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

Community-based compulsory treatment orders in Scotland: the early evidence

S. Lawton-Smith

London: King’s Fund, 2006

This report looks at the first six months of the new Scottish system for ensuring that mental patients discharged into the community adhere to their treatment plans. This system is designed to deal with patients discharged from psychiatric hospital into the community who then stop taking medication and end up back in hospital. If certain criteria are met, the new system allows health professionals to enforce treatment for these patients, to prevent them from relapsing to the point where they need to be re-admitted to hospital. The new arrangements have generally been welcomed in Scotland and the process appears to be working well.

Do personality disorders exist?

A.U. Sale and S. Brody

Community Care, Oct.26th - Nov.1st 2006, p. 28-29

The authors present the views of two experts on the contentious issue of whether personality disorders exist and how they can be treated. Services for people with this diagnosis are sparse and pressure needs to be put on the government for more funding.

Doing better by depression

A. Woodhouse, M. Maxwell and A. McCollam

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

The Doing Well by People with Depression initiative was established by the Scottish Executive to promote stepped care approaches to the identification, management and treatment of depression in Scotland. The programme placed particular emphasis on the development of self-help and guided self-help initiatives. This approach has produced some encouraging results.

Fair Access to Care Services (FACS): implementation in the mental health context of the UK

L. Cestari and others

Health and Social Care in the Community, vol.14, 2006, p.474-481

Since April 2003, all adults requiring social care services must have an assessment to determine their eligibility which is set within the four-level framework of Fair Access to Care Services (FACS). This paper examines the implementation of FACS by community mental health teams in eight sites in mental health partnership trusts and one in a mental health and social care trust in the UK. The research suggests that FACS implementation in mental health services has been somewhat haphazard and has brought to light real differences between health and social care approaches to eligibility determination, assessment and priorities. On balance, it has revealed and reinforced a growing separation, rather than an integration of mental health and social care ideas and practices.

Housing and community care

R. Johnson, C. Griffiths and T. Nottingham

Mental Health Today, Nov. 2006, p.25-28

This study explored what housing staff thought would work to improve co-ordination and collaboration between agencies to help maintain individuals with mental health problems in ordinary mainstream housing. Interviewees said that the following were required:

  • More recognition of the degree of involvement of housing staff in the management of mental health issues.
  • A better understanding by housing and mental health services of each other’s work processes
  • More training in mental health issues for housing staff
  • More joint working by housing and mental health staff in resolving difficulties for tenants
  • Work to build tolerant and inclusive communities in which people with mental health problems receive support to remain in their own homes.

“It makes life more ordinary”

N. Valios and M. Ahmed

Community Care, Nov. 2nd-8th 2006, p.26-27

The In Control project is a partnership between the Valuing People Support Team, Mencap, local authorities and independent organisations. It gives people with learning difficulties a personalised budget which they and their care managers can use to put together a tailored package of support. A recent evaluation shows that the In Control pilots have improved the quality of life of people with learning difficulties at no extra cost to councils.

A late delivery

A.U. Sale

Community Care, Nov. 9th-15th 2006, p.26-27

Government introduced the Delivering Race Equality in Mental Health programme in 2004 to improve the experiences of ethnic minorities in the mental health system. Part of the plan was to appoint 500 community development workers to build bridges between the ethnic minorities and the system. However, serious difficulties have emerged in recruiting these staff.

Mental health matters

T. Burke

Young People Now, Nov. 1st-7th 2006, p.14-15

Government expects every region in England to have a comprehensive child and adolescent mental health service in place by December 2006. Improvements have been made, but there are huge variations in access to services across the country.

Mind the gaps

A. James

Mental Health Today, Nov. 2006, p.8-9

The Department of Health has announced a new initiative to tighten up procedures for assessing and managing the risk of violence posed by psychiatric patients. The proposals are based on an independent review by Prof. Tony Maden and include the use of compulsory treatment in the community for patients with a serious mental illness and a history of violence.

New roles in mental health: the creation of the approved mental health practitioner

J. Rapaport

Journal of Integrated Care, vol.14, Oct. 2006, p.37-46

Approved Social Workers (ASWs) provide an independent professional opinion when compulsory hospital admission of a person with mental health problems is proposed. They safeguard the civil liberties of the patient and ensure that procedures are followed. If proposed legislation comes into force in England and Wales, Approved Social Workers will be replaced by Approved Mental Health Practitioners, who may be nurses or other mental health professionals. This change has implications for patients, carers and the mental health workforce.

Our choices in mental health: a framework for improving choice for people who use mental health services and their carers

CSIP Choice and Access Programme


This document sets out the national framework that will make more choice available locally to mental health service users in England. It will give people:

  • Power to choose their own path through services and keep control of their lives
  • Possibility of choosing how, when and where they are treated, and what treatment they receive
  • Personalised services organised around their lifestyles.

It also includes positive practice examples, showing how these improvements are already being achieved in many areas.

“People who really want to do this make a huge difference …”

L. Eaton

Health Service Journal, vol.116, Nov. 23rd 2006, p.22-24

Roll out of early intervention in psychosis services across England can only be described as patchy. Models of provision also vary widely, from a standalone service to one fully integrated with other youth provision in the area. Research suggests that early intervention could save as much as 53% on the cost of a conventional service.

Unsure start

C. Jackson

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

The government is developing a new initiative to prevent the intergenerational transmission of poverty through provision of extra support to disadvantaged mothers and their babies in the first two years of life. The support would be offered by health visitors through an intensive home visiting programme. Mental health professionals are calling for a different approach, which would involve use of intensive psychotherapy by skilled practitioners to improve mothering and infant mental health.

What’s it worth? The social and economic costs of mental health problems in Scotland

Sainsbury Centre for Mental Health

Glasgow: Scottish Association for Mental Health, 2006

This study examined the costs of providing health and social care services, losses to the economy and the personal costs of mental health problems in Scotland. Findings indicate that, in 2005, the total cost of mental health problems in Scotland was £8.6bn. This is more than the total amount spent in Scotland by the NHS on all health conditions combined, and is the equivalent of 9% of GDP.

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