scholarly journals Psichikos sveikatos priežiūros deinstitucionalizacija Lietuvoje: minimalūs pokyčiai „maksimalistinėse“1 organizacijose

2014 ◽  
Vol 8 ◽  
pp. 89-99
Author(s):  
Eglė Šumskienė

Vilniaus universitetoFilosofijos fakulteto Socialinio darbo katedraUniversiteto g. 9/1, VilniusTel. (8~5) 266 76 10El. paštas: [email protected] Remiantis institucionalizmo teorija straipsnyje nagrinėjama institucinės aplinkos įtaka psichikos sveikatos priežiūros įstaigų struktūrai, funkcijoms ir prisitaikymui prie aplinkos, jų inertiškumas ir priešinimasis psichikos sveikatos priežiūros sistemos reformai. Remiantis atsakingų institucijų renkamais statistiniais duomenimis, įvertinama įstaigų veiklos, gyventojų, pacientų ir darbuotojų skaičiaus dinamika, leidžianti spręsti apie pokyčius socialinės globos bei psichikos sveikatos priežiūros sistemoje. Atsiliepdamos į deinstitucionalizacijos reikalavimus, organizacijos modifikuoja savo veiklą – diegia naujas paslaugas, kuriomis siekia atsiliepti į naujus poreikius bei reikalavimus, tačiau tai – minimalūs pokyčiai, faktiškai nekeičiantys įstaigos dydžio ir darbo principų, o deklaruojami inovatyvūs požiūriai ir veiklos tikslai prasilenkia su tikrove institucijos viduje.Pagrindiniai žodžiai: institucionalizmo teorija, deinstitucionalizacija, psichikos sveikatos priežiūra, socialinė globa.Deinstitutionalisation in Lithuania: Minimal Changes in the “Maximalist” Organisations Eglė Šumskienė Summary The article employs the institutional theory to examine the influence of institutional environments on the structure and function of mental health and social care organizations as well as their resistance to the reform. On the basis of statistical data collected by responsible organizations, the dynamics of mental health and social care organizations’ practice, changes in the numbers of clients and employees are analysed. These alterations allow evaluating the status quo and actual direction of the mental health care reform. The usual institutional response to deinstitutionalization is the modification of activities by introducing new services which respond to the emerging requirements. Nevertheless, these are minimal changes since they do not influence the size of an institution and the principles of its work. Innovative attitudes and organisational goals are of declarative character as they do not correspond to the poor institutional reality. Key words: institutional theory, deinstitutionalisation, mental health and social care

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711569
Author(s):  
Jessica Wyatt Muscat

BackgroundCommunity multidisciplinary teams (MDTs) represent a model of integrated care comprising health, social care, and the voluntary sector where members work collaboratively to coordinate care for those patients most at risk.AimThe evaluation will answer the question, ‘What are the enablers and what are the restrictors to the embedding of the case study MDT into the routine practice of the health and social care teams involved in the project?’MethodThe MDT was evaluated using a mixed-method approach with normalisation process theory as a methodological tool. Both quantitative and qualitative data were gathered through a questionnaire consisting of the NoMAD survey followed by free-form questions.ResultsThe concepts of the MDT were generally clear, and participants could see the potential benefits of the programme, though this was found to be lower in GPs. Certain professionals, particularly mental health and nursing professionals, found it difficult to integrate the MDT into normal working patterns because of a lack of resources. Participants also felt there was a lack of training for MDT working. A lack of awareness of evidence supporting the programme was shown particularly within management, GP, and nursing roles.ConclusionSpecific recommendations have been made in order to improve the MDT under evaluation. These include adjustments to IT systems and meeting documentation, continued education as to the purpose of the MDT, and the engagement of GPs to enable better buy-in. Recommendations were made to focus the agenda with specialist attendance when necessary, and to expand the MDT remit, particularly in mental health and geriatrics.


2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.


2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.


2018 ◽  
Vol 28 (5) ◽  
pp. 481-488 ◽  
Author(s):  
A. Crowther ◽  
A. Taylor ◽  
R. Toney ◽  
S. Meddings ◽  
T. Whale ◽  
...  

AbstractAimsRecovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.MethodsInductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.ResultsCandidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.ConclusionsThis study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.


Author(s):  
Sarah McKenna ◽  
Aideen Maguire ◽  
Dermot O'Reilly

Background Research has consistently found a high prevalence of mental ill-health among children in out-of-home care. However, results have varied significantly by study location, type of care intervention, sample population and mental health measurement, and concerns have been raised about appropriate reference populations. In addition, little is known about children known to social services who remain with their birth families. Aim To examine mental ill-health amongst children known to social services based on care exposure including those who remain at home, those placed in foster care, kinship care or institutional care and the general population not known to social services. Methods Northern Ireland is unique in that has an integrated health and social care system and holds data centrally on all children known to social services. Social services data (1995-2015) will be linked to hospital discharge data (2010-2015), prescribed medication data (2010-2015), self-harm data (2010-2015) and death records (2010-2015) to investigate mental health outcomes in terms of psychiatric hospital admissions, psychotropic medication uptake, self-harm and suicide. Results Data cleaning has been completed and analysis is underway. Preliminary results will be available by December 2019. Descriptive statistics will provide a mental health profile of children in care compared not only to children in the general population but to those who are known to social services but remain in their own home. Regression models will determine which factors are most associated with poor mental health outcomes. Conclusion This project is the UK’s first population-wide data linkage study examining the mental health of children in the social care system, including looked-after children and those known to social services who remain in their own home. Project partners in the Department of Health recognise the potential of these findings to inform future policy relating to targeting interventions for children in receipt of social care services.


2022 ◽  
Author(s):  
Nicola Cogan ◽  
Chloe Kennedy ◽  
Zoe Beck ◽  
Lisa McInnes ◽  
Gillian ◽  
...  

Rapid studies have highlighted the adverse mental health impact of COVID-19 on health and social care workers (HSCWs). Complementing this work, we report on the psychosocial factors that have helped HSCWs adapt to the adversities associated with COVID-19 and protect staff wellbeing in Scotland. The ENACT study collected data from HSCWs (n= 1364) in Scotland during the third national lockdown. Using a cross-sectional design, participants completed an online survey providing quantitative data and free responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low wellbeing scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut off for acute stress. Adaptive coping strategies and increased perceived team resilience helped mitigate against the adverse impact that COVID-19 stressors have on HSCWs’ mental wellbeing. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems. Barriers to formal help-seeking were identified including stigma and fears of consequence of disclosure. HSCWs most valued peer support, workplace supports, visible leadership and teamwork. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs’ wellbeing and will inform future intervention development to increase positive adaptation amongst staff. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.


2020 ◽  
Vol 70 (2) ◽  
pp. 89-94
Author(s):  
G Kinman ◽  
L Grant

Abstract Background Compassion, described as the act of providing care based on empathy, dignity and respect, is intrinsic to effective health and social care. Although delivering compassionate care has wide-ranging benefits for service users, more insight is needed into its effects on health and social care professionals. The emotional demands of ‘helping’ work can engender compassion fatigue that may impair well-being, whereas compassion satisfaction and feelings of compassion towards the self could be protective. Aims To examine the effects (direct and indirect) of compassion satisfaction, compassion fatigue and self-compassion on mental health in a cohort of social workers. Methods We used validated scales to measure emotional demands, compassion satisfaction and fatigue, and self-compassion and the General Health Questionnaire-12 to assess mental health. We tested the main and moderating effects of emotional demands and the three facets of compassion using hierarchical regression analysis. Results The study sample comprised 306 social workers (79% female). Participants who reported higher levels of compassion satisfaction and self-compassion tended to report better mental health, whereas compassion fatigue was a significant risk factor for well-being. The models explained 44–53% of the variance in mental health symptoms. We found some evidence that compassion satisfaction and self-compassion buffer the negative effects of emotional demand on mental health, contributing 2 and 3%, respectively, to the incremental variance. Conclusions Our findings suggest that evidence-based interventions are needed to reduce compassion fatigue and enhance compassion satisfaction and self-compassion in social care work. We consider ways to accomplish this using targeted interventions.


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