Community care: a brief overview

2020 ◽  
pp. 5-14
Author(s):  
Ian Cummins
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Community Care ◽  
Penal State ◽  
Fiscal Conservatism ◽  
The Way

This short chapter provides a brief overview of the development of community care. It examines the way that the asylum became an obsolete institution - certainly one that few defenders in the early 1980s. In giving a brief overview of the intellectual underpinnings of community care, the chapter introduces a series of issues such as: deinstitutionalisation and the penal state, community care inquiries and the asylum/community binary that are examined in depth in subsequent chapters. Community care is a complex and highly influential shift in mental health services. As with all policies, there were a series of drivers behind the policy - a combination of progressive idealism that attacked the whole notion that institutions could ever provide humane, dignified care and fiscal conservatism

scholarly journals Understanding health and care expenditure by setting – who matters to whom?

2020 ◽  
pp. 135581962093672
Author(s):  
Jenny Shand ◽  
Stephen Morris ◽  
Manuel Gomes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Hospital Care ◽  
Service Use ◽  
Community Care ◽  
Mental Health Service Use ◽  
Total Expenditure ◽  
System Perspective

Objective To assess service use and associated expenditure across a range of care settings in one local authority in London, United Kingdom. Methods An analysis of linked electronic health and council records of adults living in the borough of Barking and Dagenham, east London, for the financial year 2016/17. Unit costs were applied to individual service use to provide expenditure at an individual and population level for five settings of care. Population and expenditure volumes were compared for 32 possible combinations of service use. Results The total expenditure for the cohort (114,393 residents) for 2016/17 was £180.1 million. Almost half (47%) of total expenditure was incurred by community care, social care and mental health services, with hospital care and primary care incurring, respectively, 35% (£63.3 m) and 18% (£32.6 m). The two most common combinations in terms of total population volume and expenditure were primary and hospital care, and primary, hospital and community care. Primary care was present in all combinations. Mental health service use accounted for just over a tenth of all expenditure in the borough, but using mental health services substantially increased mean expenditure per patient. Conclusions A whole system perspective across all settings of care improves understanding of service user patterns. Setting-level analysis remains important, particularly for mental health users.

The balanced care model for global mental health

2012 ◽  
Vol 43 (4) ◽  
pp. 849-863 ◽  
Author(s):  
G. Thornicroft ◽  
M. Tansella
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Mental Health System ◽  
Community Care ◽  
Care Model ◽  
Adult Mental Health ◽  
High Resource

BackgroundFor too long there have been heated debates between those who believe that mental health care should be largely or solely provided from hospitals and those who adhere to the view that community care should fully replace hospitals. The aim of this study was to propose a conceptual model relevant for mental health service development in low-, medium- and high-resource settings worldwide.MethodWe conducted a review of the relevant peer-reviewed evidence and a series of surveys including more than 170 individual experts with direct experience of mental health system change worldwide. We integrated data from these multiple sources to develop the balanced care model (BCM), framed in three sequential steps relevant to different resource settings.ResultsLow-resource settings need to focus on improving the recognition and treatment of people with mental illnesses in primary care. Medium-resource settings in addition can develop ‘general adult mental health services’, namely (i) out-patient clinics, (ii) community mental health teams (CMHTs), (iii) acute in-patient services, (iv) community residential care and (v) work/occupation. High-resource settings, in addition to primary care and general adult mental health services, can also provide specialized services in these same five categories.ConclusionsThe BCM refers both to a balance between hospital and community care and to a balance between all of the service components (e.g. clinical teams) that are present in any system, whether this is in low-, medium- or high-resource settings. The BCM therefore indicates that a comprehensive mental health system includes both community- and hospital-based components of care.

WHAT DO PEOPLE WANT FROM SPECIALIST MENTAL HEALTH SERVICES AND CAN THIS BE MEASURED IN ROUTINE SERVICE SETTINGS?

2000 ◽  
Vol 28 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Media Coverage ◽  
Community Care ◽  
Public Image ◽  
Routine Practice ◽  
Service Users ◽  
Measurement Instruments ◽  
Routine Service

The level of public satisfaction with mental health services is low. This is evident in adverse media coverage and the Government's view that community care has failed. Some components of a comprehensive mental health service are in disrepair and others are missing altogether. Surveys of those who use services show that many are dissatisfied with the care they receive. One of the actions that services must take to improve their effectiveness, acceptability and public image is to understand better what people want from the services they use. Surveys of service users have identified what these issues are. It is now important that these factors are incorporated into measurement instruments that can be used in routine practice settings. This paper summarizes what service users have indicated that they want from services, lists the desirable attributes of instruments that might measure these factors, and gives brief descriptions of four instruments that meet some aspects of the specification.

scholarly journals Does community care work? A model to evaluate the effectiveness of mental health services

2008 ◽  
Vol 2 (1) ◽  
pp. 10 ◽  
Author(s):  
Emiliano Monzani ◽  
Arcadio Erlicher ◽  
Antonio Lora ◽  
Piergiorgio Lovaglio ◽  
Giorgio Vittadini
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Community Care ◽  
Care Work

Mental Health Services in Transition: the United States and the United Kingdom

1992 ◽  
Vol 161 (5) ◽  
pp. 589-593 ◽  
Author(s):  
James Raftery
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Health Services ◽  
Health Services ◽  
Community Care ◽  
The United States ◽  
The Past ◽  
The United Kingdom ◽  
The Us ◽  
The Uk

Mental health services are of interest not only because of the large burden they impose, but also because they have been subject to more change than virtually any other type of health service over the past four decades. Although both the US and UK have taken to ‘deinstitutionalisation’ with enthusiasm, the US has so far proceeded somewhat further down that road than the UK. While both countries face similar problems, the NHS and Community Care Act 1990 may now lead to considerable further changes in the UK.

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