scholarly journals Developing case management for the long-term mentally ill

1993 ◽  
Vol 17 (7) ◽  
pp. 409-411 ◽  
Author(s):  
Richard Ford ◽  
Alan Beadsmoore ◽  
Paul Norton ◽  
Anna Cooke ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Care ◽  
Chronically Ill ◽  
Integrated Services ◽  
Psychiatric Services ◽  
Health Policies ◽  
Mental Health Policies ◽  
Bed Numbers

Mental health policies and the focus of psychiatric services have shifted over the last three decades from hospital to community care. Greater care in the community and reduced psychiatric bed numbers have contributed to the discharge or non-admission of many patients with severe and persistent disorders who formerly would have been cared for in hospital. Increasing numbers of the chronically ill in the community will necessitate the development of systems to provide continuous and integrated services for such people.

scholarly journals Using Fraser’s model of ‘progressive neoliberalism’ to analyse deinstitutionalisation and community care

2020 ◽  
Vol 8 (1) ◽  
pp. 77-93
Author(s):  
Ian Cummins
Keyword(s):  
Mental Health ◽  
Community Care ◽  
Free Market ◽  
Mental Health Policy ◽  
Health Policies ◽  
Economic Policies ◽  
Health Service Provision ◽  
The Uk ◽  
Mental Health Service Provision ◽  
Mental Health Policies

This article will argue that Nancy Fraser’s (2017, 2019) notion of ‘progressive neoliberalism’ provides a conceptual lens that can be effective in the development of a critical analysis of mental health policy in England and Wales during the period of deinstitutionalisation and community care. Mental health policies that came steeped in an originally progressive discourse of choice, empowerment and wider service user rights were introduced by governments largely committed to the free market. In the UK and US, this produced a contradictory position where moves towards a community-oriented vision of mental health service provision were overseen by administrations that were committed to a small state and fiscal conservatism. There were similar developments in other areas. Fraser (2017, 2019) terms this mixture of socially progressive rhetoric and market economics ‘progressive neoliberalism’. Fraser’s model of progressive neoliberalism argues that neoliberalism has colonised progressive discourses. The article outlines this theoretical model and then applies it to the development of community care. It argues that policy responses to the perceived failings of community care focused on increased powers of surveillance, including the introduction of legislation that allows for compulsory treatment in the community. This focus on legislation was at the expense of social investment. The article concludes that the introduction of austerity in the UK has strengthened these trends. For example, The Coalition government (2010‐15) introduced new mental health policies such as ‘No decision about me without me’, which emphasised inclusive approaches to service organisation and delivery. At the same time, it followed social and economic policies that increased inequality, reduced welfare payments and entitlements, and cut services. These are all factors that contribute to higher levels of mental distress across society.

scholarly journals “Pay attention when turning a corner”: an overview of mental health policies in Brazil

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Naomi Sordan Borghi ◽  
Igor Euflauzino ◽  
Maria Alice Silva Ferraz de Araújo
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Historical Context ◽  
Health Policies ◽  
Model Of Care ◽  
Health Politics ◽  
Mental Health Patients ◽  
History Of ◽  
The Individual ◽  
Mental Health Policies

Introduction: Brazilian’s history of psychiatric care is complex and has some dark periods, but the country managed to get international recognition for its mental health policies in the last years. Those have been currently suffering setbacks. Purpose: Review the historical context of mental health in Brazil, assessing the changes made after 2016, and carry out a critical analysis of the current inclination. Methodology: literature and narrative review using official governmental documents. Results and Discussion: Through its history, Brazil’s had ups and downs in the care of mental health patients. After almost 30 years of policies that are centered around the individual, and not only the individual’s disease, the hospitalocentric model of care has been subtly making its comeback, together with normatives that revogue rights before acquired and corroborates with segregation of the mentally ill. Conclusions: The current changes in the Mental Health politics are not walking alongside the line with movements responsible for the implementation of a biopsychosocial care. It provokes and invites us to continue fighting for fair health programs and for the continuation of the Universal Health System

scholarly journals The role of long term care centers in the Polish system of mental health care

2018 ◽  
Vol 19 (1) ◽  
pp. 30-40
Author(s):  
Krzysztof Siejko ◽  
Aneta Tylec ◽  
Halina Dubas-Ślemp ◽  
Piotr Książek ◽  
Bartłomiej Drop ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Community Care ◽  
Care Center ◽  
Term Care ◽  
Health Care Center

Abstract Objective: The aim of this work is to review the role of mental health care center and treatment center specialized in psychiatry in the Polish system of mental health care as a whole. Review: For many years in Poland, the process of transformation of psychiatric care model from the institutional (inpatient setting, most expensive) to community care model (personalized, much cheaper), has been taking place. The effective - coordinated system of community care should significantly improve cooperation in the treatment, while the community forms of health care should ensure full availability, complexity, and continuity of care provision. In many cases, the community support is inadequate and cannot provide patient with care at his home environment. For mentally ill, there may be a need for the use of the long term health care centers specialized in psychiatry. Conclusions: A long term mental health care center specialised in mental health plays an important role in long-term care for the mentally ill. As far as a mental health service user’s perspective is concerned, the continuity of care and treatment in the long term health care center (as a health care unit) appears to be more useful and satisfying compared to a residential home for people with chronic mental illnesses. There is a need for broad discussion on the special place of the long term health care center specialized in psychiatry in the present Polish system of mental health care and on the improving of care pathways between inpatient-, day care-and, community care package.

scholarly journals Mental health policy issues and development in Lithuania

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I R Rubikas
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Mental Health Policy ◽  
Well Being ◽  
Health Impact ◽  
Health Policies ◽  
Social And Emotional ◽  
Suicide Rates ◽  
Mental Health Policies ◽  
The Eu

Abstract Background Lithuanian has experienced rapid and relatively successful transition to capitalism and transatlantic-Western values and practices in recent decades. Suicide and legal alcohol consumption rates remain the highest in the EU and OECD, and Lithuania's Positive emotions index score has been consistently amongst the 10 lowest in the world in recent years. Emigration rate is the highest in the EU and OECD, social inequality is amongst the highest in the same groups. Despite a relatively strong economy these changes are not automatically transferred to better social and emotional well-being. Methods This unconventional situation calls for strong and unconventional policy responses in the area of mental health, amongst others. Health impact assessment using theory-based approach and desk research. Results Recent attempts include strategic reorientation towards social and emotional well-being, stronger focus on prevention and promotion and primary care, intensifying efforts to reduce suicide rates, and implementation of strong regulatory measures to reduce alcohol use. Suicide rates have been declining since 2013 but remain high. Effort is made to implement best practices in media reporting, recognition and providing appropriate help for those in suicide crisis, expanding prevention efforts. Conclusions Finally, WHOs “best buys” in alcohol control were implemented since 2017, including steep increases in excise taxes, ban on alcohol advertisement, increase of allowed age, reducing alcohol trading hours and others. This resulted in the steepest decline of legal alcohol consumption in decades. The chosen policy route may be called iterative policy-making, whereby improvements are made along the way, which allows for quicker policy decisions and results. Key messages Mental health policies need to be based on the socio-political context of the specific country. Smaller countries such as Lithuania might benefit form flexible approaches to mental health policies.

scholarly journals 18.L. Workshop: Public mental health policies - experiences and challenges

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Policy ◽  
Participatory Research ◽  
Policy Development ◽  
Mental Health Policy ◽  
Public Mental Health ◽  
Health Policies ◽  
National Mental Health ◽  
Mental Health Policies

Abstract The workshop has the aim to help developing and strengthening policies for Public Mental Health and support experience sharing platform for Public Mental Health policy development. Mental health policy defines the vision for the future mental health of the national population and internationally. The WHOs developed three recommendations for the development of mental health policy, strategic plans and for organizing services which are to deinstitutionalise mental health care; to integrate mental health into general health care; and to develop community mental health services. For each this aim a situational analysis and needs assessment is recommended as first step. Therefore, this workshop consists of four talks in the development of mental health policies at the regional and national level. First, the process of population consultations and participatory research is described (Felix Sisenop). Participatory research enables exchanging experiences, results and key challenges in Public Mental Health. Participatory research can contribute greatly in empowering people to discuss and deal with mental health issues and therefore is a step towards a more involved and active general public. Second, a policy development at the regional level is described (Elvira Mauz). On behalf of the federal ministry of health the Robert Koch Institute as the German public health institute is currently developing a concept for a national Mental Health Surveillance (MHS). In the talk objectives, framework model and work processes are presented. The MHS should systematically gather, process and analyze primary and secondary data, thus an integrating and monitoring system is working. Third, the Public Mental Health policy in Malta will be described (John Cachia) Over the last 7 years CMH Malta developed a strategic framework for the mental health with the input of patients, families, service providers, NGOs and civil society. The Maltese National Mental Health Strategy 2020-2030 was published in July 2019. This strategy will be described in the Talk. Fourth presenter (Ignas Rubikas) will introduce the national perspective on development of Lithuanian mental health policy addressing major public mental health challenges of suicide prevention, alcohol control policies and mental health promotion in a broader context of national mental health care. Key messages Participatory research in Public Mental Health is an approach to involve the population in policy development. Development of mental health policies can benefit from sharing experiences and lessons learned on a national and regional levels.

The DEMoBinc Study in Portugal: Development and First Results

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Cardoso ◽  
C. Coelho ◽  
J. Caldas de Almeida
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Residential Care ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Physical Restraint ◽  
National Literature ◽  
Standards Of Care ◽  
Delphi Exercise

The DEMoBinc study's main objective is to develop an instrument for assessing the living conditions, the quality of care, and the human rights of long-term mentally ill patients in psychiatric and social residential care. It started on March 2007, with 11 centres and 10 countries participating.The Portuguese centre has carried out a national literature review of mental health legislation, standards of care related with residential care for mental patients, and mandatory procedures for physical restraint and seclusion.A three-round Delphi exercise with four groups of experts - advocates, mental health professionals, service users, and carers - was also developed. In the first round the participants were asked to state the ten more important components of care helping recovery in institutional care for the long-term mentally ill. The results were sent back to be rated for their importance on a 5-point scale. Finally, the participants were asked to confirm or change their own scores in comparison with the calculated group median. Between twelve and 18 participants by group were contacted, and the overall rate of participation was 73%.A pilot study using the first draft of the DEMoBinc instrument was done, and refinement of the instrument is being carried out in twenty institutions and will be completed during the next months.The results of the Portuguese centre on the national literature review, the Delphi exercise, and the first phase refinement of the DEMoBinc instrument will be presented and discussed.

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