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

Acting out, acting in

J. Shucksmith and others

Mental Health Today, May 2006, p.30-33

Schools in Scotland have been given a key role in promoting the mental health and emotional well-being of their pupils. Research explores the different models of partnership that they have adopted as part of their response to new policy pressures to deliver more inclusive education and stronger integration with other welfare services. Three approaches were identified:

  1. Exporting the problem by referring troubled children to expert services delivered off site.
  2. Importing skills into schools to solve mental health problems and indiscipline, but devolving authority to another agency
  3. Retaining ownership of the problem in school, importing skills and personnel but using these in integrated service teams to develop new approaches that are embedded in school life.

“Buzzing since I came back …”

N. Valios

Community Care, May 4th-10th 2006, p.30-31

Describes how two projects in the USA support people with learning difficulties in developing sexual relationships and making responsible choices about sexual health.

Delayed discharge from mental health hospitals: results of an English postal survey

R. Lewis and J. Glasby

Health and Social Care in the Community, vol.14, 2006, p.225-230

There has been debate about extending financial penalties for delayed discharge to mental health services, fining social services departments if patients have to stay in hospital because arrangements for community care are not in place. This paper reports the results of a postal survey of English mental health trusts and primary care trusts with responsibility for providing mental health services aimed at exploring the extent and causes of delayed discharges in mental health inpatient services. Results showed high levels of delayed discharges, with between 4% and 16% of beds affected depending on speciality. The causes of delayed discharges are varied, with a range of factors interacting. A significant number of older people with mental health problems and a small number of people with complex needs experienced delays in discharge due to lack of appropriate follow-up community services.

Depression is the UK’s biggest social problem, government told

S. Boseley

Guardian, April 28th 2006, p.9

Impacting significantly on the economy, depression and other mental illnesses have passed unemployment as the UK’s biggest social problem according to a health economist advising the government. While drug therapies are not recommended, an extra 10,000 therapists are proposed to provide the specialist help needed and reduce hospitalisation.

The development of a Local Index of Need (LIN) and its use to explain variations in social services expenditure on mental health care in England

P. McCrone and others

Health and Social Care in the Community, vol.14, 2006, p.254-263

Wide variations in deprivation exist across England and it is likely that these variations translate into differences in the need for mental health care. Social services departments in England account for a substantial proportion of mental health expenditure. It is important that the distribution of expenditure reflects mental health needs. This paper aims to 1) describe the development of a new indicator of mental health needs; 2) use the index to explain variations in social services expenditure on mental health; and 3) compare the index with other measures of need.

The impossible save

M. Gould

Health Service Journal, vol.116, May 25th 2006, p.24-26

Concern is mounting that budget cuts and staff redundancies are impacting most heavily on mental health services. Recovery plans in some areas will see mental health trusts burdened with making a disproportionately large share of the savings. Trust managers are having to resort to service redesigns and reductions that stand to disadvantage the most vulnerable patients. However, some argue that the redesigns will lead to improvements in patient care.

Participation: why bother?

H. Blakey

Mental Health Today, May 2006, p.23-26

Five community workshops were organised in Bradford to encourage ethnic minority participation in NHS mental health service development. The workshops aimed to consider: 1) how minority communities’ opportunities to influence service development could be improved; 2) organisational barriers to participation within the NHS; and 3) the value and purpose of participation.

Partnership and privacy - tension or settlement? The case of adult mental health services

Perri 6 and others

Social Policy and Society, vol.5, 2006, p.237-248

Article explores how managers and professionals in mental health services deal with conflicts between the imperatives of partnership working and the duty to respect patients’ rights to privacy and confidentiality. Collaborative working requires sharing of information with partners, which may breach client confidentiality and privacy. Some illustrative interview data showing how professionals deal with these tensions in practice is offered.

Personality disorder and Community Mental Health Teams: a practitioner’s guide

M. J. Sampson, R. A. McCubbin, P. Tyrer (editors)

Chichester: Wiley, 2006

The book considers the various difficulties encountered by the practitioners in Community Mental Health Teams (CMHTs), with reference to current thinking about the origins, maintenance and treatment of personality disorder. The first section outlines recent government initiatives relating to personality disorder and introduces key theories underlying psychological and biological treatments. The second focuses specifically on the role of the CMHT in relation to patients with these difficulties, including:
1. The assessment of personality functioning
2. Developing coherent plans for treatment and support
3. Managing self-harming behaviour
4. Optimising the therapeutic relationship

Plans up in smoke

S. Walker

Community Care. May 25th-31st 2006, p.34-35

Government set a target in the 2004 National Service Framework for Children, Young People and Maternity Services for the establishment of a comprehensive child and adolescent mental health service in England and Wales by 2006. This target is unlikely to be achieved due to the financial crisis now affecting primary care and mental health trusts. Vital joint working between child and adolescent mental health services and partners such as youth offending teams, behavioural and educational support teams and learning support units is also at risk.

Read our hands

L. Main

Mental Health Today, May 2006, p.10-11

Reports that deaf people, although more prone to mental ill health than the general population, have difficulties in accessing services due to lack of provision of sign language interpreting. There are concerns that central government funding given to primary care trusts to improve access has been diverted to other purposes.

The right to choose

J. Seward

Mental Health Today, May 2006, p.16-18

Ensuring choice for mental health service users is fundamental to the National Institute for Mental Health England’s (NIMHE) modernisation and improvement agenda. Research has identified four areas where users would like to be given more choice: promotion and support of life choices; choices in accessing and engaging with services; choices in assessment; and choices in care pathways. Article reports progress in service reform to provide choice in these four areas.

Show some support

L. Ward
Community Care, May 25th-31st 2006, p.32-33

Children of people with learning difficulties are often removed by social services because of concerns for their well-being and absence of support for the parents. Article reports on recent research which shows that, with appropriate professional help, people with learning difficulties can successfully bring up their children.

Value added

B. McIntosh and H. Sanderson

Community Care, Apr. 20th-26th 2006, p.30-31

This first evidence-based evaluation of person centred planning for people with learning difficulties was carried out by several organisations working in partnership on four sites. The research highlighted that people with learning difficulties who had a person-centred plan experienced a 30% increase in the size of their social networks, 2.4 times more contact with family, 41% increased contact with friends, and a 35% increase in activities.

Which way to turn?

K. Leason

Community Care, May 11th-17th 2006, p.26-27

Government has dropped its Draft Mental Health Bill in the face of concerted opposition from professionals and service users. It is now proposing to amend the Mental Health Act 1983. The amendments planned include some of the most unpopular policies from the Draft Bill, while some positive advances have been dropped.

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