A report provided findings from a study of what worked in preventing and treating poor mental health of children in care. The report made a wide range of recommendations for policy and practice.
Source: Nikki Luke, Ian Sinclair, Matt Woolgar, and Judy Sebba, What Works in Preventing and Treating Poor Mental Health in Looked after Children?, NSPCC/Rees Centre, University of Oxford
An article examined perceptions of social justice among people with mental illness who were living in poverty. It said that research participants expressed a need for support of self-determination, and that there were multiple unmet needs, which required a multi-faceted approach in order to address them.
Source: Abraham Rudnick, Phyllis Montgomery, Robin Coatsworth-Puspoky, Benita Cohen, Cheryl Forchuk, Pam Lahey, Stewart Perry, and Ruth Schofield, 'Perspectives of social justice among people living with mental illness and poverty: a qualitative study', Journal of Poverty and Social Justice, Volume 22 Number 2
An article examined potential explanations for mental health service users' greater satisfaction with crisis houses (specialist residential placements in community settings), compared with services delivered in acute settings (hospital wards), and the factors that impeded and facilitated therapeutic relationships in acute settings.
Source: Angela Sweeney, Sarah Fahmy, Fiona Nolan, Nicola Morant, Zoe Fox, Brynmor Lloyd-Evans, David Osborn, Emma Burgess, Helen Gilburt, Rosemarie McCabe, and Sonia Johnson, 'A mixed-methods study exploring therapeutic relationships and their association with service user satisfaction in acute psychiatric wards and crisis residential alternatives', Health Services and Delivery Research, Volume 2 Issue 22
An article examined the roles and functions of the organizations that were responsible for regulating health and adult social care in England and for monitoring the operation of the Mental Health Act 1983 currently (the Care Quality Commission) and formerly (the Mental Health Act Commission). The article compared the two organizations in terms of their ability to provide a legitimate system of regulation and an effective safeguard for detained psychiatric patients. It said that the CQC did have the capacity to monitor detention, enforce standards, and improve the quality of psychiatric patient care, as long as it continued to uphold certain principles and standards and maintain its independence from the state.
Source: Judy Laing, 'Protecting the rights of patients in psychiatric settings: a comparison of the work of the Mental Health Act Commission with the CQC', Journal of Social Welfare & Family Law, Volume 36 Number 2
The government began consultation on proposed changes to the Mental Health Act 1983: Code of Practice. The Code provided guidance to mental health professionals and others in respect of the Act, to help them to safeguard patient's rights and ensure that they worked within the law, and also provided people detained or treated under the Act with information about their rights and expectations. The revised version would incorporate changes that arose following the Winterbourne View care home investigation, as well as changes and updates in legislation, policy, case law, and professional practice. The consultation would close on 12 September 2014.
Source: Stronger Code: Better care – consultation on proposed changes to the Code of Practice: Mental Health Act 1983, Department of Health
A report by a committee of MPs said that achieving the government's agenda to change and improve adult social care would require unprecedented levels of co-ordinated working between government departments, between central and local government, and across local authorities and health bodies. The committee questioned whether expectations were too high, and the report outlined concerns and made recommendations in three areas: for collaboration across all bodies involved in the care system; for better understanding of the capacity of the system and whether money was reaching frontline services; and for the government's oversight arrangements to reflect the overriding importance of quality of care. The committee raised concerns about the nature of employment contracts in the care sector and, in particular, the use of zero-hours contracts and the numbers of staff earning the minimum wage.
Source: Adult Social Care in England, Sixth Report (Session 201415), HC 518, House of Commons Public Accounts Select Committee, TSO
An article examined the use and potential of self-care support for mental health for children and young people (CYP), and how such support interfaced with statutory and non-statutory service provision. It said that key elements of self-care support included the acquisition of knowledge and skills, peer support, and the relationship with the self-care support agents: but CYP had different perceptions from adults about what was important. It said that effective self-care support services were predicated on: flexibility; straightforward access; non-judgemental, welcoming organizations and staff; the provision of time and attention; opportunities to learn and practice skills relevant to self-care; and systems of peer support. The article concluded that mental health self-care support interventions for CYP were modestly effective in the short to medium term.
Source: Steven Pryjmachuk, Rebecca Elvey, Susan Kirk, Sarah Kendal, Peter Bower, and Roger Catchpole, 'Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study', Health Services and Delivery Research, Volume 2 Issue 18
A report examined progress made during the five years since the publication of the Bradley Report, which reviewed the extent to which offenders with mental health problems or learning disabilities could be diverted from prison. The report said that there had been progress in developing liaison and diversion services in police stations and courts, but such work could only be effective if local health, social care, housing, and other vital services were also available to meet often multiple and complex needs. The report called for further work to provide greater consistency in the provision of mental health support in prisons, and the extension of the liaison and diversion operating model to all stages, including prevention, treatment, and resettlement, with 'through the gate' support for offenders as they left prison. It also recommended: training in mental health and learning disability awareness for frontline staff in all criminal justice services; better adherence to the Youth Justice Liaison and Diversion model; consistent availability of Appropriate Adults and intermediaries; a review of appropriate accommodation for offenders with vulnerabilities; and further research.
Source: Graham Durcan, Anna Saunders, Ben Gadsby, and Aidan Hazard, The Bradley Report Five Years On: An independent review of progress to date and priorities for further development, Centre for Mental Health
A report examined liaison and diversion services in police stations and courts that aimed to identify and support people with mental health problems, learning difficulties, and other vulnerabilities, drawing on research with staff, service users, and partners in four liaison and diversion schemes in different areas of England. It said that most users of the services had at least moderate mental health problems and most had come into contact with the liaison services after committing offences. The past histories of the service users showed missed opportunities for intervention, and people had additional needs for help with issues such as housing, personal finances (including debt), benefits, and employment. It said that staff were knowledgeable and client-focussed, and good services linked with a range of organizations to build support packages, offered case management for people while they put support in place, and stayed in touch with people after they had moved on to other services. The report summarised the key aspects of successful services, and made a range of recommendations for service providers and commissioners.
Source: Graham Durcan, Keys to Diversion: Best practice for offenders with multiple needs, Centre for Mental Health
A report examined the prevalence of mental health conditions and intellectual disability in the United Kingdom, their relationship with physical health, and the actions needed to reduce disparities in morbidity and mortality among the group of people with such conditions, compared with the rest of the population. It called for a range of changes, including: a national mortality review system; better prevention and early intervention strategies for mental health; enhanced training and workforce planning to improve the quality of care; more joined-up care, particularly through improving commissioning and delivery processes; and greater research focus on mental-physical multi-morbidity.
Source: Recognising the Importance of Physical Health in Mental Health and Intellectual Disability: Achieving parity of outcomes, British Medical Association
The Scottish Government published its response to a consultation on proposals to amend the regulations on the frequency of local authority guardianship supervision visits, and the requirement to provide information to local authorities.
Source: Adults with Incapacity (Supervision of Welfare Guardians etc. by Local Authorities) (Scotland) Regulations 2002: Scottish Government response to the consultation, Scottish Government
The Northern Ireland Executive began consultation on proposals to to give effect to a major recommendation of the Bamford Review into mental health and learning disability services by providing a new, single, legislative framework governing all situations where a decision needed to be made in relation to the care, treatment, or personal welfare of a person aged 16 or over who lacked capacity to make the decision for themselves. The document discussed the draft provisions relating to civil society, and outlined a proposed approach for people within the criminal justice system. The consultation would close on 2 September 2014.
Source: Draft Mental Capacity Bill (NI): Consultation document, Northern Ireland Executive
An article examined how forensic mental health service users actively attempted to manage their risk status, drawing on research in an inner city forensic mental health medium secure service in the United Kingdom. It said that that service users attempted to understand the system of assessment and sought to affect and reduce their risk status by engaging in overt, compliant behaviours. The article discussed the adverse effects of this approach.
Source: Lisa Reynolds, Julia Jones, Jacqueline Davies, Della Freeth, and Bob Heyman, 'Playing the game: service users' management of risk status in a UK medium secure forensic mental health service', Health, Risk & Society, Volume 16 Issue 3
A report said more research was needed into the nature and prevalence of mental health problems among children and young people from black and minority-ethnic communities, in order to support the planning, commissioning, and provision of appropriate mental health support in England. It said it was also important to recognize the specific needs of different ethnic groups and individuals, and to understand the barriers that deterred young people from accessing mental health services. The report called for commissioners and service providers to work with children and young people to develop evidence-based and culturally appropriate services, including early intervention services.
Source: Paula Lavis, The Importance of Promoting Mental Health in Children and Young People from Black and Minority Ethnic Communities, Race Equality Foundation
An article examined support for mental health services users who were 'hard to engage'. It said that: relationships with staff were central to maintaining engagement; there were often negative perceptions of inpatient care; the full ranges of people's needs were often not met; and service users were discouraged by a focus on medication. It discussed the importance of service users' preferences and priorities and concluded that difficulties in sustaining engagement with mental health services did not always mean that people did not want help.
Source: Rosemary Laura Davies, Pauline Heslop, Steve Onyett, and Tony Soteriou, 'Effective support for those who are ï¿½hard to engageï¿½: a qualitative user-led study', Journal of Mental Health, Volume 23 Number 2
The government launched a consultation (in the form of a survey) as part of its review of the operation of Sections 135 and 136 of the Mental Health Act 1983. This legislation gave the police powers to remove temporarily people who appeared to be suffering from a mental health crisis and who needed urgent care in a 'place of safety', to facilitate assessment or treatment. The review would aim to determine whether changes to the legislation were needed in order to improve outcomes for those experiencing mental health crisis. The consultation would close on 3 June 2014.
Source: Review of the Operation of Sections 135 and 136 of the Mental Health Act 1983 in England and Wales: A survey, Department of Health/Home Office
An article examined the use of ethnographic research to examine the effectiveness of community treatments orders in mental health settings, considering for whom they might work, in what circumstances, and why. Drawing on an ethnographic study, it considered the role of qualitative research in exploring causality, and considered how the research might fit within a realist framework.
Source: Hannah Jobling, 'Using ethnography to explore causality in mental health policy and practice', Qualitative Social Work, Volume 13 Number 1
A report examined the impact of the introduction of a market system (Any Qualified Provider) for the provision of psychological therapies in primary care in England. The AQP programme was introduced to allow for patient choice, and aimed to raise both service quality and efficiency through competition between providers. The report said that some waiting lists had been reduced, but raised a number of concerns, including the use of payment by results, the emergence of perverse incentives, levels of payment, the use of zero value contracts, concerns about the method and impact of outcome measurement, and concerns over the impact on smaller organizations. The report made recommendations for policy-makers, commissioners, and ongoing research.
Source: Steve Griffiths, Joan Foster, Scott Steen, and Patrick Pietroni, Mental Health's Market Experiment: Commissioning psychological therapies through Any Qualified Provider, Centre for Psychological Therapies in Primary Care, University of Chester
A government department published a policy paper on mental health in England. It set out 25 areas for action, including: patient choice in where they receive care; waiting time standards from 2015; an expansion in talking therapies; rolling out talking therapies for children and young people across the country by 2018; better support for young people as they move into adult services; and the allocation of up to £43 million from the Care and Support Specialized Housing Fund to support the construction of a small number of specialist housing projects.
Source: Closing the Gap: Priorities for essential change in mental health, Department of Health
Links: Report | DH press release | Written ministerial statement | MHF press release | NHS England press release | PHE press release | RCN press release | Turning Point press release | BBC report | Guardian report | Telegraph report
An article drew on participatory action research with asylum-seekers and refugees in Scotland to explore participants' views on mental health problems, stigma, and discrimination. Migration could have adverse effects on mental health and well-being, due to racism and the asylum process; and this was worsened by stigma and discrimination.
Source: Neil Quinn, 'Participatory action research with asylum seekers and refugees experiencing stigma and discrimination: the experience from Scotland', Disability & Society, Volume 29 Number 1