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

Capacity to protect: the Mental Capacity Act explained

T. Williams

Journal of Adult Protection, vol. 9, Mar. 2007, p. 25-32

This article summarises the provisions of the Mental Capacity Act from the point of view of adult protection. The Act comes into force in 2007. Its provisions cover: 1) assessment of capacity to make decisions; 2) determining the best interests of a person who lacks capacity; 3) living wills and a new Lasting Power of Attorney; and 4) the creation of a new Court of Protection and Independent Mental Capacity Advocate service.

Choose Life: early experiences of implementing Scotlandís suicide prevention strategy

J. Gordon and C. Stark

Journal of Public Mental Health, vol. 6, Mar. 2007, p. 20-24

Choose Life, the Scottish national suicide prevention strategy, was launched in December 2002. Choose Life provides seed corn funding to each of Scotlandís 32 local authorities, which, through community planning partnerships, produce local suicide prevention plans. Each area appoints a Choose Life co-ordinator who assumes lead responsibility for implementing the local action plan. Results of a survey revealed that co-ordinators faced challenges in promoting suicide prevention in a policy environment with many competing priorities, in persuading local agencies to provide mainstream rather than project funds, and in keeping up to date with research findings.

Community hospitals: a solution to the stigma and dislocation of acute inpatient hospital admission

H. Gwilym

Journal of Public Mental Health, vol. 6, Mar. 2007, p.6-9

This article looks at the changing nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is another shift of acute psychiatric inpatient care away from psychiatric units to community hospitals.

Drawing the line

C. Jackson

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

It is proposed that all psychotherapists, counsellors and psychologists should be subject to regulation and registered with the Health Professions Council before they can practice. The Commission for Healthcare Regulatory Excellence has been charged by government with investigating ďboundary violationsĒ by healthcare professionals, and producing guidance and information for the public, professionals themselves and employers. The Clear Sexual Boundaries Project will also produce standards for pre- and post-registration education and training.

Following the IMCA trail

D. Hayes

Community Care, Mar. 29th - Apr. 4th 2007, p. 24-25

The Mental Capacity Act 2005 created the independent mental capacity advocate (IMCA) service to support people who lack capacity, and who have no family or friends, in making decisions about medical treatment and change of residence. The service will be rolled out nationally from April 2007. From then local authorities and NHS trusts will be required to appoint an advocate to represent the client if there is no-one else to support them.

Getting a move on

D. Crone and L. Stembridge

Mental Health Today, Apr. 2007, p. 30-32

Physical activity has been shown to be effective in improving psychological well-being and in addressing the particular physical health concerns of people with mental health problems, such as obesity. However, despite supporting evidence and guidance, there is a widespread perception that physical exercise is under-used in the treatment of mental illness. This article presents the results of a survey of physical activity provision for people with mental illness in the South West of England, with recommendations on how such provision could be developed.

Improving mental health in a changing NHS

K. Tyson

Mental Health Review, vol.12, Mar. 2007, p. 31-33

Significant progress has been made through the implementation of the National Service Framework for Mental Health in improving services. More needs to be done to sustain these improvements and, in the current context of system and focus change in the NHS, success will depend on identifying the most promising areas to make progress.

Matching skills to needs

C. Merchant

Mental Health Today, Apr. 2007, p. 23-25

Some elements of the Bill to amend the Mental Health Act 1983 which is currently before Parliament relate to changes in the roles and responsibilities of qualified mental health professionals. This article looks at the implications for the workforce and service users of the introduction of two new roles: those of responsible clinician and approved mental health professional.

The Mental Health Bill 2006: what effect on children?

C. Daly

ChildRight, issue 234, 2007, p.22-25

This article traces the history of the Mental Health Bill 2006 and, as it passes through Parliament, looks at some of the issues that have been raised by the Joint Committee on Human Rights, the National Childrenís Bureau in its Child Impact Statement, and YoungMinds in relation to its impact on childrenís rights. The main aim of the Bill is to update the Mental Health Act 1983 to ensure that people with serious mental disorders can be treated, whether or not they consent, in order to prevent them from harming themselves or others.

National Suicide Prevention Strategy for England

K. Foster

Mental Health Review, vol. 12, Mar. 2007, p. 27-30

Describes how the National Institute for Mental Health in England is taking forward implementation of the National Suicide Prevention Strategy through the Care Services Improvement Partnership. Results of the strategy so far are encouraging as suicide rates have fallen by 7.4% since 1995/96/97.

The new independent mental capacity advocate service

A. Bradley

Working with Older People, vol.11, Mar. 2007, p. 13-16

The government has asked English local authorities to lead the commissioning of the new independent mental capacity advocate (IMCA) service which comes into operation in April 2007. This article summarises guidance on commissioning, outlines some of the key challenges for commissioners, and goes on to highlight the particular issues for advocacy organisations and older people.

(See also Working with Older People, vol.11, Mar. 2007, p. 17-20

Palliative care and the Mental Capacity Act

S. Chapman and N. Hayes

Working with Older People, vol.11, Mar. 2007, p. 21-24

The authors examine the impact of the Mental Capacity Act 2005 on palliative care services, covering the role of relatives in decision-making on behalf of a person who lacks capacity, advance care planning and living wills, and the replacement of enduring powers of attorney with the new lasting powers of attorney.

PALS in mental health: white knight or white elephant? The South London and Maudsley experience

G. Kerr

Mental Health Review, vol.12, Mar. 2007, p. 34-36

Patient Advice and Liaison Services (PALS) were introduced into the NHS in England as a result of the 2000 NHS Plan. They were to act as a source of information on services for patients and as a route to help resolve any concerns. This article looks at the experience of one inner city mental health trust in developing PALS, and whether this work achieved significant change for service users and their carers.

Policy, service pathways and mortality: a 10-year longitudinal study of people with profound intellectual and multiple disabilities

J. Hogg, K. Juhlberg and L. Lambe

Journal of Intellectual Disability Research, vol. 51, 2007, p. 366-376

Government policy in Scotland since the early 1990s has promoted community living rather than institutional care for people with profound intellectual and multiple disabilities. This paper employs a longitudinal design to track the implementation of these policies with respect to a cohort of such people. Results showed that, ten years after the policy change, people with profound intellectual and multiple disabilities were still either living with their families or in congregate care in large group homes. This situation is not consistent with current policy regarding accommodation for people with intellectual disabilities in Scotland, which recommends individualised provision.

Skin deep?

F. de Luca

Professional Social Work, Apr. 2007, p. 14-15

Black and minority ethnic people in the UK are heavily over-represented in the mental health system. This is due to their behaviour being judged on the basis of what the White majority population views as normal or abnormal, and due to the poverty and discrimination which they suffer generally and which breed mental ill health. They also suffer regular negative portrayal in the media, which increases their exclusion and alienation.

Stop, look and listen: service user and carer consultation can make a genuine difference to a service

H. Oldknow

Working with Older People, vol. 11, Mar. 2007, p.32-36

The author describes the aims and objectives of the Doncaster and South Humber NHS Trustís clinical audit of its community mental health nursing team. Users were involved through a postal questionnaire which achieved a 22% response rate. As a result of the audit, users are now given out-of-hours contact details for the team, a simple change which has made a genuine difference to their lives.

Tales of the city

E. Dent

Health Service Journal, vol. 117, Apr. 26th 2007, p. 24-26

Evidence suggests that London has a higher incidence of serious mental illness than the rest of the country. Inpatient and community services are both under strain, and services for people with mild to moderate problems are particularly lacking. At the same time, a bewildering number of organisations, both statutory and voluntary, provide services and accessing the right help can be complicated, especially for people from minority communities.

Transitions: graduating between general and old age psychiatry services in England and Wales

S. Bawn and others

Mental Health Review, vol.12, Mar. 2007, p. 21-26

In 2002, a council report (CR110) from the Royal College of Psychiatrists set out good practice for clients with an enduring or relapsing mental illness under the care of working-aged adult mental health services who were making the transition to older adult mental health services (OAMHS). One of CR110ís key messages is that a personís 65th birthday should act as a trigger for re-assessing their needs, rather than triggering an automatic transfer of their care to OAMHS. This study investigated how CR110 has influenced policies relating to the transfer of people with longstanding mental health problems across the interface between working-aged adult and older adult mental health services.

Young pioneers

A. Pearson

Community Care, Apr. 19th-25th 2007, p. 32-33

Social workers are increasingly located within multi-disciplinary teams that have no established understanding of the social work role. The author describes his experience as a social worker in an in-patient psychiatric unit for young people.


A. James

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

So-called 'experts by experience' (mental health service users and their carers) are increasingly in demand to run training courses for the police, universities, and service providers. In 2005 The European Commissionís Leonardo da Vinci Programme provided 375,000 euros to fund a two-year project, called Ex-In, to develop Experts by Experience qualifications that would lead to paid work in the mental health sector for service users.

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