Targeting mental health services to severe mental illness

1995 ◽  
Vol 4 (3) ◽  
pp. 181-186
Author(s):  
Graham Thornicroft

SummaryThis paper argues within the mental health services that people who are most disabled by mental illness, the severely mentally ill (SMI), should be afforded the highest priority, and that services should be provided in relation to need. For this to occur the priority groups need first to be defined. Second, if a service wishes to provide for all prevalent cases of people suffering from severe mental illness, then a systematic method of recording local information about these people is required, and this may draw upon information about patients who are in contact with health services, social services, family health services and who contact voluntary sector and other agencies. One approach to estimating the need for services for people with SMI is by using indicative norms for service requirements. Finally, managerial methods are proposed to monitor how far targeting services to the SMI occurs in clinical practice.

1999 ◽  
Vol 175 (5) ◽  
pp. 422-425 ◽  
Author(s):  
Justine Schneider ◽  
John Carpenter ◽  
Toby Brandon

BackgroundSince 1991, English mental health policy guidelines have been explicit in recommending inter-professional working, involvement of patients and carers, harmonisation between health and social services and targeting at people with severe mental illness.AimsTo explore the structure and operation of mental health services in practice and relate them to measurable data.MethodA survey of mental health trusts was conducted in 1997–1998. Responses were compared with a concurrent survey of social services departments. Some qualitative data were collected. Harmonisation and targeting scores were devised and tested for association.ResultsThe response rate was 79%. The frequency with which different professionals, patients and carers were involved in the care process is described. Reasons for this are discussed briefly. Levels of harmonisation and targeting were found to vary widely and to be positively associated.ConclusionsThis survey portrays mental health services' practice in relation to Government policy. However, adherence to guidelines cannot be taken as a guarantee of service quality or efficiency.


2009 ◽  
Vol 24 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Todd P. Gilmer ◽  
Victoria D. Ojeda ◽  
Dahlia Fuentes ◽  
Viviana Criado ◽  
Piedad Garcia

2021 ◽  
Author(s):  
Elizabeth Newbronner ◽  
Panagiotis Spanakis ◽  
Ruth Wadman ◽  
Suzanne Crosland ◽  
Paul Heron ◽  
...  

Aims: To explore: how satisfied people with severe mental illness (SMI) are with the support received during the pandemic; understand any difficulties encountered when accessing both mental health and primary care services; consider ways to mitigate these difficulties; and assess the perceived need for future support from mental health services. Materials and Methods: A representative sample was drawn from a large transdiagnostic clinical cohort of people with SMI, which was recruited between April 2016 and March 2020. The sample was re-surveyed a few months after the beginning of the restrictions. Descriptive frequency statistics were used to analyse the quantitative data. The free text responses were analysed thematically. Results: 367 participants responded to the survey. Two thirds were receiving support from mental health services with the rest supported in primary care or self-managing. A quarter thought they would need more mental health support in the coming year. Half had needed to used community mental health services during the pandemic and the majority had been able to get support. A minority reported that their mental health had deteriorated but they had either not got the supported they wanted or had not sought help. The biggest service change was the reduction in face-to-face appointments and increasing use of phone and video call support. Nearly half of those using mental health services found this change acceptable or even preferred it; acceptability was influenced by several factors. Participants were more likely to be satisfied with support received when seen in person. Discussion: Although most participants were satisfied with the mental health support they had received, a minority were not. This, couple with findings on future need for mental health support has implications for post pandemic demand on services. Remote care has brought benefits but also risks that it could increase inequalities in access to services.


2007 ◽  
Vol 16 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Peter Tyrer

SummaryAims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).


1993 ◽  
Vol 17 (2) ◽  
pp. 82-83
Author(s):  
John Barnes ◽  
Greg Wilkinson

Much of the medical care of the long-term mentally ill falls to the general practitioner (Wilkinson et al, 1985) and, for example, a survey in Buckinghamshire showed that these patients consult their general practitioner (GP) twice as often as mental health services. Lodging house dwellers are known to show an increased prevalence of major mental illness and to suffer much secondary social handicap, presenting a challenge to helping services of all disciplines. For this reason we chose a lodging house in which to explore further the relationships between mental illness and residents' present contact with their GP, mental health services and other local sources of help.


2021 ◽  
Vol 21 (8) ◽  
pp. 477-484
Author(s):  
Ruth Crawford ◽  
Sisilia Finau Peini ◽  
Teramira Christine Schutz

Introduction: Metabolic Syndrome is a prevalent condition in New Zealand and worldwide, affecting adult populations, especially those who are in long-term  antipsychotic medications for severe mental illness. Registered nurses play a crucial role in improving the health of this population. Methods: Five registered nurses with at least two years of working experience in the mental health settings participated in this qualitative, exploratory study, underpinned by the Kakala Research Framework. Semi-structured face-to-face interviews with the participants were undertaken to gather research data and thematic analysis was used to find common themes. Findings: Registered nurses in mental health services are experiencing clinical and professional enablers as well as professional, organisational and systematic barriers in assessing people with severe mental illness for metabolic syndrome. Conclusion: Skilled registered nurses in mental health services are required to take the responsibility for providing a “one-stop-shop” for people with metabolic syndrome.


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