Welfare Reform on the Web (January 2006): Mental health services - UK

Advocacy and people with learning disabilities in the UK: how can local funders find value for money?

J. Rapaport and others
Journal of Intellectual Disabilities, vol.9, 2005, p.299-319

The article reviews the literature in respect of models of evaluation of advocacy schemes for people with learning difficulties.  It identifies and analyses six main models . The authors conclude that, while fears exist about the potential for evaluation to infringe advocacy schemes’ autonomy, funders need to undertake such a process for reasons of public accountability.

Blackstone’s guide to the Mental Capacity Act 2005

P. Bartlett
Oxford: OUP, 2005

The Mental Capacity Act 2005 comes into force in 2007 and radically reforms the law under which decisions will be made for those who lack mental capacity. This guide contains a copy of the Act and examines both the impact of the changes introduced and the principles and key concepts.

Book prescriptions:  a strategy for delivering psychological treatment in the primary care setting

N. Frude
Mental Health Review, vol.10, Dec.2005, p.30-33

Article presents an innovative strategy for making psychological therapies available to people with mild to moderate mental health problems being treated in primary care.  It involves “prescribing” patients self-help books which are adaptations of proven clinical treatments.  The books are dispensed via the public library system.

Community treatment orders in England and Wales:  how many people will be affected?

S. Lawton-Smith
Mental Health Review, vol.10, Dec. 2005, p.21-24

The government is planning to introduce community-based treatment orders in England and Wales through a Mental Health Bill.  Research undertaken by the King’s Fund suggests that in the first few years of the legislation up to 5,000 people will be subject to compulsory treatment in the community, rising to 7,800 to 13,000 after 10 to 15 years.

Count me in: results of a national census of inpatients in mental health hospitals and facilities in England and Wales

Mental Health Act Commission, National Institute for Mental Health in England, Healthcare Commission.
London: Healthcare Commission, 2005

This first census of people using inpatient mental health services has shown that Black African and Caribbean people are more likely to go into hospital than the general population.  They are also more likely than most to be admitted under the Mental Health Act and, once in hospital, are more likely to experience seclusion or physical restraint.  Mental health officials see the census as a significant step forward that for the first time provides a baseline for ethnicity monitoring at a national level.

(For comment see Guardian, Dec.7th 2005, p.5)

Draft three-year strategic plan for assessing and encouraging improvement in the health and healthcare of adults with learning disabilities 2006-2009

Healthcare Commission
London:  2005

People with a learning disability die younger and are more likely to suffer from cancer and respiratory disease than the general population.  The Healthcare Commission is committed to improving their care, and this consultation document outlines its plans to:

• Audit all inpatient care being provided for learning disability service users across the NHS and the independent sector, including commissioning arrangements
• Investigate the remaining long-stay hospitals for people with learning difficulties to ensure they are providing a safe and acceptable service
• Review the care of people with learning difficulties who are placed outside their local area, away from family and friends
• Increase the accessibility of the Commission’s services so that people with a learning difficulty can better raise complaints about their care
• Establish champions, at the Commission’s regional offices, responsible for monitoring services.

Empowerment and the architecture of rights-based social policy

T. Stainton
Journal of Intellectual Disabilities, vol.9, 2005, p.289-298

Article identifies four elements of a rights based social policy for people with learning difficulties:

• Support for people to articulate their wants, needs and choices
• Independent support to assist people to identify, obtain and manage the resources necessary to act on their choices
• Ensuring individual control over resources through, for example, direct payments
• Control of service planning and funding allocation by people with learning difficulties and their families

Examples drawn from the UK and British Columbia, Canada are used to illustrate these elements.

Empowerment, policy levels and service forums

T. Brandon
Journal of Intellectual Disabilities, vol.9, 2005, p.321-331

Organisations serving people with learning difficulties present themselves publicly as being committed to politically correct values such as user empowerment and choice.  However, the day-to-day working practices of staff, as experienced by service users, remain disrespectful and disempowering.  Article uses a case study of a day centre for adults with learning difficulties to demonstrate the tension between public posture and actual staff culture.

Empowerment, self-advocacy and resilience

D. Goodley
Journal of Intellectual Disabilities, vol.9, 2005, p.333-343

Self-advocacy can be defined as the public recognition of the resilience of people with learning difficulties.  Article presents two case studies of self-advocacy groups, showing how they “politicize” people with learning difficulties and enable them to fight back against disempowerment, paternalism and labelling by service providers and in the wider society.

Keep quiet about it

M. Carter
Community Care, Dec.8th-14th 2005, p.38-39

The existence of mental health stigma means that people with a history of mental illness worry that they may be less accepted, or shunned outright, should others find out about their condition.  Recent research in North West Wales has shown that people avoid rejection and discrimination by not disclosing their mental health problem on, for example, job application forms.

Learning disability: a life cycle approach to valuing people

G. Grant and others (editors).
Maidenhead: Open University, 2005

The book adopts a life cycle approach in order to reveal important dimensions in the lives of people with learning disabilities and the effects upon them and their families. It tackles issues about transitions in people’s lives and how services, professionals, advocates, allies and wider communities can support people with learning disabilities in achieving healthy and valued lives.

The Mental Health Declaration for Europe:  implications for the UK

A. McCulloch and others
Mental Health Review, vol.10, Dec. 2005, p.39-42

The Mental Health Declaration for Europe commits signatory states to implementing policies to promote mental well-being, prevent the development of mental illness, counter stigma and discrimination, address the mental health needs of marginalised groups, encourage partnership working, and increase the social inclusion of people with mental health problems.  Article discusses the implications of the Declaration for the UK.

Protecting patients’ rights: future regulation and monitoring of the Mental Health Act

K. Patel
Journal of Adult Protection, vol.7, Dec. 2005, p.32-40

The draft Mental Health Bill 2004 proposes transferring the main monitoring functions of the Mental Health Act Commission to the Healthcare Commission or its successor body.  Author argues that a separate independent monitoring body should be retained to protect detained patients.

Recovery, values and e-learning

P. Allott and others
Mental Health Review, vol.10, Dec 2005, p.34-38

Article discusses how the concept of mental health recovery, values-based practice and e-learning can transform the way in which services are delivered to people diagnosed with a mental disorder.

The route to work

E. Forrest
Health Service Journal, vol.115, Dec.15th 2005, p.24-26

Over one million people are claiming Incapacity Benefit due to mental health problems.  Statistically, those who have been signed off work with mental health problems are unlikely to return.  South West London and St George’s Mental Health Trust is working on strategies to employ service users and improve their job prospects.

Sense of failure:  the scale of teenage self-harm.

M. Honigsbaum
Guardian, November 28th 2005, p.5

A survey of 1,000 young people aged between 12 and 19 published by the Priory, which specialises in treating mental health problems and addictions, shows that as many as one in five girls between the ages of 15 and 17 has harmed herself.  Just under one in five adolescents has considered self harming behaviour.

A sociology of mental health and illness. Third edition

A. Rogers and D. Pilgrim
Maidenhead: Open University, 2005

This updated edition provides a clear overview of the major aspects of the sociology of mental health and illness. It asks:

• How have sociologists theorized and researched mental health and illness?
• In what ways do sociologists approach this topic differently to those from other disciplines?
• How do we understand mental health problems in their social context?

Using a whole system approach to service development in rehabilitation and continuing care services

T. Ryan
Mental Health Review, vol.10, Dec. 2005, p.16-20

In the past 20 years, Victorian mental hospitals have been closed and replaced by a wide range of community-based rehabilitation and continuing care services.  However, this growth has been patchy and uncoordinated.  Article presents three case studies which demonstrate the benefits of a whole systems approach to service development.

Walking the happy talk

M. O’Hara
Guardian, November 30th 2005, p.1 & 2

Radical plans for mental health services reforms are anticipated following a report advocating 10, 000 new NHS posts offering psychological therapies to people with mild and moderate mental health problems.  It is hoped that this approach will enable patients to leave Incapacity Benefit and return to work.  This article looks at concerns including the therapies’ efficacy, the validity of back to work assumptions, recruitment and management, and financial realities.