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

Tackling neglect and mental health reform in a devolved system of governance

J. Costa-Font and others

Journal of Social Policy, vol. 40, 2011, p. 295-312

Mental health care has been a traditionally neglected component of the welfare policy agenda, and it is argued that reforms have been driven by a) an increasing awareness of the social and economic impacts of mental ill health and b) increasingly evidence-based actions to reduce those impacts. In Spain, regional devolution of health and social care responsibilities has been key in providing an opportunity for policy and institutional innovation, has enhanced coordination within and external to the healthcare sector, and has assisted evidence-based decision-making through the action of health technology agencies. Moreover, devolution has also helped to curb the move towards means-testing of services.

Why do families relinquish care? An investigation of factors that lead to relinquishment into out-of-home respite care

K. Nankervis, A. Rosewarne and M. Vassos

Journal of Intellectual Disability Research, vol. 55, 2011, p. 422-433p

In an Australian context, this article looks at why families caring for a person with an intellectual disability place that person in out-of-home respite care for an extended stay. Evidence was gathered from a review of 32 case files. Results showed that the factors which led families to relinquish care could be categorised as:

1. characteristics of the client (high support needs, high medical needs, limited communication)
2. characteristics inherent in the family (psychological distress, single parent family, marital breakdown, desire for a normal life)
3. characteristics associated with the support context (availability of respite care, relinquishment being used as a strategy to gain out-of-home permanent placement).

It emerged that long term respite care was being used as a 'band aid' to avoid addressing underlying difficulties. It is suggested that demand could be reduced by interventions aimed at enhancing the carer's ability to cope, such as parent training, linkage to informal support and interventions to reduce client challenging behaviours.