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Welfare Reform on the Web (January 2011): Mental health services - UK

Back from the abyss

N. Valios

Community Care, Dec. 2nd 2010, p. 22-23

In 2007, the Healthcare Commission heavily criticised Sutton and Merton Primary Care Trust for institutional abuse at Orchard Hill long stay hospital for people with learning disabilities. Orchard Hill formally closed in April 2009, and the majority of its former residents are now flourishing in supported living schemes in the community.

Cathy's come home

J. Verge

Learning Disability Today, Nov. 2010, p. 14-15

There is growing demand for independent housing from people with learning disabilities, but insufficient social housing to meet it. Private rented housing should be considered as an alternative. With the right support and planning, people can access good quality accommodation at affordable costs.

(For a case study of discrimination against people with learning disabilities seeking private rented accommodation see Learning Disability Today, Nov. 2010, p. 16-17)

CornerHouse - a mental health community development hub

P. Field

Mental Health and Social Inclusion, vol.14, Nov. 2010, p.7-12

CornerHouse in Woking, Surrey actively encourages and fosters the creation, maintenance and development of new and existing mental health services and self-help groups. It assists these groups in their activities by providing advice, support and a place where meetings and social events can be held. It has become the hub for all voluntary sector mental health service provision in the local area. It provides a model which could be adopted in other areas.

Getting to the heart of advocacy

J. Macarthy

Learning Disability Today, Oct. 2010, p. 20-21

This article explains the techniques which independent advocates use to discover and represent the views of partners who are unable to instruct them due to mental incapacity.

How adults with learning disabilities view living independently

R.J. Bond

British Journal of Learning Disabilities, vol. 38, 2010, p. 286-292

One of the key principles enshrined in English government policy is to enable people with learning disabilities to have greater choice and control over their lives, including where they live, and support to live independently. This qualitative study explored the experiences of nine adults with mild learning disabilities who lived alone with minimal support. The people interviewed valued and desired greater rights, choice, inclusion and independence, but said that they often had difficulties in their everyday lives and struggled to manage their health and safety and to carry out practical tasks associated with independent living.

How day services can meet government targets of social inclusion and recovery while retaining buildings-based services

K. Wilkinson, A. Walters and A. Crawford-Docherty

Mental Health and Social Inclusion, vol. 14, Nov. 2010, p. 40-47

There are two main ideas about day service provision for people with mental health problems in the UK. The traditional buildings-based model focuses on fostering attachment and belonging, while the community-based model prioritises social integration and recovery. This article describes the approach taken to the modernisation of adult mental health day services in Sandwell, which retains a building-based element to provide for attachment and belonging, while developing community-based models that promote social integration and recovery.

An incredible journey

S. Sly

Learning Disability Today, Oct 2010, p. 14-16

The positive impact on the lives of people with learning disabilities of moving out of residential care into a home of their own with support is immense. Care workers who formerly looked after them in residential homes need to be retrained to provide personal support and facilitate access to communities. Workers are also expected to maximise the individual's income either through benefits or employment.

Managing demand and capacity within child and adolescent mental health services: an evaluation of the Choice and Partnership Approach

D. Robotham, K. James and E. Cyhlarova

Mental Health Review Journal, vol.15, Sept. 2010, p. 22-30

The 2008 review of Child and Adolescent Mental Health Services (CAMHS) suggested that demand and capacity within these services may be unbalanced. This study evaluated the implementation of the Choice and Partnership Approach (CAPA), a clinical system designed to improve the management of demand and capacity within these services. It aimed to investigate how CAPA had been implemented within CAMHS in England, to explore the experiences of staff working within teams which had implemented the system, and to determine the benefits and challenges of implementing CAPA in practice. The results showed that, if well managed and implemented, demand and capacity models such as CAPA can provide teams with structured, formal planning mechanisms. However, if implemented poorly and without adequate management, then these models could contribute to confusion and overworking among staff. The investigation found the presence of facilitative management to be absolutely crucial for successful implementation of models of demand and capacity.

The modernisation of mental health day services: participatory action research exploring social networking

W. Bryant and others

Mental Health Review Journal, vol. 15, Sept. 2010, p. 11-21

The modernisation of mental health day services has been shaped by concerns about the social exclusion of people with enduring mental health problems. Initiatives have emphasised the use of mainstream facilities and an individualised approach. In contrast, service users have sought to safeguard opportunities for peer support in safe places. This participatory action research brought together service users, staff and others involved to explore how these different views could be transformed into modernised services in an outer London borough.

Road to inclusion

A. Mathers

Learning Disability Today, Nov. 2010, p. 34-36

Little attention has been paid to designing outdoor environments, such as streets, transport networks and parks, to meet the needs of people with learning disabilities. This article describes how participatory research with the learning disability community in Sheffield was used to identify the problems they experienced using local buses. Results were then used to influence public transport policy.

Social psychiatry and social policy for the 21st century - new concepts for new needs: the 'psychologically-informed environment'

R. Johnson and R. Haigh

Mental Health and Social Inclusion, vol. 14, Nov. 2010, p. 30-35

This article introduces and explains the concept of the psychologically-informed environment (PIE). When any agency has effective control over many aspects of the day-to-day lives of the people living there - as for example in a hospital, a hostel or a prison - we have in effect a highly managed environment. When, in addition, the primary task of the service is the treatment or other management of problematic behaviour, we have an environment that can be to some degree consciously planned for the purpose. The PIE approach can help to manage the psychological and emotional needs of some of those most excluded from mainstream society, and to support them into recovery.

Support workers within learning/intellectual disability services perception of their role, training and support needs

D. Windley and M. Chapman

British Journal of Learning Disabilities, vol. 38, 2010, p. 310-318

To achieve personalised services for people with learning disabilities which promote enablement, the skills of staff at all levels need to be developed. However, there is little research on the perception of paid carers of their support and training needs. This qualitative study used a focus group and semi-structured interviews to explore the attitudes of these staff towards their role, and their training and support needs. It is concluded that normalisation may no longer provide the most effective framework to guide support staff; the adoption of more generic human rights principles in combination with person centred planning may provide them with a better understanding of their role.

Supported living: making the move: developing supported living options for people with learning disabilities

A. Wood and R. Greig

National Development Team for Inclusion, 2010

Report finds that, despite increasing numbers of people with learning disabilities wanting to buy or rent their own home, residential care and group homes remain the options favoured by local authorities for them. Local authorities are continuing to promote use of residential care despite evidence that it leads to negative outcomes. Options such as shared ownership and renting in the public, not-for-profit or private sectors are highlighted as working well for people with learning disabilities, but to date only a minority are able to access them.

Survey finds discrimination is still rife

A. Penwarden

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

A survey by Turning Point has shown that discrimination against people with learning disabilities is widespread, due in part to lack of public understanding, and some suffer financial, emotional and physical abuse.

Taking service providers to court: people with learning disabilities and Part III of the Disability Discrimination Act 1995

J. Lerpiniere and K. Stalker

British Journal of Learning Disabilities, vol.38, 2010, p.245-251

Part III of the Disability Discrimination Act (DDA) 1995 places a legal obligation on providers to offer accessible services to disabled people, including those with learning disabilities. However, it has been little used by people with learning disabilities to take legal action about unfair treatment by shops, banks, sports centres, GPs, etc. This article investigates the effectiveness of legal action based on Part III of the DDA in promoting equal treatment for people with learning disabilities. Effectiveness is gauged through analysis of the legal process engaged in by two people with learning disabilities who made claims against service providers under Part III of the Act.

Time is not on our side

I.A. McMillan

Learning Disability Today, Oct. 2010, p. 28-31

Cases of dementia are on the rise among people with learning disabilities as more survive into old age. Although advances have been made in the past decade, services for people with learning disabilities and dementia are patchy across the UK. The author calls on commissioners to invest in relatively cheap and simple initiatives such as raising family carers' awareness of dementia, conducting regular assessments to check for changes, and offering practical suppor

Why are providers failing in-patients?

G. Carson

Community Care, Nov. 18th 2010, p. 24-25

The Care Quality Commission's annual report on the use of the Mental Health Act shows that poor practice continues to taint psychiatric in-patient services. The Commission found that some providers were imposing blanket restrictions on detained in-patients, failing to assess or record patients' consent to treatment and not involving them in decisions about their care. Frontline staff may be too busy and pressured to properly engage with patients and require training on their obligations under the Human Rights Act.

Working for a change?

A. Jahoda, P. Banks and D. Dagnan

Learning Disability Today, Oct. 2010, p.35-37

This study examined the impact of moving into supported employment on the quality of life and emotional well-being of people with learning disabilities. Results suggest that work can help to foster positive self-perceptions. However there was little evidence of people with learning disabilities in work experiencing increased social interaction either within or outside the work setting. Struggles with work can also raise people's awareness of the limits of their abilities. Employment services need to offer longer-term support and be imaginative in attempting to offer a wider range of job opportunities.

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