scholarly journals Why Trieste matters

2021 ◽  
pp. 1-2
Author(s):  
S. P. Sashidharan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Community Psychiatry ◽  
Mental Healthcare ◽  
Healthcare Systems ◽  
Local Region ◽  
Right Wing ◽  
Service Model ◽  
The World

Trieste mental health service is considered as one of the best mental healthcare systems in the world. This service is now under threat from right-wing politicians in the local region. We argue that this is a threat to progressive community psychiatry beyond Trieste and Italy. It is important for us to join forces with international colleagues and organisations in the campaign to defend and preserve the current service model in Trieste.

scholarly journals The effect of a youth mental health service model on access to secondary mental healthcare for young people aged 14–25 years

2018 ◽  
Vol 43 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Sarah Maxwell ◽  
Obianuju Ugochukwu ◽  
Tim Clarke ◽  
Brioney Gee ◽  
Emmet Clarke ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Youth Mental Health ◽  
Service Model ◽  
Youth Service

Aims and methodThe Norfolk Youth Service was created in 2012 in response to calls to redesign mental health services to better meet the needs of young people. The new service model transcends traditional boundaries by creating a single, ‘youth friendly’ service for young people aged 14–25 years. The aim of this study was to investigate the effect of the transition to this new model on patterns of referral, acceptance and service use. We analysed routinely collected data on young people aged 14–25 years referred for secondary mental healthcare in Norfolk before and after implementation of the youth mental health service. The number of referrals, their age and gender, proportion of referrals accepted and average number of service contacts per referral by age pre- and post-implementation were compared.ResultsReferrals increased by 68% following implementation of the new service model, but the proportion of referrals accepted fell by 27 percentage points. Before implementation of the youth service, there was a clear discrepancy between the peak age of referral and the age of those seen by services. Following implementation, service contacts were more equitable across ages, with no marked discontinuity at age 18 years.Clinical implicationsOur findings suggest that the transformation of services may have succeeded in reducing the ‘cliff edge’ in access to mental health services at the transition to adulthood. However, the sharp rise in referrals and reduction in the proportion of referrals accepted highlights the importance of considering possible unintended consequences of new service models.Declaration of interestsNone.

Clinical risk assessment rating and all-cause mortality in secondary mental healthcare: the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) Case Register

2011 ◽  
Vol 42 (8) ◽  
pp. 1581-1590 ◽  
Author(s):  
C.-Y. Wu ◽  
C.-K. Chang ◽  
R. D. Hayes ◽  
M. Broadbent ◽  
M. Hotopf ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Healthcare ◽  
Research Centre ◽  
Case Register ◽  
All Cause Mortality ◽  
Unit Increase ◽  
Clinical Risk Assessment

BackgroundMental disorders are widely recognized to be associated with increased risk of all-cause mortality. However, the extent to which highest-risk groups for mortality overlap with those viewed with highest concern by mental health services is less clear. The aim of the study was to investigate clinical risk assessment ratings for suicide, violence and self-neglect in relation to all-cause mortality among people receiving secondary mental healthcare.MethodA total of 9234 subjects over the age of 15 years were identified from the South London and Maudsley Biomedical Research Centre Case Register who had received a second tier structured risk assessment in the course of their clinical care. A cohort analysis was carried out. Total scores for three risk assessment clusters (suicide, violence and self-neglect) were calculated and Cox regression models used to assess survival from first assessment.ResultsA total of 234 deaths had occurred over an average 9.4-month follow-up period. Mortality was relatively high for the cohort overall in relation to national norms [standardized mortality ratio 3.23, 95% confidence interval (CI) 2.83–3.67] but not in relation to other mental health service users with similar diagnoses. Only the score for the self-neglect cluster predicted mortality [hazard ratio (HR) per unit increase 1.14, 95% CI 1.04–1.24] with null findings for assessed risk of suicide or violence (HRs per unit increase 1.00 and 1.06 respectively).ConclusionsLevel of clinician-appraised risk of self-neglect, but not of suicide or violence, predicted all-cause mortality among people receiving specific assessment of risk in a secondary mental health service.

scholarly journals Mental health service activity during COVID-19 lockdown among individuals with potential neurodevelopmental disorders: South London and Maudsley data on services and mortality from January to July 2020

2020 ◽  
Author(s):  
Evangelia Martin ◽  
Eleanor Nuzum ◽  
Matthew Broadbent ◽  
Robert Stewart
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Neurodevelopmental Disorders ◽  
Mental Healthcare ◽  
Home Treatment ◽  
Treatment Team ◽  
Health Service Provider ◽  
Data Resource ◽  
Face To Face

AbstractThe lockdown and social distancing policy imposed due to the COVID-19 pandemic is likely to have had a widespread impact on mental healthcare service provision and use. Previous reports from the South London and Maudsley NHS Trust (SLaM; a large mental health service provider for 1.2m residents in South London) highlighted a shift to virtual contacts among those accessing community mental health and home treatment teams and an increase in deaths over the pandemic’s first wave. However, there is a need to quantify this for individuals with particular vulnerabilities, including those with learning disabilities and other neurodevelopmental disorders. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource with 24-hourly updates of electronic mental health records data, this paper describes daily caseloads and contact numbers (face-to-face and virtual) for individuals with potential neurodevelopmental disorders across community, specialist, crisis and inpatient services. The report focussed on the period 1st January to 31st July 2020. We also report on daily accepted and discharged trust referrals, total trust caseloads and daily inpatient admissions and discharges for individuals with potential neurodevelopmental disorders. In addition, daily deaths are described for all current and previous SLaM service users with potential neurodevelopmental disorders over this period. In summary, comparing periods before and after 16th March 2020 there was a shift from face-to-face contacts to virtual contacts across all teams. The largest declines in caseloads and total contacts were seen in Home Treatment Team, Liaison/A&E and Older Adult teams. Reduced accepted referrals and inpatient admissions were observed and there was an 103% increase in average daily deaths in the period after 16th March, compared to the period 1st January to 15th March (or a 282% increase if the 2-month period from 16th March to 15th May was considered alone).

scholarly journals A hidden activism and its changing contemporary forms: Mental health service users / survivors mobilising

2018 ◽  
Vol 6 (2) ◽  
pp. 728-744 ◽  
Author(s):  
Diana Rose
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Community Psychology ◽  
Mental Distress ◽  
Psychological Problem ◽  
Service Users ◽  
Welfare Benefits ◽  
The World ◽  
The Uk

This commentary concerns how the organisation of State welfare benefits in the UK have changed over the last 20 years, arguing that this has had harmful, even fatal, consequences for people with disabilities and particularly those with mental distress of psychosocial disabilities. This current situation may be called that of austerity. The paper describes how a ‘hidden activism’ has emerged to contest this situation and explains why it is, and to a degree, must be hidden. I then focus on the discourse of responsibilisation where every citizen must take responsibility for embodying the virtues of the good, working person. To ensure this, unemployment has been framed as a psychological problem and psychologists are now employed to ‘treat’ this problem in order that everybody might enter the world of work. I argue that in current conditions this is not possible for all with mental distress. Engaging then with community psychology, I address the issue of allies and how the absence of attention to mental distress might be remedied by this form of work. I draw on the emerging field of user / survivor-led research in mental health and argue that collaboration with community psychology will not be without problems.

Occupational health in mental health services: a qualitative study

2019 ◽  
Vol 13 (1) ◽  
pp. 32-44
Author(s):  
Jennifer Oates ◽  
Rasiha Hassan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Occupational Health ◽  
Lived Experience ◽  
Mental Healthcare ◽  
Working Environment ◽  
Small Scale ◽  
Structured Interviews ◽  
Content Type

Purpose The purpose of this paper is to explore occupational health (OH) clinicians’ perspectives on employee mental health in the mental health workplace in the English National Health Service. Design/methodology/approach Thematic analysis of data from seven semi-structured interviews is performed in this paper. Findings Three themes emerged under the core theme of “Situating OH services”: “the Uniqueness of the mental health service setting”, “the Limitations of OH services” and “the Meaning of mental health at work”. An important finding came from the first theme that management referrals in mental health may be due to disputes about workers’ fitness to face violence and aggression, a common feature of their working environment. Research limitations/implications This was a small scale study of a previously unresearched population. Practical implications These findings should be used to refine and standardise OH provision for mental healthcare workers, with a particular focus on exposure to violence and workers’ potential “lived experience” of mental illness as features of the mental health care workplace. Originality/value This is the first study to explore OH clinicians’ perspectives on the mental health service working environment.

scholarly journals The crucible of co-production: Case study interviews with Recovery College practitioner trainers

2019 ◽  
Vol 78 (8) ◽  
pp. 977-987
Author(s):  
Mark Dalgarno ◽  
Jennifer Oates
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Single Site ◽  
Future Research ◽  
Service Users ◽  
Structured Interviews

Objectives: This study explored healthcare professionals’ accounts of being practitioner trainers in a mental health Recovery College, where they worked with peer trainers, who were people with lived experience of mental illness, to co-produce workshops for mental health service users and staff. The aim of this study was to understand the process of co-production in the Recovery College from the perspective of practitioner trainers. Design: Single-site case study. Setting: A Recovery College in the South of England, open to staff and service users from one mental health care provider organisation. Methods: Semi-structured interviews with eight mental healthcare professionals. Transcripts were thematically analysed. Results: A central image of ‘the workshop as crucible’ emerged from the three themes derived from the analysis. Co-facilitating the workshop was a ‘structured’ encounter, within which health professionals experienced ‘dynamism’ and change. For them, this involved experiences of ‘challenge and discomfort’. Conclusion: Findings from this study contribute to the evidence base for the evaluation of Recovery Colleges by focusing on the training impact on staff. Findings suggest that taking on a trainer role in Recovery College co-production is beneficial for healthcare professionals as well as mental health service users, especially if healthcare professionals are open to the dynamism and possible discomfort of these workshop encounters. Future research, however, should expand beyond single-site case studies to test the extent to which this metaphor and themes are appropriate to describing the ‘transformative’ element of co-production.

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