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Welfare Reform on the Web (October 2009): Mental health services - UK

Debt and mental health: an overview of selected evidence, key challenges, and available tools

C. Fitch

Mental Health Today, Sept. 2009, p. 27-31

There is a strong evidence base showing an association, although not a causal relationship, between personal debt and mental health problems. Key challenges to addressing the link are: improving health and social care professionals skills' in supporting patients with debt problems; improving awareness among creditor organisations and customer confidence in disclosing a mental health issue; improving information resources for individuals and carers; and developing joint working between health, advice and creditor services. The link between debt and mental health is gaining recognition from the government, the finance sector and health and social care professionals. However, investment is essential during the recession to ensure that these challenges are adequately met.

Expert advice

P. Beresford

Mental Health Today, Sept. 2009, p. 10-11

The Care Quality Commission came into existence in April 2009 to take on the responsibilities of the former Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission. The author calls for all service users, especially mental health service users, to be fully involved in its regulatory work.

Green Light for mental health in Hampshire

J. Eastwood

Advances in Mental Health and Learning Disabilities, vol.3, June 2009, p. 3-7

Green Light is a toolkit for evaluating and improving mental health support services for people with learning disabilities. The toolkit is designed as an aid for assessing how well local services measure up to standards of good practice set out in government policy. A multi-agency project in Hampshire has evaluated and improved the quality of existing service provision using Green Light.

Low-intensity workers: lessons learned from supervising primary care mental health workers and dilemmas associated with such roles

M. Shepherd and M. Rosairo

Mental Health in Family Medicine, vol. 5, 2008, p. 237-245

In 2006, the UK government launched the Improving Access to Psychological Therapies (IAPT) programme. As a first option, this programme offers low-intensity, low-cost treatments delivered by large numbers of Low Intensity Workers (LIWs). The LIW role is similar to that of the Primary Care Mental Health Workers (PCMHWs), who are already offering brief, evidence-based interventions. Based on their experiences as clinical supervisors of a team of PCMHWs, the authors explore some of the clinical governance, training, and supervision dilemmas associated with the roles of such workers. They discuss how IAPT service characteristics may provide solutions to some of these dilemmas.

Mental disorder and legal control

P. Bean

Cambridge: CUP, 2009

The 1983 Mental Health Act in England and Wales introduced far-reaching changes in the control of mentally disordered people and this series of essays describes various features of that Act. The book is divided into three main sections, which discuss the admission of mentally ill patients, their control in hospital and community and their rights. The concluding essay points out that the Act is a piece of reforming legislation and not a radical one, but it is also innovative. Although the discussion is based on the provisions of the 1983 Mental Health Act in England and Wales, the topics covered are of international importance.

Mental health services for people with a learning disability

S. Cumella

Advances in Mental Health and Learning Disabilities, vol. 3, June 2009, p. 8-14

Many countries are developing specialist mental health services for people with a learning disability. Government policy in England appears to favour a move in the opposite direction, rationalised as promoting inclusion. However, distinctive clinical skills are needed to assess, treat and support effectively people with a learning disability who have mental health and/or behavioural problems. Specialist services are required, and should include acute admission facilities, outreach services in the community and long term support.

Most mental health patients do not feel safe, survey reveals

O. Bowcott

The Guardian, Sept. 24th 2009, p. 7

The first ever official survey of NHS mental health inpatients has revealed high levels of dissatisfaction with services, with only a minority of respondents saying they 'always felt safe' on the wards. Based on interviews with 7,500 people recently discharged from 64 NHS trusts across England, the survey was carried our by the Care Quality Commission (CQC), the body responsible for regulating health and social care. The findings show only a third of patients felt fully involved in their care and treatment. Many were denied access to counselling or so-called 'talking therapies', while the side-effects of medicines were inadequately explained. The commission has promised it will act to ensure that NHS trusts improve services.

The needs of primary care mental health service users: a Q-sort study

M. Papworth and L. Walker

Mental Health in Family Medicine, vol. 5, 2008, p. 203-212

Since the 1980s, there has been a growing requirement for patients' views to be taken into account in healthcare services commissioning and delivery. This research aimed to uncover the views of a group of 28 individuals who experienced common adult mental health difficulties about their treatment in primary care. It attempted to identify subsamples of patients with common needs, with a view to facilitating service delivery. The results suggest that differing individual needs exist within diagnostic categories, which, unless considered, may impede service engagement.

New Ways of Working and the issue of responsibility and accountability

C. Vize

Journal of Mental Health Training, Education and Practice, vol.4, June 2009, p. 8-12

New Ways of Working is about the creation of multidisciplinary teams working with efficient processes to deliver person-centred care. It has however brought questions of accountability and responsibility to the fore. The Department of Health has produced guidance on responsibility which will be published on the New Ways of Working website as soon as it is finalised.

New Ways of Working for psychiatrists: the achievements and the challenges

S. Pidd

Journal of Mental Health Training, Education and Practice, vol. 4, June 2009, p. 18-22

The New Ways of Working national programme was started by psychiatrists when it became apparent that the roles they were required to play were unrealistic in their demands. This had contributed to a drop in recruitment and early retirement for psychiatrists in post. The New Ways of Working programme led to a reconfiguration of mental health services in many areas, an increase in the numbers of psychiatrists in post, and improved levels of job satisfaction. Psychiatrists now function as valued members of multidisciplinary teams.

Reflections on the impact of New Ways of Working for Applied Psychologists

T. Lavender

Journal of Mental Health Training, Education and Practice, vol.4, June 2009, p. 23-28

This paper provides reflections about the impact of three of the reports produced by the New Ways of Working for Applied Psychologists Working Group. The three reports reviewed are concerned with leading and managing psychological services, career pathways and roles, and training models. The organisational change model of Beckhard and Harris (1989) is used to evaluate why the recommendations of the reports are being adopted at different speeds.

Seeing double

A. Gorry and T. Dodd

Mental Health Today, Sept. 2009, p. 24-25

Dual Diagnosis is a term used to describe the coexistence of mental health and drug and alcohol problems. The Dual Diagnosis Programme was set up in 2005 in response to national guidance to improve services for this complex and often excluded client group. The programme aims to promote the mainstreaming of services for this group at local level across mental health services and beyond instead of relying on specialist teams.

Service user perspectives on a new model of inpatient care: a qualitative study

C. Healey and others

Journal of Mental Health Training, Education and Practice, vol.4, June 2009, p. 29-36

The New Ways of Working (NWW) initiative was launched in 2004 to build a more flexible and skilled mental health workforce collaborating in multidisciplinary teams. This paper explores, through interviews with 14 service users, the journey through inpatient care under a new acute care team model, piloted in Mersey Care NHS Trust as part of the redesign of services under NWW.

Staff training in the mental health needs of people with learning disabilities in the UK

P. Woodward and S. Halls

Advances in Mental Health and Learning Disabilities, vol.3, June 2009

Diagnosis of mental health problems in people with learning disabilities can be difficult due to limited communication, diagnostic and behavioural overshadowing, and reliance on frontline staff to identify signs. There are concerns that support staff working with people with learning disabilities do not have the appropriate skills and knowledge in the field of mental health problems. There is research evidence that attending training improves staff's skills, awareness and knowledge in this field, but how this affects the care and treatment of people with learning disabilities is still unknown.

Systemic working in learning disability services: a UK wide survey

G. Kaur, K. Scior and S. Wilson

Journal of Learning Disabilities, vol. 37, 2009, p.213-220

Systemic therapy works not just with an individual but with the group of family, friends and care providers who support that person. This approach has received increasing attention in learning disability settings in recent years. However, to date little has been known about the provision of systemic therapy in learning disability services in the UK. This article provides an overview of systemic therapy and reports findings from a national survey. Results showed the existence of a range of therapeutic models and formats in the field. Training levels varied widely as did the use of technical resources.

Values and behaviours: using the Ten Essential Shared Capabilities to support policy reform in mental health practice

I. McGonagle

Journal of Mental Health Training, Education and Practice, vol. 4, June 2009, p. 13-17

The 10 essential shared capabilities (ESCs) promulgated by the Department of Health in 2004 were developed as an articulation of the core values and capabilities expected by service users and carers in their interaction with mental health practitioners and services. In essence, the 10 ESCs are a set of values with associated behaviours that mental health professionals should hold and display in order to build a collaborative relationship with patients.

Working with primary care practices to improve service delivery for people with learning disabilities: a pilot study

J. Webb

Journal of Learning Disabilities, vol. 37, 2009, p. 221-227

People with learning disabilities have worse health than the general population, due to the failure of primary care practitioners to improve the accessibility of the service they offer. This article presents the results of an evaluation of a North Essex project which involved working with three GP surgeries to raise staff awareness, improve their training and help them adapt their working practices. All practices worked to produce a Practice Development Plan which resulted in improved accessibility for people with a learning disability.

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