Mental Health Services Today and Tomorrow. Part 1: Experiences of Providing and Receiving Care and Part 2: Perspectives on Policy and Practice

Purpose – In his recent report, Lord Adebowale (2013) described mental health issues as “core police business”. The recent retrenchment in mental health and wider public services mean that the demands on the police in this area are likely to increase. Mental health triage is a concept that has been adapted from general and mental health nursing for use in a policing context. The overall aim of triage is to ensure more effective health outcomes and the more effective use of resources. The purpose of this paper is to examine the current policy and practice in this area. It then goes on to explore the models of mental health triage that have been developed to try and improve working between mental health services and the police. Design/methodology/approach – The paper outlines the main themes in the research literature regarding mental illness and policing, including a brief overview of section 136 MHA. It then examines recently developed models of triage as applied in these settings. Findings – The models of triage that have been examined here have developed in response to local organisational, demographic and other factors. The approaches have two key features – the improved training for officers and improved liaison with mental health services. Practical implications – Wider mental health training for officers and improved liaison with community-based services are the key to improving police contacts. Social implications – The current pressure on mental health services has increased the role that the police have in responding to these sorts of emergencies. This situation is unlikely to change in the short term. Originality/value – This paper contributes to the wider debate about policing and mental illness. It highlights the fact that section 136 MHA use has tended to dominate debates in this area to the detriment of a broader discussion of the police role.

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Rehabilitation in the United Kingdom: Research, Policy, and Practice

The Canadian Journal of Psychiatry ◽

10.1177/070674370204700704 ◽

2002 ◽

Vol 47 (7) ◽

pp. 628-634 ◽

Cited By ~ 5

Author(s):

Frank Holloway ◽

Jerome Carson ◽

Sarah Davis

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Government Policy ◽

Research Policy ◽

Psychosocial Interventions ◽

Mental Illnesses ◽

Policy And Practice ◽

Care Programme ◽

The Uk

Objective: To review research, policy, and practice in psychiatric rehabilitation in the UK. Method: We undertook a literature review and review of government policy documents. Findings: Most individuals with severe, disabling mental illnesses are cared for by generic community mental health services under the Care Programme Approach (CPA). Current government policy requires the introduction of assertive outreach and early psychosis services and is highly consistent with the adoption of the recovery paradigm within UK mental health services. Research and development activities have demonstrated the success of the UK hospital-closure program and have contributed to the worldwide resurgence of interest in psychosocial interventions in psychosis. Conclusions: A need remains to focus research and practice on those who are most disabled by their illnesses and to improve the skills of the workforce in psychosocial interventions.

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“It comes down to just how human someone can be”: A qualitative study with young people from refugee backgrounds about their experiences of Australian mental health services

Transcultural Psychiatry ◽

10.1177/1363461516662810 ◽

2016 ◽

Vol 54 (1) ◽

pp. 23-45 ◽

Cited By ~ 27

Author(s):

Madeleine C. Valibhoy ◽

Ida Kaplan ◽

Josef Szwarc

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Young People ◽

Health Services ◽

Mental Health Professionals ◽

Cultural Sensitivity ◽

Research Policy ◽

Treatment Strategies ◽

Policy And Practice ◽

Mental Health Awareness

While much literature documents the mental health needs of young people from refugee backgrounds, and the barriers they face in accessing mental health services, researchers have yet to document the perspectives of service users from this population about their contacts with clinicians and services. We therefore individually interviewed 16 young people (aged 18–25 years) who were refugees about their experiences of seeing mental health professionals. Participants were born in 9 different countries and had lived in Australia for an average of 5.2 years. They placed most emphasis on in-session factors, and particularly on interpersonal considerations. Among the main themes identified via thematic analysis were the practitioner's sensitivity to the young person's cultural background and to the stressors affecting him or her, including traumatic refugee experiences, and the therapeutic relationship—especially the qualities of trust, understanding, respect, and a caring connection. The participants had diverse reactions to treatment strategies. They emphasised the role of their preconceptions around mental health services, and called for systematic mental health awareness-raising for young people from refugee backgrounds. Implications for research, policy, and practice are discussed with a focus on findings that may guide efforts to improve service acceptability, accessibility, and effectiveness. In particular, there is a need for practitioners to attend to their clients' experiences of sessions, to adopt an attuned, contextualised, systemic approach, and especially to take a nuanced approach to cultural sensitivity.

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Collaborating to improve child and youth mental health in Nunavik

Études/Inuit/Studies ◽

10.7202/1040143ar ◽

2017 ◽

Vol 40 (1) ◽

pp. 23-41 ◽

Cited By ~ 1

Author(s):

Sarah Fraser ◽

Rémy Rouillard ◽

Lucie Nadeau ◽

Léna D’Ostie Racine ◽

Raymond Mickpegak

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Youth Mental Health ◽

Power Dynamics ◽

Policy And Practice ◽

Change Policy ◽

Regional Project ◽

Care Models ◽

Regional Partnership

Following various reports highlighting the lack of mental health services for children and youth in Nunavik (Quebec, Canada), high rates of child placements under youth protection, and gaps in the coordination of services, the Regional Partnership Committee of Nunavik decided to prioritize collaborative, community-based approaches to the health and wellbeing of children, youth, and their families. It is in this context that the regional project Ilagiinut (‘For families’) was initiated and is being piloted in Kuujjuaraapik. In mental health care, collaborative practices are highly valued, and various models are flourishing. However, collaborative care models are not necessarily easy to implement and involve a variety of ingredients, including trust, strong partnerships, clarity of roles, and power dynamics, all of which are influenced by culture and context. In this study, we conducted a total of 54 interviews with administrators, clinicians, and Inuit family members to explore their everyday expectations for and experiences with child and youth mental health services and collaboration between people involved in care. In our analysis we explore how context influences expectations, beliefs, and experiences, and ultimately how these factors impact the nature of services offered to children, youth, and families. The aim is to shed light on obstacles to and facilitators of collaboration in child and youth mental health in order to inform individuals, communities, and organizations that are trying to change policy and practice.

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Responses to inpatient victimisation in mental health settings in England and Wales

International Review of Victimology ◽

10.1177/0269758018816568 ◽

2018 ◽

Vol 25 (2) ◽

pp. 141-156

Author(s):

Louise Ellison ◽

Kathryn Berzins

Keyword(s):

Mental Health ◽

Criminal Justice ◽

Mental Health Services ◽

Health Services ◽

Evidence Base ◽

Future Research ◽

Policy And Practice ◽

Systematic Analysis ◽

England And Wales ◽

Mental Health Settings

Mental health inpatients are known to be at risk of criminal victimisation, but the experiences of this vulnerable victim population seldom receive mention in the victimological literature. Against this backdrop, this article explores to what extent and in what ways mental health inpatients report victimisation, and provides the first systematic analysis of what the existing evidence base tells us about the subsequent responses of mental health services and criminal justice agencies, particularly in England and Wales. Identified knowledge gaps are problematised as impediments to evaluation of both policy and practice in this context. An agenda for future research is additionally sketched out.

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Mental health services in the prisons of Bangladesh

BJPsych International ◽

10.1192/bji.2021.34 ◽

2021 ◽

pp. 1-4

Author(s):

Al Aditya Khan ◽

Howard Ryland ◽

Tayeem Pathan ◽

Helal Uddin Ahmed ◽

Amir Hussain ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Research Policy ◽

Health Conditions ◽

Policy And Practice ◽

Middle Income ◽

Mental Health Conditions ◽

Middle Income Countries ◽

Correctional Settings

In this narrative review we consider what is known about mental health conditions in the prison system in Bangladesh and describe the current provision of mental health services for prisoners with mental health needs. We contextualise this within the literature on mental health conditions in correctional settings in the wider sub-continental region and low- and middle-income countries (LMICs) more broadly. We augment findings from the literature with information from unstructured interviews with local experts, and offer recommendations for research, policy and practice.

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Risk: more questions than answers

Advances in Psychiatric Treatment ◽

10.1192/apt.10.4.273 ◽

2004 ◽

Vol 10 (4) ◽

pp. 273-274 ◽

Cited By ~ 5

Author(s):

Frank Holloway

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Services ◽

Health Services ◽

Social Role ◽

Mental Health Policy ◽

Assessment Tools ◽

Health Staff ◽

Mental Health Staff ◽

Policy And Practice

The rise of the risk industry in psychiatry in England and Wales can be given a precise date: 17 December 1992. That was the day that Christopher Clunis, a man who had been in contact with psychiatric services for some 6 years, murdered Jonathan Zito in an unprovoked attack. This tragedy received enormous publicity and resulted in a flurry of activity within the Department of Health. As a result of the moral panic surrounding Clunis, which crystallised long-term trends, the assessment and management of risk became a central focus of mental health policy and practice (Holloway, 1996). Risk remains a core issue, and indeed mental health services have come to be seen as a key element in a strategy for public protection that aims to keep people who are identified as a potential risk to others off the streets. (We await, with some professional trepidation, the legislation that will provide a sufficiently broad definition of mental illness to fully legitimate this social role.) Mental health staff are now required by government policy and their employers to assess an ever-expanding range of risks – most recently, following the Victoria Climbié Inquiry (House of Commons Health Committee, 2003), risks to dependent children, generally with the aid of unvalidated risk assessment tools. Increasingly, mainstream mental health services are being expected to provide interventions for people whose presenting problems are risky behaviours (or even risky feelings) rather than to offer treatment for mental illness.

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The future for psychiatry

Psychiatric Bulletin ◽

10.1192/pb.15.7.396 ◽

1991 ◽

Vol 15 (7) ◽

pp. 396-401 ◽

Cited By ~ 8

Author(s):

John Reed

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Services ◽

Health Services ◽

Policy And Practice ◽

The Public ◽

Mental Handicap ◽

The Future ◽

History Of

Policy for mental health services in England is based on two straightforward principles. These are, first that care should be provided as locally to where a person lives as is reasonably possible, and secondly that treatment should be available in the least restrictive conditions that are compatible with the safety of the patient, of those looking after him and of the public at large. I make no apology for reviewing the history of policy and practice; it is not possible to understand the mental health services that we are trying to achieve for the future without understanding how the service has developed over the years. I shall use the mental illness service as an example – similar considerations apply to the mental handicap services.

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Pilot implementation of child psychosocial framework in Kenya, Turkey and Brazil

Journal of Children s Services ◽

10.1108/jcs-02-2019-0008 ◽

2019 ◽

Vol 14 (4) ◽

pp. 303-316 ◽

Cited By ~ 1

Author(s):

Panos Vostanis ◽

Seyda Eruyar ◽

Esther Smit ◽

Michelle O’Reilly

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Service Research ◽

Skills Acquisition ◽

Participatory Action ◽

Policy And Practice ◽

Middle Income ◽

Content Type ◽

Pilot Implementation

Purpose The purpose of this paper is to develop a child psychosocial framework among stakeholders in areas of disadvantage in three low- and middle-income countries (LMIC), i.e. Kenya, Turkey and Brazil, and to capture their proposed recommendations through action plans according to this framework. Design/methodology/approach Workshops were facilitated with a total of 54 participants from different disciplines. The framework addressed safety and child-centredness, quality of care, resilience-building in schools and communities, enhancing competencies within existing roles, counselling and psychological interventions, and access to mental health services. Stakeholders’ perspectives were captured through a participatory action procedure. Findings The emerging 33 categories across the framework dimensions and the three sites led to four overarching and inter-linked themes. These related to community awareness; empowerment and “mobilization” of children, young people and families; inter-agency policy and practice; and capacity-building on skills acquisition at different levels. Research limitations/implications The next stage in this service research should be full implementation and evaluation in different LMIC contexts. Practical implications It is feasible to implement such a child psychosocial framework in contexts of conflict and disadvantage, and in the absence of specialist mental health services. Active stakeholder engagement and co-production should be central to the next phase of service transformation in LMIC. Originality/value This study captured the views and experiences of stakeholders in LMIC areas of disadvantage, and demonstrated their readiness to establish interdisciplinary networks and re-focus existing services.

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Qualitative Analysis of Recommendations in 79 Inquiries after Homicide Committed by Persons with Mental Illness

International Journal of Mental Health and Capacity Law ◽

10.19164/ijmhcl.v0i8.333 ◽

2014 ◽

pp. 262 ◽

Cited By ~ 1

Author(s):

Melissa McGrath ◽

Femi Oyebode

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Adverse Events ◽

Mental Health Policy ◽

Policy And Practice ◽

Care Needs ◽

Health And Social Care ◽

Health Policy And Practice ◽

Independent Inquiry

‘Building a Safer NHS for Patients’ proposes significant changes to the reporting of adverse events in Britain’s healthcare system including the place of inquiries in the analysis of adverse events. Within mental health services, since 1994 an independent inquiry has been mandatory for all homicides committed by persons in contact with mental health services. The inquiry reviews the care the patient was receiving at the time of the incident, the suitability of that care with regard to the patients history, health and social care needs, and the extent to which the care corresponded with statutory obligations of the health service. A report is usually published following each inquiry including a set of recommendations based on the findings of the inquiry. The assumption is that these recommendations are intended to influence mental health policy and practice. However, many critics argue that inquiry reports and their recommendations have yet to substantially alter policy and practice.

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