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Information sharing and risk: a survey of psychiatrists

Abstract Objectives: Historical information is central to decision making in mental health care. Clinical information in the Irish mental health services is currently mostly paper based. Mental health care in Ireland has moved from an institutional medical model towards a community based multidisciplinary model in recent years. This change has resulted in a dispersal of information between multiple sites and professionals, rendering it less accessible, particularly in emergency settings. This study sought to find out if psychiatrists working in Ireland were experiencing information problems, their ideas about and attitudes towards electronic solutions to these problems, and their views as to what particular pieces of information are indispensable in emergency mental health assessments. Method: A questionnaire was designed to answer these questions and sent to a representative sample of 150 psychiatrists working in Ireland. Results: One hundred and nineteen questionnaires (79.3%) were returned complete. Of the 119 respondents 98(82.4%) stated that they had performed emergency mental health assessments within the past year without access to key information and 79(66.4%) said they would have made different decisions in some cases had they had all the available information. Information deficits were particularly apparent in liaison and forensic psychiatry. Of the respondents 110(92.4%) stated that they would welcome an electronic database designed to support emergency mental health assessments. Misgivings were expressed regarding forms of consent, data quality, breach of confidentiality, resources and much more. Risk factors (ie. self-harm potential), a high alert message and medication details were the data items thought to be most critical. Conclusions: A shareable set of essential pieces of information (a minimum data set) would offer a balance between patient safety, confidentiality and shareability. A wider debate about solutions to the information deficits in mental health care in Ireland needs to take place among all stakeholders so that this idea can be moved forward.