Welfare Reform on the Web (April 2007): Mental health services - UK

Bournewood provisions

J. Dow

Journal of Integrated Care, vol. 15, Feb. 2007, p. 34-36

There are proposals in the Mental Health Bill 2006 for the introduction of safeguards to protect the rights of people who lack capacity to consent or object to deprivation of liberty where this is considered to be in their best interests. Under the proposals, care homes and hospitals will need to obtain authorisation from the local authority or PCT if it is considered necessary to deprive a person lacking capacity of their liberty in order to provide care or treatment.

Cold comfort farm

M. Gould

Health Service Journal, vol. 117, Mar. 1st 2007, p. 22-24

Multidisciplinary community mental health teams evolved as part of the shift from hospital to community-based care. However for the past few years they have been overshadowed by more glamorous assertive outreach teams and have been criticised for stagnation and failure to engage with users. There is also concern that they provide only poor access to talking therapies. This situation is made more difficult by disagreements about which talking therapies should be used.

Come in and help

C. Moss and others

Community Care, Mar. 8th - 14th 2007, p. 32-33

The Welsh Assembly strongly supports the idea that people with mental health difficulties and their carers should be involved as equal partners in the planning and commissioning of services. This article presents a case study of how these ideas have been put into practice in Bridgend.

Early promise turns sour for mental health chiefs

C. Santry

Health Service Journal, vol.117, Mar. 15th 2007, p. 14-15

Presents results of a survey of mental health trust chief executives' views on New Labour policies after ten years in power. Chief executives' initial euphoria has turned to disillusion in the face of imposition of ill-thought-out, rushed policies which create chaos, fail and are then abandoned. They are also resentful of having to bail out other NHS bodies which have failed financially, and mistrustful of the commissioning abilities of their local primary care trusts.

Empty rhetoric

D. Burke

Mental Health Today, Mar. 2007, p.14-15

Pattigift is the UK's first registered specialist psychiatric hospital for people of African and Afro-Caribbean descent. It faces closure in April 2007 because it cannot fill any of its 13 beds. It offers a culturally sensitive inpatient recovery programme based on talking therapies and specialist training for Afro-Caribbean health professionals to work with Afro-Caribbean service users. The main issue appears to be that it does not take patients who have been sectioned, and primary care trusts have so far not funded preventative care.

Having a good day? A study of community-based day activities for people with learning disabilities

A. Cole and others

London: Social Care Institute for Excellence, 2007 (Adults' services knowledge review; 14)

This review addresses the question of what has, and what has not, contributed to the successful provision of community-based day activities for all people with learning disabilities. The review focuses on case studies based in ordinary communities, the changing needs and diversity of people with learning disabilities, and ways forward.

Health care provision and people with learning disabilities: a guide for health professionals

J. Corbett

Chichester: Wiley, 2007

The book provides information to assist health care providers in gaining greater understanding of people with learning disabilities and managing their needs. It describes what is expected from the various health care teams and offers solutions to potential challenges and barriers they may be faced with. It includes information regarding specialist support services that can offer assistance to the individual and to the mainstream staff teams, while ideas are also offered on how to present information in a format people who have communication difficulties can understand. The chapters cover issues such as:

• Health inequalities
• Communication needs of people with learning disabilities
• Gaining consent
• Roles and responsibilities of carers

The illusion of power

C. Riddington

Community Care, Mar. 1st-7th 2007, p. 32-33

Learning disability partnership boards were set up almost six years ago to enable service users and family carers to influence the planning and commissioning of services in their area. However, research has shown that the partnership between public sector managers and lay members of boards is not equal and the latter have little influence on decisions in practice.

In search of a blueprint

L. Eaton

Health Service Journal, vol.117, March 29th 2007, p.21-22

Historical circumstances mean that some primary care trusts (PCTs) are also providing mental health services , at odds with the policy of being commissioners only. These trusts are trying different models for mental health services, raising provision and care pathway issues. One compromise would be to put the provider at arm's length within the organisation.

Integrated care: foundation trust or social enterprise?

R. Hill

Journal of Integrated Care, vol.15, Feb. 2007, p. 20-23

The Ridgeway Partnership is one of only two specialist learning disability NHS trusts in the country. It provides health care and social support to people with a learning disability through a Health Act s.31 pooled budget, with social services as its lead commissioner. Ridgeway is seeking a new organisational vehicle for its services and is considering the advantages and disadvantages of becoming a foundation trust or a social enterprise.

International experiences of using Community Treatment Orders

R. Churchill and others

Department of Health, 2007

This is the most comprehensive and thorough review of research into international experiences of using Community Treatment Orders, summarising evidence from 72 studies undertaken in six countries. Research in this area has been beset by conceptual, practical and methodological problems, and the general quality of empirical evidence is poor. Although stakeholder views are positive, there is currently no robust evidence about either the positive or negative effects of Community Treatment Orders on key outcomes, including hospital readmission, length of hospital stay, improved medication compliance, or patients' quality of life.

The media get the message

P. Bispham and I. Cameron

Community Care, 22nd-28th Feb. 2007, p. 34-35

This article describes the innovative approach taken by Leeds Primary Care Trust, the City's social services, the voluntary sector and service users to tackle the negative portrayal of people with mental health problems in the media. An evaluation has shown that, by working with media producers and increasing the media skills of service users, more positive coverage can be achieved.

Mental Capacity Act 2005 code of practice

Department for Constitutional Affairs

London: TSO, 2007

The code provides guidance on how the Act will work on a day to day basis for anyone who cares for people who lack capacity, including family, friends and unpaid carers. The code has statutory force, which means that certain categories of people have a legal duty to have regard to it when working with or caring for adults who may lack capacity to make decisions for themselves. The code:

• Explains how the Act defines 'a person who lacks capacity to make a decision'
• Explains what the Act means by acting in the best interests of someone who lacks capacity to make a decision
• Covers the grant of Lasting Powers of Attorney
• Describes the role of the new Court of Protection
• Explains the procedures to be followed if someone wishes to make an advance decision to refuse medical treatment to come into effect when they lack capacity
• Describes the role of Independent Mental Capacity Advocates

Port in a storm

C. George

Mental Health Today, Mar. 2007, p. 12-13

Kaya House in Barnet, North London is the UK's first crisis house to be set up, managed and staffed entirely by people who have personal experience of using the mental health services. It offers a safe and supportive non-medical environment for people experiencing a mental health crisis who do not require admission to a psychiatric hospital. The staff receive three weeks training in first aid, food hygiene, de-escalation and listening skills.

Sound systems

J. Wallace

Mental Health Today, Mar. 2007, p. 8-10

This article profiles the work of VOX, the new national representative body for all Scotland's mental health service users. The new body faces the challenge of forging meaningful relationships with existing user-led groups and other stakeholders. VOX is taking a community development and awareness raising approach to creating such relationships and seeks to be as inclusive as possible.

A very capable act

S. Richards

Community Care, Mar. 22nd - 28th 2007, p. 30-31

This article summarises the provisions of the Mental Capacity Act 2005 and its effects on the social care sector. The Act provides that:

• Any doubt over a person's capacity to make decisions must be proven, following procedures laid down by the Act
• People with capacity can plan ahead for a time when they may lack capacity through an advance decision or a lasting power of attorney
• Staff working with people who lack capacity can make day to day decisions about care and treatment on their behalf, provided that these are in the person's best interests.

A world to belong to

K. Berzins

Mental Health Today, Mar. 2007, p. 29-31

Researchers conducted interviews with mental health service users, a representative sample of the Scottish population, and a range of professionals. Results showed that the mental health service users were socially isolated. More than four times more mental health service users lived alone than people from the general population, and they also had less contact with family and friends. Mental health services should encourage users to develop new relationships, especially with those outwith the mental health field, and support clients to maintain existing relationships.