scholarly journals Can we learn from our mistakes? A case study of problems in implementing evidence-based mental health policy.

2020 ◽  
Author(s):  
David Foreman
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Public Administration ◽  
Mental Health Policy ◽  
Policy Research ◽  
Evidence Based ◽  
Qualitative Synthesis ◽  
Services Research ◽  
Adequate Funding ◽  
The Uk

I examined the failure of the UK mental health framework policy NSF-9 to sustain the intended development in Child and Adolescent Mental Health Services (CAMHS) in England from its inception in 2003. NSF-9 used Evidence-Based Policy/Practice (EBP) with Key Performance Indicators (KPIs) derived from both research and expert practitioner advice. Adequate funding was provided, the workforce was engaged from the outset, and the KPIs were supported by dedicated data collection and dissemination systems, so failure was unexpected. I reviewed theories from the social sciences of Public Administration and Policy Research (PAPR) from the perspective of three questions. 1. Are there applicable Public Administration Theories (PATs) that can account for this unexpected outcome?2. Did the metrics used, or their delivery, have administrative or policy characteristics which undermined their expected impact?3. Are there organisational factors, separate from EBP commitment, which could have jeopardised the NSF model?I undertook a qualitative synthesis of the findings of several qualitative and quantitative datasets, using constant comparison between the datasets’ results and candidate PATs. I concluded that the currently accepted explanation; NSF-9’s failure was caused by inadequacies in culture and values was incomplete, as they resulted from weaknesses in the EBP model itself. When I applied relevant PATs to the data, it was clear NSF-9 had many faults as a policy within the NHS bureaucracy, which were not compensated within its design, and drove its eventual failure. I concluded that policy success without including evidence from PAPR is extremely uncertain, and is a continuing structural risk, as there is currently a disjunction between PAPR and Health Services Research. This needs urgent correction.

Francis, Berwick and culture change – an opportunity to engage patients and increase transparency in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Sophie Corlett
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Policy ◽  
Health Service Provision ◽  
Content Type ◽  
Recent Developments ◽  
The Uk ◽  
Mental Health Service Provision

Purpose – The Policy Watch series reflects on recent and forthcoming developments in mental health policy across the UK. The purpose of this paper is to review recent developments in mental health policy, specifically the implications and learning for mental health services of recent scandals such as Mid Staffordshire and Winterbourne View and the various responses to them. Design/methodology/approach – This paper reviews and summarises recent developments in national mental health policy in England and their implications for mental health service provision. Findings – The paper outlines how learning from recent scandals such as Mid Staffordshire and Winterbourne View can be applied in mental health services. Originality/value – The paper updates and discusses recent policy developments in the NHS and their implications for mental health services.

Evidence-based mental health services research. The contribution of some recent EU-funded projects

2004 ◽  
pp. 173-187 ◽  
Author(s):  
Thomas Becker ◽  
Lorenza Magliano ◽  
Stefan Priebe ◽  
Hans-Joachim Salize ◽  
Matthias Schützwohl ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services Research ◽  
Health Services ◽  
Evidence Based ◽  
Services Research ◽  
Mental Health Services Research

scholarly journals The Need for an Evidence-Based Encyclopaedia in Health Services Research in Pharmacy

2020 ◽  
Vol 17 (7) ◽  
pp. 2549 ◽  
Author(s):  
Zaheer-Ud-Din Babar
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Pharmacy Practice ◽  
Practice Research ◽  
Evidence Based ◽  
Global Level ◽  
Services Research ◽  
The Uk ◽  
The Impact

Pharmacy practice research (PPR) is a specialty field within the wider area of health services research and it focuses on studies of how and why people access pharmacy services. This stream of research is also referred to as more universally recognized term such as health services research in pharmacy. The health services research in pharmacy has increased manifold; however, the impact of this research is not visible at the global level. The editorial explains several issues on quality and quantity of evidence produced including how evidence produced could contribute to improve quality of care and patients’ health outcomes. It also narrates examples from the UK and Australia showing how health services research in pharmacy has made an impact on healthcare service delivery. The editorial argues that building an encyclopaedia in health services research in pharmacy is vital to enhance the visibility and impact of this research.

Operation and organisation of services for people with severe mental illness in the UK

1999 ◽  
Vol 175 (5) ◽  
pp. 422-425 ◽  
Author(s):  
Justine Schneider ◽  
John Carpenter ◽  
Toby Brandon
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Social Services ◽  
Mental Health Policy ◽  
Care Process ◽  
Or Efficiency ◽  
The Uk

BackgroundSince 1991, English mental health policy guidelines have been explicit in recommending inter-professional working, involvement of patients and carers, harmonisation between health and social services and targeting at people with severe mental illness.AimsTo explore the structure and operation of mental health services in practice and relate them to measurable data.MethodA survey of mental health trusts was conducted in 1997–1998. Responses were compared with a concurrent survey of social services departments. Some qualitative data were collected. Harmonisation and targeting scores were devised and tested for association.ResultsThe response rate was 79%. The frequency with which different professionals, patients and carers were involved in the care process is described. Reasons for this are discussed briefly. Levels of harmonisation and targeting were found to vary widely and to be positively associated.ConclusionsThis survey portrays mental health services' practice in relation to Government policy. However, adherence to guidelines cannot be taken as a guarantee of service quality or efficiency.

scholarly journals Improving the delivery and organisation of mental health services: Beyond the conventional randomised controlled trial

2002 ◽  
Vol 180 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Simon Gilbody ◽  
Paula Whitty
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Controlled Trial ◽  
Mental Health Policy ◽  
Randomised Trial ◽  
Experimental Designs ◽  
Random Allocation ◽  
Services Research ◽  
Quasi Experimental

BackgroundThere is an ethical imperative to evaluate service and policy initiatives, such as those highlighted in the recent National Service Framework, just as there is to evaluate individual treatments.AimsTo outline the best methods available for evaluating the delivery and organisation of mental health services.MethodWe present a narrative methodological overview, using salient examples from mental health services research.ResultsCluster randomised studies involve the random allocation of groups of clinicians, clinical teams or hospitals rather than individual patients, and produce the least biased evaluation of mental health policy, organisation or service delivery. Where randomisation is impossible or impractical (often when services or policies are already implemented), then quasi-experimental designs can be used. Such designs have both strengths and many potential flaws.ConclusionsThe gold standard remains the randomised trial, but with due consideration to the unit of randomisation. Use of quasi-experimental designs can be justified in certain circumstances but should be attempted and interpreted with caution.

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.

The Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA): Aims, model, outputs, and implications for clinical academic advocacy

2021 ◽  
pp. 103985622110528
Author(s):  
Jeffrey C.L. Looi ◽  
Stephen Allison ◽  
Tarun Bastiampillai ◽  
Stephen R. Kisely
Keyword(s):  
Mental Health ◽  
Policy Research ◽  
Mental Healthcare ◽  
Evidence Based ◽  
Services Research ◽  
Wide Range ◽  
Population Mental Health ◽  
Policy And Planning ◽  
Research And Policy ◽  
Independent Model

Objective: We describe an independent model of clinical academic mental health services research that is able to provide synthesised views for medico-political organisations that are engaged in advocacy for national and state evidence-based policy and planning of mental healthcare. Conclusions: CAPIPRA focuses on independent research and policy analysis using publicly available datasets on population mental health at national and state/territory levels, published in international and national peer-reviewed journals (>50 papers since 2019). We partner with medico-political organisations in evidence-based advocacy across a wide range of issues.

scholarly journals Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

2017 ◽  
Vol 46 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Laura Pass ◽  
Carl W. Lejuez ◽  
Shirley Reynolds
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Adolescent Depression ◽  
Psychological Intervention ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Behavioural Activation ◽  
Evidence Based Treatments ◽  
The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

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