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

Adult protection in mental health and inpatient settings: an analysis of the recognition of adult abuse and use of adult protection procedures in working with vulnerable adults

D. Galpin and J. Parker

Journal of Adult Protection, vol. 9, May 2007, p. 6-14

Although there has been a commitment to developing a policy and legislative framework to protect vulnerable adults at risk of abuse, there remains concern about its lack of use in NHS mental health and learning disability services. A gap between policy and practice appears to have developed, which leaves inpatients vulnerable to inadequate responses to allegations of adult abuse. Drawing on critical policy analysis, this article identifies factors which influence practitioners in their interpretation and implementation of existing policy and legislative frameworks in adult protection.

Dangerous disclosures

N. Stanley and others

Mental Health Today, June 2007, p. 24-27

Employers and higher education institutions have often struggled to reconcile professional demands and fitness for practise concerns with disability discrimination legislation. For those with unseen disabilities, such as mental health issues, the application of fitness to practise standards may depend on their own disclosure of a problem. This article reports on a study of the processes and consequences of disclosing invisible disability in the workplace and in training organisations undertaken as part of a formal investigation of fitness to practise standards in the social work, nursing and teaching professions. Evidence from the study suggests that providing concrete information about the process and benefits of disclosure, and ensuring a disabled-friendly environment, might encourage more practitioners to take the risk of disclosing a mental health issue.

Degrees of distress

A. Wilson and others

Mental Health Today, June 2007, p. 28-31

The number of students in higher education experiencing mental health difficulties is increasing. This research study aimed to look at how organisational structures and processes in higher education institutions impact on student mental health, and how these may be changed or adapted to foster a more preventative and supportive approach. Interviews with 12 students experiencing mental health difficulties revealed their reluctance to seek help, while academics felt uncertain about how to respond if approached. While some institutions had developed relevant mental health promotion policies, these had had little impact on practice.

Doing it for themselves

C. Jackson

Mental Health Today, June 2007, p. 10-11

The Expert Patient Programme launched in 2002 aimed to train people with chronic physical health problems to self-manage their condition. The generic course has now been adapted for mental health service users. The adapted course runs over seven consecutive weeks and is led by a tutor and volunteer facilitator. It covers relaxation and symptom management, depression and anxiety management, problem-solving, healthy eating and exercise, medication, set-back strategies, and making an action plan.

An examination of the use of coercion by assertive outreach and community mental health teams in Northern Ireland

G. Davidson and J. Campbell

British Journal of Social Work, vol. 37, 2007, p. 537-555

The move away from hospital-based care for people with mental health problems has meant that people with higher levels of need are now being supported by community mental health services. This change has required mental health social workers and their professional colleagues to reconsider the way they understand issues of risk and coercion. This paper begins with an exploration of the literature on coercion and mental health practice and, in doing so, highlights arguments about the relative effectiveness of strategies and ethical dilemmas which are prevalent in this field. This forms the background to the presentation of a comparative study of the work of Assertive Outreach and Community Mental Health Teams in Northern Ireland. Results suggest that Assertive Outreach may be more effective in reducing perceived coercion, minimising the need for coercive strategies, engaging high-risk clients, and reducing in-patient bed use.

The final days of the NHS campus

S. Gillen

Community Care, June 14th 2007, p. 12-13

The government has pledged to close all NHS residential campuses for people with learning disabilities by 2010, but is uncertain about how many residents will need to be resettled in the community. Barriers to change include lack of funding and reluctance of people with learning disabilities and their families to agree to move on.

Healing the wounds

L. Palmer and others

Mental Health Today, June 2007, p. 32-35

Self-harm is one of the top five reasons for admission to hospital for emergency medical treatment. In 2005 the Royal College of Psychiatrists launched a national quality improvement programme to drive up standards in the assessment and care of people who self-harm. The aim of the programme is to help emergency services audit and improve their performance against a set of best practice standards. This article reports on an evaluation of the impact of the programme.

Leading change

C. Kitson

Mental Health Today, June 2007, p. 16-18

This article introduces the Leading Change Project, which is intended to kick-start actions and cultural change under the Scottish Executive’s Delivering for Mental Health strategy, and lead to the creation of a more joined-up and recovery-focused mental health service that is shaped around users’ needs and preferences. Seven health boards have been chosen to pilot leadership development programmes over the three-year life of the project.

The Mental Capacity Act so far: more prosecutions for abuse and neglect in care homes likely

J. Landau

Caring Times, June 2007, p. 12

Section 44 of the Mental Capacity Act 2005 introduces a new criminal offence of ill-treatment or neglect of a person lacking capacity. This is likely to lead to more prosecutions of care home staff and managers. The Act also introduces independent mental capacity advocates, whose reports (good and bad) are likely to influence decisions of commissioners about buying places in a given home.

School's out: pathways for young people with intellectual disabilities from out-of-area residential schools or colleges

P. Heslop and D. Abbott

Journal of Intellectual Disability Research, vol. 51, 2007, p. 489-496

Previous research has suggested that transition planning is failing young people with intellectual disabilities and their families in the UK. Youngsters placed away from home in residential schools are likely to be at the greatest risk of poor transition planning. This study interviewed the parents of 15 young people about what they thought contributed to a smooth transition from an out-of-area residential school or college to the next phase of their life. Parents identified four main issues:

  1. being well connected with other parents or with key professionals
  2. being proactive
  3. having sufficient information
  4. good forward planning.

Shaping the future of mental health policy and legislation in Northern Ireland: the impact of service user and professional social work discourses

G. Wilson and M. Daly

British Journal of Social Work, vol. 37, 2007, p. 423-439

The Bamford Review of Mental Health and Learning Disability, which began work in 2002, is the most extensive re-examination of policy and legislation in this field ever undertaken in Northern Ireland. This analysis explores the potential within the Review for social workers to develop new relationships and more empowering forms of practice with service users. Although Northern Ireland’s technocratic/legalistic culture of welfare seems to possess certain enduring characteristics which present significant challenges to progress, this paper suggests that there are opportunities for social workers and the service user movement to work together to have a positive influence on developing mental health care.

When carers need caring

C. Williams

Community Care, June 7th 2007, p. 32-33

An increasing number of people with learning disabilities are caring for partners or elderly parents. In this situation they can become isolated and stressed. This article introduces the work of the Who Cares for Us? Campaign, which was launched by two carers with learning difficulties. The Campaign co-ordinates a national information sharing and support network, and has a wider role in developing direct services.

Who decides now? Protecting and empowering vulnerable adults who lose the capacity to make decisions for themselves

R. Johns

British Journal of Social Work, vol.37, 2007, p. 557-564

The Mental Capacity Act 2005 consolidates and extends provision for people who lose capacity to make decisions for themselves. This article alerts practitioners and researchers to the key issues that will arise from the implementation of the Act from April 2007, covering the meaning of incapacity and best interests, advance directives about treatment and care, provisions for delegating decision-making, and safeguards from 'intrusive' research.

Works for me

M. Broad

Community Care, May 31st 2007, p. 28-30

A survey of 451 human resources professionals showed that 59% of organisations employed people with learning disabilities, 77% recruited them through normal channels, and the same high proportion of organisations described their experience as positive. However a simultaneous survey of 1,000 people with learning disabilities showed that only 22% had a job, although 66% wanted one. The article goes on to give expert reaction to the survey results.

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