scholarly journals Changing practices in mental health care: a lesson from America

1990 ◽  
Vol 14 (12) ◽  
pp. 730-732
Author(s):  
Tom Butler ◽  
Philip Thomas
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Service Delivery ◽  
Mental Health Care ◽  
Social Care ◽  
The Political ◽  
Rehabilitation Services ◽  
Health And Social Care ◽  
The Usa ◽  
Changing Practices

Health and social care in Britain is undergoing the most profound changes in its structure and organisation since its inception (Griffiths, 1988); indeed, some would argue that it is about to change beyond recognition. The purpose of this article is to describe contemporary developments in the delivery of such services in the USA. Given that many of the political changes here have been directly influenced by thinking and practice in that country, it is argued that there are two important lessons to be learnt. The first concerns the coordination of service delivery between different agencies, the second involves an emphasis on the delivery of acute and rehabilitation services in the community. In short the traditional distinctions between the two would be blurred.

scholarly journals Social care: an essential aspect of mental health rehabilitation services

2018 ◽  
Vol 28 (1) ◽  
pp. 4-8 ◽  
Author(s):  
T. J. Craig
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Care ◽  
Vital Role ◽  
Rehabilitation Services ◽  
Service Users ◽  
Personal Recovery ◽  
Social Interventions ◽  
The Individual

AbstractThis study is aimed at the importance of social care in rehabilitation. A brief overview of the social care theme is used as the methodology. There is a tension in mental health care between biological and psychological treatments that focus on deficits at the individual level (symptoms, disabilities) and social interventions that try to address local inequalities and barriers in order to improve access for service users to ordinary housing, employment and leisure opportunities. The history of mental health care tells us that social care is often underfunded and too easily dismissed as not the business of health care. But too much emphasis on a health model of individual deficits is a slippery slope to institutionalisation by way of therapeutic nihilism. Rehabilitation services follow the biopsychosocial model but with a shift in emphasis, recognising the vital role played by social interventions in improving the functional outcomes that matter to service users including access to housing, occupation, leisure facilities and the support of family and friends. In conclusion, rehabilitation is framed within a model of personal recovery in which the target of intervention is to boost hope and help the individual find a meaning to life, living well regardless of enduring symptoms.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed-methods study of mental health care staff

2021 ◽  
Author(s):  
C. A. Wilson ◽  
C. Dalton-Locke ◽  
S. Johnson ◽  
A. Simpson ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

AbstractThe aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (‘perinatal’ women). Secondary analysis was undertaken of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Delivery of perinatal care needs to be tailored to women’s needs; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed methods study of mental health care staff

2020 ◽  
Author(s):  
Claire A Wilson ◽  
Christian A Dalton-Locke ◽  
Sonia Johnson ◽  
Alan Simpson ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

Purpose: the aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (perinatal women). Methods: secondary analysis of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Results: staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Conclusions: delivery of perinatal care needs to be tailored to the needs of women; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

Depressions Plural

2017 ◽  
Author(s):  
K W M (Bill) Fulford ◽  
David Crepaz-Keay ◽  
Giovanni Stanghellini
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Personal Values ◽  
The Political ◽  
Medical Law ◽  
Isaiah Berlin ◽  
Political Philosopher

This chapter examines how values influence the heterogeneity of depression. The plurality of values is increasingly significant for contemporary person-centred mental health care with its emphasis on quality of life and development of self-manvnagement skills. Values-based practice is a partner with medical law invn working with the plurality of personal values. The chapter explains what values are, shows how the plurality of values influences the heterogeneity of depression at several levels, and provides an overview of values-based practice. It looks at the resources available for combining values-based practice with medical law in contemporary person-centred care and indicates some of the challenges this raises. It concludes with a brief reflection on these challenges understood as an instance of what the political philosopher Isaiah Berlin called the challenge of pluralism.

scholarly journals Efforts and Challenges to Ensure Continuity of Mental Healthcare Service Delivery in a Low Resource Settings During COVID-19 Pandemic—A Case of a Kenyan Referral Hospital

2021 ◽  
Vol 11 ◽  
Author(s):  
Edith Kwobah ◽  
Florence Jaguga ◽  
Kiptoo Robert ◽  
Elias Ndolo ◽  
Jane Kariuki
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Service Delivery ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Referral Hospital ◽  
Number Of Patients

The rising number of patients with Covid-19 as well as the infection control measures have affected healthcare service delivery, including mental healthcare. Mental healthcare delivery in low and middle income countries where resources were already limited are likely to be affected more during this pandemic. This paper describes the efforts of ensuring mental healthcare delivery is continued in a referral hospital in Kenya, Moi Teaching and Referral hospital, as well as the challenges faced. These efforts are guided by the interim guidelines developed by the Kenyan ministry of health. Some of the adjustments described includes reducing number of patients admitted, shortening the stay in the inpatient setting, using outdoors for therapy to promote physical distancing, utilization of electronic platforms for family therapy sessions, strengthening outpatient services, and supporting primary care workers to deliver mental health care services. Some of the challenges include limited ability to move about, declining ability for patients to pay out of pocket due to the economic challenges brought about by measures to control Covid-19, limited drug supplies in primary care facilities, inability to fully implement telehealth due to connectivity issues and stigma for mental health which results in poor social support for the mentally ill patients. It is clear that current pandemic has jeopardized the continuity of usual mental healthcare in many settings. This has brought to sharp focus the need to decentralize mental health care and promote community based services. Meanwhile, there is need to explore feasible alternatives to ensure continuity of care.

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