ABSTRACT
OBJECTIVE: The mobile intensive treatment team (MITT) of the Valley Integrated Adult Mental Health Service in Brisbane, Australia, aims to provide services in the community to people with severe and persistent mental illness who have traditionally been heavily reliant on inpatient services (i.e. heavy service users). The MITT screening instrument (MITTSI) was developed to provide an objective measure to appropriately identify patients for referral to the service. METHOD: A literature review and a panel of multidisciplinary clinicians were consulted to identify a list of specific attributes that would assist in the detection of heavy service users. These attributes were then formulated into an easy-to-administer screening instrument entitled the MITTSI. The MITTSI was administered in an interview format to MITT case managers (intensive case management) and to case managers in standard case management with prospective MITT patients (prospective heavy service users). RESULTS: Analyses of the responses indicated support for the MITTSI as a valid screening instrument in identifying heavy service users and for determining appropriate patients for referral to the MITT. CONCLUSION: The MITTSI is an easy-to-administer screening instrument which provides clear guidelines for inclusion and exclusion, and is an objective measure regarding the patients' urgency for referral to the MITT. Follow-up of the MITTSI within a broader, longer-term project will attempt to further refine the MITTSI and to further determine its validity. Outcomes will be published at a later stage.
Subject(s)
Critical Care/statistics & numerical data , Health Services Misuse/statistics & numerical data , Mental Disorders/epidemiology , Mobile Health Units/statistics & numerical data , Patient Care Team/statistics & numerical data , Adult , Case Management/statistics & numerical data , Crisis Intervention , Female , Humans , Male , Medical Records, Problem-Oriented , Middle Aged , Psychiatric Status Rating Scales , Queensland/epidemiology , Referral and Consultation/statistics & numerical data , Surveys and QuestionnairesABSTRACT
Evidence of previous spontaneous regression was found in 6% of 400 randomly selected basal cell carcinomas. A further 14% showed small foci of active regression usually less than 1 high power field in area and characterized by a lymphocytic infiltrate of tumor nests associated with many apoptotic tumor cells. Spontaneous regression of basal cell carcinomas has been paid scant attention in the past.