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Welfare Reform on the Web (April 2008): Mental health services - UK

Community learning disability teams: developments, composition and good practice: a review of the literature

E. Slevin and others

Journal of Intellectual Disabilities, vol.12, 2008, p. 59-79

This article presents findings from a literature review related to community learning disability teams. It covers historical and philosophical influences on the development of these teams; their structure and common composition; the main challenges that they face; and the barriers that impact on their effective working. Based on the available evidence a number of good practice suggestions are put forward.

Loss of doctor-to-doctor communication: lessons from the reconfiguration of mental health services in England

C. Chew-Graham and others

Journal of Health Services Research and Policy, vol. 13, 2008, p. 6-12

In the mental health services over the past 20 years, there has been a gradual change from direct referral of patients from a GP to a psychiatrist towards referral from the GP to a multi-disciplinary team. This qualitative study explored the perspectives and attitudes of GPs, psychiatrists and managers of community mental health teams (CMHTs) to this change. GPs described the need for access to specialist knowledge, which they perceived to lie with the psychiatrist, and referral to a team was not considered as allowing this access. A personal threshold was identified by GPs, after which they referred the patient to secondary care. CMHTs and psychiatrists recognised that this personal threshold differed between GPs, but their criteria for accepting referrals did not seem to allow for a flexible response to referral requests, leading to some referrals being labelled as 'inappropriate'. The lack of direct doctor-to-doctor communication was perceived as contributing to a fragmentation of patient care. Strategies were described whereby the system was bypassed to achieve doctor-to-doctor communication, which undermined the team.

Mental Capacity Act

J. Dow

Journal of Integrated Care, vol. 16, Feb.2008, p. 18-21

This article examines the implications of changes introduced by the Mental Capacity Act for health and social care staff, covering: 1) the new requirement for staff to follow the 'best interests checklist' before making a decision on behalf of an incapable adult; 2) the Lasting Power of Attorney; 3) the introduction of Independent Mental Capacity Advocates; and 4) the duty laid on professionals to have regard to the Mental Capacity Act Code of Practice when caring for an incapable adult.

One foot in the door

S. Morgan and K. Hunte

Mental Health Today, Mar. 2008, p. 32-35

The Department of Health set targets for mental health services in England to implement 335 crisis resolution and home treatment teams by 2005. The research reported here investigated the impact the new teams were having on assessments for hospital admission, and how well they were understood by other parts of the local mental health services.

Partnerships work

H. Pearce-Willis

Mental Health Today, Mar. 2008, p. 16-17

This article reports on innovative work going on under the Department of Health's Delivering Race Equality (DRE) programme, which was launched as a five year action plan in 2005 with the aim of helping the mental health system reach out to black and minority ethnic communities. This paper focuses on an initiative to reach out to the Pakistani community in Sheffield in partnership with imams and the local Pakistani Muslim Centre. The Centre and the imams provide support for members of the community receiving home treatment for mental health difficulties.

Services for people whose behaviour presents a challenge: the revised Mansell report

J. Mansell

Learning Disability Today, vol. 8, Feb. 2008, p. 38-40

The revised version of the Mansell report on services for people with learning disabilities who present challenging behaviour was published in October 2007. It confirms the analysis found in the original 1993 report. It recommends that:

  • The capacity of local services to understand and respond well to challenging behaviour should be developed and expanded - local specialist services should be in place to support good mainstream practice as well as directly serving a small number of people with the most challenging needs.
  • Commissioners should stop sending people to high-cost out-of-area placements
  • Local authorities, which have the lead responsibility for learning disability, should implement the report's findings.

Support for living? The impact of the Supporting People Programme on housing and support for adults with learning disabilities

R. Fyson, B. Tarleton and L. Ward

Policy Press, 2007

This book reports the findings of research which examined the impact that the Supporting People Programme has had on housing with support for adults with learning disabilities. The research showed that definitions of housing related support varied between local authorities, but that all definitions had one thing in common: the aim of ensuring that the cost of individual support packages was limited. Although the operational definition of housing-related support was key to determining which individuals were eligible for Supporting People funding, the definition used did not appear to translate directly into outcomes for people with learning difficulties. Rather, their lives were shaped by the various frameworks used by provider organisations to deliver services. Differences in outcomes were related to whether people lived alone or in shared accommodation, and whether they received floating or accommodation-based support.

Sustaining a recovery-oriented workforce

R. Holtom, K. Guest and G. Marlton

Mental Health Today, Mar. 2008, p. 23-25

Support, Time and Recovery (STR) workers are support staff who work alongside mental health professionals to provide person-centred care, based on recovery and self-management principles. Their role is to promote independent living; provide companionship and friendship within appropriate boundaries; and provide regular and practical support with daily living. They may themselves have had experience of using the mental health services and can draw on personal knowledge and expertise to support clients. STR workers were introduced at 19 first wave national implementation sites in 2003. This article explains how the scheme was rolled out at Plymouth Primary Care Trust.

Why we need a coalition

H. Honour

Learning Disability Today, vol. 8, Feb 2008, p. 8-11

Cuts to services for people with learning disabilities are getting worse. Ten organisations have got together to form the Learning Disability Coalition to campaign for better services and ensure that people with learning disabilities do not lose out in the wider debate about the social care needs of all vulnerable groups.

Who decides? Using the Mental Capacity Act to support people

M. Jepson

Learning Disability Today, vol. 8, Feb. 2008, p. 22-27

This article seeks to provide useful pointers for frontline staff on applying the Mental Capacity Act in their work with vulnerable adults. It gives some real-life examples of the practical outworking of the Act, and explores the training needs of frontline staff.

You don't know like I know

T. Basset

Mental Health Today, Mar. 2008, p. 26-28

Argues for the re-writing of the national occupational standards for mental health workers to recognise the primacy of service-user knowledge. These standards currently lay down the competencies required by mental health workers to do things for or with service users. They do not cover situations where service users do things for themselves, and need to be re-written to incorporate self-management in its true, user-led form.

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