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

Alternative pathways for black and minority ethnic groups

S. Sandhu

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

The East London NHS Foundation Trust is a focused implementation site for the Department of Health's Delivering Race Equality programme. Using programme funding, it has developed the Alternative Pathways Project which aims to reduce the compulsory detention of black patients under the Mental Health Act. This paper highlights the key findings of the Alternative Pathways project and sets out the actions formulated in response.

Blackstone's guide to the Mental Health Act 2007

P. Bowen

Oxford: OUP, 2007

The Mental Health Act 2007 introduces substantial amendments to the Mental Health Act 1983 and the Mental Capacity Act 2005, including the new Bournewood safeguards to bring domestic law into line with human rights law following HL v United Kingdom (2004). The 2007 Act is expected to come into force in October 2008. This practical guide contains a chapter by chapter analysis of the amendments in two parts: Part I, 'Reform of the Mental Health Act 1983', and Part II 'The Mental Capacity Act 2005 and its amendments'. Where appropriate the Human Rights Act implications of the changes are considered. Part I contains a discussion of the background to the reform of the Mental Health Act 1983 with a detailed analysis of the changes made to it by the 2007 Act, in particular amendments to the criteria for guardianship and detention, additional safeguards for patients in relation to admission and detention, the new procedure for Supervised Community Treatment (SCT), and amendments to the provisions for medical treatment for community patients on SCT. Part II gives an overview of the law governing substituted decision-making for incapacitated adults and children in personal welfare matters, both in common law and under the Mental Capacity Act 2005.

A critique of NHS culture as applied to psychiatry

R. Shankar

British Journal of Healthcare Management, vol. 14, 2008, p. 147-152

Psychiatry is a relatively new discipline and is more amenable to change and willing to adopt new approaches to service delivery than some other long established medical professions. In the 1990s it moved more rapidly than any other medical specialism towards service delivery via multidisciplinary teams. This article explores how team members from different disciplines with different work cultures relate to each other. It appraises the advantages and disadvantages of this intermingling of work cultures and presents proposals for making the composite team culture more robust.

Forced medication: the unreason of psychiatry

B. Gray

Mental Health Today, May 2008, p. 26-27

The author argues that psychiatrists are over-reliant on powerful anti-psychotic drugs and need to make more use of less invasive treatments such as counselling and cognitive behavioural therapy. Current practices of forcible administration of medication to suppress symptoms such as hallucinations violates patients' human rights.

How safe are places of safety?

J. Symington

Mental Health Today, May 2008, p. 32-34

Under section 136 of the Mental Health Act 1983 (amended 2007), police may take a person believed to be suffering from a mental disorder and to be in need of care or control to a 'place of safety', which may be a police station, psychiatric hospital or hospital emergency department. There are concerns about the suitability of police stations for holding a person suffering from severe mental distress. This article introduces and summarises new guidelines produced by a Royal College of Psychiatrists working group on the use of this legislation.

Implementing a model for future workforce design and planning in child and adolescent mental health services

Y. Anderson and B. Nixon

Journal of Mental Health Training, Education and Practice, vol.2, Dec. 2007, p. 48-55

This article provides an overview of the national child and adolescent mental health service workforce planning programme 2006/07, which used early implementer sites in each of the eight English regions to produce a specialist CAMHS workforce plan.

Inpatient for change

J. Cosh

Mental Health Today, May 2008, p. 12-13

All health boards are required to set up acute inpatient forums by April 2009 under the Scottish Government's Delivering for Mental Health action plan. These forums are required to meet at least five times a year, and to visit all inpatient facilities in their area at least once a year. Members include health board senior managers, nurse managers, voluntary sector and advocacy service representatives, local authority partner agencies, and users and carers. The Scottish government says that improving patients' experiences on wards should be their main priority.

Is there an optimum model of practice for the newly developed child and adolescent primary mental health worker posts?

N. Hickey, T. Kramer and M.E. Garraida

Journal of Mental Health Training, Education and Practice, vol. 2, Dec. 2007, p. 10-18

The role of primary mental health worker (PMHW) was introduced into the child and adolescent mental health services in the mid-1990s. Different organisational structures have emerged and it is important to understand the advantages and disadvantages associated with different PMHW practice models. This study uses a large, representative sample of PMHWs and operationalises practice models according to their self-reported location and team alignment. Three models are identified: CAMHS outreach, primary care based and dedicated PMHW team. Comparisons between the models are made in relation to organisation and management, inter-agency links, and job satisfaction with the aim of exploring the strengths and weaknesses of each.

Learning disability and other intellectual impairments: meeting needs throughout health services

L.L. Clark and P. Griffiths (editors)

Chichester: Wiley, 2008

The book identifies the skills and knowledge that health care students and professionals need in order to work with intellectually impaired patients whether they are in the hospital or at home. It gives accounts of the experiences of professionals who have worked with this patient group, and provides ways in which delivery of patient services can be improved upon. The book integrates the academic and clinical approaches and provides coverage of intellectual impairment as a whole – for example it looks at people with acquired brain injury, dementia and long-term mental health issues which have resulted in cognitive deficit, rather than just focusing on people with learning disabilities.

Mapping the CAMHS workforce 2003-2006

R. Wistow

Journal of Mental Health Training, Education and Practice, vol. 2, Dec. 2007, p. 30-39

This paper provides an overview of developments in the CAMHS (child and adolescent mental health services) workforce reported across the 2003 to 2006 national mapping exercises carried out by Durham University. Changes in the overall workforce, vacancy rate and the professional mix of the workforce are explored, as are the professional mix in different types of CAMHS teams and the amount of time spent by specialist CAMHS workers supporting Tier 1. Tier 1 includes services that contribute to the mental health care of children and young people, but not as a primary function, for example schools. Finally, the paper examines the CAMHS workforce in terms of capacity to address the needs of the population.

Me when I cheer my mummy up by dancing

C. Jackson

Mental Health Today, May 2008, p. 16-18

Up to half of all mental health service users are parents of children under 18, and one in ten have children under five. However, this central aspect of their lives is often ignored by both adult mental health services and local authority children's services. The Social Care Institute for Excellence and the National Institute for Health and Clinical Excellence are preparing good practice guidelines that are nearing completion. This article describes some initiatives which are currently addressing the problem.

Paying the price: the cost of mental healthcare in England to 2026

P. McCrone and others

King's Fund, 2008

Recognising the significance of mental health in terms of both expenditure and the overall health of the population, the King's Fund commissioned a review. This report presents current and projected needs for mental health services and their related costs. It gives details on a number of specific disorders, including depression, schizophrenic disorders and dementia. Paying the Price suggests that without the right level and type of investment we will all pay the price – not just in wasted resources but also in wasted lives.

Person centred practice for professionals

J. Thompson, J. Kilbane and H. Sanderson (editors)

Maidenhead: Open University and McGraw-Hill Education, 2008

The book offers a range of practical, person centred and evidence based approaches to tackling challenges faced by professionals working with people with learning disabilities. It analyzes issues relating to person centred practice and citizenship and considers the implications of this key government initiative for health and social care professionals. The book's aim is to support professionals in working through this changing agenda, whilst identifying the interface between their own professional practice and person centred approaches to working with people who have a learning disability. The book includes well referenced practical approaches to the subject area, alongside creative and innovative thinking. In addition, the book:

• Explores the historical context of learning disability services and how this has contributed to the development of person centred services
• Introduces a range of practical person centred thinking tools that can be readily used within professional practice
• Contains a model to inform the delivery and integration of person centred practice within professional practice
• Considers the contribution of a range of different professional roles to the person centred and self directed support approach
• Evaluates the relevance of person centred thinking and planning to people from different cultural backgrounds and those undergoing the transition from adolescence to adulthood

Putting recovery into mental health practice

G. Shepherd, J. Boardman and M. Slade

Mental Health Today, May 2008, p. 28-31

Recovery provides a new rationale for mental health services and could bring about their transformation in England. This article presents some key ideas embodied in the recovery approach and considers their implications for the delivery of mental health services. Recovery-oriented services provide patients with resources (information, skills, networks and support) to enable them to manage their condition and lead fulfilling lives.

Split personality

S. Allen and H. Hurford

Health Service Journal, May 8th 2008, p. 25

In healthcare we persist in treating mental and physical illnesses in different systems. This has a negative impact on the patient and also creates inefficiency and costs which a more integrated approach could eliminate.

Swings and roundabouts

R. Shrubb

Mental Health Today, May 2008, p. 10-11

The Mental Health Act 2007 gives a statutory right to independent mental health advocacy for all detained patients in England. Fears are now being expressed that voluntary patients may lose out, and that advocacy providers will struggle to meet the costs of training.

Taking over the asylum

M. Gould

Health Service Journal, May 8th 2008, p. 22-24

In 1948 when the NHS was launched care of the mentally ill meant incarcerating them in asylums. In 1953 almost half of NHS beds wee used for mentally ill people and costs were spiralling. The Victorian asylums began to be phased out in the 1960s, and by 1975 the population of mental hospitals had been massively reduced, but low staff levels meant care standards had declined. Critics argue that the recent emphasis on protection of the public from mental patients being treated in the community is a retrograde step which may lead to more people being detained in hospital.

Transition for adolescents and young adults with learning disabilities and mental health problems/challenging behaviour: the parent carers' views

G. Unwin and others

Advances in Mental Health and Learning Disabilities, vol. 2, Mar. 2008, p. 22-28

The transition process refers to the movement of young people from child to adult health and social care services. Many children with learning disabilities and mental health problems/challenging behaviours do not have access to rigorous transition planning. Those who leave school at 16 do not have access to adult services until they reach the age of 18. This research scoped the issues of concern at transition for these young people from the perspective of parent carers, using a focus group. Several themes emerged from the analysis of the interview transcripts including poor access to information about rights and services available to the child and conflicts between parents and professionals.

Understanding the key workforce issues facing child and adolescent mental health services

B. Nixon

The Journal of Mental Health Training, Education and Practice, vol. 2, Dec. 2007, p. 40-47

Changes that are necessary to enable agencies to deliver high quality and effective child and adolescent mental health services will require fundamental modernisation of the workforce. This article reviews the challenges to be addressed, including:

• Improving workforce design and planning so as to root it in local service planning and delivery
• Using creative means to recruit and train staff
• Facilitating new ways of working across professional boundaries
• Creating new roles to tap into a new recruitment pool and so complement existing staff types
• Developing the workforce through revised education and training at both pre- and post-qualification levels
• Developing leadership capabilities.

When the chain breaks

E. Parsons

Community Care, May 29th 2008, p. 26-27

Buckinghamshire Council and Oxfordshire and Buckinghamshire Mental Health Partnership Trust jointly run a care home for people with severe learning disabilities. The two agencies have both been found guilty of maladministration causing injustice to a resident of the home through physical neglect. In their report the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman pointed to problems with the partnership arrangements leading to poor management of the home.

Young people supporting parents with mental health problems: experiences of assessment and support

G. Grant, J. Repper and M. Nolan

Health and Social Care in the Community, vol. 16, 2008, p. 271-281

In legislative and policy terms, it has been recognised for some time that children and young people can shoulder heavy care-giving burdens that may affect their health, education and well-being. This paper looks at what can be done to identify, assess and support young people caring for a parent with mental health problems. It describes the work of Barnardo's Action with Young Carers and Keeping the Family in Mind projects in Liverpool in supporting young people caring for parents with mental health problems. Based on face-to-face interviews with 10 young people caring for a mother with mental health problems, the paper provides an account of how they talk about, make sense of and evaluate the support they have received through the combined initiatives.