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

Access to primary mental health care for hard-to-reach groups: from 'silent suffering' to 'making it work'

M. Kovandzic and others

Social Science and Medicine, vol. 72, 2011, p. 763-772

Adequate and timely support for common mental health problems within primary care is less likely to be accessed by certain groups, such as those with advanced cancer, people with medically unexplained symptoms and people from minority ethnic groups. Given that the UK NHS has an explicit equity-driven health policy framework, it is necessary to understand how and why inequity of access to professional help for common mental health problems is sustained. This study contributes to understanding by comparing the experiences of people from five exemplar groups known to be at risk of inequitable access. The main barriers to access were found to be stigma and lack of effective information. The main facilitator of equitable access was communicated availability of acceptable services.

Ball and chain

R. Clawson

Learning Disability Today, Apr. 2011, p. 26-28

Forced marriages of young people with learning disabilities are a largely hidden problem but the effects on the person concerned can be devastating. Frontline professionals have a key role in protecting people with learning disabilities from forced marriage. With this in mind, the Forced Marriage Unit has published new practice guidelines for professionals.

The Butterfly Project: making creative use of individual budgets

S. Kelly

Community Living, vol. 24, no.3, 2011, p. 14-15

This article introduces the work of the Butterfly Project, a newly established social enterprise that supports young people with learning difficulties during their transition into adult life. The approach is unusual in that the young people supported by the company are buying services with, effectively, pooled individual budgets. The company runs workshops for young people and their personal assistants to guide them into a good route towards paid work.

The coalface of closures

R. Mair

Learning Disability Today, Apr. 2011, p. 10-11

People with learning disabilities are facing the loss of well-loved services due to local authority budget cuts. This article presents a case study showing the impact of the closure of People First Lambeth, an advocacy service for people with learning disabilities which has lost three contracts from the local authority which made up 90% of its income.

Delayed discharges in mental health beds

A. Manzano-Santaella and B. Goode

British Journal of Healthcare Management, vol.17, 2011, p. 113-119

The Department of Health has identified a high number of hospital delayed discharges in mental patients. Since 2006, the weekly monitoring of these delays has been required for all non-acute and mental health trusts. An exploration of the performance indicators designed for delays in acute beds reveals that mental health conditions cannot be categorised in a simplistic or linear way. Although there is a need for close monitoring and rigorous analysis of mental health delayed discharges, the over-reliance on quantitative data underestimates the complexity of mental health conditions, the current legal framework and the shortage of specialised services for this population. These limitations must be taken into consideration when market mechanisms such as Payment by Results are applied to people with a mental illness.

Improving access to psychological therapies (IAPT): are they applicable to people with intellectual disabilities?

K. Dodd and others

Advances in Mental Health and Intellectual Disabilities, vol. 5, Mar. 2011, p. 29-34

The Improving Access to Psychological Therapies (IAPT) programme was established to support primary care trusts in treating people with mild to moderate depression and anxiety disorders. Although the programme has published a Positive Practice Guide for applying psychological therapies to people with intellectual disabilities, no primary care trust has declared a special interest in adapting IAPT to meet the needs of this group. This article considers whether current IAPT services can meet the needs of people with intellectual disabilities, along with adaptations that would be needed to create a service accessible to them.

Improving services through partnership and consultation: a case example

E. Chaplin and others

Advances in Mental Health and Intellectual Disabilities, vol. 5, Mar. 2011, p. 3-7

Monitoring of care quality is integral to modern health service delivery. This paper describes how a specialist in-patient mental health assessment and treatment service for people with intellectual disabilities put in place a process to improve and reprovide the service, in partnership with local stakeholders following a series of audits. The paper highlights the need for transparent and honest working relationships with stakeholders, along with the role of audit and quality monitoring in determining the effectiveness of services.

Learning disabilities ... an easy target for a blunt axe

A. Holman

Community Living, vol.24, no.3, 2011, p. 18-19

In the future the UK government will be reducing the amount of money it spends on services for people with learning disabilities. This article looks at how interest groups and campaigning charities are mobilising to fight the cuts.

A place of my own

M. McGoogan

Learning Disability Today, Apr. 2011, p. 14-16

It is estimated that more than half of people with a learning disability live with family, while 19% live in a registered care home, 13% live in supported accommodation, and 13% have some form of tenancy. Mencap is campaigning for a wider range of housing alternatives for people with learning difficulties, including private renting and home ownership.

Spot the difference

A. Penwarden

Learning Disability Today, Apr. 2011, p. 20-21

Due to the recession, learning disability service providers are under pressure to demonstrate that their offer produces positive outcomes for clients. Because of the many variables involved, it is difficult to measure the quality of a learning disability service. The charity Turning Point is developing and introducing a tool called SPOT (support planning outcomes tool), which is designed to help staff ensure that a service user's needs, wishes, goals and progress can be documented and evidenced.

What do people labelled with learning difficulties think about their access to direct payments?

Carlisle People First Research Team

Learning Disability Today, Apr. 2011, p. 30-33

People with learning difficulties can use direct payments to take greater control of their lives, but may have to assume more responsibility for managing their own care. This research collected the views of 108 people with learning difficulties in Cumbria on direct payments. It emerged that participants had difficulties getting information about direct payments and considered them complicated. There were sometimes long waits for social worker support and assessment. People also found the bureaucracy involved in applying for and managing a direct payment daunting, and some dreaded the prospect of having to take responsibility for a large sum of money.

Where is the person at the centre of all this block commissioning?

J. Clare

Community Living, vol. 24, no.3, 2011, p. 6-7

This article argues that the block contracts for learning disability services let by local authorities in recent years cannot deliver the brave new world of self-directed support. Instead of re-tendering, it advocates for the use of existing contract re-negotiation to encourage innovation, lay the foundation of personalisation, and drive prices down.

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