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Welfare Reform on the Web (September 2002): Mentail Health Services - UK

ADAPTING TO CHANGE

R Hargreaves

Professional Social Work, July 2002, p.14-15

Argues that any revision of the Mental Health Act 1985 should safeguard the independence of approved social workers. Present reform proposals would allow health professionals to take on the approved social worker's (ASW) role and would remove the prohibition on ASWs being directly employed by Care Trusts. They would therefore no longer be independent of the organisation which is trying to compulsorily detain certain people with mental health problems. The main statutory responsibility of approved social workers under the 1985 Mental Health Act is to make application for compulsory admission to hospital where appropriate.

ADOLESCENTS WITH MENTAL HEALTH PROBLEMS: WHAT DO THEY SAY ABOUT HEALTH SERVICES?

K Buston

Journal of Adolescence, vol. 25, 2002, p.231-242

Reports a study which used qualitative methods to elicit detailed information from a group of UK adolescents with chronic mental health problems regarding their views on the health care they received from the NHS. Data reported focus on adolescents' perceptions, and, as such, may be of use as a starting point in designing strategies to improve the user friendliness of the services, so boosting attendance rates and improving compliance with treatments. The main theme that emerged from these interviews was the value placed on understanding and supportive clinical relationships.

BEYOND INVOLVEMENT: MAKING CHOICES AND TAKING CONTROL

D Davidson and N Vick

Mental Health Review, vol.7, June 2002, p.25-28

Discusses the feasibility of local authorities extending the system of direct payments to people with mental health problems so that they can purchase their own care packages.

CARE PLANNING: MEETING THE NEEDS OF WOMEN

G Aitken

Mental Health Review, vol.7, June 2002, p.21-24

Paper attempts to show that effective care planning for women with mental health problems must extend beyond medical care to meet a range of needs relevant to their well being. However, lack of awareness of the impact of gender on all aspects of women's lives and the way in which professionals understand and negotiate meeting women's needs can mean that the balance of power remains firmly with the systems of care and treatment. Statutory services need to build true partnerships with female users themselves.

THE CARE PROGRAMME APPROACH: RECASTING THE VISION

M Aslan

Mental Health Review, vol.7, June 2002, p.21-24

Argues that the Care Programme Approach to planning the care of people with mental health problems fails to embrace the concepts of inclusion and recovery. Care Programmes need to be recast as personal recovery programmes developed jointly by the service user and the professional.

CHILDREN WITH SEVERE LEARNING DISABILITIES: NEEDS, SERVICES AND COSTS

J Beecham and others

Children and Society, vol.16, 2002, p.168-181

Study explores the current use and associated costs of formal care services for children with severe learning disabilities living at home. Results suggest that supporting these children at home is expensive, costing on average £17,100 per year. Around 70% of these costs are born by the local education authority and 30% by health and social services. Analyses show that support costs rise with increasing severity of disability and behaviour problems, that as a group these children require access to a wide range of services, but that there is underprovision relative to need, particularly for mental health services.

DANGER SIGNALS

P Smith

Health Service Journal, vol.112, July 4th 2002, p.10-11

Up to now people with dangerous severe personality disorder who might pose a threat to the public could not be detained because the condition is untreatable. The new draft bill issued for consultation drops the treatability test and allows such people to be incarcerated even though they have committed no crime. This has infuriated mental health groups, service users and clinicians.

(See also Community Care, July 4th-10th 2002, p.18-19)

DANGEROUS PSYCHOPATHS MAY BE HELD INDEFINITELY

A Frean

Times, June 26th 2002, p.10

Reports the publication for consultation of a draft Mental Health Bill. This defines mental disorder as any disability or disorder of the mind or brain which results in an impairment or disturbance of mental functioning. Its main proposals are:

indefinite detention of potentially dangerous people with a mental health disorder even though they have not committed a crime;

  • powers to force patients in the community to take their prescribed medication;
  • a new mental health tribunal to regulate use of compulsory powers for more than 28 days and to consider appeals against compulsory treatment orders;
  • independent advocates to protect patients' interests;
  • new rights for victims of deranged criminals to know when their attacker is to be released.

(See also Financial Times, June 26th 2002, p.6; Independent, June 26th 2002, p.4; Guardian June 26th 2002 p.4)

DRAFT MENTAL HEALTH BILL

Department of Health

London: TSO, 2002 (Cm 5538)

This command paper is in three parts: the Bill, the explanatory notes and a consultation document. The draft bill proposes the creation of mental health tribunals that will authorise all compulsory treatment beyond 28 days. Decisions will be based on a care plan submitted by the patient's clinician. Under the 1983 Mental Health Act patients cannot be detained in hospital if their conditions cannot be alleviated. The draft bill drops this "treatability test". Compulsory treatments will take place in the community as well as in hospital. Prisoners will be given compulsory treatment in gaol. A healthcare inspectorate will police the application of the new Act, replacing the Mental Health Act Commission. Organisations like Mind had asked for a right to assessment for people with mental health problems but this has been refused.

ETHNIC DIFFERENCE IN THE CONTEXT AND EXPERIENCE OF PSYCHIATRIC ILLNESS: A QUALITATIVE STUDY

W O'Connor and J Nazroo (eds)

London: TSO, 2002

Reports the results of a survey of ethnic minority mental health in the UK. Found that all groups used similar terms to describe mental distress except for non-English speaking South Asians. Some South Asian groups, particularly first generation immigrants, somatise their symptoms, describing mental distress as a physical symptom. Differences between generations mean that symptoms of mental distress are presented differently within ethnic groups. Causes of mental distress are broadly similar but impact differently according to ethnic group. Religion is an important coping mechanism for Black Caribbean and South Asian groups. Language, lack of practice nurses in GP surgeries, time constraints and practice location are barriers to some groups, particularly South Asians, accessing mental health treatment.

IN SEARCH OF "NORMALITY"

H Hurford

Community Care, June 20th-26th 2002, p.36-37

Crisis resolution teams are required to be in place by 2004. It is important for mental health services commissioners and providers to ensure that plans for these services are developed in consultation with users.

LEARNING DISABILITY - A SOCIAL APPROACH

D G Race (ed)

London; Routledge, 2002

By looking at how people's lives are affected by human services, this book covers specific policies and service issues, different aspects of working with people and the key debates surrounding those people with learning disabilities in the UK.

MAD, BAD AND DANGEROUS LAW

C Muller

Guardian, June 27th 2002, p.20

Argues that the new Mental Health Bill's proposals for compulsory detention of dangerous psychopaths and compulsory treatment of mental patients in the community represents an over-reaction to public fears. It is unacceptable to lock up innocent people in the name of prevention. Failure by mental patients in the community to take their medication could be reduced by prescribing different drugs with fewer unpleasant side effects.

MAKING CHOICES TO MAKE CHANGES

A Lawton

Mental Health Today, July 2002, p.18-21

Reports a study of the resources and support needed to enable people with mental health problems in addition to learning difficulties to express choice. Present barriers to participation centre on lack of time, lack of information and communication problems.

MAPPING THE ROUTES TO RECOVERY

D Turner

Mental Health Today, July 2002, p.29-31

Article describes the "recovery approach" to mental health care. This involves supporting people with mental health problems to "take control" of their lives and to make real choices based on objective information and a developing sense of self-worth. It encourages people to learn from experience within an environment of hope for the future.

A NEW PARADIGM FOR DELIVERING RECOVERY ORIENTED SERVICES FOR PEOPLE WITH SERIOUS MENTAL ILLNESS: IMPLICATIONS FOR SERVICE DELIVERY

P Allott and L Loganathan

Mental Health Review, vol.7, June 2002, p.6-13

Article aims to review what is known about recovery from severe mental illness and identifies practice that is likely to increase the rates of recovery within the context of developing mental health services in England.

A PRICE WORTH PAYING

Anon

Mental Health Today, July 2002, p8-9

Reports that the National Institute for Clinical Excellence has recommended that atypical antipsychotics should be made available throughout the NHS as a first treatment for schizophrenia. The recommendation is made largely on the grounds that these drugs have fewer side effects than those at present in use.

PROVIDING MENTAL HEALTH ADVOCACY IN A PATIENT-CENTRED NHS

M Kinton

Mental Health Review, vol.7, June 2002, p.29-31

Discusses the developing role of mental health advocacy in health service reform. Suggests that mental health advocates should be able to: 1) help patients to formulate their concerns and wishes; 2) act as their voice in putting these forward to the right people; and 3) open possibilities for patients to represent themselves.

SERVICES FAIL TO FOCUS ON THE NEEDS OF ETHNIC MINORITIES

D Hayes

Community Care, June 27th-July 3rd 2002, p.20-21

Argues that mainstream mental health services do not understand or respond to the needs of minority ethnic communities. They are over-reliant on referring people to voluntary and independent sector service providers. There is also a failure to engage the communities themselves in service co-ordination and development. Services need to recruit more minority ethnic staff who can meet the needs of their communities.

A THERAPEUTIC SOCIAL WORK TEAM IN PRACTICE

D Walker and J Hext

Journal of Social Work Practice vol.16, 2002, p.29-35

In 1996 Leeds Social Services Department brought together three different groups of social workers from the Child and Adolescent Mental Health Service, the Education Psychology Family Advisory Service and a multi-agency post-abuse service. These groups formed the centrally managed Therapeutic Social Work Team, which offers services to children and families. Paper describes the work of the team by focusing on four areas: the context of interagency collaboration, therapeutic work in the child protection process, managing different theoretical approaches in one team, and evaluating practice.

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