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Welfare reform on the Web (September 2006): Mental health services - UK

Choice and decision-making

L. Warner and others

Mental Health Today, July/Aug. 2006, p.27-30

This article presents the results of a literature review on choice and decision-making in mental health commissioned by the Department of Health as part of a themed review of choice in mental health service provision in England. The review covers treatment choices, self-management programmes, care planning and user involvement in service development. Results suggest that, despite examples of good practice, the government’s vision of greater patient choice is a long way from becoming reality for mental health service users.

Help us do it our way

G. Morgan

Mental Health Today, July/Aug. 2006, p.31-33

This article presents the results of discussions about recovery within the Highland Users Group, a network of people with mental health problems in the Scottish Highlands. It includes attempts to define recovery, to identify barriers and to describe the role of the mental health services in the process.

A job well done

B. McPherson

Community Care, Aug. 10th-16th 2006, p.36-37

The author argues that social services departments should do more to offer employment to people with learning difficulties. He provides examples of best practice and shows the positive impact on staff that can result from having a colleague with a learning difficulty.

Lost in a moral maze

S. Gillen

Community Care, Aug.17th-23rd 2006, p.26-27

This article looks at the dilemmas facing staff in psychiatric inpatient wards in policing sexual relationships. There is anecdotal evidence of reluctance to act on complaints of sexual harassment on the grounds that complainants could be suffering from delusions, and alleged perpetrators are not responsible for their behaviour because they are ill.

Offer us what we want

L. Pembroke

Mental Health Today, July/Aug. 2006, p.16-18

There remains significant discrimination against people who self-harm. Those who have experienced self-harm need to be involved in a meaningful way in changing how it is perceived and treated in the NHS. Better training is needed for Accident & Emergency department staff in how to respond to people who self-harm. The article includes extensive discussion of the role of harm minimisation in the NHS response to the condition.

On the sunny side

K. Linsky

Community Care, Aug.10th-16th 2006, p.34-35

The Disability Discrimination Act 2005 puts a positive duty on councils and other public sector organisations to actively promote equality for disabled people. This article presents examples of good practice by councils in the field of learning difficulties, including engagement with self-advocacy organisations and improving access to mainstream services.

Opportunity unlimited?

C. Jackson

Mental Health Today, July/Aug. 2006, p.8-9

In May 2006 the first three mental health NHS trusts were granted foundation status. Foundation trusts are governed not by the Department of Health but by the local community through a membership structure and an elected board of governors. This structure offers mental health service users and carers unprecedented opportunities to influence decision making and service development.

A picture of progress

E. Dent

Health Service Journal, vol.116, Aug.31st 2006, p.20-22

Discusses progress in developing a payment by results system for mental health services. A group of trusts in the North have banded together to define 13 clusters of care based on the needs of adults and older people. They range from care for people with mild, short term mental health problems in cluster 1 to assertive outreach services for patients with severe mental health problems, who are also difficult to engage, in cluster 13. At the same time the Information Centre for health and social care is collecting patient data in preparation for developing its own classification system.

Psychiatric inpatient units for children and adolescents with intellectual disability

P. Smith and T.P. Berney

Journal of Intellectual Disability Research, vol.50, 2006, p.608-614

Inpatient beds for the psychiatric assessment and treatment of young people with intellectual disability have become scarce nationally in the UK, although there is pressure to redevelop them. Sixty-three per cent of such beds in the UK are at Prudhoe Hospital. This study examines their role and utility in relation to community services both locally and nationally. It concludes that admission is necessary for a small number of young people who are not readily managed within mainstream units. While their number may be reduced by better community provision, this is likely to be partially offset by better case finding. Inpatient facilities should be closely linked with community services to prevent delays in discharge.

Walk the talk

E. Dent

Health Service Journal, vol.116, Aug. 3rd 2006, p.22-24

At present only a tiny minority of those likely to benefit are offered psychotherapy on the NHS. Better access to psychotherapy could enable many people with depression and anxiety disorders to return to work, reducing spending on Incapacity Benefit. This article introduces two pilot schemes aimed at making talking therapies, mainly cognitive behavioural therapy, accessible to people with mild to moderate mental health problems.

What services do young children with autism spectrum disorders receive?

H. McConachie and G. Robinson

Child, vol.32, 2006, p.553-557

In recent years, standards of good practice have been set for services to young children with autism. Three key recommendations can be highlighted: 1) involvement of a multi-disciplinary team of professionals; 2) nomination of a key worker to co-ordinate services; and 3) access to 15 hours per week of specialist provision for preschool children. This paper reports on whether a sample of families of young children with autism perceive that they have access to such services. For most families, the services they received did not meet the standards set in the Autistic Spectrum Disorders Good Practice Guidance and the National Autism Plan for Children.

Working across boundaries: clinical outcomes for an integrated mental health service for people with intellectual disabilities

I. Hall and others

Journal of Intellectual Disability Research, vol.50, 2006, p.598-607

This study examines a specialist mental health service for people with intellectual disabilities serving two inner city London boroughs. The service consists of specialist inpatient provision and a community “virtual” team. The inpatient service consists of four beds for people with intellectual disabilities on a 16-bed acute psychiatric inpatient ward, but also offers access to specialist input from intellectual disabilities services. The community team is made up of care managers, community support workers, and healthcare professionals. This study aimed to evaluate clinical outcomes for this integrated approach to service provision. Results showed significant improvements across a range of outcome measures for users of both inpatient and community services.

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