Welfare Reform on the Web (July 2005): Mental Health Services - Overseas

Evidence-based mental health practice: a textboo

R. E. Drake, M. R. Merrens and D. W. Lynde (editors)

New York: Norton, 2005

The term evidence-based medicine was introduced in 1990 to refer to a systematic approach to helping doctors apply scientific evidence to decision-making regarding the treatment of individual patients. Evidence-based practice (EBP) has affected all fields of health care, including mental health where it has emerged as a viable and effective approach for persons with severe mental illness and their families. This textbook is an essential primer for all practitioners and students who are grappling with the new age of evidence-based practice. The contributors examine some of the complex challenges in implementing EBPs, and highlight the opportunities that are inherent in this paradigm shift.

Housing as a social integration factor for people classified as mentally ill

H. Dorvil and others

Housing Studies, vol.20, 2005, p.497-519

Study identifies four types of housing for discharged psychiatric patients in Montreal. These are custodial housing (e.g. foster homes), supportive housing (therapeutic residential communities), supported housing and autonomous one-room apartments. Study explored the perception of mental health service users regarding their quality of life and degree of empowerment in relation to these various types of accommodation. Twenty-on Montrealers with mental health problems and living in the four types of housing were interviewed. Results show that apartment-style housing offers greater autonomy than residential accommodation, but also a greater risk of isolation.

Patient incompetence and substitute decision-making: an analysis of the role of the health care professional in Dutch law

S.P.K. Welie and others

Health Policy, vol.73, 2005, p.21-40

In the Netherlands, there is a system of substitute decision-making through representation for patients lacking mental competence. However, in the Dutch model, health care professionals are not at the mercy of patient representatives. On the contrary, health care professionals are supposed to judge their patients' interests and may eventually overrule patient representatives. Article calls for a debate about this state of affairs.