The future of services for the chronically mentally ill: a priority case?

1993 ◽  
Vol 17 (10) ◽  
pp. 582-585 ◽  
Author(s):  
Som D. Soni ◽  
Rafeek F. Mahmood ◽  
Anant Shah
Keyword(s):  
Mental Illness ◽  
National Health Service ◽  
Health Service ◽  
Royal College ◽  
Mentally Ill ◽  
Psychiatric Care ◽  
Economic Cost ◽  
High Quality ◽  
High Prevalence

Research into delivery of psychiatric care has shown that the chronic mentally ill (CMI) patients continue to pose major difficulties not only in terms of economic cost to patients, their families and the state but also in the ability of authorities to provide adequate facilities in the community. The latter is especially important now because of rapid discharge of patients into the community from long-stay wards of mental hospitals, often with little rehabilitative preparation and even less consideration of the effects of the environment into which they are relocated. Although follow-up in some cases has been of exceptionally high quality, a majority have filtered through the network into inadequate residence; this surely is unacceptable. The high prevalence of mental illness among the homeless and the difficulties of providing care for them by an inflexible health service have been highlighted by a recent report of the Royal College of Psychiatrists (Bhugra et al, 1991). This paper attempts to define the possible adverse consequences of the recent reorganisation of National Health Service (NHS) on the care of the chronic mentally ill.

scholarly journals Scottish rehabilitation services: eight year follow-up

1993 ◽  
Vol 17 (6) ◽  
pp. 341-344
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson ◽  
Lesley J. Robertson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mentally Ill ◽  
Support Services ◽  
Psychiatric Rehabilitation ◽  
Rehabilitation Services ◽  
Local Authorities

A survey of Scottish psychiatric rehabilitation and support services, carried out in 1983 (McCreadie et al, 1985), found that although there were wide between-hospital differences, the National Health Service in Scotland was making considerable efforts to provide services for the long-term mentally ill. However, services provided by local authorities were seriously deficient.

Psychiatric Out-Patients in Plymouth—An Area Service Analysed

1965 ◽  
Vol 111 (470) ◽  
pp. 10-17 ◽  
Author(s):  
Neil Kessel ◽  
Christine Hassall ◽  
Robert Blair ◽  
John M. Gilroy ◽  
Francis Pilkington ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Community Care ◽  
Psychiatric Patients ◽  
Patient Department

Out-patient services in Britain for psychiatric patients have expanded enormously under the National Health Service. Well over half a million patients are seen at clinics annually. Concomitant with this increase the out-patient department has changed in function. No longer is it principally concerned with providing follow up and support for discharged mental hospital in-patients; instead, because of the greatly increased demand for psychiatric care for less severe disorders and under the influence of the movement for community care it now should play a part not at all subservient to the in-patient department. The clinic, properly run, should be an arena of treatment in its own right.

scholarly journals Who uses a day hospital and for how long?

1989 ◽  
Vol 13 (2) ◽  
pp. 62-65
Author(s):  
M. Conway ◽  
I. A. Davidson ◽  
M. E. Dewey
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Mentally Ill ◽  
Day Care ◽  
Regional Variation ◽  
Psychiatric Care ◽  
Essential Element ◽  
Day Hospital ◽  
Mentally Disordered ◽  
Care Facilities

The dichotomy caused by the National Health Service Act, Section 28, which split the responsibility for the mentally disordered between the Minister of Health and local authorities has remained with us. Along with a separate GP service this dichotomy has caused inconsistencies, confusion and overlap in day care facilities. Although psychiatric day care has now become accepted as an essential element in the comprehensive psychiatric care of the mentally ill, its development has been unplanned and there is a great regional variation (Vaughan, 1983).

scholarly journals Licensing and Physician Mental Health: Problems and Possibilities

2007 ◽  
Vol 93 (2) ◽  
pp. 6-11
Author(s):  
Herbert Hendin ◽  
Charles Reynolds ◽  
Dan Fox ◽  
Steven I. Altchuler ◽  
Phillip Rodgers ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Medical Care ◽  
Help Seeking ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Health Related ◽  
Seeking Help ◽  
Medical License

ABSTRACT A number of factors appear to discourage physicians from seeking help for mental illness. This reluctance may be exacerbated by fears – well-founded or imagined – that by seeking help, physicians may put their medical license in jeopardy. To examine this risk, an analysis of all state medical board (SMB) license applications was followed by a seven-item survey mailed to SMB executive directors, and 70 percent responded. Follow up interviews were conducted with a sample of those not responding and also with a small group of directors whose responses were problematic. Thirteen of the 35 SMBs responding indicated that the diagnosis of mental illness by itself was sufficient for sanctioning physicians. The same states indicated that they treat physicians receiving psychiatric care differently than they do physicians receiving medical care. In follow-up interviews all 13 indicated that without evidence of impairment or misrepresentation any such sanctioning was likely to be temporary. A significant percentage (37 percent) of states sanction or have the ability to sanction physicians on the basis of information revealed on the licensing application about the presence of a psychiatric condition rather than on the basis of impairment. The same percentage state they treat physicians receiving psychiatric care differently than they do those receiving medical care. Physicians’ perceptions of this apparent discrimination is likely to play a role in their reluctance to seek help for mental health-related conditions. Suggestions are made for how SMBs and state physician health programs and state and county medical societies might collaborate in ways that while protecting patients decreases barriers to physicians help seeking.

scholarly journals The Health Service Ombudsman

1994 ◽  
Vol 18 (11) ◽  
pp. 694-695
Author(s):  
R.A. Oswald
Keyword(s):  
Mental Illness ◽  
Health Service ◽  
Mentally Ill ◽  
Professional Standards ◽  
Local Management ◽  
Independent Investigation ◽  
Care And Treatment

“We have no credibility”. That was the response of a woman with a mental illness who put a complaint to the Health Service Ombudsman. Unlike many – not just patients but also a significant number of NHS staff – she had heard that the Ombudsman could carry out a completely independent investigation of complaints although she was not clear about the extent of his jurisdiction. Some people feel intimidated when trying to take on what they see as a powerful and defensive NHS and others experience a sense of despair that because of their illness their concerns have no validity. Those providing care and treatment generally do the best they can to attain high professional standards but delivery does not always match expectations and the outcome can be a complaint. Services for the mentally ill are not immune from shortcomings and, if local management fails to satisfy the complainant, the Ombudsman can step in.

scholarly journals Stigma 1, Psychiatrists 0

1999 ◽  
Vol 23 (7) ◽  
pp. 430-430 ◽  
Author(s):  
Geoffrey Searle
Keyword(s):  
Mental Illness ◽  
Public Education ◽  
Royal College ◽  
Mentally Ill ◽  
The Public ◽  
Education Campaign ◽  
Public Education Campaign ◽  
The Media

I think I can honestly say that I am a seasoned complainer, although I am careful not to attempt to be Mary Whitehouse and I do not assiduously scan the media looking for trouble. My interest in the area of stigmatization started with an episode of the TV drama Boon, where they suddenly had a character become ‘mentally ill’ so that he could conveniently shoot the hero to achieve a cliff-hanging end-of-series episode. Subsequently I specialised in the portrayal of mental illness in dramatic productions, joined the Public Education Campaign divisional network and had some media training. I have been listed as an expert in the portrayal of mental illness for five years but have never been approached for my advice on this area. However, following this year's announcement of the new Royal College of Psychiatrists' campaign ‘Changing Minds: Every Family in the Land’, I obtained all the names and addresses in Deborah Hart and Jill Phillipson's article above and stood ready to ‘do my bit’ for truth and honesty.

scholarly journals CPD and the portfolio psychiatrist

2007 ◽  
Vol 13 (3) ◽  
pp. 157-160 ◽  
Author(s):  
John Gunn
Keyword(s):  
Professional Development ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Royal College ◽  
Peer Group ◽  
Flexible Approach

As the age at which psychiatrists leave the National Health Service falls, and as the importance of CPD grows, there is an increasing urgency to assist the professional development and the licensing of portfolio practitioners. A survey undertaken to gain an impression of the experiences of this group of members of the Royal College of Psychiatrists highlighted considerable difficulties for some. Recommendations are made here both for individual members and for the CPD structures within the College. In particular, it is suggested that the College help with the appraisal of members who are outside managed organisations and that enhanced responsibilities be given to regional CPD coordinators. Individual members should see the peer group as the centre of their CPD activities, take a flexible approach to their own CPD, and advise other members of their peer group accordingly.

Memorandum on Amalgamation of Psychiatric with General Hospital Groups

1967 ◽  
Vol 113 (495) ◽  
pp. 235-237 ◽  
Keyword(s):  
Mental Illness ◽  
National Health Service ◽  
Health Service ◽  
General Hospital ◽  
National Health ◽  
Psychiatric Hospitals ◽  
Mental Subnormality

At the inception of the National Health Service, most of the large psychiatric hospitals were constituted independent administrative “Groups”. In some cases a mental and a mental subnormality hospital, or two mental subnormality hospitals were joined to form a Group; and a number of the smaller psychiatric hospitals (either for mental illness or for mental subnormality) were attached to Groups consisting mainly of general and specialist hospitals for bodily diseases.

scholarly journals Translating the Strengthening and Stretching for Rheumatoid Arthritis of the Hand Programme from clinical trial to clinical practice: An effectiveness–implementation study

Hand Therapy ◽  
2020 ◽  
Vol 25 (3) ◽  
pp. 87-97
Author(s):  
Esther Williamson ◽  
Cynthia Srikesavan ◽  
Jacqueline Thompson ◽  
Eda Tonga ◽  
Lucy Eldridge ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Routine Care ◽  
Service Organizations ◽  
Implementation Study ◽  
Health Service Organizations

Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand programme is a hand exercise programme for people with rheumatoid arthritis. It was clinically effective when delivered during a clinical trial but there was a need to evaluate translation into routine care. Methods We conducted an effectiveness–implementation study. We adapted the trial training into an online format for National Health Service hand therapists. Educational outcomes included confidence and capability to deliver the programme. Implementation outcomes included training reach and adoption. Therapists were invited to collect clinical outcomes. Patients receiving the programme provided data on function (Michigan Hand Questionnaire function scale), pain and grip strength at baseline, treatment discharge and four-month follow-up. Results A total of 790 therapists (188 National Health Service organizations) enrolled in the training; 584/790 (74%) therapists (162 National Health Service organizations) completed the training; 448/790 therapists (145 National Health Service organizations) (57%) evaluated the training and were confident (447/448, 99.8%) and capable (443/448, 99%) to deliver the programme with 85% intending to adopt it (379/448). Follow-up data were provided by 116/448 (26%) therapists. Two-thirds (77/116; 51 National Health Service organizations) reported adopting the programme. One hundred and eighteen patients (15 National Health Service trusts) participated. Patients reported improved function (mean change Michigan Hand Questionnaire scores: 10 (95% CI 6.5–13.6) treatment discharge; 7 (95% CI 3.8–10.2) 4-month follow-up). Grip strength increased 24.5% (left) and 31% (right). Pain was stable. Discussion Online training was an effective way to train therapists with good reach. Clinical outcomes were similar to the clinical trial providing preliminary evidence of successful translation into routine care.

scholarly journals The expansion of the Foundation Programme in psychiatry

2016 ◽  
Vol 40 (4) ◽  
pp. 223-225 ◽  
Author(s):  
Jennifer Perry ◽  
Ann Boyle ◽  
Simon Wessely
Keyword(s):  
Mental Illness ◽  
Communication Skills ◽  
Royal College ◽  
Multidisciplinary Teams ◽  
High Quality ◽  
Career Intentions ◽  
Future Career ◽  
Foundation Programme

SummaryThe Broadening the Foundation Programme report has led to an expansion in the number of psychiatry foundation placements. This change will have far-reaching benefits for foundation doctors doing psychiatry, no matter what their future career intentions. Doctors will develop a better understanding of mental illness, they will improve their communication skills and they will gain experience of working within multidisciplinary teams. Recruitment into psychiatry is also likely to improve. The Royal College of Psychiatrists is putting in place a number of measures to ensure that placements are of a high quality so that foundation doctors have a good experience of psychiatry.

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