Journal articles on the topic 'Community mental health services – Planning'
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1
Wilkinson, Greg. "Mental Health Services Planning." Bulletin of the Royal College of Psychiatrists 9, no. 7 (July 1985): 138. http://dx.doi.org/10.1192/s0140078900022161.
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A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.
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Wilkinson, G. "Community care: planning mental health services." BMJ 290, no. 6479 (May 11, 1985): 1371–73. http://dx.doi.org/10.1136/bmj.290.6479.1371.
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Adey, E. "Community care: planning mental health services." BMJ 290, no. 6484 (June 15, 1985): 1825–26. http://dx.doi.org/10.1136/bmj.290.6484.1825-b.
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Goulder, T. J. "Community care: planning mental health services." BMJ 290, no. 6484 (June 15, 1985): 1826. http://dx.doi.org/10.1136/bmj.290.6484.1826.
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Jensen, Elsabeth, Patty Chapman, Amy Davis, Cheryl Forchuk, Bill Seymour, Penny Witcher, and Denise Armstrong. "An Evaluation of Community-Based Discharge Planning in Acute Mental Health Care." Canadian Journal of Community Mental Health 29, S5 (January 1, 2010): 111–24. http://dx.doi.org/10.7870/cjcmh-2010-0038.
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This study assessed the effectiveness of a discharge planning service that was remodelled and relocated from a hospital to community-based setting. The study used a single group program evaluation strategy. In this “in-reach” model, the discharge planner is based with the community service, and visits the hospital daily to meet with all admitted clients to offer discharge services. Through analyses of administrative data and interviews with clients, the study found that readmission rates were 40% lower in the year following the change in service delivery model. This change was statistically significant. Agency partners used the findings to modify their program during the course of the evaluation. Findings will be helpful for other acute care mental health services.
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Thornicroft, Graham, Geraldine Strathdee, and Sonia Johnson. "The case for catchment areas for mental health services." Psychiatric Bulletin 19, no. 6 (June 1995): 343–45. http://dx.doi.org/10.1192/pb.19.6.343.
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The establishment of mental health teams which take responsibility for small geographical catchment areas has been a fundamental element in the planning of community services in most Western European countries over the last decade. This idea is challenged in the companion paper in this issue of Psychiatric Bulletin which refers to catchment areas as a “relic of the past”. The case is put for catchment areas in terms of their planning, service delivery and quality advantages for the development of comprehensive inter-agency mental health services. In brief, it is argued that community mental health services are still in many areas poorly developed (Audit Commission, 1994; Faulkner et al, 1994), and that catchment areas are necessary but not sufficient for their fuller realisation.
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Santhanam, Radhika, Ernest Hunter, Yvonne Wilkinson, Harvey Whiteford, and Alexandra McEwan. "Care, Community Capacity: Rethinking Mental Health Services in Remote Indigenous Settings." Australian Journal of Primary Health 12, no. 2 (2006): 51. http://dx.doi.org/10.1071/py06022.
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In 2002 a project was initiated to evaluate and restructure the Child and Youth Mental Health (CYMH) services in three health Service Districts: Cape York, the Torres Strait and Northern Peninsula Area and remote Cairns. The objective was to develop, establish and evaluate models of best practice for remote area CYMH services for Indigenous families living in far north Queensland. For the purposes of the project, an action research framework was adopted to guide the project design, methodology, implementation and evaluation. The first phase involved mapping of needs, the second phase focused on service restructure and outcomes were measured in the third phase. The planning/implementation/planning cycle was an ongoing part of the project and raised five significant themes: service equity, service quality, service sufficiency, Indigenous workforce, and service structure/ infrastructure. The principal project outcome was the establishment of a defined model of service delivery that incorporates the identified themes and sits within a community development framework. Other significant outcomes include the implementation of regular supervision and professional development activities and improvements in service data collection. This paper is a descriptive account of the process of service restructure and discusses the key project outcomes.
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Fallot, Roger D. "Planning Community Mental Health Services for Women: A Multiprofessional Handbook." Psychiatric Services 49, no. 5 (May 1998): 706. http://dx.doi.org/10.1176/ps.49.5.706.
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Wasylenki, Donald, Paula Goering, and Eric Macnaughton. "Planning Mental Health Services: I. Background and Key Issues*." Canadian Journal of Psychiatry 37, no. 3 (April 1992): 199–206. http://dx.doi.org/10.1177/070674379203700311.
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Planning mental health services is a complex task requiring an understanding of background developments and key issues related to mental health services. In Canada, the deinstitutionalization of patients attempted to shift the locus of care from provincial psychiatric hospitals to general hospital psychiatric units. This resulted in the isolation of provincial psychiatric hospitals, general hospital psychiatric units and community mental health programs, with little overall accountability for the services provided — three solitudes. To move toward the creation of responsible, integrated systems a number of issues must be addressed: target population(s); the roles of provincial psychiatric and general hospitals; community support services; continuity of care; co-morbidity; consumerism; and methods of integration. In the development of a comprehensive mental health plan, each issue should be recognized and decisions made which are in keeping with current knowledge. A companion report will survey Canadian initiatives in mental health planning and discuss approaches to many of the issues identified.
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Choy-Brown, Mimi, Victoria Stanhope, Nathaniel Williams, and Lynden Bond. "Delivering Person-Centered Care in Community Mental Health Programs." Research on Social Work Practice 30, no. 8 (August 6, 2020): 907–17. http://dx.doi.org/10.1177/1049731520944568.
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The aim of this study was to examine the extent of and variation in person-centered care across programs within community mental health clinics. Service plans ( N = 160) from programs within eight clinics were assessed for person-centered care planning using an objective fidelity measure. Univariate statistics calculated overall fidelity to person-centered care planning and mixed-effect regression models examined person-centered care planning by program type. Overall, providers demonstrated low levels of competency in person-centered care planning. There were significant differences according to program type, with providers from assertive community treatment programs demonstrating the highest level of competency. Providers need more training and support to implement person-centered care consistently across community mental health programs. Those program types with associated fidelity measures that include person-centered care had a higher level of competence confirming the value of fidelity measurement in promoting quality services.
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Mkize, D. L., R. W. Green-Thompson, P. Ramdass, G. Mhlaluka, N. Dlamini, and J. Walker. "Mental health services in KwaZulu-Natal." South African Journal of Psychiatry 10, no. 1 (April 1, 2004): 6. http://dx.doi.org/10.4102/sajpsychiatry.v10i1.116.
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This article is a summary of a document prepared by a task team appointed by the Superintendent-General, Head: Department of Health, KwaZulu-Natal. The terms of reference of the task team were to scrutinise all available documents on mental health in the province and to come up with a new doc- ument entitled ‘Strategic and Implementation Plan for Delivery of Mental Health Services in KwaZulu-Natal’, with operational plans and time frames, and to make specific recommendations with regard to community mental health services and forensic psychiatry.The documents used to prepare the new document were: A Framework for the Delivery of Mental Health Services by Institutions in KwaZulu-Natal;Mental Health Services Planning Report; Strategic Policy Document for Mental Health Services in KwaZulu-Natal; Community Mental Health Services at Indlovu Region, KwaZulu-Natal; KwaZulu-Natal Health Care Act 2000; Mental Health Act 2002; World Health Report on Mental Health 2001; and Mental Health and Substance Abuse Report.The article is divided into nine sections, namely organisational structure; education, training and research; mental health ser- vice provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.
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Commander, Martin, Sue Odell, and Sashi Sashidharan. "Birmingham community mental health team for the homeless." Psychiatric Bulletin 21, no. 2 (February 1997): 74–76. http://dx.doi.org/10.1192/pb.21.2.74.
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Mental health services have been criticised for failing to respond to the needs of the rising number of homeless mentally ill. We report on the first year of referrals to a community mental health team established to meet the needs of the severely mentally ill homeless in Birmingham. Most users had a psychotic disorder and a lengthy history of unstable housing, and experienced a range of other disadvantages. Although the team is successfully reaching its priority group, examination of other characteristics of users has highlighted a number of issues which should inform the future planning and development of the service.
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Bhugra, Dinesh, and Janet La Grenade. "Community organisations' expectations of mental health statutory services." Irish Journal of Psychological Medicine 14, no. 2 (June 1997): 57–59. http://dx.doi.org/10.1017/s0790966700003001.
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AbstractObjective: Community organisations provide care for psychiatric patients at multiple levels. With increasing emphasis on joint planning and purchasing of care it is important to ascertain the views of such organisations towards statutory organisations and services the latter provide.Method: All community organisations working within one inner city catchment area in London were approached in order to obtain their views and experiences on the mental health services provided by the secondary care services. This was a postal survey and non-responders were contacted by personal calls.Results: Sixty organisations out of a total of 100 in the database responded. More than half had experiences of statutory services and these were generally negative. The services provided were perceived as being rigid and inflexible. A large majority of the organisations wished services to be more flexible as well as provide more training for voluntary organisations.Conclusion: The survey suggests that the perceptions of the statutory services and co-working with voluntary organisations can succeed only if the two groups work together closely to make good quality community care possible.
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Wang, Lu, and Joseph Ariwi. "Mental health crisis and spatial accessibility to mental health services in the city of Toronto: A geographic study." International Health Trends and Perspectives 1, no. 2 (July 7, 2021): 191–213. http://dx.doi.org/10.32920/ihtp.v1i2.1427.
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Abstract: Mental illness includes a wide range of disorders that affect mood, thinking, behaviour and overall wellbeing. One in five Canadians has mental health care needs, many of which are unmet. Within the City of Toronto, the provision of specialized mental health care is delivered by over 100 public and private community service organisations and over 700 physicians with a psychiatric specialization - each providing community-based general or specialised care to residents in need. Research has shown that travel distance is an enabling factor of health service utilisation, thus equitable spatial access to services remains a key priority. Using spatial quantitative methods, this study examines potential spatial accessibility to both general and specialized mental health services within the City of Toronto, and levels of statistical association between access to care and prevalence of mental health crisis events. The main datasets analyzed including geo-referenced Census data and occurrence data on mental health crisis (represented by apprehensions under the Mental Health Act undertaken by the Toronto Police Service). The enhanced two-step floating catchment area (E2SFCA) method is used to model spatial accessibility to mental health services based four modes of transportation: driving, walking, cycling and public transit. Areas that are underserved by mental health specialists and mental health community services are identified and shown to have different socioeconomic characteristics. The study reveals spatially explicit patterns of access to various mental health services in Toronto, providing detailed data to inform the planning of and policy on mental health care delivery concerning severe mental health crisis.
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Silburn, Kate, and Virginia Lewis. "Commissioning for health and community sector reform: perspectives on change from Victoria." Australian Journal of Primary Health 26, no. 4 (2020): 332. http://dx.doi.org/10.1071/py20011.
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Commissioning health and community services is a complex task involving planning, purchasing and monitoring services for a population. It is particularly difficult when attempting system-level reform, and many barriers to effective commissioning have been documented. In Victoria, the state government has operated as a commissioner of many services, including mental health community support and alcohol and other drug treatment services. This study investigated the perceived consequences of a reform process in these two sectors after recommissioning was used as a mechanism to achieve sector-wide redesign. Semi-structured interviews were conducted with 23 senior staff from community health, mental health and drug and alcohol services 6 months after implementation. The process was affected by restructuring in the commissioning department resulting in truncation of preparatory planning and technical work required for system design. Consequently, reform implementation was reportedly chaotic, costly to agencies and staff, and resulted in disillusionment of enthusiastic reform supporters. Negative service system impacts were produced, such as disruption of collaborative and/or comprehensive models of care and strategies for reaching marginalised groups. Without careful planning and development commissioning processes can become over-reliant on competitive tendering to produce results, create significant costs to service providers and engender system-level issues with the potential to disrupt innovative models focused on meeting client needs.
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Kelly, Ann, and Wayne Jones. "Small Area Variation in the Utilization of Mental Health Services: Implications for Health Planning and Allocation of Resources." Canadian Journal of Psychiatry 40, no. 9 (November 1995): 527–32. http://dx.doi.org/10.1177/070674379504000905.
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Objective To determine the variables associated with utilization of mental health services and to develop a planning model to predict service utilization that incorporates these factors. Method A regression analysis of service utilization and demographic characteristics was used to assess the relative importance of alternative service, supply of psychiatrists and demographics in explaining variations of services use. A model using socioeconomic factors was applied to the population to predict need. Results The percentage of divorced males was the only factor significantly and positively correlated with the utilization of hospital inpatient and provincial psychiatric beds. Predicted need exceeds utilization in 7 out of 10 areas for all services. Conclusions Small area variations in inpatient psychiatric utilization is correlated with community characteristics, not supply of psychiatrists or utilization of alternative services. A model has been developed using census data to allocate resources according to need.
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Foulds, Georgina, Helen Wood, and Kamaldeep Bhui. "Quality day care services for people with severe mental health problems." Psychiatric Bulletin 22, no. 3 (March 1998): 144–47. http://dx.doi.org/10.1192/pb.22.3.144.
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This paper describes the process of involving mental health service users in the planning and running of a community service. PACT (Psychiatric Assertive Outreach and Continuing Care Team) is based in south London and provides care for people who have severe and enduring mental health problems. We present an approach based on three years of intensive collaboration with service users. Community services will only become effective if they respond to need and develop new partnerships with people in contact with them. People require the opportunity to experience new ways of becoming involved at all levels of service provision and, therefore, efforts need to be made to develop a variety of opportunities for people to put forward their views. This takes time and determination by all involved.
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Fagin, Leonard, and Harry Pursher. "Development of the Waltham Forest Local Mental Health Case Register." Bulletin of the Royal College of Psychiatrists 10, no. 11 (November 1986): 303–6. http://dx.doi.org/10.1192/pb.10.11.303.
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608 is a Community Mental Health Centre (CMHC) in Waltham Forest Health District which came into service in February 1983. It serves a catchment area in North East London of approximately 95,000, and caters primarily for the 16 to 65 age group. It is linked with the services provided by a large psychiatric hospital—Claybury—which has been scheduled for closure by 1993. Planning is now under way to provide alternative services in each of the five districts covered by the hospital.
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Spear, Jon, Andrew Cole, and Jan Scott. "A cross-sectional evaluation of a community-orientated mental health service." Psychiatric Bulletin 19, no. 3 (March 1995): 151–54. http://dx.doi.org/10.1192/pb.19.3.151.
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Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.
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Ancona, Giuseppina, Eleonora Fulco, and Simone Marchese. "COMMUNITY MENTAL HEALTH: HEALTH BUDGETS IN A MULTIFACTORIAL CONTEXT." Mental Health: Global Challenges Journal 2, no. 1 (October 11, 2019): 5–12. http://dx.doi.org/10.32437/mhgcj.v2i1.40.
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In the last three years the Department of Mental Health of the ASP (Provincial Health Company) Agrigento (Italy) has become the protagonist of an attempt to change the cultural reality of mental health in its own territory, to ready local communities to overcome the prejudices linked to the stigma connected to psychiatric pathology through the implementation of an experimental project funded by the Sicily Region, the PON (National Operational Plan) 19.2. At the same time, the Department of Mental Health of the Provincial Health Authority (ASP) has experimented with the introduction of flexibility in care pathways for serious patients so as to pursue a model of integrated intervention combining the efforts public health, private social, citizens (training / work, residential care) in which public health continues to respect the responsibility and ownership of the service but is enriched with new human resources to promote patient citizenship itineraries.
All this is in order to prevent mental health problems, stimulate the inclusion and active participation of those suffering from mental health problems - recognizing the experience and skills of patients and caregivers as an essential basis for the planning and development of mental health services.
The goal of the project was to reduce the isolation of psychiatric patients by adopting new methods that determined an economic saving and a higher quality in therapeutic results: tools within the Health Budget
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Spencer, Greg, and David Jolley. "Planning services for the elderly." Advances in Psychiatric Treatment 5, no. 3 (May 1999): 202–12. http://dx.doi.org/10.1192/apt.5.3.202.
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“The psychiatric aspects of ageing are a major problem in any country which, like our own, has a low net reproduction rate and a high standard of social responsibility. The proportion of old people in the community steadily increases so that they provide an increasingly high proportion of our mentally infirm who must be cared for”.
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Blenkiron, Paul, Kwai Hong Mo, John Cuzen, and Anne Christine Hammill. "Involving service users in their mental health care: the CUES Project." Psychiatric Bulletin 27, no. 09 (September 2003): 334–38. http://dx.doi.org/10.1017/s095560360000297x.
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Aims and MethodTo assess the impact of Carers' & Users' Expectations of Services –User version (CUES–U) upon clinical care planning in working age adults with mental health problems. Eighty-six individuals who were receiving input from the community mental health team gave their views.ResultsLife and service satisfaction ratings ranged from 49% to 88%. The CUES–U discussion led to a change in clinical care for 49% of respondents. Care coordinators rated CUES–U as a good use of their time in 64% of cases. Women and those with a shorter duration of mental disorder were rated as more engaged in the consultation process.Clinical ImplicationsCUES–U appears to be a useful tool for supporting individual clinical care and the evaluation of community mental health services.
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Blenkiron, Paul, Kwai Hong Mo, John Cuzen, and Anne Christine Hammill. "Involving service users in their mental health care: the CUES Project." Psychiatric Bulletin 27, no. 9 (September 2003): 334–38. http://dx.doi.org/10.1192/pb.27.9.334.
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Aims and MethodTo assess the impact of Carers' & Users' Expectations of Services –User version (CUES–U) upon clinical care planning in working age adults with mental health problems. Eighty-six individuals who were receiving input from the community mental health team gave their views.ResultsLife and service satisfaction ratings ranged from 49% to 88%. The CUES–U discussion led to a change in clinical care for 49% of respondents. Care coordinators rated CUES–U as a good use of their time in 64% of cases. Women and those with a shorter duration of mental disorder were rated as more engaged in the consultation process.Clinical ImplicationsCUES–U appears to be a useful tool for supporting individual clinical care and the evaluation of community mental health services.
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Fernandopulle, Sudarshini, Neil Thalagala, and Simon Barraclough. "Mental Health in Sri Lanka: Challenges for Primary Health Care." Australian Journal of Primary Health 8, no. 2 (2002): 31. http://dx.doi.org/10.1071/py02024.
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Using a societal approach to the determinants of mental health, a survey of knowledge about mental health problems in Sri Lanka is presented, including the consequences of years of civil and military conflict and economic retardation. Sri Lanka has the highest suicide rate for females, and one of the highest rates for males, in the world. Mental health care services and their limitations are described. Major problems include under-funding of services and medicinal drugs, overcrowded institutions, shortages of trained personnel, and under-developed community health services. Desirable policy and planning reforms are identified; in particular the need for expanded primary mental health care.
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Salisbury, Christine. "A Health Service and Aboriginal & Torres Strait Islander Partnership to Develop and Plan Mental Health Services." Australian Journal of Primary Health 4, no. 4 (1998): 18. http://dx.doi.org/10.1071/py98058.
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The aim of this study was to examine the effects of an action research partnership between the Tweed Valley Health Service (TVHS) and the Aboriginal & Torres Strait Islander community for the development and delivery of Aboriginal & Torres Strait Islander Mental Health Services. This partnership was based upon Labonte's (1989) view of empowerment where it is suggested that to be empowered means to have increased capacity to define, analyse and act upon one's problems. It was proposed that the establishment of a 'partnership' based upon these principles would assist in operationalising Indigenous community participation in TVHS planning. To achieve this type of 'partnership', the health service had to be willing to enter the partnership and to give the authority to the Aboriginal & Torres Strait Islander Health Outcome Council to seek and trial solutions on Aboriginal & Torres Strait Islander Mental Health matters. Key outcomes were defined as the extent to which the re-organised services proved to be acceptable and utilised by the local Aboriginal & Torres Strait Islander population. Outcomes were operationalised through measures of service utilisation and consumer satisfaction with accessibility, process and outcomes. The study trialed participatory action research as a method for Indigenous participation in Mental Health Service planning and development and concludes that it is a valid model for cross cultural research and health service development in a complex medical setting.
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Tait, Lynda, and Sonal Shah. "Partnership working: a policy with promise for mental healthcare." Advances in Psychiatric Treatment 13, no. 4 (July 2007): 261–71. http://dx.doi.org/10.1192/apt.bp.106.003178.
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This article describes the literature specific to partnership working across the National Health Service, social services and voluntary and community sector in order to summarise the potential advantages and challenges of partnerships. We explore the meaning of partnership working and review the policy developments and investment initiatives underpinning the Government's emphasis on partnership working between statutory services and the voluntary and community sector. A number of barriers hinder effective partnership working and we examine some possible solutions to overcome these. We then address the key issues influencing the approach to increasing the voluntary sector's participation in partnership activities within mental health services and provide brief examples of good practice. Finally, we discuss practical issues relevant to planning partnerships and the role consultant psychiatrists can play in initiating and developing partnership working between the voluntary sector and statutory mental health services.
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Yotsidi, Vasiliki, and Kalliope Kounenou. "Experiences of mental health service users on their empowerment and social integration in the community." European Journal of Counselling Psychology 7, no. 1 (October 31, 2018): 165–80. http://dx.doi.org/10.5964/ejcop.v7i1.147.
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The transition from institutionalized towards community mental health services demands the evolution from social exclusion to integration practices. Empowerment of people with mental disorders, through their involvement in planning and service provision, prevails as a cutting-edge in such practices. Along these lines, this study adopted a structured bottom-up research methodology to explore the experiences of people with severe mental disorders on nine areas of their community participation. Three focus groups of 18 persons with psychotic disorders who were treated on an out-patient community mental health centre were set up. Qualitative data analysis showed that the areas of treatment, housing, education, and entertainment have turned to be more accessible for mental health service users than those of employment, active citizenship, social relations, social networks and activities in the community. The latter were revealed to still be obstructed by specific personal and social variables, which should be taken into account for community-based treatment to become more responsive and tailor-made. Results are discussed in relation to the role of counselling psychology in improving community mental health services and ensuring that service providers empathize with and respond to individuals' understanding of their condition and what contributes to their care and well-being.
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Powell, Robin, Geraldine Strathdee, and Graham Thornicroft. "A short course in planning, development and evaluation of community mental health services." Psychiatric Bulletin 20, no. 4 (April 1996): 234–36. http://dx.doi.org/10.1192/pb.20.4.234.
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In response to the expressed needs of trainees for training in the planning development, and evaluation of mental health services, a short course was designed and is described here. The course was run several times and proved flexible enough to be presented to either multidisciplinary, inter-agency audiences or to a solely medical audience.
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Leese, Morven, Sonia Johnson, Mike Slade, Sue Parkman, Frank Kelly, Michael Phelan, and Graham Thornicroft. "User perspective on needs and satisfaction with mental health services." British Journal of Psychiatry 173, no. 5 (November 1998): 409–15. http://dx.doi.org/10.1192/bjp.173.5.409.
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BackgroundMeasurement of the impact of different types of service provision on the views of service users is important in planning mental health services.MethodNeeds (met and unmet) and satisfaction with services, were assessed. People with psychosis (n=131) were interviewed before (Time 1) and after (Time 2) the introduction of two community mental health services in south London. One was intensive, with two specialist teams, the other standard. Outcomes were compared at Time 2, controlling for the Time 1 values.ResultsOverall, 70% of needs were met and mean satisfaction was between ‘mixed’ and ‘mainly satisfied’. There was evidence for higher met needs in the intensive sector, but no evidence for lower unmet needs in the intensive sector or for differences in satisfaction. The additional needs met by the intensive service were associated with aspects of basic living situation. Satisfaction was negatively correlated with both unmet and met needs.ConclusionsBoth services were reasonably successful, with little difference from the user perspective. The intensive service provided benefits in terms of met needs, but this has to be balanced against a possible increase in unmet needs.
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George, M. K., N. R. Parashar, and C. Leek. "Provision of perinatal mental health services in a community setting." European Psychiatry 26, S2 (March 2011): 1096. http://dx.doi.org/10.1016/s0924-9338(11)72801-2.
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IntroductionPsychiatric illness and suicide in particular have been a leading overall cause of maternal mortality in the United Kingdom. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer leading causes, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children's subsequent development.AimsTo identify the current practice for management and prevention of perinatal mental illness within a community mental health setting.To identify the extent to which policy recommendations from NICE “Antenatal and postnatal mental health” been implementedMethodsThe audit included all women who are pregnant, breastfeeding or who are planning to become pregnant and referred to the CMHT between November 2008 to April 201020 Cases identified by asking all team members to recall relevant clients.Results65% of those referred were in the antenatal period and 25% were in the post natal period. 40% of those referred had a pre existing mental illness and 60% were new onset during antenatal & postnatal period.The main diagnosis was depression and anxiety disorders.55% of those referred to the CMHT were on Psychotropic medications. However following the assessment and follow up by CMHT, only 25% of those referred needed to be on the psychotropics.Good compliance was achieved in the documentation of past psychiatric history and family history, provision of appropriate psychosocial interventions and specific considerations for the use of antidepressant medication during pregnancy and the postnatal period.
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Blais, Régis, Jean-Jacques Breton, Mylène Fournier, Marie St-Georges, and Claude Berthiaume. "Are Mental Health Services for Children Distributed According to Needs?" Canadian Journal of Psychiatry 48, no. 3 (April 2003): 176–86. http://dx.doi.org/10.1177/070674370304800306.
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Objectives: The purpose of this study was twofold: 1) to determine whether publicly funded mental health services and resources available in 4 large regions in the province of Quebec were distributed according to the mental health needs of children aged 6 to 14 years and 2) to assess whether the variations in mental health services and resources across the 4 regions had changed over a 5-year period. Methods: Indicators of need according to the child's parent (presence of mental disorder, measure of adaptation, and perception of need for help) from an epidemiologic survey of 2400 noninstitutionalized children were compared with both in-school and community professional resources and with physician and hospital services in 1992–1993. Resource and service data were also collected for 1997–1998. Resource and service data came from professional colleges and government administrative databases. Results: No significant regional differences were found for need indicators, but there were large discrepancies in mental health resources and services in 1992–1993. Differences in professional resources were largest for special education teachers in the school system and for psychiatrists in the community. The regional differences in resources and services were as large in 1997–1998 as they were in 1992–1993. Conclusions: Despite universal health care in Quebec and a government mental health policy stressing equity of access, the available mental health resources for children aged 6 to 14 years are not distributed across regions according to needs. More evidence-based planning is required, specifically using epidemiologic survey data, to match resources to needs and to monitor changes over time.
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Brooker, Charles, and Paul Beard. "Psychiatric Nursing — Quo Vadis?" Bulletin of the Royal College of Psychiatrists 9, no. 4 (April 1985): 70–72. http://dx.doi.org/10.1192/s0140078900001668.
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In the last year or so the future of mental health services in this country has been intensively discussed. COHSE, MIND, and the Richmond Fellowship have produced their ‘blueprints', outlining details of the way they see services being organized. All variety of professional organizations have been busy presenting evidence to the House of Commons Social Services Committee which is specifically examining community care. The DHSS has committed more joint finance to ‘care in the community’ projects and Regional Health Authorities are examining the strategies to close large psychiatric hospitals. Consequently, District Health Authorities, in many cases, are planning the shape of a new mental health service which places increasingly less reliance on the large institution. The phrase ‘community care’ has now become so hackneyed in planning circles that for many it has lost whatever meaning it may have once had. However, despite all the rhetoric, and indeed all the planning activity, psychiatric nurses themselves have still to voice coherently their thoughts and fears about the shape of things to come.
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Gutman, Sharon A. "Promoting Occupational Therapy Mental Health Research: Proceedings From the 2017 AOTF Mental Health Planning Grant Collective." OTJR: Occupation, Participation and Health 41, no. 3 (April 2, 2021): 143–52. http://dx.doi.org/10.1177/15394492211005459.
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Although occupational therapists were once integrally involved in mental health practice, the percentage of therapists presently working in this clinical area is low. In 2017, the American Occupational Therapy Foundation convened a planning grant collective (PGC) to generate research to support populations with serious mental health challenges. The PGC’s primary mission was to identify key research areas in which occupational therapists and colleagues could work collaboratively to demonstrate evidence for occupational therapy services supporting mental health community participation. Participants included 21 members from six professions and three program officers from federal funding establishments. The PGC identified seven overarching research concepts, three broad areas of research inquiry, and eight possible studies addressing occupational therapy’s contribution to research promoting community participation and health outcomes for people with mental illness. This article provides a summary of the PGC proceedings so that researchers can collaboratively implement identified research topics.
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Salgado, Glaucia, and Sharon Koehn. "COMMUNITY-BASED SERVICES AND OLDER ADULTS: A COMBINATION IN MENTAL HEALTH PROMOTION." Innovation in Aging 3, Supplement_1 (November 2019): S845—S846. http://dx.doi.org/10.1093/geroni/igz038.3112.
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Abstract Mental health promotion among older adults has been considered an important goal by the World Health Organization (WHO, 2017). Mental health has been understood as not necessarily the absence of mental illness, but in fact, points on a continuum that although are not mutually exclusive, and it may intersect at times (Cowen, 1991; Keyes & Westerhof, 2012). With such complex health component, medical practices—although extremely critical in many cases—are often one factor of in the equation. Other practices, such as positive relationships among individuals and measures to tackle isolation are relevant and successful when planning practice for mental health promotion (Wister & McPherson 2014; Newall & Menec, 2019). A study done at a community-based seniors service in Vancouver – Canada shows that these spaces are considered a critical resource for visible minority older adults. Two focus groups were conducted at a community-based senior service with visible minority older adults between ages 55 to 80 years old. Results show that visible minority older adults strongly rely on this sector to maintain the connection with the society, and to the services provided in the wider community. Community-based seniors service provide opportunities for social inclusion and interactions, learning new things, and it has an inverse association with feeling isolated and lonely at home—a constant issue stated in the research. These findings indicate the critical role of this sector in ameliorating and promoting the mental health of visible minority older adults.
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Duncombe, Rohena H. "Receptionists in intake in community health." Australian Health Review 35, no. 2 (2011): 164. http://dx.doi.org/10.1071/ah09833.
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Receptionists are employed as administrative assistants, but in Community Health Centres, especially rural ones, they are the first step in service delivery, the intake system. This has implications for the people seeking services and for receptionists. This paper looks at receptionist data from an intake study alongside relevant literature and makes findings relating to the occupational health and safety (OH&S) of receptionists and for intake systems. What is known about the topic? Little attention has been given to the role of receptionists in health services. What is known suggests that receptionists would benefit from training related to mental illness and communications skills. It also indicates benefits from involving receptionists in system review and planning. What does this paper add? This paper identifies convergence between four sources of literature (receptionists in health, emotional labour, work and health (the Whitehall studies), and workplace learning) and the experience of receptionists in community health. What are the implications for practitioners? There is potential for managers to take into account the receptionist role as the first point in intake and service delivery. The OH&S of receptionists can be protected by ensuring receptionists are resourced, supported in their role, and included in intake system development. The ‘situated learning’ used by reception could be supplemented by in house training. Attention to reception, the clients’ first point of contact, has the potential to improve the engagement of and outcomes for people seeking services.
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Riordan, Sharon, Helen Smith, and Martin Humphreys. "Alternative Perceptions of Statutory Community Aftercare: Patient and Responsible Medical Officer Views." International Journal of Mental Health and Capacity Law, no. 7 (September 8, 2014): 119. http://dx.doi.org/10.19164/ijmhcl.v0i7.348.
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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.
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Williams, Ruth F. G. "Community Mental Health Services as a Process Innovation: Appropriate Economic Evaluation." Prometheus 25, no. 4 (December 2007): 393–414. http://dx.doi.org/10.1080/08109020701689243.
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Pillay, Anthony L. "Is deinstitutionalisation a cheap alternative to chronic mental health care?" South African Journal of Psychology 47, no. 2 (May 10, 2017): 141–47. http://dx.doi.org/10.1177/0081246317709959.
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Worldwide, there has been a dominant belief that the deinstitutionalisation of the mentally ill is a cost-saving approach, leading health authorities to embark on such initiatives without adequate community-based health and social service resources and supports. These have resulted in disaster, even in high-income countries, when insufficient planning and preparation have been effected. The recent experience in South Africa that saw the deaths of approximately 100 people with chronic mental illness within 1 year of being moved from a mental health facility is further evidence of the need for more concerted and deliberate planning and resourcing of mental health care services. The article examines various issues relating to deinstitutionalisation and urges authorities to re-examine their approach to mental health care and especially the priority accorded to this marginalised group.
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Oyebode, Jan R. "Carers as partners in mental health services for older people." Advances in Psychiatric Treatment 11, no. 4 (July 2005): 297–304. http://dx.doi.org/10.1192/apt.11.4.297.
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The role that carers play in supporting older people with mental health needs in the community is well recognised by professionals and in current government policy. This article promotes the view that a systematic planned approach that engages the carer as an integral part of the system of care has potential benefits for patients, carers and services. Ways of working in partnership are outlined and evidence that psychosocial interventions with carers are effective is briefly reviewed. Examples of individual and group interventions for dementia carers are given, drawing on clinical experience and research literature. Areas for further development are highlighted, including greater partnerships with carers in primary and continuing care, as well as at the level of planning and service development.
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Fantuzzi, Claudia, and Roberto Mezzina. "Dual diagnosis: A systematic review of the organization of community health services." International Journal of Social Psychiatry 66, no. 3 (January 20, 2020): 300–310. http://dx.doi.org/10.1177/0020764019899975.
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Background: Dual diagnosis (DD), as the co-occurrence of a substance use disorder and a psychiatric disorder, is underestimated, under-diagnosed and often poorly treated throughout the world, although it is highly prevalent in people suffering from a mental disorder. Aims and methods: This review analyzed 48 studies from a PubMed and PsycINFO databases search, in order to verify the state of the art regarding the organization of community health services for DD treatment. Results: Four macro-themes have been identified: service organization, critical issues, assessment tools and evidence-based interventions. An effective service recognizes the complexity of DD, promotes a common staff culture, and tailors the organization to local needs. The main critical issues in its implementation include the lack of specific staff training, the poor management of resources and the need for greater personalization of care plans, with attention to psychosocial interventions. Integrated service assessment tools can be used as a benchmark measure at the program level for implementation planning and at the national level to affect policy change. The integrated treatment model for DD should also aim to improve access to care and offer treatments based on scientific evidence. It is also evident that the integration of services can improve outcomes but it is not a guarantee for it. Conclusion: There is an urgent need to improve networking between mental health and addiction services in order to deal with DD and create new integrated intervention models, paying attention to an approach to the whole person, seen in his/her absolute uniqueness.
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Izquierdo, Adriana, Michael Ong, Esmeralda Pulido, Kenmeth B. Wells, Marina Berkman, Barbara Linski, Vivian Sauer, and Jeanne Miranda. "Community Partners in Care: 6- and 12-month Outcomes of Community Engagement versus Technical Assistance to Implement Depression Collaborative Care among Depressed Older Adults." Ethnicity & Disease 28, Supp (September 6, 2018): 339–48. http://dx.doi.org/10.18865/ed.28.s2.339.
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Objective: Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 95 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engagement and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care in underserved communities. This exploratory subanalysis examines 6- and 12-month outcomes among CPIC participants aged >50 years.Design: Community-partnered, cluster-randomized trial conducted between April 2010 and March 2012.Setting: Hollywood-Metropolitan (HM) and South Los Angeles (SLA) Service Planning Areas (SPAs), Los Angeles, CaliforniaParticipants: 394 participants aged >50 years with depressive symptoms (8-item Patient Health Questionnaire score ≥ 10).Intervention: A community-partnered multi-sector coalition approach (Community Engagement and Planning [CEP]) vs individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care.Main Outcome Measures: Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), community-prioritized outcomes including mental wellness, homelessness risk and physical activity, and services utilization.Results: At 6 months, CEP was more effective than RS at improving MHRQL and mental wellness among participants aged >50 years; no differences were found in the effects of CEP vs RS on other outcomes. No significant outcome differences between CEP and RS were found at 12 months.Conclusions: A multisector community coalition approach may offer additional benefits over individual program technical assistance to improve outcomes among depressed adults aged >50 years living in underserved communities. Ethn Dis.2018;28(Suppl 2):339-348; doi:10.18865/ed.28.S2.339.
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Killaspy, Helen, Sarah White, Tatiana L. Taylor, and Michael King. "Psychometric properties of the Mental Health Recovery Star." British Journal of Psychiatry 201, no. 1 (July 2012): 65–70. http://dx.doi.org/10.1192/bjp.bp.111.107946.
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BackgroundThe Mental Health Recovery Star (MHRS) is a popular outcome measure rated collaboratively by staff and service users, but its psychometric properties are unknown.AimsTo assess the MHRS's acceptability, reliability and convergent validity.MethodA total of 172 services users and 120 staff from in-patient and community services participated. Interrater reliability of staff-only ratings and test–retest reliability of staff-only and collaborative ratings were assessed using intraclass correlation coefficients (ICCs). Convergent validity between MHRS ratings and standardised measures of social functioning and recovery was assessed using Pearson correlation. The influence of collaboration on ratings was assessed using descriptive statistics and ICCs.ResultsThe MHRS was relatively quick and easy to use and had good test–retest reliability, but interrater reliability was inadequate. Collaborative ratings were slightly higher than staff-only ratings. Convergent validity suggests it assesses social function more than recovery.ConclusionsThe MHRS cannot be recommended as a routine clinical outcome tool but may facilitate collaborative care planning.
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Wright, Michael, Alex Brown, Patricia Dudgeon, Rob McPhee, Juli Coffin, Glenn Pearson, Ashleigh Lin, et al. "Our journey, our story: a study protocol for the evaluation of a co-design framework to improve services for Aboriginal youth mental health and well-being." BMJ Open 11, no. 5 (May 2021): e042981. http://dx.doi.org/10.1136/bmjopen-2020-042981.
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IntroductionMainstream Australian mental health services are failing Aboriginal young people. Despite investing resources, improvements in well-being have not materialised. Culturally and age appropriate ways of working are needed to improve service access and responsiveness. This Aboriginal-led study brings Aboriginal Elders, young people and youth mental health service staff together to build relationships to co-design service models and evaluation tools. Currently, three Western Australian youth mental health services in the Perth metropolitan area and two regional services are working with local Elders and young people to improve their capacity for culturally and age appropriate services. Further Western Australian sites will be engaged as part of research translation.Methods and analysisRelationships ground the study, which utilises Indigenous methodologies and participatory action research. This involves Elders, young people and service staff as co-researchers and the application of a decolonising, strengths-based framework to create the conditions for engagement. It foregrounds experiential learning and Aboriginal ways of working to establish relationships and deepen non-Aboriginal co-researchers’ knowledge and understanding of local, place-based cultural practices. Once relationships are developed, co-design workshops occur at each site directed by local Elders and young people. Co-designed evaluation tools will assess any changes to community perceptions of youth mental health services and the enablers and barriers to service engagement.Ethics and disseminationThe study has approval from the Kimberley Aboriginal Health Planning Forum Kimberley Research Subcommittee, the Western Australian Aboriginal Health Ethics Committee, and the Curtin University Human Research Ethics Committee. Transferability of the outcomes across the youth mental health sector will be directed by the co-researchers and is supported through Aboriginal and non-Aboriginal organisations including youth mental health services, peak mental health bodies and consumer groups. Community reports and events, peer-reviewed journal articles, conference presentations and social and mainstream media will aid dissemination.
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Tannahill, M. M. "Health Services Development Resource Assumptions and Planning Guidelines 1990/1991." Psychiatric Bulletin 14, no. 5 (May 1990): 316. http://dx.doi.org/10.1192/pb.14.5.316.
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In August 1989 the NHS Management Executive of the Department of Health issued Health Authorities with Circular HC(89)24 which lays down planning guidelines and resource assumptions for 1990/91. In five terse pages, the document sets the scene for the Government's priority health issues over the next two years. Several of these issues are of interest and importance to psychiatrists, as they are concerned with the implementation of the White Paper Caring for People: Community Care in the Next Decade and Beyond. Health Authorities are asked to “identify the health care needs of their populations” and to set targets, based on reports of their Directors of Public Health, to improve the overall health of their population.
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Bertram, Mark, and Louise Howard. "Employment status and occupational care planning for people using mental health services." Psychiatric Bulletin 30, no. 2 (February 2006): 48–51. http://dx.doi.org/10.1192/pb.30.2.48.
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Aims and MethodThe aim of the study was to identify the employment rates of people using local mental health services and examine any evidence in care plans for vocational or occupational interventions. We investigated case notes retrospectively.ResultsA total of 297 case notes were examined: 88% of the patients were unemployed, but there was evidence of documentation relating to vocational needs in only 18% of out-patients; 8% in patients of community mental health teams; and 39% in acute wards; 8% of patients were engaged in work schemes; 10% of patients were in education; and 9% were engaged in vocational interventions with their care coordinator; the latter was less likely if the patient was from a Black or minority ethnic group (OR=2.44, 95% CI 0.18–1.05).Clinical ImplicationsDespite high rates of unemployment, patients with psychiatric disorders are not referred for vocational interventions. Growing professional awareness of vocational possibilities for patients with severe mental illness should mean that many patients could return to competitive employment and return to mainstream society.
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Manthorpe, Jill, and Kevin Goodwin. "Advanced care planning: an exploratory study of community-based mental health practitioners’ views and experiences of ACP in practice with people with dementia." Working with Older People 23, no. 4 (November 28, 2019): 195–207. http://dx.doi.org/10.1108/wwop-07-2019-0016.
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Purpose Advanced care planning (ACP) involves the discussion of preferences relevant to a possible future time when one’s ability to make decisions may be compromised. ACP is considered as having potential to enhance choice and control and thereby to improve the experience of care for people with dementia and their carers. Care coordinators have been highlighted as possibly playing a central role in facilitating these discussions among people with long-term care needs. However, there is limited evidence of how ACP is facilitated by community mental health professionals who may be supporting people with dementia and carers. The paper aims to discuss this issue. Design/methodology/approach This exploratory study took the form of qualitative semi-structured interviews to explore the views and experiences of community mental health professionals when discussing ACP with people with dementia and/or their carers. A convenience sample of 14 participants working in community mental health services in one NHS Mental Health Trust in London, England, was recruited and interview data were analysed using a framework approach. Findings Five themes emerged from the interviews – knowledge and experience, use of ACP, inhibitors of discussion, service influences and the future. The depth of ACP facilitation appeared dependent on the knowledge, confidence and skills of the individual professional. Limited resources leading to service rationing were cited as a major barrier to ACP engagement. Helping people with dementia and their carers with ACP was not viewed as a priority in the face of competing and increasing demands. A further organisational barrier was whether ACP was viewed by service managers as “core business”. Findings indicate that practice was generally to refer people with dementia to other agencies for ACP discussions. However, pockets of ACP practice were reported, such as explaining proxy decision making options for finances. Research limitations/implications This exploratory study took place in the community mental health services in one NHS Mental Health Trust that may not be representative of other such teams. Case records were not scrutinised or clinical conversations with people with dementia or carers. Practical implications Barriers to initiating ACP discussions were cited, such as limited resources, lack of time and knowledge; unclear role remit, uncertain service direction and poor documentation sharing processes. However, participants held a common belief that ACP for people with dementia is potentially important and were interested in training, a greater team focus on ACP and pathway development. This indicates the potential for staff development and continuing professional development. Originality/value Few studies have asked a wide range of members of community mental health services about their knowledge, skills and confidence in ACP and this study suggests the value of taking a team-wide approach rather than uni-professional initiatives.
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Kalinich, Dave, Paul Embert, and Jeffrey D. Senese. "INTEGRATING COMMUNITY MENTAL HEALTH SERVICES INTO LOCAL JAILS: A POLICY PERSPECTIVE." Review of Policy Research 7, no. 3 (March 1988): 660–70. http://dx.doi.org/10.1111/j.1541-1338.1988.tb00861.x.
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Duncan, Monica. "Population health management and its relevance to community nurses." British Journal of Community Nursing 24, no. 12 (December 2, 2019): 596–99. http://dx.doi.org/10.12968/bjcn.2019.24.12.596.
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Local services can provide better and more joined-up care for patients when different organisations work collaboratively in an integrated system. Population health management (PHM) provides the shared data about local people's current and future health and wellbeing needs. Joint care planning and support addresses both the psychological and physical needs of an individual recognising the huge overlap between mental and physical wellbeing. Joint posts and joint organisational development are likely to become more commonplace and community nurses will have a vital contribution to planning and delivery of integrated care to improve health and care outcomes for their local populations.
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Pithara, Christalla, Michelle Farr, Sarah A. Sullivan, Hannah B. Edwards, William Hall, Caroline Gadd, Julian Walker, Nick Hebden, and Jeremy Horwood. "Implementing a Digital Tool to Support Shared Care Planning in Community-Based Mental Health Services: Qualitative Evaluation." Journal of Medical Internet Research 22, no. 3 (March 19, 2020): e14868. http://dx.doi.org/10.2196/14868.
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Background Mental health services aim to provide recovery-focused care and facilitate coproduced care planning. In practice, mental health providers can find supporting individualized coproduced care with service users difficult while balancing administrative and performance demands. To help meet this aim and using principles of coproduction, an innovative mobile digital care pathway tool (CPT) was developed to be used on a tablet computer and piloted in the West of England. Objective The aim of this study was to examine mental health care providers’ views of and experiences with the CPT during the pilot implementation phase and identify factors influencing its implementation. Methods A total of 20 in-depth telephone interviews were conducted with providers participating in the pilot and managers in the host organization. Interviews were audio recorded, transcribed, anonymized, and thematically analyzed guided by the Consolidated Framework for Implementation Research. Results The tool was thought to facilitate coproduced recovery-focused care planning, a policy and organizational as well as professional priority. Internet connectivity issues, system interoperability, and access to service users’ health records affected use of the tool during mobile working. The organization’s resources, such as information technology (IT) infrastructure and staff time and IT culture, influenced implementation. Participants’ levels of use of the tool were dependent on knowledge of the tool and self-efficacy; perceived service-user needs and characteristics; and perceptions of impact on the therapeutic relationship. Training and preparation time influenced participants’ confidence in using the tool. Conclusions Findings highlight the importance of congruence between staff, organization, and external policy priorities and digital technologies in aiding intervention engagement, and the need for ongoing training and support of those intended to use the technology during and after the end of implementation interventions.
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Doodson, Jeff, and Sara Davies. "Community care plans and the Mental Illness Specific Grant." Psychiatric Bulletin 18, no. 5 (May 1994): 260–62. http://dx.doi.org/10.1192/pb.18.5.260.
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Mental Illness Specific Grant was made available to local authorities for the care of people with severe mental illness, as part of care in the community. Although only a small sum of money it has had the effect of giving the newly created community care planning system a boost start. It has enabled professionals from all agencies to see tangible benefits from collaborative working. MISG is time limited but has already shown that health and social services can work together to make a reality of community care.