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

5m scheme to divert mentally ill offenders from prison

S. Morris

The Guardian, March 28th 2011, p. 6

The health secretary Andrew Lansley and the justice secretary Ken Clarke have found 5m to put into 100 'diversion sites' in England and Wales; the first stage in setting up a national service to divert mentally ill people from prison.

Broadmoor patient makes history with court appeal

J. Taylor

The Independent, March 9th 2011, p. 16

The article reports that a patient who has been held at Broadmoor, the high-security psychiatric facility, for the past twenty-three years has won the right to have a review of his detention held in public at the Mental Health Tribunal. Under the Mental Health Act, such tribunals are not open to the public because in them personal medical details are disclosed. Mental health campaigners have hailed the ruling as a landmark.

Changing jobs

S. Strong

Learning Disability Today, Feb./Mar. 2011, p. 16-17

It is currently much harder for people with learning disabilities to access employment, due to the tough economic climate. Funding from Northamptonshire Learning Disability Partnership Board has enabled a unique project to be developed in Kettering General Hospital NHS Trust. The funding has paid for two people with learning disabilities and a support worker to be employed in a role aimed at changing staff attitudes to learning disability.

Clusters and pathways in mental health: what are the implications for inequalities?

M. Clark

Ethnicity and Inequalities in Health and Social Care, vol. 3, Dec. 2010, p. 30-35

Mental health care in England has been transformed by a series of policy initiatives since the launch of the National Service Framework in 1999. The Delivering Race Equality strategy launched in 2005 produced momentum, learning and some actual improvements, but more needs to be done to provide equal access to services. This article considers the potential of two current policy initiatives to address inequalities, namely the movement to care clusters and payment by results in mental healthcare.

Could planning for safety be a realistic alternative approach for those deemed vulnerable?

F. Parley

Journal of Adult Protection, vol. 13, Feb. 2011, p. 6-18

In recent years, policy has been developed for the protection of vulnerable people. However, each policy uses its own language and is based on particular service-oriented views of vulnerability and abuse. Therefore it may either fail to protect or overprotect those it seeks to cover. Drawing on findings of a research study into care staff views of vulnerability and abuse within learning disability services, safety planning is offered as an alternative, more positive approach to risk management when considering adult protection. The approach is person-centred while risk management is often, though not always, professionally or organisationally inclined.

Distant voices, still lives: reflections on the impact of media reporting of the cases of Christopher Clunis and Ben Silcock

I. Cummins

Ethnicity and Inequalities in Health and Social Care, vol. 3, Dec. 2010, p.18-29

It is generally believed by the British public that people with mental health problems are potentially violent and/or dangerous. This paper explores the ways in which media reporting of the cases of Christopher Clunis and Ben Silcock helped to sustain the stereotype of people with acute mental health problems as being violent. It also considers the way in which the media reports helped to shape mental health policy, culminating in the introduction of more coercive mental health legislation and Community Treatment Orders.

A father and a son reunited. a secret court forced to open its doors

A. McSmith

The Independent, Mar. 1st 2011, p. 12

The article reports on the successful legal battle to allow the press to witness and write about the proceedings of the Court of Protection in the case of Mark Neary against Hillingdon Council. Mr Neary is fighting the Council's decision to deprive him of the custody of his son Steven, who has autism. Mr Neary had been looking after his son for twenty years when, having become ill with the flu in 2009, he asked the Council to temporarily put Steven into care. While separated from his father, Steven's behaviour deteriorated and, with Mr Neary's approval, Steven was moved to a specialist behavioural unit. He subsequently escaped from the unit and was involved in a minor incident with a member of the public. Hillingdon Council issued a Deprivation of Liberty Order, under the Mental Health Act, which meant Steven was only allowed home for two hours at a time and was prevented from staying overnight. Having obtained legal representation, Mr Neary is fighting the council and the case will be heard in the Court of Protection, whose hearings are usually secret to protect privacy. In this case, however, a challenge led by The Independent was successful in obtaining a judicial ruling allowing the press to be present at the hearings and to report on them.

A flexible response: person-centred support and social inclusion for people with learning disabilities and challenging behaviour

S. Carnaby and others

British Journal of Learning Disabilities, vol. 39, 2011, p. 39-45

A central message of UK government policy is that all people with learning disabilities, including those with the most challenging behaviour, should have the same rights and choices as other citizens. However, the evidence suggests that much needs to be done before it can be said that individuals with challenging behaviour are included in a meaningful way as a result of the 'capable environments' supporting them. This article describes the philosophy, development, operationalisation and evaluation of a person-centred day opportunities and supported lifestyle service which is successfully placing users at the heart of their local community. Its innovation lies in embedding clinical input directly in the support model, creating interdependent partnership working across agencies.

'How long are we able to go on?': issues faced by older family caregivers of adults with disabilities

K. Dillenburger and L. McKerr

British Journal of Learning disabilities, vol. 39, 2011, p. 29-38

Research-informed policy and practice are needed to help older parents supporting adult children with intellectual and developmental disabilities in the light of increased longevity. These caregivers are often under tremendous strain because of failing health, financial pressures, bereavement and worry about the future of their children. This article reports on a study of parents of adult children with disabilities in Northern Ireland. Following a brief review of local, national and international literature, caregiver voices are heard through phenomenological reports about issues such as relationships, social support and future planning. Findings show a severe lack of support, respite care and future planning which causes high stress levels for caregivers.

Improving the health of people with learning disabilities: the role of health checks

H. Roberts and others

Learning Disability Today, Feb./Mar. 2011, p. 32-34

People with learning disabilities have poorer physical and mental health than the non-disabled population. This may be because they have difficulties in recognising that they are ill, in communicating their health needs, or in accessing healthcare services. Annual health checks can help to address these issues and so provide one way to improve the health of this group.

In the area

R. Meier

Mental Health Today, Feb. 2011, p. 16-18

There is concern about the increasing use of out of area placements for psychiatric patients requiring access to long-term rehabilitation services. The problem has been caused by the closure of large mental hospitals in recent decades, coupled with disinvestment in local rehabilitation services. The Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists aims reverse the trend by training rehabilitation psychiatrists so that they are equipped with the necessary information and tools to influence commissioners and service managers and to put the case for local rehabilitation facilities.

Inclusion and healthcare choices: the experiences of adults with learning disabilities

M. Ferguson, D. Jarrett and M. Terras

British Journal of Learning Disabilities, vol. 39, 2011, p. 73-83

People with learning disabilities have fewer choice opportunities than the general population. This research explored the choices such people were able to make about every day issues and about healthcare through interviews with them and/or their primary carers and a focus group with physiotherapy staff. The individuals with learning disabilities interviewed described experiences of, and opportunities for, making everyday choices, but generally identified 'others' as being responsible for making their healthcare choices.

It's only right that we get involved: service-user perspectives on involvement in learning disability services

L. Hoole and S. Morgan

British Journal of Learning Disabilities, vol. 39, 2011, p. 5-10

Promotion of user and carer involvement is part of the mainstream policy agenda in health and social care. However, people with learning disabilities don't always get as much of a say as other groups. This article describes a focus group that was conducted to explore the lived experiences of people with learning disabilities as service users. The group said that sometimes they were treated unfairly, but at other times were listened to. They wanted more of a say about what happens in services and had some ideas on how the bring this about.

No health without mental health: a cross-government mental health outcomes strategy for people of all ages

Department of Health


The strategy focuses on prevention across the whole life course, set out under six outcomes. The centrepiece of the coalition government's new strategy for mental health services is the expansion of access to talking therapies to all who need them, including children, older people and those with severe mental illnesses, by 2014/15, building on the work of the existing Improving Access to Psychological Therapies programme. The pledge is backed by 400m of new funding from 2011-15. However, this money is not ring fenced and it will be up to primary care trusts, and GP consortia from 2013, to choose whether or not to spend it on talking therapies. There will also be greater choice for individuals about the services they receive, including expansion of personal budgets, improved practice in involving carers, and greater public involvement through Healthwatch leading to more effective service provision.

(For comment see Community Care, Feb. 10th 2011, p. 6-7)


Social psychiatry and social policy for the 21st century: new concepts for new needs - the 'Enabling Environments' Initiative

R. Johnson and R. Haigh

Mental Health and Social Inclusion, vol. 15, Feb. 2011, p. 17-23

This article outlines the development of the Royal College of Psychiatrists' Enabling Environments initiative. Based on early developments in the therapeutic community movement, this initiative attempts to identify the key features in any setting that foster a sense of connected belonging and suggests a process by which these principles can then be adapted for specific settings such as hospitals, prisons, schools and workplaces.

Somebody to lean on

I.A. McMillan

Mental Health Today, Feb. 2011, p. 12-13

This article introduces an innovative project in Hackney run by the charity Family Action to provide support to women from minority ethnic groups who are pregnant, or who have a child under one, and who are experiencing mental health problems. The project offers support from volunteers drawn from minority ethnic groups who have a one-to-one relationship with the families as well as helping with liaison with statutory services.

A suitable case for treatment?

S. Gillen

Mental Health Today, Feb. 2011, p. 10-11

Community Treatment Orders were intended to ensure that people with mental health problems living at home continued to take their medication and avoided repeated hospital admissions. Since their introduction in 2008, they have been used ten times more than the government predicted, sometimes for patients with no history of non-compliance with medication. At the same time, the rate of compulsory hospital admissions has gone up, instead of falling as expected. Patients themselves report a lack of liaison and communication between hospital and community mental health services, with negative results for continuity of care.

'They say every child matters, but they don't': an investigation into parental and carer perceptions of access to leisure facilities and respite care for children and young people with Autistic Spectrum Disorder (ASD) and Attention Deficit, Hyperactivity Disorder (ADHD)

D. Thompson and M. Emira

Disability and Society, vol. 26, 2011, p. 65-78

This article looks at barriers to leisure activities as defined by parents and carers of children and young adults with autistic spectrum disorder and attention deficit hyperactivity disorder. It discusses three major themes that emerged from the focus group interviews: a sense of isolation, training needs and staff attitudes that relate to the 'hidden' nature of these impairments, and whether to disclose the nature of the impairment. There is also a discussion of the choices parents face regarding whether to use mainstream or special provision. The research highlights the fragility of the progress made on inclusion generally and compares this to areas such as education.

Transition from children and adolescent to adult mental health services for young people with intellectual disabilities: a scoping study of service organisation problems

A. Kaehne

Advances in Mental Health and Intellectual Disabilities, vol. 5, Jan. 2011, p. 9-16

Social care and education transitions for people with intellectual disabilities have received much attention from researchers and policy makers, but little is known about how mental health services link with existing transition partnerships. Eight mental health professionals in three local authorities in Wales were interviewed to sketch potential research themes in this area. The findings revealed a remarkable lack of engagement of mental health professionals with transition partnerships for young people with intellectual disabilities and significant service gaps.

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