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

Deserving people

A. McMahon and L. Treliving

Mental Health Today, Sept. 2007, p. 18-19

The authors outline an initiative to improve the care and treatment offered to people in Scotland with a personality disorder diagnosis. The work culminated in the formation of the Scottish Personality Disorder Network, currently housed within NHS Grampian. The Network has developed a set of standards for integrated care pathways for borderline personality disorder. It is now exploring provision of a wider range of psychological interventions for people with a personality disorder diagnosis.

Good in parts

C. Jackson

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

The Mental Health Act 2007 became law on 19th July of that year. This article reports expert comment on its pros and cons. There is widespread concern about probable over-use of the new Community Treatment Orders which will compel people with mental disorders to comply with treatment after discharge from hospital. However, there is a welcome for some late amendments to the Act, including:

  • A statutory right to advocacy for all detained patients
  • A 'treatability test' clause ensuring any compulsory treatment is strictly therapeutic
  • A requirement that children cannot be treated on adult mental health wards.

The Healthcare Commssion's national audit of services for people with learning disabilities

F. Ritchie and K. Lawrence

Learning Disability Today, vol. 7, Aug. 2007, p. 37-40

The Healthcare Commission has undertaken a national audit of services for people with learning disabilities in England. The audit was carried out in two stages. The first stage consisted of data collection from over 600 individual NHS and independent healthcare services. The second stage involved peer review visits by small teams to 155 of these. Each team included one person with learning disabilities or a family carer, and a clinician or a manager from learning disability services.

How bias starts at 65

G. Lishman

Community Care, Aug. 30th 2007, p. 30-31

The independent UK Inquiry into Mental Health and Well-being in Later Life has found widespread discrimination in services for older people with mental health problems. This leads to doctors telling older people that depression is an unavoidable symptom of ageing and to people being asked to leave day care services they have used for many years as soon as they are 65. The inquiry calls for age equality in mental health, where individual need, rather than chronological age, determines access to services.

Impact of graduate mental health workers upon primary care mental health: a qualitative study

P. Farrand, F. Duncan and R. Byng

Health and Social Care in the Community, vol. 15, 2007, p. 486-493

The role of the primary care graduate mental health worker (GMHW) was developed to improve access to mental health interventions for patients with common mental illnesses. However, little is known about the impact of the role on primary care mental health services. Data from semi-structured interviews with 27 key stakeholders showed a range of ways in which the GMHW role was making a significant contribution to primary care mental health. Many of these were associated with increasing access to mental health services afforded by the range of interventions provided. Working clients were sometimes unable to benefit because of lack of out-of-hours appointments. Concerns arose about inappropriate referrals of clients with difficulties too severe for the interventions provided made by some general practitioners.

Improving access to primary care

L. Seymour and B. Morris

Mental Health Today, Sept. 2007, p. 33-35

In 2006 the Disability Rights Commission completed a formal inquiry into inequalities in physical health and care experienced by people with learning difficulties or mental health problems. This article reports on interviews with service users and carers about their experiences of primary care carried out as part of the inquiry. Interviewees though that primary care services could be much improved, especially with regard to the communication skills of GPs and practice staff. Primary care practitioners also need to acquire knowledge of physical health problems common among these groups. Local champions can also be very helpful in spreading good practice.

Independent sector mental health care: a 1-day census of private and voluntary sector placements in seven Strategic Health Authority areas in England

B. Hatfield and others

Health and Social Care in the Community, vol. 15, 2007, p. 407-416

Rapid diversification of mental health care provision has occurred in recent decades in England, fuelled by large-scale closures of public hospitals and care homes and by a sustained political emphasis on the contestability of public services. Faced with a reduction of beds in public psychiatric hospitals, commissioners have purchased places from private and voluntary sector providers. This study aimed to:

  1. map the extent of all mental health placements in the independent sector for adults of working age and elderly people on a census date in seven strategic health authorities
  2. to identify the characteristics of the population in placements
  3. to explore some of the characteristics of the placements and the pattern of use within the private and voluntary sectors
  4. to identify the funding source of placements and cost differences between the private and voluntary sectors.

Mental health: special report

E. Dent (editor)

Health Service Journal, vol.117, Sept. 13th 2007, p. 27-35

Inpatient mental health care in England is characterised by overcrowded wards inhabited by a disproportionately large number of black and minority ethnic patients, excessive lengths of stay and potential dangers to women in older institutions still without adequate segregation of the sexes. The report presents examples of how mental health trusts are working to improve the situation.

New ways are working

C. Jackson

Mental Health Today, Sept. 2007, p. 16-17

New Ways of Working is a joint programme initiated in 2003 by the National Institute for Mental Health in England (NIMHE) and the Royal College of Psychiatrists to tackle the shortage of qualified psychiatrists in the NHS. It shifts some of the responsibilities and tasks traditionally owned by psychiatrists to other professionals such as nurses, psychologists, occupational therapists, and graduate mental health workers. This article presents a case study of the successful implementation of this approach in Easington, one of the most deprived communities in England.

Part of the community

A. Felton and L. Chisholm

Mental Health Today, Sept. 2007, p. 27-29

Oaktree Manor, Nottingham is a unit for people with serious mental health problems. It aims to support individuals to maximise their potential and live independently in the community. Oaktree staff continue to provide intensive support to individuals who have moved on from the residential unit. A team of workers from a local housing association helps service users leaving the residential unit to find privately rented accommodation locally and offers support with benefit and tenancy issues. The Oaktree team has also attempted to widen users' social networks by developing links with local agencies and individuals, including the police, libraries, health centres and neighbours. The research reported in this article explored service users' experiences in the community through semi-structured interviews.

Peer mentorship: promoting advocacy and friendships between young people

N. Jay

Learning Disability Today, vol.7, Aug. 2007, p. 18-21

The Peer Mentorship Project brings together teenagers with and without learning disabilities in school hours to share time, space and activities. The young people meet on a weekly basis to support each other to create their own person-centred portfolio, and to build friendships. The non-disabled students also support their peers in their Connexions interviews if invited by their disabled friend. The majority of advocacy currently provided for disabled young people is through adults. However, peers who have got to know the disabled young person over time may speak more effectively on their behalf.

Star quality

E. Dent

Health Service Journal, vol.117, Sept. 20th 2007, p. 22-24

Around 150 wards are participating in the voluntary Star Wards scheme to provide mental health inpatients with more activities with therapeutic value. Suggested activities range from a library to horse racing, internet access and a comedy. Service users are particularly keen to have more exercise, which can be a challenge in inpatient settings.

Supporting people with complex behavioural difficulties and autistic spectrum disorder in a community setting: an inclusive approach

L. Sergeant, G. Dewsbury and S. Johnstone

Housing, Care and Support, vol.10, Aug. 2007, p. 23-29

This paper describes the approach taken by Aberdeen to designing living environments which, combined with appropriate support services, enable people with autism and those with extremely challenging behaviours to live in the community and develop skills for coping with daily life. Assistive technology was also used to enable clients to live as independently as possible.

Time for some added value

J. Williams and A. Holman

Community Care, Sept. 6th 2007, p. 30-31

The authors debate the achievements of the Valuing People policies for those with learning disabilities and discuss the kinds of changes that should be introduced in the 2007 'policy refresh'. They call for more employment opportunities for people with learning disabilities, improved access to healthcare, the closure of remaining NHS campuses, and promotion of direct payments and individual budgets. More needs to be done for people with multiple disabilities, people from an ethnic minority, those with autism, and parents with learning disabilities.

Time to step up to patient-centred care

A. Claire

Health Service Journal, vol.117, Sept. 6th 2007, p. 16-17

Barnsley Primary Care Trust is moving towards a model in which health and social care support for an individual will be delivered through self-assessment of needs, self-managed care and individual budgets for planned services that can be spent to meet agreed outcomes. The Trust will commission care navigators to support people in organising their own care package. For people with deterioration issues such as cognitive decline there will be maximum use of advanced directives. The model also requires sound information on quality, outcomes, alternative sources of provision and care options.

We can all dream: choice and control for people on the autistic spectrum

A. Tyson and M. Mattingly

Learning Disability Today, vol. 7, Aug. 2007, p. 28-31

The government is currently pursuing a personalisation agenda for social care. A new project called We Can Dream aims to find out whether this agenda can help young people with autism have more choice over their lives using the In Control model. In Control promises to bring choice into people's lives using an empowering seven-step process. Professionals delivering services to people with autism need to adjust their practice to hand over control to users. This article outlines some of the adjustments that may need to be made.

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