UK hospitals miss mental illness in quarter of patients
A new study led by researchers at University College London (UCL) has found that severe mental illness diagnoses are being missed in over a quarter of patients when they're admitted to hospital for other conditions. The percentage is higher in people from ethnic minorities.
The study involved 13,786 adults who had been diagnosed with severe mental illnesses including bipolar disorder and schizophrenia between 2006 and 2017. Researchers linked this data to 45,706 emergency hospital admissions for the same people over the same period, to see whether the conditions were recorded when they were admitted to hospital for a separate health issue.
In 2006 mental illnesses were missed more than half the time (48%), however this rose to 75% by 2017. However not all of the recordings included the specific diagnosis, as the figures include any recording of a psychiatric illness. There were specific recordings of schizophrenia in only 56% of people with this condition. Bipolar disorder was only recorded 50% of the time, meaning there may be cases of misdiagnosis for other, possibly less severe mental illnesses.
People from ethnic minority backgrounds were more likely to have missed diagnoses. Those from Black African or Caribbean backgrounds were 38% more likely to have their diagnosis unrecorded compared to those from white backgrounds. Researchers say one possible reason is that clinicians were less able to detect these conditions in people from other ethnicities, or perhaps due to language barriers or stigma felt by the patients.
Hassan Mansour, who led the study said: “The disparities we found between ethnic groups are concerning because previous studies have identified particularly poor health outcomes for people from minority ethnic groups with severe mental illnesses. Training in culturally-sensitive diagnosis may be needed to reduce inequalities in medical care.”
Married people also had frequent missed diagnoses, which researchers believe could be due to stigma, if spouses providing information to hospital staff are reluctant to mention a mental illness diagnosis or are unaware of it.
The overall improvements could be due to NHS commitments towards whole person-centred care, financial incentives, improvements in coding practices, or expansions of liaison psychiatric services in hospitals, the researchers said. However they are calling for better sharing of data between health services.
Senior author Dr Andrew Sommerlad (UCL Psychiatry and Camden and Islington NHS Foundation Trust) said: “If someone with a severe mental illness comes to hospital physically unwell, it might be an indicator that their mental health is getting worse. It could be a critical time to identify issues with mental and physical health, and an opportunity to access support for their mental illness.
“It’s important to understand that physical and mental health are interlinked, and should not be seen as separate entities. Both can impact the other, so more needs to be done to bridge the gap and achieve truly integrated care that’s accessible to everyone.”
Dubai's new smart neuro spinal hospital: need to know
We take a look at Dubai's new smart hospital.
What: The Neuro Spinal Hospital and Radiosurgery Centre is a new hospital featuring state-of-the-art technology for spinal, neurosurgical, neurological, orthopaedic, radiosurgery and cancer treatments. The 700 million AED hospital, (equivalent to £138 million), has 114 beds, smart patient rooms, and green spaces for patient rehabilitation, and is four times the capacity of its former premises in Jumeirah. It is also the UAE’s first hospital to have surgical robots.
Where: The hospital is located in the Dubai Science Park. Founded in 2005, Dubai Science Park is home to more than 350 companies from multinational corporations in life sciences, biotechnology and research; over 4,000 people work here each day.
Who: The UAE's Neuro Spinal Hospital and Radiosurgery Centre was first established in Jumeirah in 2002 by Dr. Abdul Karim Msaddi, as the first as the first "super-specialty" neuroscience hospital.
Why: With advanced diagnosis and robotics, the hospital will provide care across neuroscience, spine, orthopaedics and oncology for people residing in the UAE, as well as international patients.
Prof. Abdul Karim Msaddi, Chairman and Medical Director of the hospital, said: “We are proud to bring world-class healthcare services to Dubai and believe our next-generation hospital will be a game-changer for the emirate’s and the region’s medical industry.
"It will not only significantly increase the availability of specialist neuroscience and radiosurgery treatments and provide better patient care but help attract and develop local and international talent. Investing in the new centre represents our continued faith in the resilience of the region’s economy, as well as a testament to our ongoing drive towards healthcare innovation in the UAE.”