Thomas Becker

Universität Ulm

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Reinhold Kilian

Universität Ulm

101

Steffi G. Riedel‐Heller

Leipzig University

Markus Jäger

University Medical Center Freiburg

Stefan Weinmann

Universitäre Psychiatrische Kliniken Basel

Bernd Puschner

Universität Ulm

Uta Gühne

Leipzig University

Graham Thornicroft

King's College London

Karel Frasch

Universität Ulm

Michele Tansella

University of Verona

Martín Knapp

London School of Economics and Political Science

Cooperative Institutions

Klinik und Poliklinik für Psychiatrie und Psychotherapie

186

Universität Ulm

179

Ludwig-Maximilians-Universität München

Heidelberg University

Genomics (United Kingdom)

Charité - Universitätsmedizin Berlin

Oregon Health & Science University

Universität Hamburg

University of Göttingen

King's College London

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Teilhabe am Arbeitsleben bei Menschen mit schweren psychischen Erkrankungen

Fortschritte der Neurologie · Psychiatrie (2014)

Katarina Stengler Thomas Becker Steffi G. Riedel‐Heller

rehabilitatives Handeln als komplexen, dynamischen Prozess zu definieren, bei dem es um die Förderung von Kompetenzentwicklung und Gesundheitsverhalten sowie um das Überwinden von Defizitorientierung bei Menschen mit psychischen Erkrankungen geht

10.1055/s-0033-1356142

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Citations (12)

Kosten medizinischer Leistungen bei Menschen mit schweren psychischen Erkrankungen: Selbstbericht vs. Kostenträgerangaben

Psychiatrische Praxis (2012)

Nadja Zentner Ildiko Baumgartner Thomas Becker Bernd Puschner

During the last years, self-reported measures of mental health service use for people with mental illness have become increasingly popular. Yet, little is known about the differences between patient report and administrative records and how these may be explained.82 of the 294 participants of the study "Outcome monitoring and outcome management in in-patient psychiatric care" were insured with a major statutory health insurance (AOK Schwaben) and gave informed consent to researchers to access their AOK administrative records. For a 6-month period prior to psychiatric hospital admission, these were compared to the costs as assessed via the German version of the "Client Sociodemographic and Service Receipt Inventory" (CSSRI-EU).Median total monthly treatment costs were 112.23 € (patient-reported) vs. 254.23 € (administrative records; paired Wilcoxon Z = - 3.75; p < 0.001). Cost differences were independent of participants' socioeconomic and clinical characteristics. Correspondence between total treatment costs was substantial for total costs (ρ = 0.48; p < 0.001) and all subtypes of costs (in- and outpatient services, medication).Despite a general tendency to underreport service use, self-report data adequately reflect the "real" health service costs as evident in the health insurance records of people with mental illness.

Receipt

10.1055/s-0031-1298869

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Citations (8)

Needs-oriented discharge planning for high utilisers of psychiatric services: multicentre randomised controlled trial

Epidemiology and Psychiatric Sciences (2011)

Bernd Puschner Sabine Steffen Kathleen Völker Carsten Spitzer Wolfgang Gäebel

Attempts to reduce high utilisation of mental health inpatient care by targeting the critical time of hospital discharge are rare. In this study, we test the effect of a needs-oriented discharge planning intervention on number and duration of psychiatric inpatient treatment episodes (primary), as well as on outpatient service use, needs, psychopathology, depression and quality of life (secondary).Four hundred and ninety-one adults with a defined high utilisation of mental health care gave informed consent to participate in a multicentre RCT carried out at five psychiatric hospitals in Germany (Düsseldorf, Greifswald, Regensburg, Ravensburg and Günzburg). Subjects allocated to the intervention group were offered a manualised needs-led discharge planning and monitoring intervention with two intertwined sessions administered at hospital discharge and 3 months thereafter. Outcomes were assessed at four measurement points during a period of 18 months following discharge.Intention-to-treat analyses showed no effect of the intervention on primary or secondary outcomes.Process evaluation pending, the intervention cannot be recommended for implementation in routine care. Other approaches, e.g. team-based community care, might be more beneficial for people with persistent and severe mental illness.

Discharge planning

10.1017/s2045796011000278

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Citations (36)

Complex interventions in mental health services research

Thomas Becker Bernd Puschner

This chapter discusses findings from a number of randomised controlled trials assessing the effectiveness of complex interventions (structuring patient–clinician communication, outcome management, supported employment, discharge planning and adherence therapy) for people with severe mental illness. The trials discussed include some that resulted in superiority of novel interventions and others with no such proof. In discussing this evidence, the authors conclude that service context is important in understanding study results, that interventions should target behavioural change, that interventions targeting both patient and key worker are promising and that new interventions should courageously add to current treatment practice. Taking into consideration incentives and disincentives driving patient and clinician behaviour is important.

Structuring

10.1002/9781118337981.ch9

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Citations (2)

Likely impact of the UN Convention on disability on mental health services

Current Opinion in Psychiatry (2017)

Ina Jahn Thomas Becker Katarina Stengler

Purpose of review After a large majority of UN member states ratified the Convention on the Rights of Persons with Disabilities (UNCRPD), this article aims to provide an overview of its implementation and possible effects in the area of mental health services in individual contract states. Recent findings This article looks at the implementation processes of the UNCRPD in individual industrialized, emerging and developing countries. In addition to changes in national legislation, potential influences on the supply and support systems for persons with mental illness are considered. Positive approaches and efforts are described. Difficulties and barriers that could be responsible for the long process of implementation of the UNCRPD are described, and so is the restructuring and development of adequate supply and support systems in the area of mental healthcare in industrialized, emerging and developed countries. Summary The UNCRPD is a groundbreaking encouragement for various changes in the area of mental health services. The path to subject orientation and individual support structures is long and slow in all countries – in industrialized, emerging and developed countries. National law and health legislation must be adjusted and developed to create an obligatory context for inclusive services required for persons with mental illnesses. Community-based care is prioritized, and this facilitates participation and inclusion.

Restructuring

10.1097/yco.0000000000000340

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Citations (3)

Laryngeal Papillomatosis

ASM Press eBooks (2014)

Thomas Becker

This chapter briefly summarizes maternally transmitted genital human papillomavirus (HPV) infections in children and problems associated with HPV-related diseases among pregnant women near parturition. Most of the discussion focuses on juvenile-onset laryngeal papillomatosis (recurrent respiratory papillomatosis [RRP]), the most challenging and costly of the diseases associated with mother-child HPV transmission. Laryngeal papillomatosis is the most common benign neoplasm of the larynx. The lesions are characterized by recurrent tumors, which cause hoarseness and upper airway obstruction. The incidence of both juvenile-onset and adult-onset papillomatosis is unknown, and the prevalence of disease has not been accurately assessed. The various forms of therapy have included different ablative and surgical techniques, topical and oral medical therapies, interferon, and laser therapy. Most of these treatment strategies have been evaluated by means of uncontrolled trials, although a few well-designed controlled clinical trials have evaluated the effects of intramuscular interferon as an adjunct therapy for control of RRP. Congenital condylomata acuminata is a rarely reported disease of newborns and infants. Several case reports, however, clearly indicate the occurrence of maternal-fetal transmission even in the absence of fetal exposure to the maternal genital tract through cesarean delivery. Research in the field of maternal transmission of HPV to infants has been hampered by the same limitations that have slowed progress in studies of genital HPV and cervical neoplasia—inability to culture or propagate the virus and uncertain test characteristics (sensitivity and specificity) in identification of HPV infection.

Recurrent Respiratory Papillomatosis

Papillomatosis

Sex organ

10.1128/9781555818210.ch17

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Trends in motor vehicle traffic fatalities among Hispanics, non‐Hispanic whites and American Indians in New Mexico, 1958–1990

Ethnicity and Health (1996)

Melissa A. Schiff Thomas Becker

Abstract Objective. New Mexico has had the highest motor vehicle fatality rate in the nation for many years. Our objective was to examine ethnic differences and trends in motor vehicle fatality rates. Design. Using death certificate data from the New Mexico Bureau of Vital Records and Health Statistics, we compiled age‐adjusted motor vehicle‐related mortality rates from 1958–1990 among the three major ethnic groups in New Mexico—Hispanics, white non‐Hispanics and American Indians. Results. Over the 33‐year study period, American Indians of both sexes had two to three times higher mortality rates than white non‐Hispanics. Hispanic males also had higher motor vehicle death rates than white non‐Hispanic males. During the 1970s fatality rates peaked, with age‐adjusted death rates of 233/100 000 for American Indian males, 74.7 for Hispanic males and 49.3 for white non‐Hispanics for the period 1973–1977. Evaluation of successive 5‐year birth cohorts showed highest mortality rates for ages 15–29 years for each ethnic group and both sexes, and a dramatic decline in most ethnic, sex and age‐specific rates during the last eight years of the study period. Conclusion. Although the recent trends indicate favorable changes in motor vehicle fatality rates, our data highlight the need for ethnic and age‐specific interventions to further reduce rates of motor vehicle‐related mortality in this state.

Death certificate

Case fatality rate

10.1080/13557858.1996.9961797

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Citations (43)

Die Prävention psychischer Erkrankungen und die Förderung psychischer Gesundheit

Springer eBooks (2006)

Reinhold Kilian Thomas Becker

10.1007/3-540-28954-2_26

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Citations (10)

Employment status and desire for work in severe mental illness: results from an observational, cross-sectional study

Social Psychiatry and Psychiatric Epidemiology (2021)

Uta Gühne Alexander Pabst Margrit Löbner Johanna Breilmann Alkomiet Hasan

Abstract Purpose People with a severe mental illness (SMI) are at particular risk of occupational exclusion. Among the approaches to occupational rehabilitation, supported employment (SE) has been proven to be the most effective. A requirement to enter SE-programs is that individuals must want to seek competitive employment. The aim of this work is to investigate the relationship between serious mental illness and the desire to work including potential predictors. Methods This is a cross-sectional observational study of patients with SMI aged 18–65 years ( n = 397). Patients were interviewed by trained staff using standardised instruments. The relationship between potential predictors and a strong preference for employment were analysed using a hierarchic binary logistic regression model. Results Only about one-quarter (27.9%) of SMI patients is in competitive employment. Another quarter is unemployed (25.9%). Results show that the desire for competitive employment is strong among more than half of the SMI patients. Among the unemployed, two-thirds express a strong desire for work. These individuals are an ideal target group for SE interventions. Comorbid chronic physical illness, diagnosis, and the subjectively judged ability to work are associated with the desire for work. Conclusion Our data confirm a substantial exclusion of individuals with SMI from the workforce. In general, care needs for workplace interventions are not being met and leave much room for improvement. In addition to employment status, the desire for work should be routinely assessed. Study registration The study was registered in the German Clinical Trials Register (DRKS) ( https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015801 ) and under the WHO-Platform “International Clinical Trials Registry Platform” (ICTRP) ( https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00015801 ) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019).

Cross-sectional study

10.1007/s00127-021-02088-8

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Citations (48)

Auf dem Weg zur Reform: Ein netzwerkanalytischer Blick auf die Akteure im Vorfeld der Psychiatrie-Enquete von 1971

Sudhoffs Archiv (2018)

Felicitas Söhner Thorsten Halling Thomas Becker Heiner Fangerau

This article focuses on the institutional development of psychiatry in West-Germany after 1945. It analyses the impact of institutional and individual relationships on the West-German Post-war psychiatry. The methods used here are an extensive research and documentary analysis as well as a qualitative content analysis of expert interviews. The main focus was on the thought collective of the Federal German reform-orientated psychiatry in the run-up of the "Psychiatrie-Enquete". The evaluation of the expert interviews as well as the institutional structures showed the central role of Caspar Kulenkampff and Heinz Häfner. Both had an excellent network in the scene of the "Psychiatrie-Enquete's" preparation phase. As a further result of this survey it can be asserted that not only protagonists, understood as central persons, appeared as influential figures, but also persons who had not been suspected in this role, e. g. the occupational therapist Christiane Haerlin or the former chairman of the Association of Statuary Health Insurance Physicians Josef Schmitz-Formes. In summary, the development initiating the Enquete was not defined by only one or few actors.

West germany

10.25162/sudhoff-2018-0006

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Citations (3)