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

Cuts leave patients waiting months for mental health help

S. Lister and M. Davies

The Times, August 2nd 2011, p. 8

A sign of the financial pressure on the NHS is the growing number of patients with depression and other mental health problems who are waiting more than three months for counseling. A drive to improve access to ‘talking therapies’ appears to have had little impact on access or waiting times. There are fears about the long-term impact of delays on recovery. People who wait less than three months for treatment are five times more likely to say that it helped them to get back to work than those who had to wait a year or more. Many people opt for private care. Health trusts have been accused of increasing waiting times to encourage people to pay for private treatment; or some patients die before they are seen.

Did the Hoskin tragedy change anything?

N. Valios

Community Care, July 7th 2011, p. 22-23

This article investigates the impact of the murder in 2006 of Steven Hoskin, a learning disabled man, on adult safeguarding practice locally and nationally. Steven’s body was found below a railway viaduct at St. Austell, Cornwall, following his murder by a gang which had tormented him for months under the noses of public services.

The importance of early intervention in mental health

A. Bell

British Journal of Healthcare Management, vol. 17, 2011, p. 272-275

The English NHS has been asked to cut its costs by £15bn over the next five years. In this context, the author looks at ways in which better value for money could be achieved in mental health care. Services will need to move towards prevention, early intervention and promotion of well being. At the same time the continued stigma attached to mental illness and the discrimination that stems from it need to be tackled.

Mental health care clusters and payment by results: considerations for social inclusion and recovery

M. Clark

Mental Health and Social Inclusion, vol. 15, no.2, 2011, p. 71-77

Both the former New Labour and the current coalition governments have been committed to moving to a model of payment by results (PbR) in mental health care based on care clusters. This paper discusses the move to PbR and its possible implications for the recovery and social inclusion agenda. It is concluded that the care clusters and developments building on them provide scope for supporting social inclusion and recovery practice, but also pose some risks. Those that are interested in furthering such practice need to engage now locally and nationally with care clusters developments.

One-fifth of patients left in hospitals for five years

V. Pitt

Community Care, July 21st 2011, p. 4-5

Information gathered under the Freedom of Information Act from 32 primary care trusts shows that 18% of people with learning disabilities under their care had been in specialist hospitals for five years or more and 3% had been resident for more than 10. Although these facilities are intended for short-term assessment and treatment, patients had been living in them for 23 months on average. The client group typically involves people with learning disabilities and challenging behaviour, or other complex needs, with places commissioned by the NHS.

Social psychiatry and social policy for the twenty-first century: new concepts for new needs: relational health

R. Johnson and R. Haigh

Mental Health and Social Inclusion, vol. 15, no.2, 2011, p. 57-65

The enabling environment approach seeks to identify and promote the core themes and values of community and positive connectedness in all areas of life, including schools, hospitals, workplaces, housing developments, faith communities and leisure centres, as a broad framework for community mental health and well-being. This article identifies and illustrates links between the enabling environment approach and contemporary social policy themes such as relational health, public health, social inclusion and the Big Society.

Tackling inequalities in primary care mental health

M.K. Ross and P. Craig

Journal of Public Mental Health, vol. 10, no.2, 2011, p. 99-109

In 2005 the Greater Glasgow NHS established the STEPs Team as one of five primary care mental health teams. Through the provision of innovative intervention models, waiting lists for the services offered by the Team were short and manageable, and increased time was available for reflection on wider public mental health issues. The Team recognised that access to services was determined by health inequalities issues, and became convinced that appropriate action was required to address these issues locally. In its attempt to progress work on inequalities, the Team found the approach offered by the Glasgow Centre for Population Health to be a valuable starting point. Through a systematic consideration of available approaches, and the baseline position, the Team began to reflect on potential interventions, and to consider ways in which outcomes could be measured and reviewed. This process, which evolved in discussion within the team and senior management, became an important starting point for longer term action. It provided a means of beginning to grapple with the impact of health inequalities on service provision, and was an important first step in prioritising possible approaches.

Where the wicked problems are: the case of mental health

B. Hannigan and M. Coffey

Health Policy, vol. 101, 2011, p. 220-227

This paper shows how ideas emphasising the interconnections within complex systems and the concept of ‘wicked problems’ can be combined to improve understanding of the challenges of public service policy and delivery, including in the arena of healthcare. These ideas are then used to underpin an examination of a decade and a half of activity in the UK’s mental health field. Mental health is a disputed field. Following a brief chronological narrative of mental health policy, the article traces how changes in mental health policy focus reveal important shifts in formulations of the problem being addressed. Fast-moving policy action and service developments in an area as complex as mental health can also bring the potential to trigger profound, cumulative consequences. In interconnected systems these can emerge in unpredictable ways, and have lasting effects. The authors consider the implications of this observation for the mental health field.