Welfare Reform on the Web (February 2004): Mental Health Services - UK

ADULTS, MENTAL ILLNESS AND INCAPACITY: CONVERGENCE AND OVERLAP IN LEGAL REGULATION

P. Bartlett

Journal of Social Welfare and Family Law, vol.25, 2003, p.341-353

Developments in English law relating to incapacitated adults and mental health have evolved largely independently. This is unfortunate since their jurisdictions contain significant elements of overlap. The mental health reforms are procedurally strong relative to the incapacity reforms, but substantively weak. The incapacity reforms have better substantive protections, but no procedural mechanisms to ensure compliance. The broad definitions of the mental health reforms allow significant intrusion into the jurisdiction of the proposed incapacity law, in practice significantly diminishing the application of the substantive safeguards it would establish.

"BLINK AND YOU'LL MISS IT"? THE IMPACT OF THE NATIONAL SERVICE FRAMEWORK FOR MENTAL HEALTH ON PRIMARY CARE

F. Pidd

Mental Health Review, vol.8, Dec. 2003, p.23-27

Discusses the impact of the National Service Framework on :

• awareness of, and the priority given to, mental health in primary care;
• mental health training and skills development in the field.

CASELOAD MANAGEMENT IN COMMUNITY LEARNING DISABILITY TEAMS: INFLUENCES ON DECISION-MAKING

T. Walker, J. Stead, S. G. Read

Journal of Learning Disabilities, Vol. 7, 2003, p.297-321

The report investigates the workings of community learning disability teams, with particular reference to decision-making processes and caseload management regarding discharge procedures. The study was based on four teams in the West Yorkshire area and both quantitative and qualitative research methods were used. It found that each team dealt with their caseloads differently and that a range of factors influence the decision-making process.

DELIVERING RACE EQUALITY

Department of Health

London: 2003

Sets out the actions that mental health service providers and commissioners need to take to improve services for people from black and minority ethnic groups over a six-year period. The framework focuses on three main areas for action: information provision, development of appropriate and responsive services, and community engagement. One of its aims is to help the NHS comply with the Race Relations (Amendment) Act, which is intended to encourage equitable public services for all groups.

DRAFT MENTAL INCAPACITY BILL

Joint Committee on the Draft Mental Incapacity Bill

London: TSO, 2003 (House of Commons papers, session 2003/03: HC1083) (House of Lords papers, session 2003/03; HL189)

Endorses the draft bill's aim of replacing common law with a comprehensive statutory framework to define mental incapacity, help those lacking it to make their own decisions where they can and enable sound decisions to be made for them where they cannot. The Bill rests on a combination of the common law principle of best interests and a presumption of capacity, an approach which the Committee considered sound. Welcomes the proposals for the establishment of a new Court of Protection, but is concerned about the limitations on the availability of legal aid. Supports the right of people to state in advance what medical treatment they would want to have if they become incapable of taking decisions, dismissing fears that this could lead to euthanasia. Finally stresses that a clear Code of Practice will be vital to the success of the Bill, and suggests that more safeguards should be introduced to protect people lacking capacity from abuse. It emphasises that the Bill should acknowledge the role of independent advocacy services in helping those lacking capacity to assert their rights.

GATEKEEPERS, PROXIES, ADVOCATES? THE EVOLVING ROLE OF CARERS UNDER MENTAL HEALTH AND MENTAL INCAPACITY LAW REFORMS

K. Keywood

Journal of Social Welfare and Family Law, vol.25, 2003, p.355-368

The proposed mental health and mental incapacity reforms anticipate a number of overlapping and at times conflicting roles for carers. Carers are required to retain the role of gatekeeper to specialist services, while at the same time advocating for the care recipient's welfare and acting as proxy decision-maker on behalf of the care recipient.

THE LONGEST WAIT IN THE NHS

J. Snell and N. Valios

Community Care, Jan.8th-14th 2004, p.28-30

Discusses delays in the closure programme for long-stay hospitals for people with learning difficulties and their resettlement in the community. Focuses on the winding down of Little Plumstead Hospital as a case study.

THE NATIONAL SERVICE FRAMEWORK FOR MENTAL HEALTH: PAST, PRESENT AND FUTURE

A. McCulloch, G. Glover and T. St. John

Mental Health Review, vol.8, Dec. 2003, p.7-17

Review found very limited evidence of progress on most of the National Service Framework standards. However, there has been significant progress in the development of intensive community mental health teams, and the position on suicide prevention is encouraging. There appears to be poor progress, or even regression, on services for carers and on stigma and discrimination, and possibly some small advances in primary care. Article identifies six key challenges to be addressed in implementing the NSF: tackling under-funding; workforce training and development; rebalancing the system; inpatient care improvement; use of new technology; and quality assurance.

NATIONAL SUICIDE PREVENTION STRATEGY FOR ENGLAND

D. Duffy and K. Foster

Mental Health Review, vol.8, Dec.2003, p.28-30

Discusses progress towards meeting the six goals of the strategy for suicide prevention in England. These are:

• reduction of risk in key high-risk groups;
• promotion of mental well-being in the wider population;
• improving reporting of suicidal behaviour by the media;
• reduction of the availability of the means of suicide;
• improvement of the monitoring and evaluation of the strategy.

THE NEW MENTAL HEALTH ACT: WHAT'S IT ALL ABOUT? A SHORT INTRODUCTION (PDF format)

S. McDougall

Edinburgh: Scottish Executive Health Department, 2004

Booklet looks at the provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003, which comes into force in 2005. Covers compulsory hospitalisation, compulsory treatment in hospital and in the community, and safeguarding patients' rights.

THE PROGRESS OF ASSERTIVE OUTREACH SERVICES: REFLECTIONS AND EXAMPLES

J. Lowe

Mental Health Review, Vol.8, Dec. 2003, p.31-34

Emphasises the importance of effective team-working in delivering assertive outreach services to people with severe mental illness.

RURAL MENTAL HEALTH AND SOCIAL GEOGRAPHIES OF CARING

H. Parr and C. Philo

Social & Cultural Geography, Vol. 4, December 2003, p.471-488

The article examines geographies of caring, looking particularly at the notion of "community care". It focuses on communities in the remote Scottish Highlands and their provision of both formal and informal care for people with mental health problems. Investigation showed that gossip networks transcended the distance between houses and that the community held both stereotypical and stoical attitudes towards mental health. This led to reluctance amongst suffers to seek treatment, leaving carers to struggle on unsupported and creating difficulty for local psychiatric nurses. A lack of treatment centres with close proximity also placed extra pressure on local GPs. The article concludes by calling for further research into this topic.

STANDARDS, QUALITY AND ACCOUNTABILITY: THE NHS AND MENTAL HEALTH: A CASE FOR JOINED-UP THINKING?

J. McHale

Journal of Social Welfare and Family Law, vol.25, 2003, p.369-382

The proposals for the reform of the Mental Health Act 1983 contained in the Draft Mental Health Bill consultation document recommend that the Mental Health Commission be abolished and its functions distributed, with many of its existing roles being entrusted to the Commission for Health Improvement and its successor body, the Commission for Healthcare Audit and Inspection. These proposals can be seen in terms of the government's emphasis on "joined-up thinking" and can be regarded as a positive step in terms of aligning scrutiny of standards in mental health, mental disability and physical illness.

SUPPORTING IMPLEMENTATION OF STANDARD 1 OF THE NSF: IMPACT ASSESSMENT OF A MENTAL HEALTH PROMOTION TRAINING PROGRAMME

L. Seymour and A. Fletcher

Mental Health Review, vol.8, Dec.2003, p.18-22

Health and social care services have a duty to promote mental health for all and to reduce social exclusion for people who have experienced mental illness. Results of the impact evaluation of four pilot mental health promotion training courses demonstrate their success in building capacity and competence within localities and in providing participants with skills and expertise to make sustainable changes.

REFORMING MENTAL HEALTH LAW AND THE ECHR: WILL THE RIGHTS OF MENTALLY VULNERABLE ADULTS BE PROTECTED?

J.M. Laing

Journal of Social Welfare and Family Law, vol.25, 2003, p.325-340

Article demonstrates a lack of coherence in the UK government's proposals for reforming mental health law. The Draft Mental Incapacity Bill attempts to put patient autonomy at the forefront, while the Draft Mental Health Bill focuses on public protection and risk management at the expense of the rights and wishes of detained patients.

A WINDOW OF OPPORTUNITY

M. Brown and others

Mental Health Today, Dec. 2003, p.22-25

Early intervention in psychosis (EIP) teams specialise in working with young people aged 14-35 who are experiencing their first episode of psychosis. They provide a range of services, including antipsychotic medications and psychological interventions, tailored to the needs of young people with a view to helping them recover. They also take an optimistic view of the person's ability to recover and avoid conventional preoccupation with symptom management.

(For case studies see Mental Health Today, Dec. 2003, p.26-34)

WORKING IN MULTIDISCIPLINARY COMMUNITY MENTAL HEALTH TEAMS: THE IMPACT ON SOCIAL WORKERS AND HEALTH PROFESSIONALS OF INTEGRATED MENTAL HEALTH CARE

J. Carpenter and others

British Journal of Social Work, Vol. 33, 2003, p.1081-1103

The study investigated the relationships between the organisation of community mental health services and professional and team identification, team functioning and the psychological well-being and job satisfaction of staff working in them. Staff in four districts in the North of England completed anonymous questionnaires on two occasions, twelve months apart. Results suggest that differing patterns of service organisation may be associated with staff perceptions of team functioning and their experience of role conflict. Overall, CMHTs in districts where health and social services are integrated and where services are targeted on people with severe mental health problems may perform better on these measures. However, service organisation had no evident impact on outcomes for staff in terms of stress or job satisfaction.