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Welfare Reform on the Web (April 2012): Mental health services - UK

15 birthday wishes

S. Sayer and M. Routledge

Learning Disability Today, Apr./May 2012, p. 18-21

Direct payments for disabled people were first introduced in 1996 under the Community Care (Direct Payments) Act. They were intended to allow people to tailor their care and support to fit their needs and ambitions by directly managing how their money was spent. However, there are concerns that direct payments have not lived up to this promise due to funding cuts, bureaucracy and restrictions placed on the use of personal budgets. There is also a mistaken belief that many people with learning disabilities cannot or do not want to control their own support.

Changing direction

P. Woods

Mental Health Today, Jan/Feb. 2012, p. 12-13

Rolling out personalisation and self-directed support for people with mental health problems has proved challenging for some local authorities. This article sets out some tips on the key questions that need to be addressed and the foundations that need to be laid with stakeholders to create an environment within which personalisation can be rolled out for people with mental health problems, their relationships with services transformed, and benefits maximised.

Client support co-ordinator: bridging the gap in brain injury legal cases

P. Brown, L. Hope and D. O' Meara

Social Care and Neurodisability, vol. 3, 2012, p. 14-19

This paper discusses the new role of Client Support Co-ordinator which some law firms are developing to help brain injury victims and their families. The intention is to help the family of brain injury survivors to navigate acute care and early rehabilitation, to signpost them towards available services and sources of support, and to be the single point of contact until a case manager is appointed.

Does early intervention for psychosis services make economic sense

P. McCrone

Mental Health Today, Jan./Feb. 2012, p. 31-33

Early intervention for psychosis services have existed in England for more than ten years. Most common are early intervention teams which treat patients who have already developed psychosis, offering a mixture of medical, social and vocational support. Existing evidence suggests that early intervention services are cost effective and produce savings, but more research is needed to make definite conclusions. Cost savings can be made in terms of increased economic activity and reduced crime, in addition to lowering costs in healthcare settings.

The effectiveness of the service user consultant role in specialist personality disorder services

A. D'Sa and M. Rigby

Mental Health Review Journal, vol. 16, 2011, p. 185-196

Service user involvement is now widely promoted in both mental health and social care. Service users hold a number of roles where their perspective is considered important in statutory and voluntary services. This paper aims to consider how these roles have evolved in specialist Personality Disorder services in relation to recruitment, employment, expectations of involvement and support received. It explores the roles of service user consultants in six of the original 11 Department of Health Community Personality Disorder pilot services; how these roles differ from the active participation traditionally encouraged in therapeutic communities; how a service user becomes a service user consultant; what responsibilities they hold; the views of both staff members and service user consultants on the role and the benefits and difficulties it creates; and how the role could be developed.

Getting personal

S. Gillen

Mental Health Today, Jan./Feb. 2012, p. 10-11

According to figures from the NHS Information Centre, only 5,495 people with a mental illness are using a personal budget to purchase support services. Barriers to take up include lack of information about personal budgets, and lack of awareness of eligibility. There is also lack of support from councils in helping people apply for them.

The impact of social policy on changes in professional practice within learning disability services: different standards for children and adults? A two-part examination: Part 2. Professional services under the coalition: the trends continue apace

D.G. Race and N.A. Malin

Journal of Intellectual Disabilities, vol.15, 2011, p. 289-299

Under the Coalition government, and in the context of public spending cuts, moves have continued towards deprofessionalisation of frontline and even provider management level personnel delivering services to adults with intellectual disabilities. Although professional qualifications remain highly necessary for work with children, they are increasingly being subordinated to the managerial demands generated by local authorities and the NHS to reduce costs, thus removing or reducing access to professional inputs such as speech therapy. In education, the focus on expanding the academies programme is putting pressure on schools with inclusive policies to reconsider, and has boosted the growth of independent special schools for children with learning disabilities, although without any changes to teacher training to resource such schools. Finally, local authorities, although outwardly compliant, have variously interpreted their responsibilities under the personalisation agenda, in particular in relation to individual budgets, and this has resulted in assessments of need being based on service hours rather than service quality or staff qualifications.

Improving health and lives: the Learning Disabilities Public Health Observatory

E. Emerson

Advances in Mental Health and Intellectual Disabilities, vol. 6, 2012, p. 26-32

Research evidence demonstrates that people with intellectual disabilities have poorer health than their non-disabled peers and that these differences are to a significant extent avoidable. This paper describes the first 15 months of operation of the Learning Disabilities Public Health Observatory (LDPHO) established in April 2010. The LDPHO aims to contribute to the reduction and eventual elimination ofhealth inequalities experienced by people with intellectual disabilities in England. It has made available to health and social care services commissioners a wealth of information on the health needs of people with intellectual disabilities; identified improvements that could be made to enhance the quality of future information; and begun working with local agencies to help them make the best use of available information.

Mental capacity issues in residential services for people with intellectual disabilities

P. Willner and others

Advances in Mental Health and Intellectual Disabilities, vol. 6, 2012, p. 33-40

The Mental Capacity Act implemented in England and Wales in 2007 introduced the principle that people must be presumed to have capacity to make their own decisions unless and until they are assessed as lacking capacity. This study aimed to ascertain the knowledge of mental capacity issues of staff working in residential services for people with intellectual disabilities. Staff working in three types of residential service were compared with two reference groups: a group of UK NHS staff working in generic services and a sample of health and social services professionals working in community teams for people with intellectual disabilities (CTIDs). The residential carers performed better at interview than the generic NHS staff but worse than the CTID professionals. However results brought to light gaps in the residential carers' understanding of mental capacity issues.

Mental health service user involvement in policy development: social inclusion or disempowerment

S. Cowan and others

Mental Health Review Journal, vol. 16, 2011, p. 177-184

The advent of New Labour with its focus on social inclusion seemingly provided opportunities for service users to participate in the development of mental health policy and thus be 'empowered' by working in partnership with other key stakeholders. This paper provides an analysis of such New Labour policy and argues that, despite the rhetoric, it frequently did not meet the needs of mental health service users in making a meaningful contribution to policy development. Ultimately the service user movement had to accommodate the welfare market demands of New Labour and its successors. The paper points to the potential value of service user groups considering alternative forms of involvement, rather than those prescribed by 'Third Way' or 'Big Society' thinking.

On the buses

P. Kinsey

Learning Disability Today, Apr./May 2012, p. 26-37

Frustrated by receiving a poor service on local buses, people with learning disabilities in Romford started a campaign for fair treatment on public transport.

A parting of the ways? The diverging nature of mental health social work in the light of the new Acts in Scotland, and in England and Wales

K. Mackay

Journal of Social Work, vol. 12, 2012, p. 179-193

This article uses the concept of citizenship to explore the recent mental health statutes within England and Wales and within Scotland. It argues that differences in the content, and practice context, heral a parting of the ways in mental health social work in the UK. The research focuses on three key differences: the reciprocity principle, the grounds for compulsory treatment, and the place of social work in compulsory treatment to demonstrate how the statutes have led to more limited legal, procedural and social rights in England and Wales than in Scotland. The result for social work is that the practice context created in England and Wales may become more risk averse and that social work may have a more limited role in the statutory mental health services.

The road to equal health

S. Turner and E. Emerson

Learning Disability Today, Apr./May 2012, p. 22-23

Despite advances in care in recent years, people with learning disabilities still face health inequalities. Social care staff, often in partnership with their health colleagues, have an important role to play in reducing them. The Improving Health and Lives Learning Disability Public Health Observatory has written guidance for social care staff. Based on this guidance, the article illustrates some of the practical steps that health and social care staff can take to improve the situation.

Speaking up about advocacy: findings from a partnership research project

M. Chapman and others

British Journal of Learning Disabilities, vol. 40, 2012, p. 71-80

Policy in England has emphasised the importance of developing advocacy support for people with learning disabilities. However, there has been confusion about what form advocacy support for this group should take, and a number of barriers have been identified which have hindered the success of advocacy. This research was undertaken by a team consisting of people with and without learning disabilities and sought to explore people's understandings of advocacy and identify gaps in provision. Results showed that advocacy was a confusing and intangible concept to many people, but also identified a clear need for independent provision.

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