scholarly journals Funding approaches for mental health services: is there still a role for clustering?

2018 ◽  
Vol 24 (6) ◽  
pp. 412-421 ◽  
Author(s):  
Rowena Jacobs ◽  
Martin Chalkley ◽  
María José Aragón ◽  
Jan R. Böhnke ◽  
Michael Clark ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
List Type ◽  
Robust Model ◽  
Starting Point ◽  
Mental Health Activity ◽  
Health Services Need ◽  
Rapid Pace

SUMMARYFunding for mental health services in England faces many challenges, including operating under financial constraints where it is not easy to demonstrate the link between activity and funding. Mental health services need to operate alongside and collaborate with acute physical hospital services, where there is a well-established system for paying for activity. The funding landscape is shifting at a rapid pace and we outline the distinctions between the three main options – block contracts, episodic payment and capitation. Classification of treatment episodes via clustering presents an opportunity to demonstrate activity and reward it within these payment approaches. We discuss the results of our research into how well the clustering system is performing against a number of fundamental criteria. We find that, according to these criteria, clusters are falling short of providing a sound basis for measuring and financing services. Nevertheless, we argue that clustering is the best available option and is essential for a more transparent funding approach for mental healthcare to demonstrate its claim on resources, and that clusters should therefore be a starting point for evolving a better funding system.LEARNING OBJECTIVES•Understand the different payment models currently being used and proposed in mental health services in England•Understand the role of clustering in measuring mental health activity and providing a basis for funding•Understand how a robust model of clustering can benefit the provision of mental health servicesDECLARATION OF INTERESTNone.

The Challenge of Psychiatric Treatments in the Deaf Population

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. DuFeu
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
National Policy ◽  
Treatment Programs ◽  
List Type ◽  
Deaf People ◽  
Treatment Needs ◽  
Client Group ◽  
Health Services Need

Delivering appropriate psychiatric treatments to a Deaf population faces many challenges:•The geographical spread of this client group, who comprise about one in a thousand of the general population.•The complexity of the treatment needs of Deaf people, who may have neurological, psychiatric, social, emotional and psychological difficulties, in addition to a deprived history, which can include significant language delay or deprivation.•The challenge of delivering multi disciplinary treatment programs in conjunction with locally based mainstream resources. Most specialist Mental Health services for Deaf people do cannot provide out of hours or crisis services, and some do not have sufficient community based staff, or any day or in patient provision.The specialist Deaf mental health services need to undertake major awareness, teaching and liaison programs:•With any agency in contact with Deaf people, including Health, Mental Health and Social work and voluntary organistions.•With the Deaf Community to raise awareness of mental health issues, to give information and remove stigma.All these initiatives need to take place locally as well as at national policy making level.

scholarly journals Qualitative investigation of relatives’ and service users’ experience of mental healthcare for suicidal behaviour in bipolar disorder

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030335
Author(s):  
Caroline Clements ◽  
Navneet Kapur ◽  
Steven H Jones ◽  
Richard Morriss ◽  
Sarah Peters
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Mental Healthcare ◽  
Service Users ◽  
Open Communication ◽  
Increased Risk ◽  
Health Services Need

ObjectivePeople with bipolar disorder are known to be at high risk of engaging in suicidal behaviours, and those who die by suicide have often been in recent contact with mental health services. The objective of this study was to explore suicidal behaviour in bipolar disorder and how this is monitored and managed by mental health services.AimsTo identify themes within relatives’ and service users’ accounts of mental healthcare, related to management and prevention of suicidal behaviour in bipolar disorder.DesignThematic analysis of 22 semistructured interviews.ParticipantsParticipants were aged 18 years or over, fluent in written and spoken English, and either had bipolar disorder with a history of suicidal behaviour, or were relatives of people with bipolar disorder who had died by suicide.SettingEngland, UK.Primary outcomeThemes identified from participants’ accounts of mental healthcare for suicidal behaviours in bipolar disorder.ResultsTwo main themes were identified. ‘Access to care’ was characterised by a series or cycle of potential barriers to care (eg, gate-keepers, lack of an accurate diagnosis) which had the potential to increase risk of suicidal behaviour if failure to access care continued over time. ‘Problems with communication’ captured the importance of maintaining open routes of communication between all parties involved in care to ensure successful monitoring and management of suicidal behaviours in bipolar disorder.ConclusionsMental health services need to be accessible and respond rapidly to people with suicidal behaviour in bipolar disorder. Open communication and inclusion of relatives in care, where appropriate, could help closer monitoring of changes in symptoms that indicate increased risk.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

2021 ◽  
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
List Type ◽  
Service Users ◽  
Diverse Range ◽  
Qualitative Interview Study ◽  
Mental Health Difficulties ◽  
Remote Care

ABSTRACTObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, co-designed with mental health service users and carers.MethodsWe conducted semi-structured, telephone or online interviews with a purposively constructed sample; a peer researcher with lived experience conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNHS secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments, and identification of deteriorating mental wellbeing. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsWhilst remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decisions about remote mental healthcare. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.ARTICLE SUMMARYStrengths and limitations of this studyStrengths include its qualitative approach in speaking to a large sample of participants with varied mental health difficulties, carers, and a diverse range of mental healthcare staff.Its novelty lies in a deep exploration of the views and experiences of remote mental healthcare during a pandemic.The methods are strengthened by the involvement of experts-by-experience and the use of peer research methods.We did not adopt a narrative method; the interviews were one-off conversations so we could not explore change as the pandemic progressed and people may have become accustomed to remote care.The study used remote methods to comply with UK lockdown regulations; this will have excluded some groups without the ability to engage remotely.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

Implementing a national case-management training program in Portugal

2011 ◽  
Vol 26 (S2) ◽  
pp. 555-555
Author(s):  
P. Mateus ◽  
M. Xavier ◽  
J. Caldas-Almeida
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Case Management ◽  
Training Program ◽  
National Level ◽  
Management Training ◽  
Role Playing ◽  
List Type ◽  
Program Content

IntroductionIn Portugal, a new National Mental Health Plan has been launched with the following objectives: equal access to care, decentralisation of mental health services and integration of mental health services in the general health services. In order to change the operational model for mental health teams, a case-management training program has been launched by the Ministry of Health.ObjectivesThis study aims to evaluate: a)the feasibility of implementing the program on a national level,b)the quality of the training program andc)the satisfaction of the trainees.MethodsThe study was carried out at 36 public mental health services in mainland Portugal. The professionals attended a case management course (SAMHSA procedures), in which they were trained by means of guidelines, demonstrative audios, scenarios and role-playing. The assessment was conducted with a questionnaire addressing logistics, program content, acquisition of skills, usefulness and overall satisfaction.Results135 professionals from the whole country have been involved. The trainees’ acquisition of competences was found rather satisfactory. Results of the training were impressive regarding satisfaction and motivation of the trainees (69% were highly satisfied). Dimensions such as organization (35% highly satisfied, 52% satisfied), program content (41% highly satisfied, 43% satisfied), practical skills gaining (35% highly satisfied, 58% satisfied) and usefulness (58% highly satisfied, 31% satisfied) were also very well rated.ConclusionsOf upmost relevance, it was possible to implement a case management training program at a national level, with no particular difficulties. The impact of courses on trainees was overall impressive.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals Improving access to mental healthcare for displaced Syrians: case studies from Syria, Iraq and Turkey

2016 ◽  
Vol 13 (4) ◽  
pp. 84-86 ◽  
Author(s):  
P. Hughes ◽  
Z. Hijazi ◽  
K. Saeed
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Primary Healthcare ◽  
Unmet Need ◽  
Mental Healthcare ◽  
Integrated Approach ◽  
World Health ◽  
Case Examples ◽  
Displaced People

The conflict in Syria has led to an unprecedented humanitarian crisis that extends across multiple countries in the area. Mental health services were undeveloped before and now face huge strain and unmet need. The World Health Organization and others have developed a programme to build capacity in the delivery of mental health services in an integrated healthcare package to refugees and displaced people. The tool used for this is the mhGAP Intervention Guide and complementary materials. In this paper we refer to training in Turkey, Iraq and Syria where health professionals were trained to roll out this community-based integrated approach through primary healthcare. We describe field case examples that show the complexity of situations that face refugees, displaced people and those caught in active conflict. Training improved the knowledge and skills for managing mental health disorders in primary healthcare. Further work needs to be done to demonstrate greater access to and utilisation of services, client outcomes and organisational change with this approach.

scholarly journals Provision of mental health services in Nigeria

2008 ◽  
Vol 5 (2) ◽  
pp. 32-34 ◽  
Author(s):  
Olufemi Olugbile ◽  
M. P. Zachariah ◽  
O. Coker ◽  
O. Kuyinu ◽  
B. Isichei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Urban Areas ◽  
Mental Healthcare ◽  
African Countries ◽  
Grass Roots ◽  
The Past ◽  
Trained Personnel

Nigeria, like other African countries, is short of personnel trained in mental healthcare. Efforts to tackle the problem have often focused on increasing the numbers of psychiatrists and nurses in the field. These efforts, over the past 20 years, have not appeared to have greatly improved service delivery at the grass roots. Most of the specialist centres where such highly trained personnel work are in urban areas and for a large part of the population access to them is limited by distance and cost.

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