scholarly journals Inpatient mental healthcare in England and Wales: patterns in NHS and independent healthcare providers

2008 ◽  
Vol 101 (11) ◽  
pp. 544-551 ◽  
Author(s):  
Veena S Raleigh ◽  
Giovanna M Polato ◽  
Stephen A Bremner ◽  
Sunderjit Dhillon ◽  
Anthony Deery
Keyword(s):  
Mental Health ◽  
Information Systems ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
England And Wales ◽  
Current Information ◽  
Health And Social Care ◽  
The Uk

Summary Objectives Independent healthcare, most of it NHS-funded, provides a significant and growing proportion of inpatient mental healthcare in the UK, but information about patients in these providers is limited. This paper examines differences in the profiles of mental health inpatients in NHS and independent providers in England and Wales, and assesses whether current information systems are adequate for monitoring patient flows and care, given the plurality of service provision. Design Data from the national censuses of inpatients in mental health services in England and Wales in 2006 and 2007 were analysed to examine differences in demographic and other characteristics between inpatients in NHS and independent providers. Setting All NHS and independent providers of inpatient mental health services in England and Wales in 2006 and 2007. Main outcome measures Patients in independent providers were younger, 60% were on low/medium secure wards (compared with 16% in the NHS), they were 44% more likely to be detained and referrals were predominantly from NHS inpatient services. For all ethnic groups, ratios of detention on admission were higher in independent providers. Conclusions This analysis highlights differences between inpatients in NHS and independent providers of mental health services. We also highlight the inadequacy of current information systems for monitoring care, and the urgent need for standardized data across all NHS-commissioned mental healthcare, irrespective of whether it is publicly or privately provided. This is especially important in view of the increases in independent sector provision, and the specialist nature of their services. Such information is critical for commissioners, regulators of health and social care, and other audiences for monitoring patient flows, the quality of care provided, usage of the Mental Health Act 2007 and compliance with equality legislation.

scholarly journals Mental healthcare and service user impact of the COVID-19 pandemic: results of a UK survey of staff working with people with intellectual disability and developmental disorders

2020 ◽  
Author(s):  
Rory Sheehan ◽  
Christian Dalton-Locke ◽  
Afia Ali ◽  
Vasiliki Totsika ◽  
Norha Vera San Juan ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disabilities ◽  
Mental Health Services ◽  
Health Services ◽  
Service User ◽  
Mental Healthcare ◽  
Free Text ◽  
Intellectual And Developmental Disabilities ◽  
Health And Social Care ◽  
The Impact

Background Very little is known about the impact of previous epidemics on the care of people with intellectual and developmental disabilities, particularly in terms of mental health services. The COVID-19 pandemic has the potential to exacerbate existing health inequalities as well as expose gaps in service provision for this vulnerable population group. Methods We investigated the responses of 648 staff working in mental healthcare with people with intellectual disabilities and/or developmental disabilities. Participants contributed to a UK-wide online survey undertaken by the National Institute for Health Research Mental Health Policy Research Unit between 22nd April and 12th May 2020. Recruitment was via professional networks, social media and third sector organisations. Quantitative data describing staff experience over three domains (challenges at work, service user and carer problems, sources of help at work) were summarised and differences between groups explored using Chi square tests. Content analysis was used to organise qualitative data focusing on service changes in response to the pandemic. Results The majority of survey respondents worked in the NHS and in community mental health services. One third had managerial responsibility. Major concerns expressed by mental healthcare staff were: difficulties for service users due to lack of access to usual support networks and health and social care services during the pandemic; and difficulties maintaining adequate levels of support secondary to increased service user need. Staff reported having to quickly adopt new digital ways of working was challenging; nevertheless, free text responses identified remote working as the innovation that staff would most like to retain after the pandemic subsides. Conclusions Understanding the experiences of staff working across different settings in mental healthcare for people with intellectual and developmental disabilities during the COVID-19 pandemic is essential in guiding contingency planning and fostering service developments to ensure the health of this vulnerable group is protected in any future disease outbreaks.

Mental health services for people with intellectual disability in the United Kingdom

2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Social Care ◽  
Community Support ◽  
Content Type ◽  
Health And Social Care ◽  
People With Intellectual Disabilities ◽  
The Uk

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.

scholarly journals Australian Mental Health Consumers’ Experiences of Service Engagement and Disengagement: A Descriptive Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10464
Author(s):  
Sharon Lawn ◽  
Christine Kaine ◽  
Jeremy Stevenson ◽  
Janne McMahon
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Online Survey ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Health Issues ◽  
Mental Health Issues ◽  
Service Engagement

Mental health issues are a severe global concern with significant personal, social, and economic consequences and costs. This paper reports results of an online survey disseminated across the Australian community investigating why people with mental health issues choose particular mental health services over others, what causes them to disengage from services, and what factors and qualities of services are important to consumers to support their continued engagement or re-engagement with mental health services. The importance of GPs was evident, given their key role in providing mental healthcare, especially to those referred to as “the missing middle”—consumers with mental health issues who fall through the gaps in care in other parts of the healthcare system. The study found that many respondents chose to engage with mental healthcare providers primarily due to accessibility and affordability, but also because of the relational qualities that they displayed as part of delivering care. These qualities fostered consumers’ sense of trust, feeling listened to, and not being stigmatized as part of help seeking and having their mental health needs met. Implications for education and practice are offered.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024803 ◽  
Author(s):  
Megan Sambrook Smith ◽  
Vanessa Lawrence ◽  
Euan Sadler ◽  
Abigail Easter
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Care Pathway ◽  
Healthcare Providers ◽  
Qualitative Studies ◽  
Health Concern ◽  
The Uk

ObjectiveLack of access to mental health services during the perinatal period is a significant public health concern in the UK. Barriers to accessing services may occur at multiple points in the care pathway. However, no previous reviews have investigated multilevel system barriers or how they might interact to prevent women from accessing services. This review examines women, their family members’ and healthcare providers’ perspectives of barriers to accessing mental health services for women with perinatal mental illness in the UK.DesignA systematic review and meta-synthesis of qualitative studies.Data sourcesQualitative studies, published between January 2007 and September 2018, were identified in MEDLINE, PsycINFO, EMBASE and CINAHL electronic databases, handsearching of reference lists and citation tracking of included studies. Papers eligible for inclusion were conducted in the UK, used qualitative methods and were focused on women, family or healthcare providers working with/or at risk of perinatal mental health conditions. Quality assessment was conducted using the Critical Appraisal Skills Programme for qualitative studies.ResultsOf 9882 papers identified, 35 studies met the inclusion criteria. Reporting of emergent themes was informed by an existing multilevel conceptual model. Barriers to accessing mental health services for women with perinatal mental illness were identified at four levels: Individual (eg, stigma, poor awareness), organisational (eg, resource inadequacies, service fragmentation), sociocultural (eg, language/cultural barriers) and structural (eg, unclear policy) levels.ConclusionsComplex, interlinking, multilevel barriers to accessing mental health services for women with perinatal mental illness exist. To improve access to mental healthcare for women with perinatal mental illness multilevel strategies are recommended which address individual, organisational, sociocultural and structural-level barriers at different stages of the care pathway.PROSPERO registration numberCRD42017060389.

scholarly journals Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Teresa Pollard ◽  
Natasha Howard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
National Health ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Mental Healthcare ◽  
Barriers And Enablers ◽  
The Uk ◽  
Asylum Seekers And Refugees

Abstract Background Since 2011, a large influx of asylum-seekers and refugees has put pressure on the UK’s under-resourced national health services and mental health services. Asylum-seekers and refugees (ASR) may experience traumatic events pre-departure, life-threating circumstances on their journeys, and difficulties integrating into host countries related to immigration policies, social isolation, poor living conditions, and unemployment, all of which can significantly affect their mental health. This topic is increasingly important due to the numbers of people seeking asylum and growing concern for their mental health on resettlement. This study examined UK-wide policies and guidance, healthcare practices, barriers, and enablers of mental healthcare for ASR residing in the UK. Methods We conducted a scoping review using Arksey and O’Malley’s 2005 framework, which included semi-structured interviews with stakeholders from non-governmental organisations, academia, UK National Health Service, and community groups. We synthesised and analysed literature and interview data thematically to examine current barriers and potential enablers of ASR mental health support in the UK. Results We included 39 literature sources, of 1,638 identified, and 10 stakeholder interviews. Sources, most published in 2019 (n = 13), included data from England (n = 13), Scotland (n = 3), Wales (n = 3), and Northern Ireland (n = 2) and covered access to care (n = 16), mental health disorders (n = 7), impacts on health (n = 7), barriers to care (n = 13), policies and plans (n = 4), and clinical recommendations (n = 3). Synthesised themes from literature and interviews included existing barriers (i.e. communication difficulties and lack of funding, resources, and political will) and potential enablers (i.e. proposed provision practices, social needs of ASR, and policy changes). Conclusions There is a gap in the literature regarding UK-wide assessment of access and delivery of mental healthcare for ASR in the UK. Time sensitive and culturally appropriate approaches are needed, with greater funding and resource support from the UK Government. This study provides justification for a call to relax hostile environment policies, and for ASR-specific mental health services and support to be considered within the UK. Further research is needed to assess implementation of guidelines across the UK.

scholarly journals Interprofessional education in mental health services: learning together for better team working

2014 ◽  
Vol 20 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Daniel Kinnair ◽  
Elizabeth Anderson ◽  
Henderikus van Diepen ◽  
Cath Poyser
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interprofessional Education ◽  
Mental Health Policy ◽  
Mental Healthcare ◽  
Team Working ◽  
Postgraduate Level ◽  
Training Programmes ◽  
The Uk

SummaryInterprofessional education, learning which brings together different professional groups, helps to prepare practitioners for effective team-based collaborative practice and is now included in all undergraduate training programmes in the health professions. We explore the merits of team-based interprofessional learning, drawing on learning theory and mental health policy. We endorse the use of a practice-based interprofessional education model involving patients in which students experience the complexity of team working and the clinical team gain a more detailed analysis of team processes, which can enhance the quality of patient care. The model has been replicated for undergraduate education in mental healthcare and could easily be used for postgraduate staff. Interprofessional education at postgraduate level could foster the ongoing team-based reflective learning needed to enable mental health services in the UK to adapt to the dramatic changes both in their organisation and in the roles and responsibilities of individual professions.

Homicide offenders including mass murder and infanticide

2012 ◽  
pp. 1937-1941
Author(s):  
Nicola Swinson ◽  
Jennifer Shaw
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
General Population ◽  
Health Services ◽  
Mass Murder ◽  
England And Wales ◽  
History Of ◽  
Perpetrators And Victims ◽  
The Uk

There is a widespread public perception of the mentally ill as violent. Until the early 1980s there was a consensus view that patients with severe mental illness were no more likely to be violent than the general population. Emerging evidence from various countries over the past two decades, however, has established a small, yet significant, association between mental illness and violence. There are 500–600 homicides annually in England and Wales. Perpetrators and victims are predominantly young males, especially when the victim is unknown to the perpetrator. In such ‘stranger homicides’ perpetrators are less likely to have a lifetime history of mental illness, symptoms of mental illness at the time of the offence, or contact with mental health services. Despite an increasing rate of homicides in the general population, convictions for infanticide and the rate of infant homicide has remained relatively constant, at around 4.5 per 100 000 live births. Infanticide has become a generic term for killing of infants, even though the criminal charge in England applies to a crime for which only a woman can be indicted. Multiple homicides, in particular serial homicides, have generated a great deal of public and media interest over recent decades yet this phenomenon is rare in the UK. The rarity of these events means that there is a lack of empirical evidence about the characteristics of perpetrators and victims in the UK, with most evidence emanating from the United States. Even then, however, there is an absence of systematic, robust evidence, with many studies being limited by small sample size. Around 1 in 10 perpetrators of homicide in England and Wales are female, which is consistent with data from other countries. Stranger homicide by females is rare. In one-quarter of cases the victims are the perpetrators’ own children and a current or former partner in over a third. Homicides perpetrated by the elderly are exceptionally rare. There is a well documented increased risk of violence in those with schizophrenia. The aim of the National Confidential Inquiry is to collect detailed clinical information on people convicted of homicide, focusing on those with a history of contact with mental health services. Nearly one in three Inquiry cases were seen during the week before the homicide, a similar proportion within 1–4 weeks and the remainder between 1–12 months. A substantial proportion had mental state abnormalities at final contact, often distress, depressive symptoms, hostility, or increased use of alcohol or drugs. Despite this immediate risk was judged to be low or absent in 88 per cent cases at the last contact.

Adolescent inpatient mental health services in the UK

2021 ◽  
pp. archdischild-2020-321442
Author(s):  
Daniel Hayes ◽  
Jemma Thievendran ◽  
Marinos Kyriakopoulos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Treatment Plan ◽  
Mental Healthcare ◽  
Inpatient Mental Health ◽  
Adolescent Inpatient ◽  
The Uk ◽  
High Level

Inpatient mental health services are an indispensable part of the mental healthcare for adolescents. They provide comprehensive assessment and treatment for young people severely affected by mental health difficulties whose presentation is associated with high level of risk or where diagnostic clarity and effective intervention cannot be achieved with less intensive community input. In the UK, a range of different mental health units have been developed with the aim to meet the needs of young people requiring admission with the appropriate expertise and in the least restrictive way possible. Although an inpatient admission is necessary and helpful for a number of adolescents, it may also be linked to some adverse effects that need to be carefully assessed and managed when such an option is considered or pursued. Collaborative working between inpatient units, community teams and young people and their families is paramount in ensuring that inpatient interventions form part of a wider treatment plan, are as efficient and effective as possible and are used in a way that fosters engagement, independence and optimal outcomes.

scholarly journals Payment by results in mental health: the current state of play in England

2007 ◽  
Vol 13 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Andrew Fairbairn
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Healthcare Sector ◽  
Department Of Health ◽  
Current State ◽  
The Uk ◽  
Acute Healthcare

The Department of Health is introducing a ‘payment by results’ system for mental health services in the UK. The system is already being used in the acute healthcare sector, but is still under development for application in mental healthcare. This article outlines the concept of payment by results, briefly reports on its use in other countries and describes the pilot study underway in England to define currencies to be used in a payment by results system planned for NHS mental healthcare throughout England and Wales.

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