Visits were classified as mental health visits if the primary reason for Return to Tiffany Cuff links visit was a common mental health symptom or disorder, a problem related to substance use, suicidal behaviors, or a need for counseling. Regression models were adjusted for year, diagnosis type, discharge status, payment source, demographic characteristics, receipt of medical care during the visit, mode of arrival, and immediacy of need for treatment. Results: The duration of all emergency department visits increased at an annual rate of 2.3%. Trends were similar for mental health visits and non-mental health visits. Throughout the period the average duration of mental health visits exceeded the average duration of non-mental health visits by 42% (p<.001). This difference was related to the longer durations of mental health visits ending in transfer and visits by persons with serious mental illness or substance use disorders. Conclusions: From 2001 to 2006, the duration of emergency department Elsa Peretti Eternal Circle cuff links made by patients presenting with mental health complaints and visits made by all other patients increased at similar rates. However, the longer visits for certain groups of mental health patients suggest that emergency departments incur higher costs in connection with the delivery of services to persons in need of acute stabilization.
Objective: This study aimed to validate brief intake screens for serious mental illnesses among New Zealand male prisoners. Methods: A prospective survey of consecutively admitted male remanded and sentenced prisoners was conducted across two New Zealand sites. Participants completed the Brief Jail Atlas cuff links Health Screen (BJMHS) and the English Mental Health Screen (EMHS) upon prison admission. The validation standard, the Mini International Neuropsychiatric Interview (MINI), was completed for all positive screens and a random selection of negative screens. Results: A total of 1,292 brief screens and 530 MINI screens were completed. Fifty-one percent of the participants met MINI criteria for one of five targeted major mental disorders.
In this study, the BJMHS performed with lower sensitivity, higher specificity, a Elsa Peretti Almond cuff links false-positive rate, a significantly higher false-negative rate, and a much higher referral rate than in the validating U.S. study. And in this study the EMHS performed with lower sensitivity, less specificity, higher false-positive and false-negative rates, and a moderately higher overall referral rate than in the validating U.K. study. For the BJMHS and EMHS, the majority of false-negative cases involved a mood disorder and Tiffany 1837 Cuff links involved psychosis. Conclusions: Although the BJMHS and EMHS did not perform well in terms of screening for MINI diagnoses, they appeared to be good at identifying a core group of prisoners who are psychotic and most likely to require urgent or semi-urgent intervention by mental health services. The most favorable clinical outcomes were achieved by defining a positive screen as one in which either the EMHS or the BJMHS criteria were fulfilled.
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