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Welfare Reform on the Web (February 2005): Mental Health Services - UK

DELAYED HOSPITAL DISCHARGE AND MENTAL HEALTH: THE POLICY IMPLICATIONS OF RECENT RESEARCH

J. Glasby and H. Lester

Social Policy and Administration, vol.38, 2004, p.744-757

Paper draws on a recent literature review to explore the feasibility of extending the system of fining social services departments responsible for delayed discharges from hospital to cover mental patients. Evidence suggests that defining delayed discharges within mental health services is a complex and often subjective task, liable to produce differing results depending on the individual clinicians involved. At the same time, factors contributing to delayed discharges are multifaceted and involve a wide range of agencies and service responses. While there would appear to be a large number of patients delayed in mental health beds, the concept of reimbursement could be seen as an over-simplistic and extremely blunt instrument for responding to a complex problem.

DELIVERING RACE EQUALITY IN MENTAL HEALTH CARE: AN ACTION PLAN FOR REFORM INSIDE AND OUTSIDE SERVICES AND THE GOVERNMENT'S RESPONSE TO THE INDEPENDENT INQUIRY INTO THE DEATH OF DAVID BENNETT

Department of Health

London: 2005

Main elements of the action plan include:

  • NHS trusts being assessed by the Healthcare Commission on their performance in challenging discrimination and providing equality of access;
  • a new commitment to reduce the disproportionate rates of compulsory detention of black and minority ethnic mental health patients;
  • creating a workforce with the knowledge and skills to deliver equitable care to the black and minority ethnic population;
  • partnership working with black and minority ethnic community organisations;
  • NHS Direct providing a national interpretation and translation service;
  • support to PCTs from 500 new community development workers.

LONE ZONE

E. Forrest

Health Service Journal, vol.115, Jan.20th 2005, p.26-28

Child and Adolescent Mental Health Services (CAMHS) are under-resourced and unable to meet growing demand. Author calls for more emphasis on early detection and intervention, introduction of more emergency on-call teams, and provision of more in-patient beds.

A MATTER OF PRINCIPLE: THE NEAREST RELATIVE UNDER THE MENTAL HEALTH ACT 1983 AND PROPOSALS FOR LEGISLATIVE REFORM

J. Rapaport

Journal of Social Welfare and Family Law, vol.26, 2004, p.377-396

Under current mental health laws the nearest relative of a patient has powers to influence a decision for or against compulsory admission to hospital. The role of the nearest relative has not been seen as a resounding success, and it will be replaced by the roles of nominated person and carer if the new Mental Health Bill become law

MOVE TO END RACE BIAS IN MENTAL HEALTH CARE

J. Carvel

The Guardian, Jan. 12th 2005, p.12

Ministers have committed the government to a five-year plan to halt racial discrimination in NHS mental health services in England, which was exposed in 2004 by an inquiry into the death of David "Rocky" Bennett. Rosie Winterton, the Health Minister, said people from black and minority ethnic communities were less likely to come forward voluntarily for mental health treatment, more likely to stay longer as in-patients in psychiatric wards, and more likely to be prescribed medication or electro-convulsive therapy instead of psychological treatment. This lack of equality was a form of racism that had to be eliminated. It contributed to circle of fear that deterred black and minority ethnic groups from seeking timely treatment, Ms Winterton said. The plan includes the first comprehensive ethnic monitoring of mental health services, beginning in April with inpatients and developing into an annual survey of all service users.

NATIONAL SUICIDE PREVENTION STRATEGY FOR ENGLAND: ANNUAL REPORT ON PROGRESS 2004

National Institute for Mental Health in England

[London]: Department of Health, 2005

The report outlines areas where progress is being made, including:

  • targeting of young men to encourage them to seek help when in distress via mental health promotion pilots in Camden, Manchester and Bedfordshire;
  • running suicide prevention training pilots for staff in mental health units and prisons;
  • setting up a study of deliberate self-harm in three centres in England;
  • launch of a five-year programme to tackle stigma and discrimination on mental health grounds.

NHS FACES MENTAL HEALTH ETHNIC SURVEY

J. Carvel

The Guardian, Jan. 10th 2005, p.9

The government will this week order the NHS to introduce comprehensive ethnic monitoring of all mental health patients in England after evidence of persistent racial discrimination against black and minority ethnic groups.

PRESCRIPTION FOR CHANGE

A. Dix

Health Service Journal, Vol. 115, Jan. 27th 2005, p.30-33

There are fewer than 300 mental health nurse prescribers in the country and 50 of them work for one trust - South Staffordshire Healthcare trust. The trust became interested in the potential of nurse prescribing when it started to look at the problem of patient non-compliance with treatment, which some studies suggested was as high as 70 per cent. The trust runs a course which includes training nurses in improving patient satisfaction and increased collaboration between consultants and GPs. Further increases to nurses' prescribing powers are on the horizon. The Department of Health is anticipating additions to the nurse prescriber's extended formulary, 'particularly for emergency care' , as well as changes allowing supplementary prescribers to prescribe controlled drugs, in the wider context of the government's response to the Shipman inquiry. The author visited South Staffordshire to check on their progress.

PSYCHIATRIC INPATIENT SERVICES FOR CHILDREN AND YOUNG PEOPLE IN SCOTLAND

Child Health Support Group, Inpatient Working Group

Edinburgh: Scottish Executive, 2004

Recommends a phased increase to 60 psychiatric inpatient beds for young people in Scotland, and states that the views of older young people should be sought on where they wish to be treated.

"THEY DON'T QUITE FIT THE WAY WE ORGANISE OUR SERVICES": RESULTS FROM A UK FIELD STUDY OF MARGINALISED GROUPS AND DEMENTIA CARE

A. Beattie and others

Disability and Society, vol.20, 2005, p.67-80

The accessibility of dementia services to two groups of marginalised service users (people under 65 and people from minority ethnic groups) was examined as part of a UK field study. In 61 interviews with a sample of professionals and paid carers, the main issue in service access related to the small number of potential users and their geographical dispersal. At present decisions on care appear to be based mainly on financial considerations and perceptions of the risk posed by people with dementia.

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