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

BETTER ORGANISATION FOR PSYCHOLOGICAL THERAPIES IN THE NHS

R. Paxton

British Journal of Health Care Management, vol.10, 2004, p.49-53

Psychological therapies are effective and valued by mental health service users, but supply is patchy in the NHS. Long waiting times are common, and some of the current varied organisational arrangements are ineffective, inefficient and unsafe. Article proposes principles for designing better organisational arrangements, and argues that these lead to multidisciplinary departments that should be expected to deliver the full range of psychological services.

BLOCKED PATHWAYS

L. Warner and A. Hoadley

Health Service Journal, vol.114, Feb.14th 2004, p.36

Both health and social care staff use the care programme approach (CPA) to plan support and treatment for people with mental illnesses. Article reports results of a study of the care pathways of almost 200 service users discharged from four inpatient units between June and August 2002. Results showed that only half the users known to the surveyed mental health services before admission had a current care plan. Follow-up care after discharge was also patchy, with no follow-up appointment recorded for between a third and half of users at three of the four service sites. Report calls on mental health services to act in a joined up way as a link in the system of care.

DEVELOPING NEW MENTAL HEALTH SERVICES FOR LOOKED AFTER CHILDREN: A FOCUS GROUP STUDY

J. Callaghan and others

Adoption and Fostering, Winter 2003, p.51-63

Article describes the use of focus groups with various stakeholders (social services staff, foster carers and residential social workers) to inform the development of a specialist mental health team for looked after children. Data from the focus groups revealed several emergent themes:

  • difficulties accessing mental health services;
  • the importance of partnership working; the need for consultation;
  • the importance of developing a service appropriate to the needs of looked after children.

Ends by describing the newly developed model of mental health provision for looked after children, and highlighting ways in which its form was influenced by the issues raised in the focus groups.

DRAFT INCAPACITY BILL DOES NOT PROTECT PEOPLE'S HUMAN RIGHTS

Community Living, vol.17, no.2, 2003, p.10-11

People First is concerned that the Scrutiny Committee studying the Draft Incapacity Bill has not told the government that people with learning difficulties must have legal rights to support with making their own decisions to prevent abuse by carers, staff and parents.

EQUAL BEFORE THE LAW?

M. K. Foolchand

Community Care, Jan.22nd-28th 2004, p.36-37

Outlines changes needed to the draft mental health bill to address concerns over the treatment of minority ethnic groups. Provisions must be added to ensure that:

  • assessments take full account of cultural, racial and religious differences;
  • patients have access to an advocate from their own culture;
  • interpreting and translation services are available;
  • care planning takes account of the cultural, spiritual and ethnic circumstances of every patient.

EVER READY

E. Forrest

Health Service Journal, vol.114, Feb.26th 2004, p.36-37

Discusses progress with the establishment of mental health crisis resolution teams. There is widespread concern about funding.

INDEPENDENT INQUIRY INTO THE DEATH OF DAVID BENNETT

Chair: J. Blofeld

Cambridge: Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, 2003

Mr Bennett, a 38-year-old African-Caribbean patient, died in Norvic Clinic, a medium secure psychiatric unit in Norwich, in October 1998 after being restrained by staff. The inquiry looked at his care, treatment, the events surrounding his death and wider mental health issues.

MISSING LINK

P. Smith

Health Service Journal, vol.114, Feb.26th 2004, p.12-13

Discusses the valuable contribution made by black and minority ethnic voluntary groups to the care of people from their communities with mental health problems. Unfortunately their role is limited by lack of funding and capacity.

NO HOLDING BACK

Guardian Society, February 11th 2004, p.4-5

Prior to the Bennett report on the 'festering abscess' of institutional racism in NHS mental health services, past and present service users and practitioners share their experiences.

PSYCHIATRIC INPATIENT CARE FOR ADULTS WITH INTELLECTUAL DISABILITIES: GENERIC OR SPECIALIST UNITS

K. Xenitidis and others

Journal of Intellectual Disability Research, vol. 48, 2004, p.11-18

When adults with learning difficulties require inpatient care for mental health problems, general psychiatric units are often used. Specialist units have emerged recently as a care option, but there is limited evidence of their effectiveness. Study aimed to describe and evaluate the effectiveness of a specialist inpatient unit compared to generic services. Patients treated in the specialist unit showed significant improvement on a range of measures including psychopathology, global level of functioning, behavioural impairment and severity of mental illness.

SECURE OR SEGREGATED?

A.U. Sale

Community Care, Jan. 22nd-28th 2004, p.26-27

Presents the arguments for and against village communities as a housing option for people with learning difficulties.

SPEND IT WISELY

K. Leason

Community Care, Feb.12th-18th 2004, p.26-27

The Court of Protection makes decisions on how to manage the finances of an individual who has been assessed as lacking capacity and appoints receivers to manage a person's affairs while he/she is unable to do so. Article discusses whether or not it is appropriate for a local authority to act as a receiver.

SYMPATHY, BUT NO PROMISE OF CHANGE FROM REID

J. Carvel

Guardian, Feb.13th 2004, p.8

The Health Secretary has refused to accept three key recommendations of an inquiry into the death of mental patient David Bennett which identified institutional racism in the NHS. He failed to openly admit to the presence of institutional racism in the mental health services, to agree to appoint an ethnicity Tsar to lead reform, and to mandate a three-minute limit on staff restraining patients by pinning them face down on the floor.

(See also Daily Telegraph, Feb.13th 2004, p.8; Independent, Feb.13th 2004, p.2)

TERMS AND CONDITIONS

E. Gale

Mental Health Today, Feb. 2004, p.27-30

Reports research on the impact that the stigma associated with mental ill health generally might have on staff recruitment and retention. Concludes that the relationship is very complex, with the stigma mostly affecting service users rather than staff. However, the stigma attached to the mental ill health generally could potentially deter new recruits.

TOO LITTLE, TOO LATE

A. Francis

Guardian Society, February 11th 2004, p.11

The Bennett inquiry should go a long way towards addressing problems in our mental health system. But, says the author, it won't go far enough.

WHY NOT?

B. Jackson

Mental Health Today, Feb. 2004, p.12-13

Discusses how patient choice could be implemented in the mental health services. Possibilities include:

  • allowing patients to see and add to their mental notes;
  • expansion of mental health services in primary care;
  • use of advance directives setting out how patients would like to be treated in the event of a crisis;
  • allowing choice of professional help.
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