Codesigned framework for organisational culture reform in South Australian older persons' mental health services after the Oakden Report

2020 ◽  
Vol 44 (6) ◽  
pp. 862
Author(s):  
Duncan McKellar ◽  
Jackie Hanson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Culture Change ◽  
Working Group ◽  
Older Persons ◽  
Organisational Culture ◽  
Service Development ◽  
Reform Process

The Oakden Report documented failures in governance, clinical practice and organisational culture occurring at the Oakden Older Persons’ Mental Health Service and drew national attention to the care of older people with complex clinical needs. Responding to the recommendations of the Report, a working group brought together stakeholders to engage in a codesign process involving literature review, gallery walks and focus groups, under the governance of the Oakden Response Oversight Committee. The working group developed a framework as a blueprint for organisational culture reform built around a central philosophy of compassionate relationship-centred care, supported by four priorities: developing a values-based workforce, cultivating psychological safety, facilitating excellence in care and providing transparent accountability. The purpose of the framework was to provide a way forward for South Australian older persons’ mental health services after The Oakden Report, and it may provide insight into similar processes of codesign and culture change in other service contexts. What is known about the topic? Changes to healthcare systems, requiring improved efficiencies and lower costs, are contributing to increasing challenges with staff satisfaction and wellbeing, and consistent delivery of dignified, meaningful care to people and their families. The need to nurture and lead healthcare organisations characterised by compassionate cultures is an increasingly prominent theme in global healthcare literature. The engagement of people with lived experience at all levels of system design supports effective and ethical service development. What does this paper add? This paper illustrates an approach to positive, compassion-focused organisational culture change, developed through codesign, occurring as a reform process following a crisis in service delivery. The paper applies key concepts in a framework that may be applied in a range of services to achieve positive organisational transformation. What are the implications for practitioners? Committed action to develop positive organisational culture characterised by compassionate relationship-centred care will have benefit for healthcare providers and the people who receive care. Keeping people with lived experience at the centre of design and development will support optimal outcomes for all stakeholders.

scholarly journals A scoping review of international policy responses to mental health recovery during the COVID-19 pandemic

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Claire McCartan ◽  
Tomas Adell ◽  
Julie Cameron ◽  
Gavin Davidson ◽  
Lee Knifton ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Suicide Ideation ◽  
International Health ◽  
Health Impact ◽  
Service Development ◽  
Design Development ◽  
Physical And Mental Health

AbstractThe COVID-19 pandemic has affected people’s physical and mental health. Quarantine and other lockdown measures have altered people’s daily lives; levels of anxiety, depression, substance use, self-harm and suicide ideation have increased. This commentary assesses how international governments, agencies and organisations are responding to the challenge of the mental health impact of COVID-19 with the aim of informing the ongoing policy and service responses needed in the immediate and longer term. It identifies some of the key themes emerging from the literature, recognises at-risk populations and highlights opportunities for innovation within mental health services, focusing on the published academic literature, international health ministry websites and other relevant international organisations beyond the United Kingdom and Ireland. COVID-19 has challenged, and may have permanently changed, mental health services. It has highlighted and exacerbated pre-existing pressures and inequities. Many decision-makers consider this an opportunity to transform mental health care, and tackling the social determinants of mental health and engaging in prevention will be a necessary part of such transformation. Better data collection, modelling and sharing will enhance policy and service development. The crisis provides opportunities to build on positive innovations: the adaptability and flexibility of community-based care; drawing on lived experience in the design, development and monitoring of services; interagency collaboration; accelerating digital healthcare; and connecting physical and mental health.

scholarly journals Consultant advisers in every service

2001 ◽  
Vol 25 (11) ◽  
pp. 441-444
Author(s):  
Louis Appleby
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Working Group ◽  
Current Process ◽  
National Director

Shortly after taking up my appointment as National Director for Mental Health, I convened a working group of consultant psychiatrists to consider how to involve psychiatrists more in the current process of changing mental health services. This was in recognition of the fact that, while psychiatrists are central to modernising services, their skills and experience are insufficiently used. It is one of the most frequent complaints that I hear from clinicians.

scholarly journals Demystifying the pathway of assessment and treatment for bipolar disorder – utilising co-production and algorithms to personalise the approach

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S150-S150
Author(s):  
Jessica Nicholls-Mindlin ◽  
Digby Quested ◽  
Matthew Taylor ◽  
Lauren Fuzi ◽  
David Gee
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Public Involvement ◽  
Psychological Intervention ◽  
Patient And Public Involvement ◽  
Service Development ◽  
Post Discharge ◽  
Nice Guideline

AimsTo develop an evidence based, patient centred treatment pathway for people experiencing symptoms of bipolar disorder (BD), modifiable to include local resources.MethodThis project was developed in line with current approaches to service development such as coproduction, with patient and public involvement (PPI) and enhancing personalisation of treatment in medicine. As part of a local initiative, a multi-disciplinary team was brought together to understand and analyse the current local pathway for those affected by BD. It was found that the approach to assessment and management was not consistent between locality teams. Two experts by experience who have a diagnosis of BD were invited to become involved with the development of the pathway. Meetings were set up to enable coproduction and elicit information from those with the diagnosis. The responses provided insight into the effectiveness of different approaches used nationally to inform the methods and resources that are most helpful and appropriate to comprehensively support those with the illness.NICE guideline evidence was used to create two algorithms to streamline the care of those with BD in both primary and secondary care. These algorithms include pharmacological, psychological and social approaches. It also considers the junctions at which referrals should be made and the criteria on which decisions are based.ResultOne algorithm was designed for use in primary care and will be distributed to local GPs to clarify the initial steps for assessment and management of BD and the criteria for referral. A second decision tree will be made available to all doctors working in mental health services with detailed medication options, when they are appropriate and whether additional psychological intervention should be considered e.g. post-discharge groups. Other specialist options such as Early Intervention for Psychosis and Perinatal Mental Health Services were also included. An information pack was created to be offered to all those with a diagnosis or possible diagnosis of BD. This contains useful resources such as skills and exercises that patients may find of benefit, external resources and websites regarding additional support and further information on BD, its nature and management.ConclusionThe approach and resources collated here will help to streamline the management of those with bipolar disorder whilst also ensuring a more consistent approach. The involvement of experts by experience and the incorporation of NICE guidelines ensures a well-rounded and comprehensive set of documents that will be helpful to both clinicians and patients.

scholarly journals Promoting meaningful recovery with digital mental health care

2020 ◽  
Vol 29 ◽  
Author(s):  
Elizabeth Carpenter-Song
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Mental Illnesses ◽  
New Approach ◽  
Use Of Technology ◽  
Barriers To Access ◽  
Integration Of Technology ◽  
Insight Into

Abstract There is growing interest in digital mental health as well as accumulating evidence of the potential for technology-based tools to augment traditional mental health services and to potentially overcome barriers to access and use of mental health services. Our research group has examined how people with mental illnesses think about and make use of technology in their everyday lives as a means to provide insight into the emerging paradigm of digital mental health. This research has been guided by anthropological approaches that emphasise lived experience and underscore the complexity of psychiatric recovery. In this commentary I describe how an anthropological approach has motivated us to ask how digital technology can be leveraged to promote meaningful recovery for people with mental illnesses and to develop a new approach to the integration of technology-based tools for people with mental illnesses.

scholarly journals Old age mental health services in Southern Balkans: Features, geospatial distribution, current needs, and future perspectives

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
P. Alexopoulos ◽  
A. Novotni ◽  
G. Novotni ◽  
T. Vorvolakos ◽  
A. Vratsista ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Old Age ◽  
Mental Health Professionals ◽  
Clinical Teaching ◽  
Healthcare Services ◽  
Service Development ◽  
Research Activity ◽  
Term Care

Abstract Background Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. Methods After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. Results A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. Conclusions Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.

Challenges in Developing Community Mental Health Services in Sri Lanka

2009 ◽  
Vol 11 (1) ◽  
pp. 195-208 ◽  
Author(s):  
Suman Fernando ◽  
Chamindra Weerackody
Keyword(s):  
Mental Health ◽  
Sri Lanka ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Systems Of Care ◽  
Subsequent Development ◽  
Well Being ◽  
Service Development ◽  
2004 Tsunami

There are several issues to be faced in developing mental health services in South Asia if they are to be culturally and socially appropriate to the needs of the communities in the region. The meanings of mental health relevant to culturally appropriate service development can be obtained by exploring local notions of well-being, systems of care available to people and current practices among those seeking help for mental health problems. Participatory research carried out in communities in Sri Lanka affected by prolonged armed conflict and by the 2004 tsunami clarified the nature of well-being as perceived by communities themselves. Subsequent development of mental health services for Sri Lanka can be based on community consultation, using methodologies and interventions that involve the participation of the communities and their local institutions, and adapting relevant western approaches to the Sri Lankan context.

scholarly journals Transfers and transitions between child and adult mental health services

2013 ◽  
Vol 202 (s54) ◽  
pp. s36-s40 ◽  
Author(s):  
Moli Paul ◽  
Tamsin Ford ◽  
Tami Kramer ◽  
Zoebia Islam ◽  
Kath Harley ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Continuity Of Care ◽  
Information Transfer ◽  
Transition Planning ◽  
Service Development ◽  
Retrospective Case ◽  
Adult Mental Health ◽  
Planning Meeting

BackgroundTransfer of care from one healthcare provider to another is often understood as a suboptimal version of the process of transition.AimsTo separate and evaluate concepts of transfer and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS).MethodIn a retrospective case-note survey of young people reaching the upper age boundary at six English CAMHS, optimal transition was evaluated using four criteria: continuity of care, parallel care, a transition planning meeting and information transfer.ResultsOf 154 cases, 76 transferred to AMHS. Failure to transfer resulted mainly from non-referral by CAMHS (n = 12) and refusal by service users (n = 12) rather than refusal by AMHS (n = 7). Four cases met all criteria for optimal transition, 13 met none; continuity of care in(n = 63) was met most often.ConclusionsTransfer was common but good transition rare. Reasons for failure to transfer differ from barriers to transition. Transfer should be investigated alongside transition in research and service development.

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