scholarly journals Zero tolerance of violence by users of mental health services: The need for an ethical framework

2005 ◽  
Vol 187 (1) ◽  
pp. 7-8 ◽  
Author(s):  
G. M. Behr ◽  
J. P. Ruddock ◽  
P. Benn ◽  
M. J. Crawford
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Zero Tolerance ◽  
Ethical Framework ◽  
Service Users ◽  
Healthcare Staff ◽  
Zero Tolerance Policy

SummaryConcerns about violent conduct of service users towards healthcare staff have prompted a ‘zero tolerance’ policy within the National Health Service. This policy specifically excludes users of mental health services. We attempt to challenge artificial distinctions between users of mental health and other services, and propose an ethical underpinning to the implementation of this policy.

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.

scholarly journals The Health and Social Care Act 2012: what will it mean for mental health services in England?

2012 ◽  
Vol 36 (11) ◽  
pp. 401-403 ◽  
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
National Health ◽  
Social Care ◽  
Health And Social Care

SummaryThe Health and Social Care Act 2012 brings in profound changes to the organisation of healthcare in England. These changes are briefly described and their implications for mental health services are explored. They occur as the National Health Service (NHS) and social care are experiencing significant financial cuts, the payment by results regime is being introduced for mental health and the NHS is pursuing the personalisation agenda. Psychiatrists have an opportunity to influence the commissioning of mental health services if they understand the organisational changes and work within the new commissioning structures.

scholarly journals Agenda setting with children using the ‘three wishes’ technique

2018 ◽  
Vol 22 (3) ◽  
pp. 419-432 ◽  
Author(s):  
Nikki Kiyimba ◽  
Michelle O’Reilly ◽  
Jessica Nina Lester
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Conversation Analysis ◽  
Multidisciplinary Team ◽  
Agenda Setting ◽  
Initial Screening ◽  
Video Recordings

The National Health Service (UK) offers initial screening appointments for children referred to child and adolescent mental health services to determine clinical need and assess risk. Conversation analysis was utilized on 28 video recordings of these assessments, lasting approximately 90 minutes each with a multidisciplinary team. This article focuses on the agenda setting strategies used to establish relevant goals with children and adolescents; specifically, the technique of offering ‘three wishes’. For example, ‘ if you had three wishes, what would you like to make happen?’ In cases where children initially volunteered an assessment-relevant wish, they tended not to articulate further wishes. Non-assessment-relevant wishes (i.e. fantasy wishes, such as being ‘rich’) were treated as insufficient, with many approaches used to realign establishing assessment relevant goals. Where responses were not institutionally relevant, practitioners undertook considerable discursive work to realign the focus of the three wishes task to assessment relevance. In these cases, the wish responses were treated as irrelevant and tended to be dismissed, rather than explored for further detail. Such work with the children’s contributions has implications for engaging children and child-centred practices.

The perspectives of people who use mental health services engaging with arts and cultural activities

2016 ◽  
Vol 20 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Anita Jensen ◽  
Theodore Stickley ◽  
Alison Edgley
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Central Component ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Museum Educator

Purpose – The purpose of this paper is to present a study of arts engagement for mental health service users in Denmark. Design/methodology/approach – The study was completed at Hans Knudsen Instituttet, Denmark. It involved analysis of emerging themes from semi-structured interviews with six participants who had participated in a structured visit to the National Gallery (Statens Museum for Kunst) in Denmark. Findings – Multiple benefits for people who use mental health services engaging in arts activities are reported. Arts activities are described as a central component of everyday life; a way of life and a significant factor in getting through the day. Barriers are identified in the interdisciplinary working between the museum educator and participants. Social implications – This study identifies that the participants benefited from taking part in the arts/cultural activity. Findings also suggest that if museums are offering activities to people who use mental health services they should equip staff with training designed to support appropriate ways of working with this group. This interdisciplinary activity offers a relatively untapped potential arena of support. Originality/value – The paper will be of relevance and value to those working with mental health and arts. The study demonstrates the importance for mental health service users to engage in creative activity and for museum staff to have appropriate skills for inclusion to be successful.

scholarly journals Co-production as an approach to developing stakeholder partnerships to reduce mental health inequalities: an evaluation of a pilot service

2016 ◽  
Vol 18 (01) ◽  
pp. 14-23 ◽  
Author(s):  
Saumu Lwembe ◽  
Stuart A. Green ◽  
Jennifer Chigwende ◽  
Tom Ojwang ◽  
Ruth Dennis
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Small Scale ◽  
Community Mental Health Service ◽  
Service Users ◽  
Ethnic Communities ◽  
Minority Ethnic

Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public health, a community group, primary mental health teams and patients – in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Background Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. Methods This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service users. Qualitative research methods, including semi-structured interviews and focus groups, were used to collect data to examine the use of co-production methods in designing and delivering an improved mental health service. Findings Twenty-five patients enrolled into the study; of these, 10 were signposted for more intensive psychological support. A 75% retention rate was recorded (higher than is generally the case for black and minority ethnic service users). Early indications are that the project has helped overcome barriers to accessing mental health services. Although small scale, this study highlights an alternative model that, if explored and developed further, could lead to delivery of patient-centred services to improve access and patient experience within mental health services, particularly for black and minority ethnic communities.

scholarly journals Survey of CAMHS clinicians about their experience of remote consultation: brief report

BJPsych Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Anupam Bhardwaj ◽  
Anna Moore ◽  
Rudolf N. Cardinal ◽  
Carol Bradley ◽  
Lauren Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Remote Consultation ◽  
Face To Face ◽  
Remote Consultations ◽  
Safe Care ◽  
Roll Out

The Covid-19 crisis necessitated rapid adoption of remote consultations across National Health Service (NHS) child and adolescent mental health services (CAMHS). This study aimed to understand practitioners’ experiences of rapid implementation of remote consultations across CAMHS in one NHS trust in the east of England. Data were collected through a brief questionnaire documenting clinicians’ experiences following remote delivery of services. The questionnaire began before ‘lockdown’ and focused on assessment consultations (n = 102) as part of a planned move to virtual assessment. As the roll-out of remote consultations was extended at lockdown, we extended the questionnaire to include all remote clinical contacts (n = 202). Despite high levels of initial concern, clinicians’ reports were positive overall; importantly, however, their experiences varied by team. When restrictions on face-to-face working are lifted, a blended approach of remote and face-to-face service delivery is recommended to optimise access and capacity while retaining effective and safe care.

scholarly journals Clinical Administration

1986 ◽  
Vol 10 (9) ◽  
pp. 226-230
Author(s):  
J. W. Affleck
Keyword(s):  
Mental Health ◽  
Social Work ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Social Workers ◽  
National Health ◽  
Historical Perspective

In times of pessimism when psychiatry is described as in decline, subject to public scepticism with the psychiatrist's role threatened by social workers, psychologists and community nurses, one's immediate reaction is to adopt a historical perspective. The advances achieved during the last 50 years which I recall are so impressive that it seems reasonable to see current legal and bureaucratic problems as resembling a ditch rather than a precipice! These advances have occurred in spite of adverse administrative situations. It is important to remember that in spite of its merits the National Health Service was not conceived with Mental Health Services in mind—nor were Social Work Services.

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