Suchergebnisse

ObjectivesTo describe the process and outcomes of establishing a unique data linkage between mental healthcare records from the South London and Maudsley (SLaM) NHS Foundation Trust with benefits records from the Department for Work and Pensions.
Methods448,404 IDs of patients who accessed secondary mental healthcare services at SLaM were sent to the DWP, including personal identifiers. Data from SLaM covered years 2007-2019, whereas data from DWP covered years 2005-2020. A deterministic data linkage approach was used.
ResultsA linkage rate of 93% was achieved. Patient groups who were less likely to be linked were women, those from a racial and ethnic minority background and younger patients. Benefit receipt was high among patients, with 83% of patients having received benefits during the 15-year follow-up period. Benefits most frequently received included unemployment related or income replacing disability benefits.
ConclusionThis data linkage is the first of its kind in the UK to demonstrate the use of routinely collected mental health and benefits data. It provides opportunities to generate much needed high-quality evidence that can be used to achieve change, investment in services and translation into policy and practice.

ObjectivesPeople with mental disorders are likely to be overrepresented among Universal Credit (UC) recipients. Despite this, individual level data is lacking on mental disorder diagnosis by UC status, and the intersectionality of different socio-demographic characteristics. Associations were explored between UC receipt, socio-demographic and diagnostic characteristics among mental health service users.
MethodsA novel data source consisting of linked electronic mental healthcare records and Department for Work and Pensions administrative benefits records of patients accessing a large mental healthcare service provider in South London was used. Benefits records were restricted to those that covered years 2013-2019. Only working-age patients were included (n=120,000).
ResultsPreliminary results indicated that of the 120,000 working-age patients with linked data, 38,000 had received UC at some point between 2013-2019. Most UC recipients were allocated to a conditionality regime that required them to look for work, followed by those who did not have to meet any work-related requirements. Adjusted analyses indicated that UC recipients were more likely to be male, younger, lived in more deprived areas, and were from a non-White ethnic background. Interestingly, having a recorded psychiatric diagnosis meant that patients were less likely to have received UC.
ConclusionPossible explanations for the findings will be discussed. In the longer term, our findings have the potential to impact welfare and public health policies, as well as patient care.

IntroductionIn the UK, mental disorders are one of the most common reasons for claiming a benefit relating to unemployment, income, sickness and disability. Limited information exists regarding the demographic characteristics and psychiatric profiles of working age individuals claiming benefits in London. Until recently, detailed data on both mental disorders and benefit receipt were unavailable.
ObjectivesTo establish and describe a cohort of working age adults accessing secondary mental health services and benefits related to unemployment, income, sickness, and disability.
MethodsUsing a novel data linkage containing electronic secondary mental health records from the South London and Maudsley (SLaM) NHS Foundation Trust and benefits data from the Department for Work and Pensions (DWP), we present descriptive statistics on sociodemographics, psychiatric diagnoses, and benefits received among a cohort of working age adults. The DWP benefits data window covers the period January 2007-June 2020, the SLaM data window covers the period January 2007-June 2019.
ResultsWe identified n = 150,348 patients (18-65 years), who had attended SLaM secondary mental health services, 78.3% of which had received a benefit relating to unemployment, income, sickness and disability. Of this group, 68% had a recorded primary psychiatric diagnosis. We found that a much higher percentage of those with a primary psychiatric diagnosis received more than one benefit (69.4%) compared to those who had not received a primary psychiatric diagnosis (30.6%). Almost 70% of claimants who obtained more than one benefit were identified as living within the two quintiles representing the highest levels of deprivation in the South-east London boroughs served by SLaM.
ConclusionsWe showed types of benefits received among working age adults accessing secondary mental health services. This cohort will be further examined to explore trajectories of mental health care and benefit receipt and provide evidence that will help to inform both DWP policies and mental health care delivery.

Background: WHO, UNODC, and UNAIDS recommend a comprehensive package for prevention, treatment, and care of HIV among people who inject drugs (PWID). We describe the uptake of services and the cost of implementing a comprehensive package for HIV prevention, treatment, and care services in Delhi, India. Methods: A cohort of 3774 PWID were enrolled for a prospective HIV incidence study and provided the comprehensive package: HIV and hepatitis testing and counseling, hepatitis B (HB) vaccination, syndromic management of sexually transmitted infections, clean needles-syringes, condoms, abscess care, and education. Supplementary services comprising tea and snacks, bathing facilities, and medical consultations were also provided. PWID were referred to government services for antiretroviral therapy (ART), TB care, opioid substitution therapy, and drug dependence treatment/rehabilitation. Results: The project spent USD 1,067,629.88 over 36 months of project implementation: 1.7% on capital costs, 3.9% on participant recruitment, 26.7% for project management, 49.9% on provision of services, and 17.8% on supplementary services. Provision of HIV prevention and care services cost the project USD 140.41/PWID/year. 95.3% PWID were tested for HIV. Of the HIV-positive clients, only 17.8% registered for ART services after repeated follow-up. Reasons for not seeking ART services included not feeling sick, need for multiple visits to the clinic, and long waiting times. 61.8% of the PWID underwent HB testing. Of the 2106 PWID eligible for HB vaccination, 81% initiated the vaccination schedule, but only 29% completed all three doses, despite intensive follow-up by outreach workers. PWID took an average of 8 clean needles-syringes/PWID/year over the project duration, with a mid-project high of 16 needles-syringes/PWID/year. PWID continued to also procure needles from other sources, such as chemists. One hundred five PWID were referred to OST services and 267 for rehabilitation services. Conclusions: A comprehensive HIV prevention, ...