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Book

Measuring mental health needs

Editors:
THORNICROFT Graham, BREWIN Chris, WING John
Publishers:
Gaskell, Royal College of Psychiatrists
Publication year:
1992
Pagination:
328p.
Place of publication:
London

Describes the different approaches that can be taken to measuring the effectiveness of mental health services.

Journal article

Sex, relationships and mental health

Authors:
PACITTI Richard, THORNICROFT Graham
Journal article citation:
A Life in the Day, 13(1), February 2009, pp.27-30.
Publisher:
Emerald

There is relatively little written about the sexuality of people with mental health problems. Staff are often unsure how to balance service users rights to live a full life with the need to protect people considered to be vulnerable. This article explores the issues of sex, relationships and mental health. The authors also mention a film, Unspoken, made by Mind in Croydon which covers these issues.

Book

Shunned: discrimination against people with mental illness

Author:
THORNICROFT Graham
Publisher:
Oxford University Press
Publication year:
2006
Pagination:
301p.
Place of publication:
Oxford

People with mental illness commonly describe the stigma and discrimination they face as being worse than their main condition. The book presents clearly for a wide readership information about the nature and severity of discrimination against people with mental illness and what can be done to reduce this.

Journal article Full text available online for free

Patient preference randomised controlled trials in mental health research

Authors:
HOWARD Louise, THORNICROFT Graham
Journal article citation:
British Journal of Psychiatry, 188(4), April 2006, pp.303-304.
Publisher:
Royal College of Psychiatrists

The relationship between psychiatric patients’ preferences for different treatments and the outcome of interventions is unclear, as the few relevant trials have tended to be underpowered. Strong patient preferences result in patients refusing to enter a trial. This leads to bias and limits generalisability, and the patient preference randomised controlled trial (RCT) design has been proposed as an alternative. Limitations and advantages of patient preference RCTs are discussed.

Journal article

The Draft Mental Health Bill in England: without principles

Authors:
THORNICROFT Graham, SZMUKLER George
Journal article citation:
Psychiatric Bulletin, 29(7), July 2005, pp.244-247.
Publisher:
Royal College of Psychiatrists

Apart from the support for advocacy, it seems reasonable to conclude that this Bill is lacking in the remaining principles enunciated in the key policy documents that have provided a framework for our discussion. The authors doubt that legislation not founded on the national and international principles underlying modern mental health services can further the objectives of those services. Instead we have concerns that such ungrounded law will undermine the aspirations of both users and providers of mental health services to act in accordance with fundamental principles such as dignity, autonomy, empowerment, access and non-discrimination. In this sense it may not only be without principles, but there is a danger that in some circumstances (for example, when there are pressures for increased social control) its use could become unprincipled.

Journal article

Legal landmark for community care of former psychiatric patients

Authors:
THORNICROFT Graham, HALPERN Adina
Journal article citation:
British Medical Journal, 24.7.93, 1993, pp.248-250.
Publisher:
British Medical Association

A recent judgment of the Lands Tribunal has set an important precedent which should decrease the potential for restrictive covenants to thwart the development of the government's care in the community programme. In 1989 a Worthing couple were permitted to convert their own house into a residential care home for former psychiatric patients. A recent ruling found that the public interest outweighed a contractual stipulation that the property should be used only for residential, non-business purposes. This is a radical change in the Land Tribunal's view of mental illness.

Journal article Full text available online for free

Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009-2012

Authors:
EVANS-LACKO Sara, HENDERSON Claire, THORNICROFT Graham
Journal article citation:
British Journal of Psychiatry, 202(s55), April 2013, pp.s51-s57.
Publisher:
Royal College of Psychiatrists

Public stigma against people with mental health problems is damaging to individuals with mental illness and is associated with substantial societal burden. This study investigates whether public knowledge, attitudes and behaviour in relation to people with mental health problems have improved among the English population since the inception of the Time To Change programme in 2009. Longitudinal trends in public knowledge, attitudes and behaviour between 2009 and 2012 among a nationally representative sample of English adults were examined. Results found improvements in intended behaviour and a non-significant trend for improvement in attitudes among the English population. There was, however, no significant improvement in knowledge or reported behaviour. The findings provide support for effectiveness of the national Time to Change programme against stigma and discrimination in improving attitudes and intended behaviour, but not knowledge, among the public in England. (Edited publisher abstract)

Journal article

Stigma among people with dual diagnosis and implications for health services

Authors:
EVANS-LACKO Sara, THORNICROFT Graham
Journal article citation:
Advances in Dual Diagnosis, 3(1), February 2010, pp.4-7.
Publisher:
Emerald

Although we know that stigma and discrimination can be apparent in personal relationships, such as intimate partner or family relationships, and in organisational settings, such as work, health care and housing, current literature suggests that stigma and discrimination against people with mental illness and people with substance abuse problems is common and makes a significant impact on people’s lives. Yet firm evidence about whether stigma and discrimination are experienced differently, or at higher levels, for people with co-occurring mental illness and substance abuse is unclear. Given the high predominance of co-occurring disorders and the high levels of need among people with co-occurring disorders, understanding the varying levels of stigma and barriers to care encountered by this group is important for healthcare practitioners. The author concludes that despite the commonality of co-occurring disorders and high levels of need experienced by people with dual diagnosis, barriers to care may be even more prominent for this group compared to people with mental illness and substance abuse conditions alone. In summary, developing better understanding of the variations in experiences of stigma and discrimination and barriers to care will be important for meeting the needs of people with dual diagnosis.

Book Full text available online for free

Actions speak louder: tackling discrimination against people with mental illness

Author:
THORNICROFT Graham
Publisher:
Mental Health Foundation
Publication year:
2006
Pagination:
77p.
Place of publication:
London

The report criticises the government's mental health anti-stigma campaign, entitled Shift and launched in 2004, for offering policymakers few recommendations for action to combat discrimination. Instead of pumping millions of pounds trying to change society's negative attitudes towards people with mental health problems, more effort should be made to ensure that anti-discrimination law actually protects such people against prejudice. Specifically, the Disability Discrimination Act should be used to protect those with a mental health diagnosis in the same way it does those with a physical disability. The act has been framed primarily in relation to physical disability, and does little to help people with mental health problems. The report  lays out actions that policy-makers and campaigners, including Shift, which is run by the National Institute for Mental Health, should make to end discrimination against people with mental health problems. Suggestions include employers allowing the mentally ill not to work if impaired by medication, and providing them with an "external job coach" for counselling and support. The report also suggests modifying employment contracts for those people likely to be unwell for prolonged periods.

Journal article

Service users' experience of violence within a mental health system: A study using grounded theory approach

Authors:
KUMAR Shailesh, GUITE Hilary, THORNICROFT Graham
Journal article citation:
Journal of Mental Health, 10(6), December 2001, pp.597-611.
Publisher:
Informa Healthcare
Place of publication:
London

This study attempts to elicit the experiences of six existing service users of mental health services at the Maudsley Hospital by running a focus group. These service users had experienced violence as perpetrators, victims or witnesses within the mental health service. Grounded theory approach was used to analyse the transcript, which identified 21 categories and six themes: imbalance of power; violence has psychological sequelae; mental Health Services are not geared to help victims of institutional violence; the present mental health system fosters violence; a radical change is needed in the infrastructure of the mental health system and reinforcement and reforms may come from parallel efforts. Significant similarities were noted in the recommendations made by the study participants about the factors that may reduce violence within the mental health system. The study demonstrates that people with mental illness do experience violence, and that they are capable of identifying measures that are known to reduce violence on the basis of their personal experiences.

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