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The effectiveness of interventions to address health inequalities in the early years: a review of relevant literature
- Author:
- HALLAM Angela
- Publisher:
- Scotland. Scottish Government Social Research
- Publication year:
- 2008
- Pagination:
- 4p.
- Place of publication:
- Edinburgh
The Scottish Government is committed to reducing inequalities in the early years and is therefore anxious to investigate the effectiveness of interventions that address a spectrum of issues, from early sexual activity through to the development of confident, secure, healthy school-age children. This Research Findings summarises the key messages and characteristics of effective interventions outlined in a review of literature, prepared by the Scottish Government’s Health Analytical Services Division, to assess the effectiveness of interventions to address inequalities in the early years.
The effectiveness of interventions to address health inequalities in the early years: a review of relevant literature
- Author:
- HALLAM Angela
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2008
- Pagination:
- 145p.
- Place of publication:
- Edinburgh
The Scottish Government is committed to reducing inequalities in the early years and is therefore anxious to investigate the effectiveness of interventions that address a spectrum of issues, from early sexual activity through to the development of confident, secure, healthy school-age children. The Scottish Government’s Health Analytical Services Division (ASD) was asked to prepare this paper to investigate the relevant evidence base and advise on the known effectiveness of specific interventions, and coordinate relevant information being gathered across the Scottish Government and more widely to support policy development and delivery. ASD coordinated and analysed data from a number of sources. These included: publications/work in progress recommended and/or produced by colleagues within the Scottish Government, NHS Health Scotland and those conducting relevant research within universities and other organisations across Scotland. In the main, data fell into two categories: reviews of earlier work and primary studies. This work is not itself a systematic review of the relevant literature, and so evidence-based recommendations on interventions policy are not made. However, the messages have been synthesised into coherent messages for policy development and delivery.
Identifying the problems of financing long-term residential care
- Author:
- HALLAM Angela
- Journal article citation:
- Mental Health Research Review, 5, May 1998, pp.17-22.
- Publisher:
- Personal Social Services Research Unit
The terms of the NHS and Community Care Act (1990) brought about major changes in the way long-term residential care is arranged and financed. This article sketches in the background and indicates tensions within the pre-reform system; highlights arrangements for funding and monitoring residential care which were implemented as part of the reforms in April 1993; focuses on the effects these arrangements are having five years down the line; and examines the concerns for the future being expressed by purchasers and providers.
Costs and outcomes for people with special psychiatric needs
- Author:
- HALLAM Angela
- Journal article citation:
- Mental Health Research Review, 3,, April 1996, pp.10-13.
- Publisher:
- Personal Social Services Research Unit
As the psychiatric hospital closure programme gathers momentum, an increasingly disabled population of 'new' long-stay patients accumulates in the remaining wards. These people were identified twenty years ago as the most difficult to support outside hospital and they are characterised by severe symptoms of mental illness and a range of additional behavioural and social problems. If the policy aim to relocate all long-stay hospital care is to be accomplished, the nature of the challenges presented by the special needs of this group of patients must be acknowledged and addressed.
Research and evaluation to support the national programme for improving mental health and well-being
- Authors:
- HALLAM Angela, STOUT Alison
- Publisher:
- Scotland. Scottish Executive Health Department Analytical Services Division
- Publication year:
- 2007
- Pagination:
- 8p.
- Place of publication:
- Edinburgh
The Health Department’s Analytical Services Division (ASD) supports Scottish Executive policy development and implementation by providing integrated evidence, advice and support. Summaries of research and evaluation projects are listed under the following headings: tracking progress towards mental health improvement aims/goals, evaluation of National Programme delivery agencies/programmes of work, co-ordination of the evidence base on suicide and suicidal behaviour, the Small Research Projects Initiative and known future plans to March 2008.
Service use and costs of support 12 years after leaving hospital
- Authors:
- HALLAM Angela, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 19(4), December 2006, pp.296-308.
- Publisher:
- Wiley
There have been major changes in the provision and organization of services for people with intellectual disabilities in England over the last 30 years, particularly deinstitutionalization and the development of the mixed economy of care. The experiences of the people who participated in the Care in the Community Demonstration Programme in the mid-1980s provide evidence of the immediate and longer-term effects of the reprovision policy. Cross-sectional and longitudinal evidence was gathered on service use and costs for over 250 people 12 years after they left long-stay hospitals for community living arrangements. Comparisons were made with the situation in hospital, and 1 and 5 years after leaving. Relationships between costs after 12 years and individual characteristics assessed before people left hospital were explored. Community care at the 12-year follow-up remained more expensive than hospital-based support, although the average cost was lower than at either of the 1- or 5-year community follow-up points. Service users were living in a wide variety of accommodation settings. Management responsibility fell on National Health Service (NHS) trusts, local authorities, voluntary agencies, or to private organizations or individuals. After standardizing for users' skills and abilities, costs in minimum support accommodation were significantly lower than those in residential and nursing homes, costs in staffed group homes significantly higher, and costs in hostels slightly lower. When looking at differences between individuals, no relationship was found between costs and outcomes although, overall, people were better off in the community than they had been when in hospital. Reprovision planning for hospital and other institutional modes of care requires major and long-term commitment of resources. Quality of life improvements can be achieved at a cost little different in the long-run from that for hospital care. The link between needs and costs (reflecting the services intended to meet those needs) would be made stronger through the individualization of care.
The cost effectiveness of specialised facilities for services users with persistent challenging behaviours
- Authors:
- HALLAM Angela, TRIEMAN Noam
- Journal article citation:
- Health and Social Care in the Community, 9(6), November 2001, pp.429-435.
- Publisher:
- Wiley
Little systematic research relates specifically to the last people to leave a psychiatric hospital at the end of closure programme. The long-running evaluation of the reprovision of services from Friern Hospital in North London allowed a special study to be made of a small group whose range of problem behaviours made placement in community settings most difficult. The patients were assessed before leaving Friern, and one and five years after relocation. Reports on the type of facilities patients were relocated to and any changes in behaviour. Results suggest that high expenditure on alternative care was justified by overall long-term outcomes. An important policy lesson from the Friern Hospital reprovision is that adequate funds should be reserved until the end of the closure programme to allow the investment of resources in provision for patients with the most severe problems.
Sheltered work schemes for people with severe mental health problems: services use and costs
- Authors:
- HALLAM Angela, SCHNEIDER Justine
- Journal article citation:
- Journal of Mental Health, 8(2), April 1999, pp.171-186.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
An exploratory study was funded by the Department of Health to describe and cost a range of schemes which provide work for people with severe mental illness in the London area. This article sets out the methods used to undertake the costing component of the study. It examines the findings in terms of accommodation arrangements, work scheme costs and uptake of all other services by study members. The article also considers the relative costs of providing sheltered work and day care.
Costs and outcomes management in supported housing
- Authors:
- JARBRINK Krister, HALLAM Angela, KNAPP Martin
- Journal article citation:
- Journal of Mental Health, 10(1), February 2001, pp.99-198.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Providers of housing engage with a variety of care needs among vulnerable mixed populations. This study aims to examine the relationship between the levels of care and support provided, on the one hand, and tenants' characteristics, needs and living environment, on the other. The costs of providing housing and the costs of services used by tenants independently of their accommodation arrangements are also explored in the context of assessed needs and characteristics.