, D. I., Roberts, D. L., Sierra, C., Fredrick, M. M., & Roach, M. J. (2016). What patients with severe mental illness transitioning from hospital to community have to say about care and shared decision-making. Issues in Mental Health Nursing, 37(6), 400–405. https://doi.org/10.3109/01612840.2015.1132289.CrossRefPubMed

Wand, T., D’Abrew, N., Acret, L., & White, K. (2016). Evaluating a new model of nurse-led emergency department mental health care in Australia; perspectives of key informants. International Emergency Nursing, 24, 16–21.CrossRefPubMed

Wand, T., D’Abrew, N., Barnett, C., Acret, L., & White, K. (2015). Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department. Australian Health Review, 39(1), 1–8. https://doi.org/10.1016/j.ienj.2015.05.003.CrossRefPubMed

Weiss, A. P., Chang, G., Rauch, S. L., Smallwood, J. A., Schechter, M., Kosowsky, J., Hazen, E., Haimovici, F., Gitlin, D. F., Finn, C. T., & Orav, E. J. (2012) Patient- and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Annals of Emergency Medicine, 60(2), 162–171.e5. https://doi.org/10.1016/j.annemergmed.2012.01.037.CrossRefPubMed

Wharff, E. A., Ginnis, K. B., Ross, A. M., & Blood, E. A. (2011). Predictors of psychiatric boarding in the pediatric emergency department: Implications for emergency care. Pediatric Emergency Care, 27(6), 483–489. https://doi.org/10.1097/PEC.0b013e31821d8571.CrossRefPubMed

Wise-Harris, D., Pauly, D., Kahan, D., Tan de Bibiana, J., Hwang, S. W., & Stergiopoulos, V. (2016). “Hospital was the Only Option”: Experiences of frequent emergency department users in mental health. Administration and Policy in Mental Health, 44, 405–412.CrossRef

Woltmann, E. M., & Whitley, R. (2010). Shared decision making in public mental health care: Perspectives from consumers living with severe mental illness. Psychiatric Rehabilitation Journal, 34(1), 29–36. https://doi.org/10.2975/34.1.2010.29.36.CrossRefPubMed

Xu, Y., Qi, J., Yang, Y., & Wen, X. (2016). The contribution of lifestyle factors to depressive symptoms: A cross-sectional study in Chinese college students. Psychiatry Research, 245, 243–249. https://doi.org/10.1016/j.psychres.2016.03.009.CrossRefPubMed

Zeller, S., Calma, N., & Stone, A. (2014). Effect of a regional dedicated psychiatric emergency service on boarding and hospitalization of psychiatric patients in area emergency departments. Western Journal of Emergency Medicine, 15(1), 1–6.CrossRefPubMedPubMedCentral

Titel: Patient-Centered Values and Experiences with Emergency Department and Mental Health Crisis Care
verfasst von: Kathleen C. Thomas
Hillary Owino
Sana Ansari
Leslie Adams
Julianne M. Cyr
Bradley N. Gaynes
Seth W. Glickman
Publikationsdatum: 30.01.2018
Verlag: Springer US
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 4/2018
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-018-0849-y

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2018

Constitutional Implications of Firearm Restrictions for Veterans with Fiduciaries

Research Driven Policy: Is Financial Capacity Related to Dangerousness?

Web-Based Training Methods for Behavioral Health Providers: A Systematic Review

The Effect of Support and Training for Family Members on Access to Outpatient Services for Veterans with Posttraumatic Stress Disorder (PTSD)