scholarly journals Full metal jacket or the emperor's new clothes?

2000 ◽  
Vol 24 (6) ◽  
pp. 207-210 ◽  
Author(s):  
Martin Deahl ◽  
Brian Douglas ◽  
Trevor Turner
Keyword(s):  
Mental Health ◽  
Reference Group ◽  
Good Practice ◽  
Self Regulation ◽  
Developmental Factors ◽  
General Psychiatry ◽  
Department Of Health ◽  
Severely Mentally Ill ◽  
National Service Framework ◽  
Professional Self

Launched with little more than a whimper during the Labour Party Conference the much vaunted National Service Framework for Mental Health (NSF–MH) outlines the Government's ‘ambitious agenda’ for mental health services (Department of Health, 1999a). The official driving force has been the desire to deliver a quality service throughout the whole NHS via clinical governance and underpinned by professional self-regulation. Developed following widespread consultation and with the advice of the External Reference Group (although some of this advice was clearly disregarded), the NSF–MH provides a series of seven core standards with examples of good practice. Although developed with general psychiatry and severe mental illness in mind, the NSF is not quite the ‘National Schizophrenia Framework’ that some envisaged, since it also acknowledges the needs of young people and the influence of developmental factors on adult mental health. The NSF–MH sets standards in five areas: mental health promotion, primary care and access to services, services for the severely mentally ill, caring about carers and preventing suicide. It is only the second to be published (the other being for coronary care) which is hopefully a reflection of the ‘priority’ once more being given to mental health. However, the near-simultaneous appointment of a cancer ‘tsar’ suggests that ‘priority’ is a readily used and easily diluted term.

scholarly journals Alternative Perceptions of Statutory Community Aftercare: Patient and Responsible Medical Officer Views

2014 ◽  
pp. 119
Author(s):  
Sharon Riordan ◽  
Helen Smith ◽  
Martin Humphreys
Keyword(s):  
Mental Health ◽  
Policy Development ◽  
Effective Means ◽  
Medical Officer ◽  
Health Care Research ◽  
Mentally Disordered ◽  
Department Of Health ◽  
Severely Mentally Ill ◽  
National Service Framework ◽  
Conditional Discharge

The need for more effective means of caring for mentally disordered individuals in the community has been given a prominent place by the Department of Health. The inclusion of user perspectives in mental health care research, to inform and improve the development of services, has also been given a high priority and the necessity of incorporating patients’ and carers’ views has been recognised by the Department of Health in the National Service Framework for Mental Health published in 1999. Studies incorporating both the service user and professional viewpoints of statutory community care have been relatively sparse. This study, looking at the process of conditional discharge of restricted hospital order patients sought the views on the benefits, deficits and recommendations for change from those people providing and receiving statutory community aftercare. The findings may assist in any future review of the Mental Health Act, policy development and in the planning and delivery of psychiatric services to other groups of severely mentally ill people.

scholarly journals Acute wards: problems and solutions: Alternatives to acute wards: users' perspectives

2002 ◽  
Vol 26 (9) ◽  
pp. 346-347 ◽  
Author(s):  
Peter Relton ◽  
Phil Thomas
Keyword(s):  
Mental Health ◽  
Civil Rights ◽  
Mental Health Professionals ◽  
Government Policy ◽  
Evidence Base ◽  
Department Of Health ◽  
National Service Framework ◽  
Problems And Solutions ◽  
Restrictive Environment ◽  
Acute Wards

The move from institutional to community care in the second half of the twentieth century arose in a climate in which civil rights became increasingly prominent, and out of which the modern survivor movement grew (Campbell, 1996). Government policy for mental health services, as set out in Standard Five of the National Service Framework (NSF; Department of Health, 1999), requires that care should be provided in hospital, or an alternative in the least restrictive environment, and as close to home as possible. At the same time, Government policy also attaches increasing importance to the involvement of service users and carers in the planning, delivery and evaluation of services. This paper examines alternatives to hospital care from a user perspective. The problem is that the evidence base for the NSF largely consists of quantitative studies designed to answer questions of concern to mental health professionals. This tells us little about the perspectives of the service user, which is the strength and value of user-led research (Faulkner & Thomas, 2002). Much of what follows is taken from this area, but in addition we describe briefly our own experience of home treatment, which the NSF sets out as one of the main alternatives to in-patient care.

scholarly journals Delivering race equality in mental health services

2008 ◽  
Vol 14 (5) ◽  
pp. 326-329 ◽  
Author(s):  
Annie Lau
Keyword(s):  
Mental Health ◽  
Care Pathway ◽  
Action Plan ◽  
Good Practice ◽  
Mental Healthcare ◽  
Policy Initiatives ◽  
Pilot Survey ◽  
The Past ◽  
Department Of Health ◽  
Clinical Engagement

‘Delivering race equality’ is a 5-year action plan for tackling race inequalities in mental healthcare in England and Wales, based on the main themes of improved services, better community engagement and better information. The perception is that clinical teams have not been sufficiently engaged with the plan and progress is slow. This article shares insights from the author's work across government departments over the past 2 years and explores the potential for linking up different initiatives across the patient care pathway in support of the plan's delivery. A summary of conclusions from a pilot survey of consultant psychiatrists, commissioned by the Department of Health in June 2007, addresses the main controversial areas in the action plan, with suggestions for improvement. Areas for clinical engagement are identified that exploit new funding, investment and policy initiatives. Examples of good practice are offered.

scholarly journals National Service Framework for Mental Health

2000 ◽  
Vol 24 (6) ◽  
pp. 203-206 ◽  
Author(s):  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
National Service ◽  
Department Of Health ◽  
National Service Framework ◽  
Local Flexibility ◽  
Working Age ◽  
And Performance ◽  
The Given ◽  
Clear Statement ◽  
Service Framework

The National Service Framework for Mental Health (NSF–MH) is a strategic blueprint for services for adults of working age for the next 10 years. It is both mandatory, in being a clear statement of what services must seek to achieve in relation to the given standards and performance indicators, and permissive, in that it allows considerable local flexibility to customise the services which need to be provided to fit the framework. This paper summarises the process by which the NSF was created, and its content, which became clear when it was published on 30 September 1999 (Department of Health, 1999).

scholarly journals Creating the infrastructure for mental health research

2002 ◽  
Vol 26 (11) ◽  
pp. 403-406 ◽  
Author(s):  
Graham Thornicroft ◽  
Jonathan Bindman ◽  
David Goldberg ◽  
Kevin Gournay ◽  
Peter Huxley
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Research Agenda ◽  
Mental Health Research ◽  
National Service ◽  
Department Of Health ◽  
National Service Framework ◽  
Service Framework

The purpose of this paper is to identify the important gaps in research coverage, particularly in areas key to the National Service Framework for Mental Health (NSF-MH) (Department of Health, 1999) and the NHS Plan (Department of Health, 2000), and to translate these gaps into researchable questions, with a view to developing a potential research agenda for consideration by research funders.

Developing mental health services in response to research evidence

2008 ◽  
Vol 17 (1) ◽  
pp. 47-56 ◽  
Author(s):  
Helen Killaspy ◽  
Sonia Johnson ◽  
Michael King ◽  
Paul Bebbington
Keyword(s):  
Mental Health ◽  
Community Treatment ◽  
Local Context ◽  
Department Of Health ◽  
Home Based ◽  
Crisis Resolution Teams ◽  
National Service Framework ◽  
The Us ◽  
Satisfaction With Services ◽  
Service Framework

AbstractOver the last thirty to forty years, psychiatric care in England has relocated from hospital-based settings to community mental health teams (CMHTs) and supported accommodation. Since the 1980s, two forms of intensive home based treatment have evolved in addition to CMHTS, assertive community treatment (ACT) and crisis resolution teams (CRTs). On the basis of evidence for their efficacy in the US and other countries, they have been implemented across England through the Government's National Service Framework for Mental Health. This paper describes this evidence and the first UK studies that were carried out to evaluate these newly implemented services.Methods– Descriptions of the evaluations of ACT and CRTs in the inner London boroughs of Camden and Islington.Results– The implementation of CRTs in North London were associated with reduced use of inpatient services, but the ACT teams were not. Both types of team were associated with greater patient satisfaction with services and the ACTs were better able to engage patients than CMHTs.Conclusions– The authors comment on the implications of the findings for service planners in terms of the difficulties in implementing innovative approaches based on the best available evidence when it originates outside the local context.Declaration of Interest:These studies were funded by Camden and Islington Health Authority, the King's Fund and the Department of Health.

scholarly journals Researchable questions to support evidence-based mental health policy concerning adult mental illness

2002 ◽  
Vol 26 (10) ◽  
pp. 364-367 ◽  
Author(s):  
Graham Thornicroft ◽  
Jonathan Bindman ◽  
David Goldberg ◽  
Kevin Gournay ◽  
Peter Huxley
Keyword(s):  
Mental Health ◽  
Mental Health Policy ◽  
Health Department ◽  
Mental Health Research ◽  
Future Research ◽  
Policy Makers ◽  
Future Research Agenda ◽  
Department Of Health ◽  
National Service Framework ◽  
Mental Health Department

Policy makers find much mental health research irrelevant to their concerns. What types of research would directly assist those who formulate policy? The two purposes of this paper are (i) to identify important gaps in completed research, particularly in relation to the National Service Framework (NSF) for Mental Health (Department of Health, 1999a) and the NHS Plan (NHS Confederation, 2001); and (ii) to translate these gaps into researchable questions that can contribute to a debate about the future research agenda for general adult mental health in England.

scholarly journals Service innovations

2005 ◽  
Vol 29 (11) ◽  
pp. 428-430 ◽  
Author(s):  
Mark Hayward ◽  
Steve West ◽  
Moira Green ◽  
Alison Blank
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Good Practice ◽  
User Involvement ◽  
Service Users ◽  
Department Of Health ◽  
Considerable Confusion ◽  
Staff Recruitment ◽  
And Training

Health policy guidelines state that people who use mental health services should be involved in the development of the services they receive (Department of Health, 1999). Examples of good practice in this respect are reported from staff recruitment (Diamond et al, 2003), research (Trivedi & Wykes, 2002) and training (Repper, 2000; Harper, 2003). However, support for user involvement is not universal (Summers, 2003; Soffe, 2004) and, most significantly, there is considerable confusion about what is meant by involvement. The following case study will address these issues by: (a) adding to the evidence regarding the successful involvement of service users in training; and (b) clarifying the process by which involvement can be safely achieved.

scholarly journals Differences between specialist community adolescent mental health teams and generic child and adolescent mental health services: training issues for specialist registrars

2006 ◽  
Vol 30 (6) ◽  
pp. 232-233 ◽  
Author(s):  
Carmen Pinto
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Department Of Health ◽  
National Service Framework ◽  
First Onset ◽  
Age Range

Following the National Service Framework (Department of Health, 2004) recommendation of extending the age range of child and adolescent mental health services to 18 years there is an increasing expectation that these generic services will provide the comprehensive care for severe mental health problems in areas where specialist teams do not exist. Services have responded to this with a variety of teams from generic adolescent teams to smaller first-onset psychosis or assertive outreach teams.

scholarly journals Training implications of community-oriented psychiatry

2001 ◽  
Vol 7 (3) ◽  
pp. 208-215 ◽  
Author(s):  
K. Linsley ◽  
R. Slinn ◽  
R. Nathan ◽  
L. Guest ◽  
H. Griffiths
Keyword(s):  
Mental Health ◽  
Community Psychiatry ◽  
Health Department ◽  
Mental Health Needs ◽  
Community Based ◽  
Department Of Health ◽  
National Service Framework ◽  
Mental Health Department ◽  
Separate Discipline ◽  
Service Framework

Over the past 20–30 years psychiatry has gradually moved from predominantly hospital-based care to care in the community. Community psychiatry embraces a variety of definitions: it may describe the practice setting, the population served or the philosophy of illness and treatment (Johnston et al, 1995). In discussing the training implications of this shift towards community models of psychiatric care, we will not consider a separate discipline of ‘adult community psychiatry’. We believe that nearly all psychiatric specialities now involve substantial elements of work outside the hospital, and we therefore contend that the new skills, knowledge and attitudes required to meet the challenge of providing both hospital- and community-based care are pertinent to all trainees. Furthermore, the development of these are essential if the consultant of the future is to provide the safe, effective and sustainable service to those with complex mental health needs detailed in the recent National Service Framework (NSF) for Mental Health (Department of Health, 1999). We will also not attempt specifically to assess the merits of the move to community psychiatry, which may be subject to a separate debate.

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