Welfare Reform on the Web (December 2010): Mental health services - UK

The adult daycare workforce in England at a time of policy change: implications for learning disability support

S. Hussein and J. Manthorpe

Journal of Intellectual Disabilities, vol.14, 2010, p. 95-110

More people with a learning disability will receive personal budgets to pay for social care services in England. Such people may or may not continue using services such as adult day centres. However, many day centres are already closing down. In this context of change, the research reported in the paper provides the first detailed analysis of the characteristics of the adult day care workforce in England with the purpose of assisting in the development of strategies to facilitate job mobility across the sector if more day centres close and to help staff provide more person-centred care in those that survive.

Anxiety: falling between primary and secondary care

N. Lidbetter and C. O'Neill

Mental Health Today, Nov. 2010, p. 17-20

The dominant model for delivering psychological therapies for anxiety and depression is the stepped care model. Unfortunately people with severe and longstanding anxiety are deemed inappropriate for primary care services (step 2 and 3 services), but cannot access secondary care services (step 4) because they are not psychotic and do not present a risk to themselves or others.

Are we just playing with DOLS?

B. Troke and N. Ward

Use of the Deprivation of Liberty Safeguards (DOLS) is not optional. Where they apply and are not used a public body is likely to be held to be unlawfully depriving a patient who lacks capacity of his or her liberty, in breach of his or her human rights, and will be open to severe judicial criticism and award of compensation. However, the application of the Safeguards is not straightforward, especially as regards the key issues of what exactly constitutes a deprivation of liberty, and the relationship between the Safeguards and the Mental Health Act. Partly due to these difficulties, and despite on-going awareness and education work, the evidence is that the Safeguards are not yet being fully implemented. To protect themselves, all hospitals, care homes, and local authorities should be taking pre-emptive legal advice on their policies and procedures, as well as advice on individual cases, to ensure compliance.

'The bad people go and speak to her': young people's choice and agency when accessing mental health support in school

J. Spratt and others

Children and Society, vol. 24, 2010, p. 483-494

Recent changes to UK policy have extended the role of schools to become sites for the delivery of 'joined up' children's services, including mental health initiatives. Drawing on a Scottish study, this paper explores issues of access when mental health services are sited in or near schools. It finds that teachers are the main referral route, and that they expect mental health initiative staff to assist pupils with obvious behavioural difficulties. School-based mental health initiatives can gain the reputation of being the places where teachers refer problem pupils, which deters children with less obvious difficulties from voluntarily exploring the services available.

Community care

J. Ralphs

Mental Health Today, Nov. 2010, p. 10-11

The 2010 NHS White Paper acknowledges that pharmacy plays a significant role in the treatment of mental ill health, but is under-used. To improve services for mental patients, there need to be strong partnerships between local authorities, GPs and other primary care colleagues such as community pharmacists. Community pharmacies can improve medicines management and compliance as well as offering an outside perspective on how to make savings within the NHS.

Death of the service user: towards wellbeing and social inclusion

R. Edwards

Mental Health Today, Nov. 2010, p. 27-31

This article proposes a radical new approach to user involvement in the planning and development of the mental health services in the UK. It argues that, since one in four of the population will develop a mental health problem at some point, clients or customers of the mental health services should be redefined as the entire population. Services should therefore seek to engage with the community to promote general mental wellbeing instead of individual patients getting involved with the organisation. This should lead to better feedback on issues.

Developing a person-centred support service for families caring for children with severe learning disabilities in rural and urban areas

L.-A. Black and others

Journal of Intellectual Disabilities, vol. 14, 2010, p. 111-131

This article describes an innovative, person-centred service provided to families who had a child or teenager with severe learning disabilities. It was delivered in three areas in Northern Ireland: two urban and one rural. The service promoted the social inclusion of young people in volunteer-run community activities, based on a person-centred plan developed with the child's family. An evaluation showed that the service helped parents to clarify their individual support needs and engaged their child in ordinary community activities.

Easy does it

A. Holman

Learning Disability Today, July 2010, p. 24-25

The author calls for the establishment of an association of easy-read literature producers that would work on the creation of quality standards for easy-read material that would be acceptable to most of the interested parties. The association would need to be independently run and funded by subscriptions from members.

Employment advice in primary care: a realistic evaluation

G. Pittam and others

Health and Social Care in the Community, vol. 18, 2010, p. 598-606

The first point of contact for most people with a common mental health problem such as mild to moderate anxiety and depression is their general practitioner. It therefore makes sense to address the issue of people falling out of the workplace due to mental health problems by locating specialist employment advisers in GP surgeries. In 2007 the Richmond Fellowship received a grant to provide four employment advisers to work with GP surgeries in Eastern England. The aim was to help people with mental health problems gain or retain employment. In this study a realistic evaluation framework was applied to provide an indication of the sort of interventions that can enable primary care clients with mental health problems to remain in work.

The legal framework of personalisation

B. Schwehr

Community Living, vol. 24, no. 1, 2010, p. 24-25

This article describes the legal principles of needs assessment, resource allocation and support planning as applied to people with learning difficulties.

Mental health and social problems: a social work perspective

N. Rovinelli Heller and A. Gitterman (editors)

London: Routledge, 2011

The book explores the complicated relationship between mental conditions and societal issues and examines risk and protective factors for the prevalence, course, adaptation to and recovery from mental illness. The book is divided into two parts. Part I addresses specific social problems, such as poverty, oppression, racism, war, violence, and homelessness, identifying the factors which contribute to vulnerabilities and risks for the development of mental health problems, including the barriers to accessing quality services. Part II presents the most current empirical findings and practice knowledge about prevalence, diagnosis, assessment, and intervention options for a range of common mental health problems - including personality conditions, eating conditions and affective conditions.

Risks and rights: making a balanced judgement

R. Trustam

Community Living, vol.24, no.1, p. 8-9

Points out that in today's blame culture we regularly see essential rights being taken away from service users with learning difficulties for fear of mistakes or adverse outcomes. Commissioning staff and local authorities have been unwilling to take risks to avoid potential fall-out if things go wrong. Staff need skills and knowledge to make good balanced judgements that consider both risks and rights.

Suicide and depression on rise across UK

N. Morris

The Independent, Nov. 18th 2010, p. 12

Rates of suicide and depression are rising in a dramatic demonstration of the human cost of Britain's economic downturn. The rate of suicide among young men has gone up from 16.8 per 100,000 in 2007 to 17.7 per 100,000 in 2008 and from 5 to 5.4 per 100,000 among young women. Nearly 427,000 people claimed incapacity benefit last year on the basis that depression makes it impossible for them to work, an increase of 15,000 on the previous year. A health minister has warned that rates of suicide and depression are expected to climb further.

We need a national advocacy group now more than ever

A. Holman

Community Living, vol. 24, no.1, 2010, p. 6-7

Attempts in the past to form a national self-advocacy group representing people with learning difficulties in England have failed. In the face of large scale government spending cuts, it is urgent that such a group is now formed. This article argues that the existing National Forum for people with learning difficulties set up in 2001 should be remodelled to become a national self-advocacy group.

Within these walls

A. Taylor

Learning Disability Today, July 2010, p. 10-11

The last NHS-run long-stay hospital for people with learning disabilities closed in 2009, and the government is nearing the end of its NHS campus closure programme. However, these institutions are being replaced by private hospitals for people with learning disabilities, which are cheaper than supported housing in the community for those with complex needs.