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.

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.

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.

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.

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 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.

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.

The beginning of a structural reform:Reorganising the front line of a mental health service

2000 ◽  
Vol 23 (1) ◽  
pp. 64 ◽  
Author(s):  
Margaret Tobin ◽  
Grances Yeo ◽  
Luxin Chen
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Front Line

National and State priorities for mental health services have directed emphasis towards earlyintervention and prevention. One of the key priorities is to ensure that entry to mental healthservices is efficient, effective and accountable. This study describes the process of restructuringthe front line of a large and complex mental health service. Adopting the total qualitymanagement approach, all stakeholders in the service collaboratively developed a single setof protocols and guidelines to achieve standardisation of documentation, assessment of risksand urgency, and to improve the overall quality of the service.

Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Derek K. Tracy ◽  
Frank Holloway ◽  
Kara Hanson ◽  
Nikita Kanani ◽  
Matthew Trainer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Integrated Care ◽  
Healthcare Delivery ◽  
Local Implementation ◽  
The Past ◽  
Care Systems

SUMMARY Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.

scholarly journals Mental health services in Luxembourg: an overview

2021 ◽  
pp. 1-3
Author(s):  
Anja Malmendier-Muehlschlegel ◽  
Niamh Catherine Power
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Care ◽  
Social Care ◽  
Medical Training ◽  
Social Health Insurance ◽  
Social Health ◽  
Medical Workforce ◽  
The Past

We describe mental health services in Luxembourg and how they have evolved over the past 50 years. Health services in Luxembourg are provided through a social health insurance-based system and mental health services are no exception. Additional services are offered through mixed-funding avenues drawing on social care budgets in the main. Luxembourg is closely connected with neighbouring countries, where a large proportion of its workforce live. No run-through medical training exists and the entire medical workforce, including psychiatrists, have trained in other countries. This is reflected in a rich but often non-uniform approach to the provision of psychiatric care.

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