scholarly journals Risk: more questions than answers

2004 ◽  
Vol 10 (4) ◽  
pp. 273-274 ◽  
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.

Mental health care in London

2005 ◽  
Vol 20 (S2) ◽  
pp. s274-s278 ◽  
Author(s):  
P. De Ponte ◽  
G. Hughes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
National Policy ◽  
Health Staff ◽  
Mental Health Staff ◽  
The Uk ◽  
Occupancy Rates

AbstractAimTo describe principles and characteristics of mental health care in London.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsLondon experiences high levels of need and use of mental health services compared to England as a whole. Inpatient andcompulsory admissions are considerably higher than the national average. Despite having more psychiatric beds and mental health staff, London has higher bed occupancy rates and staffing shortages. At the same time there is a trend away from institutionalised care to care in the community.ConclusionMental health services in the UK are undergoing considerable reform. These changes will not remove the greater need formental health services in the capital, but national policy and funding lends support to cross-agency and pan-London work to tackle some of the problems characteristic of mental health in London. Whilst various issues of mental health care in London overlap with those in other European capitals, there also are some specific problems and features.

scholarly journals Policing and street triage

2016 ◽  
Vol 18 (1) ◽  
pp. 40-52 ◽  
Author(s):  
Ian Cummins ◽  
David Edmondson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Research Literature ◽  
Mental Health Training ◽  
Policy And Practice ◽  
Mental Health Nursing ◽  
Content Type ◽  
Use Of Resources

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.

Preferences of dress and address: views of attendees and mental health professionals of the psychiatric services

2012 ◽  
Vol 29 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Christina Sim ◽  
Brian Hallahan ◽  
Colm McDonald
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Service User ◽  
Psychiatric Services ◽  
Health Staff ◽  
Mental Health Staff ◽  
Medical Terms

AbstractObjectives: The aim of this study was to determine the views of both individuals attending the mental health services (attendees) and mental health professionals in relation to how attendees and staff should be addressed, how attendees should be described, and how staff should be attired.Methods: We surveyed 132 attendees of the West Galway Mental Health Services and 97 mental health professionals in relation to how they prefer to be addressed (first name/ title and surname/ no preference) the description of attendees (patient / client / service user / no preference) and the attire of mental health staff (casual / smart / no preference). We also ascertained how mental health professionals believed attendees would view these issues.Results: Attendees preferred to be described as patients rather than clients or service users by all mental health professionals, with 46-54% of attendees preferring this term “patient” compared to 14-17% preferring the term “client”, 11-13% preferring the term “service user” and 20-25% having no preference (p < 0.001). They preferred to address doctors by their title and surname (61%) but other mental health professionals by their first names (60-69%) (p < 0.001). Attendees had a strong preference for being addressed by their first names by all the mental health professionals (86-91%) (p < 0.001). Doctors preferred to be attired formally (88%), compared to nurses (50%) or other mental health professionals (42%) (p = 0.002). Attendees had no preference in relation to the attire of doctors but preferred other mental health professionals to be attired informally.Conclusions: The study demonstrates that despite the increased use of several non-medical terms to describe attendees of mental health services; the preferred term of attendees of the psychiatric services in both in-patient and out-patient settings remains ‘patient’. However, this is not universally the case, and the ascertainment of the preference of the attendee at the first encounter with the health professional should be ascertained. We also demonstrated that attendees preferences in relation to both “dress and address” of doctors is significantly different to their preference for nurses or other allied mental health professionals; which may reflect a wish for a less familiar and more formal interaction with doctors.

Delivering recovery focused mental health care in Ireland: implications for services and practice development

2014 ◽  
Vol 33 (2) ◽  
pp. 121-128 ◽  
Author(s):  
S. A. Shah ◽  
M. Nolan ◽  
M. Ryan ◽  
J. Williams ◽  
D. Fannon
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Mental Health Policy ◽  
World Health ◽  
Health Staff ◽  
Personal Recovery

IntroductionThe recovery approach provides a key organising principle underlying mental health policy throughout the English speaking world with endorsement by agencies such as the World Health Organisation. In Ireland, personal recovery is one of the quality markers identified by users of mental health services and has become central to national mental health policy.Aim and objectiveThe aim of this study was to explore the implications for mental health services and professional practice arising from a structured investigation of what personal recovery means for people using specialist mental health services and the extent to which services support their individual recovery.MethodTen service user participants in a service initiative were assessed using a novel measure based on an empirically based conceptual framework of recovery. The INSPIRE determines the level of recovery promoting support received from mental health staff and the quality of the supportive relationship as perceived by individual service users.ResultsA consistent pattern of beliefs about recovery in keeping with national guidelines and the international literature was apparent. All respondents indicated that support by other people was an important part of their recovery with high levels of support received from mental health professionals. There was less consistent endorsement of the quality of relationships with professionals and recovery-oriented practice as perceived by participants.ConclusionThe findings are highly relevant to the development of recovery focused, clinically excellent services. Further work is needed to improve the process of translating recovery guidance into mental health practice.

General Practitioners and Mental Health Staff Sharing Patient Care: Working Model

2005 ◽  
Vol 13 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Deborah Horner ◽  
Kim Asher
Keyword(s):  
Mental Health ◽  
General Practitioner ◽  
Mental Health Services ◽  
Health Services ◽  
General Practitioners ◽  
Shared Care ◽  
Health Staff ◽  
Mental Health Staff ◽  
Care Programme ◽  
Care Protocol

Objective: The paper describes a shared care programme developed by mental health services and general practitioners for shifting patients with chronic psychiatric disorders to the care of a general practitioner. The programme is characterized by: (i) a dedicated mental health service general practitioner liaison position to manage the programme and provide support to both patients and doctors; (ii) a multidisciplinary care planning meeting that includes mental health staff, the patient, the general practitioner and a carer; and (iii) a jointly developed individual management plan that specifies patient issues, strategies to deal with these issues, persons responsible for monitoring and a review date. Methods: The shared care protocol, the results of a review of patient mental health indicators and general practitioner satisfaction with the programme are described. Results: Outcomes to date suggest that patients' mental health is not compromised and may be enhanced by transfer to general practitioners within the shared care model. Indicators of mental health outcomes (Health of the Nation Outcome Scale and Life Skills Profile scores) show improved patient symptomatology and functioning in most cases. Conclusions: The programme fits the model of recovery-based mental health services and complies with current local, state and Commonwealth policies that encourage integrated and collaborative approaches by mental health services and general practitioners in delivering mental health care to persons with chronic mental illness.

Operation and organisation of services for people with severe mental illness in the UK

1999 ◽  
Vol 175 (5) ◽  
pp. 422-425 ◽  
Author(s):  
Justine Schneider ◽  
John Carpenter ◽  
Toby Brandon
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Social Services ◽  
Mental Health Policy ◽  
Care Process ◽  
Or Efficiency ◽  
The Uk

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.

scholarly journals Improved investment in mental health services: value for money?

2008 ◽  
Vol 192 (2) ◽  
pp. 88-91 ◽  
Author(s):  
David Goldberg
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Local Level ◽  
Health Staff ◽  
Central Control ◽  
Front Line ◽  
Mental Health Staff ◽  
The Past ◽  
Local Initiatives

BackgroundThis paper examines what has been achieved in the specialist mental health services by the vastly increased health expenditures that the National Health Service (NHS) has enjoyed in the past 5 years.AimsTo describe the way money has been spent in specialist mental health services and examine why problems remain after such admirable changes to already available resources.MethodChanges in staff employed by mental health services, where the extra staff are deployed, and patterns of expenditure within the whole service and within community mental health teams are examined.ResultsSome of the new expenditure has been well spent, and has produced improvements in the service. However, one must also take account of the costs of the greatly increased numbers of managers, who impose two sorts of costs: that of their own salaries, and the opportunity costs of front-line staff having to attend meetings and write reports rather than seeing patients. Throughout the rest of the NHS, money has been wasted on needless reorganisations, on consultant and general practitioner contracts, and on information technology that has so far failed to deliver tangible advantages.ConclusionsThe emphasis on central control undermines local initiatives and wastes resources. Some central control is inevitable, but policies need to be developed in collaboration with clinicians. At local level, expenditure by primary care trusts and mental health trusts also needs to be scrutinised by committees that should include representatives of front-line mental health staff.

scholarly journals Evaluating patients and healthcare professionals' understanding of voting rights for patients in government elections

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S301-S301
Author(s):  
Mark Winchester ◽  
Madiha Majid ◽  
Ashok Kumar
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Professionals ◽  
Psychiatric Patients ◽  
Voting Rights ◽  
Health Staff ◽  
Mental Health Staff ◽  
Staff Members ◽  
Right To Vote

AimsTo understand whether mental health patients vote in government electionsTo ascertain the barriers that prevent them from doing soTo explore ways in which mental health services can support patients to voteTo determine whether mental health staff are aware of patients’ right to voteBackgroundMembers of Parliament (MPs) can influence decisions regarding the National Health Service (NHS) and mental health legislation. The general election on 12th December 2019 highlighted that many patients were not using their democratic right to vote. It also appeared that many staff members were not aware that patients under the Mental Health Act (MHA) were entitled to vote (except for those under ‘forensic’ sections of the MHA). We therefore conducted a survey to ascertain both patient and staff understanding of their democratic rights and to better understand how we could increase the rate of voting amongst psychiatric patients.MethodTwo questionnaires were produced, one for patients and the other for staff members. This was tested by the clinical governance team before approval was granted. Data were collected at the Coventry and Warwickshire Partnership NHS Trust in the form of paper forms or electronically through a survey website. Forty-two patients and twenty-five staff members responded.ResultNo staff members had received formal training with regards to patients’ right to vote. Over half of staff members incorrectly believed that patients under Section 2 or 3 of the MHA and those lacking capacity couldn't vote. More than half of the team members surveyed stated that they had not supported patients in registering or casting a vote. Roughly one third of healthcare professionals felt that it was their responsibility to promote patients’ right to vote, with one third disagreeing and the remaining third unsure.Over 75% of patients did not vote but less than one quarter of all patients surveyed felt support from mental health services would increase the likelihood of them voting. The main barriers to voting were being mentally unwell, hospital admission or a lack of knowledge on the candidates and election process.ConclusionBasic training is required to improve staff knowledge of patients’ voting rights, which should help improve their ability to support patients to vote. Trusts should have a clear protocol in place in the event of future elections, with information on who can vote, how to request a postal vote and the candidates in that area.

scholarly journals The future for psychiatry

1991 ◽  
Vol 15 (7) ◽  
pp. 396-401 ◽  
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.

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

2014 ◽  
pp. 262 ◽  
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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