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Making a real difference
- Author:
- NEWBIGGING Karen
- Journal article citation:
- Mental Health Today, September 2005, pp.27-30.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The National Institute for Mental Health England (NIMHE) was established in 2002, and from the beginning had a commitment to put people who use services at the centre of their work, and involve service users and carers in the planning and delivery of work. In 2004 the NIMHE executive team conduced a review of service users and carer involvement at all levels within NIMHE, with the aim of identifying what action was needed to develop a more co-ordinated and strategic approach. This article provides a brief overview of the review, its key findings and recommendations.
Not so easy
- Author:
- NEWBIGGING Karen
- Journal article citation:
- Mental Health Today, October 2002, pp.12-13.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Looks at how primary care services are responding to standard two of the National Service Framework for Mental Health, that anyone who contacts their primary health care team with a common mental health problem should be assessed and offered treatment or referral to a specialist mental health service.
Promoting social inclusion
- Author:
- NEWBIGGING Karen
- Journal article citation:
- Mental Health Review, 6(3), September 2001, pp.5-12.
- Publisher:
- Pier Professional
The National Service Framework for Mental Health (Department of Health, 1999) highlights the need for health and social services to tackle stigma and discrimination and to promote the social inclusion of people with mental health problems, but there are doubts as to how effectively this will be translated into action. This article aims to provide a basis for practical action by starting with the experience of exclusion by people with mental health problems, exploring the meanings of social inclusion and exclusion, identifying some useful contributions to thinking about social inclusion and considering what these might mean in practice. Argues that if social inclusion is to be translated into reality for people with mental health problems then the ambiguities within practice and policy need to be recognised, the reasons for exclusion made explicit, and an acknowledgement that promoting inclusion is necessarily a demanding endeavour.
Implementing the National Service Framework - challenges and opportunities
- Author:
- NEWBIGGING Karen
- Journal article citation:
- Mental Health Review, 4(4), December 1999, pp.6-13.
- Publisher:
- Pier Professional
This paper examines the challenges and opportunities facing local stakeholders in the implementation of the National Service Framework. What is the introduction of the National Service Framework likely to mean for local services? What issues will effect its implementation and the consequent development of good quality comprehensive mental health services? This paper explores these questions.
The contribution of the voluntary sector to mental health crisis care: a mixed-methods study
- Authors:
- NEWBIGGING Karen, et al
- Journal article citation:
- Health and Social Care Delivery Research, 8(29), 2020, Online only
- Publisher:
- National Institute for Health Research
- Place of publication:
- London
Background: Weaknesses in the provision of mental health crisis support are evident and improvements that include voluntary sector provision are promoted. There is a lack of evidence regarding the contribution of the voluntary sector and how this might be used to the best effect in mental health crisis care. Aim: To investigate the contribution of voluntary sector organisations to mental health crisis care in England. Design: Multimethod sequential design with a comparative case study. Setting: England, with four case studies in North England, East England, the Midlands and London. Method: The method included a scoping literature review, a national survey of 1612 voluntary sector organisations, interviews with 27 national stakeholders and detailed mapping of the voluntary sector organisation provision in two regions (the north and south of England) to develop a taxonomy of voluntary sector organisations and to select four case studies. The case studies examined voluntary sector organisation crisis care provision as a system through interviews with local stakeholders (n = 73), eight focus groups with service users and carers and, at an individual level, narrative interviews with service users (n = 47) and carers (n = 12) to understand their crisis experience and service journey. There was extensive patient and public involvement in the study, including service users as co-researchers, to ensure validity. This affected the conduct of the study and the interpretation of the findings. The quality and the impact of the involvement was evaluated and commended. Main findings: A mental health crisis is considered a biographical disruption. Voluntary sector organisations can make an important contribution, characterised by a socially oriented and relational approach. Five types of relevant voluntary sector organisations were identified: (1) crisis-specific, (2) general mental health, (3) population-focused, (4) life-event-focused and (5) general social and community voluntary sector organisations. These voluntary sector organisations provide a range of support and have specific expertise. The availability and access to voluntary sector organisations varies and inequalities were evident for rural communities; black, Asian and minority ethnic communities; people who use substances; and people who identified as having a personality disorder. There was little evidence of well-developed crisis systems, with an underdeveloped approach to prevention and a lack of ongoing support. Limitations: The survey response was low, reflecting the nature of voluntary sector organisations and demands on their time. This was a descriptive study, so evaluating outcomes from voluntary sector organisation support was beyond the scope of the study. Conclusions: The current policy discourse frames a mental health crisis as an urgent event. Viewing a mental health crisis as a biographical disruption would better enable a wide range of contributory factors to be considered and addressed. Voluntary sector organisations have a distinctive and important role to play. The breadth of this contribution needs to be acknowledged and its role as an accessible alternative to inpatient provision prioritised. Future work: A whole-system approach to mental health crisis provision is needed. The NHS, local authorities and the voluntary sector should establish how to effectively collaborate to meet the local population’s needs and to ensure the sustainability of the voluntary sector. Service users and carers from all communities need to be central to this. (Edited publisher abstract)
Filling the chasm: reimagining primary mental health care
- Authors:
- NEWBIGGING Karen, et al
- Publisher:
- Centre for Mental Health
- Publication year:
- 2018
- Pagination:
- 24
- Place of publication:
- London
This briefing paper, from the Centre for Mental Health and University of Birmingham, identifies promising initiatives that could provide the basis for a framework or set of standards for primary mental health care to support commissioning and provision. It also highlights the value of primary care in providing early intervention and prevention for people experiencing poor mental health and its potential to work closely with other health services, local authorities, and community and voluntary sector organisations. The paper describes approaches in eight local areas which bridge the gap between primary care and secondary care mental health services. The areas are: Bradford, Cambridge and Peterborough, Catterick, Cornwall, Norfolk and Suffolk, Northamptonshire, Swindon and Tower Hamlets. Based on learning from the examples, the report identifies key elements for future primary mental health care developments. These include identifying the opportunities for prevention and promotion of mental health; maximising social interventions for mental health and improving awareness of community resources; embracing the holistic approach, valuing social support and linking to physical health initiatives; empowering the person and enabling people to make their own decisions about what they need to focus on, addressing social factors and causes of mental health problems; and bridging the gap between primary and secondary care, for example by co-locating services or employing senior staff to provide consultancy and supervision. (Edited publisher abstract)
Mental health in the West Midlands Combined Authority: a report for the West Midlands Mental Health Commission
- Authors:
- NEWBIGGING Karen, PARSONAGE Michael
- Publisher:
- University of Birmingham
- Publication year:
- 2017
- Pagination:
- 91
- Place of publication:
- Birmingham
This study assesses the current costs of mental ill health and current service provision across the West Midlands region. It estimates the financial impact of poor mental health on the region to be over £12 billion per year, including nearly £2 billion a year as a direct cost to the NHS – equivalent to more than £3000 for every person living in the area. As well as the significant financial impact of poor mental health identified in the study, other key findings include: nearly one in four adults (23.8%) in the region are experiencing mental health problems at any given time; there are strong links between mental health and socio-economic conditions (for example, women living in the poorest households are nearly three times as likely as men living in the most well-off households to be diagnosed with a common mental health problem, and people living in the poorest socio-economic circumstances are ten times more at risk of suicide than those in well-off households); if the high costs of poor mental health are to be substantially reduced, the mental health of children and young people needs to be a priority, both for its immediate benefits and because intervention in the early years has been shown to reduce mental health problems in adulthood; organisations in the WMCA have been pioneers in developing innovative models of care. However, there is variation between CCGs and Local Authorities in terms of the range of provision and performance on national performance indicators. This means that some people will find it harder to access the support they need. (Edited publisher abstract)
Independent mental health advocacy: the right to be heard: context, values and good practice
- Authors:
- NEWBIGGING Karen, et al
- Publisher:
- Jessica Kingsley
- Publication year:
- 2015
- Pagination:
- 336
- Place of publication:
- London
This book takes an appreciative but critical view of independent mental health advocacy, locating the recent introduction of independent mental health advocates (IMHAs) within a broader historical, social and policy context, and anticipates future developments. Independent mental health advocacy is a crucial means of ensuring rights and entitlements for people sectioned under the Mental Health Act. The text includes the voices of service users throughout, both as authors and research participants. Drawing on their research, the authors provide a historical overview of mental health advocacy, independent mental health advocacy in relation to the law, the role and responsibilities of IMHAs, essential values, knowledge and skills required of advocates, relationships with service providers, commissioning, measuring advocacy outcomes, and how IMHA services can be made accessible and appropriate to diverse groups. (Edited publisher abstract)
‘When you haven't got much of a voice’: an evaluation of the quality of Independent Mental Health Advocate (IMHA) services in England
- Authors:
- NEWBIGGING Karen, et al
- Journal article citation:
- Health and Social Care in the Community, 23(3), 2015, pp.313-324.
- Publisher:
- Wiley
Given the context of increasing numbers of people detained under the Mental Health Act and heightened awareness of the potential for neglect and abuse in human services, statutory advocacy is an important safeguard supporting human rights and democratising the social relationships of care. This article reports findings from a national review of Independent Mental Health Advocate (IMHA) provision in England. A qualitative study used a two-stage design to define quality and assess the experience and impact of IMHA provision in eight study sites. A sample of 289 participants - 75 focus group participants and 214 individuals interviewed - including 90 people eligible for IMHA services, as well as advocates, a range of hospital and community-based mental health professionals, and commissioners. The research team included people with experience of compulsion. Findings indicate that the experience of compulsion can be profoundly disempowering, confirming the need for IMHA. However, access was highly variable and more problematic for people with specific needs relating to ethnicity, age and disability. Uptake of IMHA services was influenced by available resources, attitude and understanding of mental health professionals, as well as the organisation of IMHA provision. Access could be improved through a system of opt-out as opposed to opt-in. Service user satisfaction was most frequently reported in terms of positive experiences of the process of advocacy rather than tangible impacts on care and treatment under the Mental Health Act. IMHA services have the potential to significantly shift the dynamic so that service users have more of a voice in their care and treatment. However, a shift is needed from a narrow conception of statutory advocacy as safeguarding rights to one emphasising self-determination and participation in decisions about care and treatment. (Edited publisher abstract)
The right to be heard: review of the quality of Independent Mental Health Advocate (IMHA) services in England
- Authors:
- NEWBIGGING Karen, et al
- Publisher:
- University of Central Lancashire. School of Health
- Publication year:
- 2012
- Pagination:
- 292
- Place of publication:
- Preston
Independent Mental Health Advocate (IMHA) services were introduced in the Mental Health Act 2007. Primary Care Trusts (PCTs) became responsible for ensuring the availability of IMHA services in April 2009. An IMHA is a specialist type of mental health advocate, granted specific roles and responsibilities under the 2007 Act. The role of the IMHA is to help qualifying patients understand the legal provisions to which they are subject under the Mental Health Act 1983, the rights and safeguards to which they are entitled, and to help these patients to exercise their rights through supporting participation in decision-making. This review of the quality of IMHA provision across England was commissioned by the Department of Health. The study was undertaken by researchers at the University of Central Lancashire (UCLan) in partnership with Equalities National Council, Aawaz, Manchester African Caribbean Mental Health Services and Comensus, a University-wide forum supporting the involvement of service users and carers in teaching and research. The main aim was to look at how IMHA services are providing help to patients under the 2007 Act, what makes for a good IMHA service, and what factors influence the quality of service provided. The study used different methods to gather information about how IMHA services are working in practice. A first stage involved: a focused literature review; 11 focus groups held across England with a range of stakeholders (advocates, mental health service users, IMHA partners, carers and mental health professionals); and shadow visits to IMHA services. A second stage involved gathering data in eight case study sites (mental health providers) to understand the experience of qualifying patients, the commissioning and delivery of IMHA services, and their relationship with mental health services. The case study sites were selected to reflect differences in the local population and the way IMHA services were organised and delivered. In total 214 people were interviewed, including 90 qualifying patients, 61 of whom had experience of using IMHA services. The report presents key findings on: experiences of the 2007 Act; access to, and understanding and provision of IMHA services; IMHA services and the diversity of qualifying patients; the mental health services context; the benefits of the service; commissioning IMHA services; and determining the quality of IMHA services. The report makes recommendations for government, the Care Quality Commission, commissioners, mental health services, IMHA services, service user, carer and community organisations, and higher education and training providers. This research has found that the IMHA role is valued and appreciated by service users, although its potential is not fully realised. Action is required to strengthen the capacity of such advocacy services; and future research needs to explore gaps in the evidence base and to further evaluate the impact of IMHA practice. (Edited publisher abstract)