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Personal budgets: risk enablement and mental health

Author:
SOCIAL CARE INSTITUTE FOR EXCELLENCE
Publisher:
Social Care Institute for Excellence
Publication year:
2012
Place of publication:
London

This film showcases the work of Stockport Council and Pennine Care NHS Trust. As part of their risk enablement strategy for personal budgets and mental health they established a risk enablement panel as a last resort for discussing final support plans for people considered to be at risk. However, in the three years since the panel was established, they have only used it twice. Stockport has also committed to a culture change where staff and service users are able to openly discuss positive risk taking and concerns about risk. This has resulted in people with mental health problems (even those with more complex needs who use a budget managed by a third party) being able to use their personal budgets more creatively. They are experiencing positive outcomes such as improved confidence and self-determination and greater levels of activity. They also have more opportunities to take up volunteering and training for employment.

Journal article

Seriousness and lethality of attempted suicide: a systematic review

Authors:
LIOTTA Marco, MENTO Carmela, SETTINERIC Salvatore
Journal article citation:
Aggression and Violent Behavior, 21, 2015, pp.97-109.
Publisher:
Elsevier

The concepts of seriousness and lethality of suicide attempts are essential to the assessment of suicide risk and, therefore, to prevent suicidal behaviour. A review of the literature was conducted in order to identify the most important factors that increase the seriousness and potential lethality of attempted suicide. The factors identified were incorporated into four main categories: progression along the suicide continuum; age and gender; mental disorders and method of suicide. Although each category contains independent risk factors for the severity of the suicide attempt, their combination both within and, above all, between them, has emerged as the most important predictor of suicidal behaviour. (Publisher abstract)

Journal article

Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study

Authors:
QIN Ping, et al
Journal article citation:
British Journal of Psychiatry, 204(6), 2014, pp.430-435.
Publisher:
Royal College of Psychiatrists

Background: People with physical illness often have psychiatric disorder and this comorbidity may have a specific influence on their risk of suicide. Aims: To examine how physical illness and psychiatric comorbidity interact to influence risk of suicide, with particular focus on relative timing of onset of the two types of illness. Method: Based on the national population of Denmark, individual-level data were retrieved from five national registers on 27 262 suicide cases and 468 007 gender- and birth-date matched living controls. Data were analysed using conditional logistic regression. Results: Both suicides and controls with physical illness more often had comorbid psychiatric disorder than their physically healthy counterparts. Although both physical and psychiatric illnesses constituted significant risk factors for suicide, their relative timing of onset in individuals with comorbidity significantly differentiated the associated risk of suicide. While suicide risk was highly elevated when onsets of both physical and psychiatric illness occurred close in time to each other, regardless which came first, psychiatric comorbidity developed some time after onset of physical illness exacerbated the risk of suicide substantially. Conclusions: Suicide risk in physically ill people varies substantially by presence of psychiatric comorbidity, particularly the relative timing of onset of the two types of illness. Closer collaboration between general and mental health services should be an essential component of suicide prevention strategies. (Publisher abstract)

Journal article

Reconciling alternative to incarceration and treatment mandates with a consumer choice housing first model: a qualitative study of individuals with psychiatric disabilities

Authors:
STEFANCIC Ana, et al
Journal article citation:
Journal of Forensic Psychology Practice, 12(4), July 2012, pp.382-408.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia

This study examined how individuals experienced participating in a Housing First (HF) programme, which was designed to operate along principles of permanent housing, consumer choice, and harm reduction, while simultaneously participating in an Alternative to Incarceration (ATI) programme that incorporates treatment mandates, abstinence monitoring, and court reporting which tended to be in tension with the HF model. Analysis of qualitative interviews with 20 participants indicated that though participants recognised the constraints of the ATI programme and legal mandates, they somewhat surprisingly experienced the HF programme in accordance with the model's stated principles. The majority of participants remained in the HF programme after four years and reported positive outcomes, which many attributed to having a home of their own. The authors concluded that having the ATI programme served as a mediator with the criminal justice system and may have allowed the HF programme to have a buffer between the participant and the legal system.

Journal article

Risk factors for mental health diagnoses among children adopted from the public child welfare system

Authors:
HUSSEY David L., FALLETTA Lynn, ENG Abbey
Journal article citation:
Children and Youth Services Review, 34(10), October 2012, pp.2072-2080.
Publisher:
Elsevier

Adoptive youth’s mental health difficulties may pose considerable problems for the stability of the adoptive placement. The aim of this study was to examine potential child and biological family risk factors for mental health diagnosis among a group of adopted children. Data were extracted from children’s charts via extensive case file reviews for 368 children placed for adoption by a special needs adoption programme between February 1997 and April 2005. The findings showed that a significant proportion of the children and biological parents had experienced serious adversity prior to adoptive placement. Demographic diagnosis predictors included: older age at adoptive placement; white race; and male gender. Other predictors included: having more than 1 placement; and a history of sexual abuse. Biological parent incarceration was significantly associated with the absence of a mental health diagnosis. The article concludes that more work is needed to understand the interplay of risk and protective factors, including how these are affected by child welfare policies, informal procedures, and resources to produce varying outcomes for children in peril.

Journal article

Too much too young

Author:
MIZEN Susan
Journal article citation:
Young Minds Magazine, 116, Summer 2012, pp.19-21.
Publisher:
YoungMinds

This article examines how the experiences of being a carer during childhood can have long-term consequences in later life. The author, a consultant running a psychotherapy service for people with serious mental health problems, had noticed that about 25% of patients had been involved in a caring capacity during childhood for a parent or sibling. The article suggests that the long-term emotional and financial costs of placing the burden of care on young people might provide an incentive to policy makers to provide adequate support to families where children are caring for sick relatives.

Journal article

Mothers with mental health problems: a systematic review

Authors:
BLEGEN Nina E., HUMMELVOLL Jan K., SEVERINSSON Elisabeth
Journal article citation:
Nursing and Health Sciences, 12(4), December 2010, pp.519-528.
Publisher:
Wiley

Three major themes were examined in the 19 studies included in the review: the vulnerability of mothers with mental health problems, fears of not being considered a good enough mother, and concern that the children might develop mental health problems. The tendency to view the mothers in medical terms rather than as women with their own voices is identified as a barrier to providing help and support to mothers with mental health problems. The need for further research on lived experiences and existential concerns of the mothers is stressed.

Journal article

Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: a systematic review

Authors:
LI Zhuoyang, et al
Journal article citation:
Social Science and Medicine, 72(4), February 2011, pp.608-616.
Publisher:
Elsevier

Fourteen case-control and cohort studies were included in this systematic review and meta-analysis. Although relative risk for suicide was much higher for psychiatric disorders compared to socioeconomic factors, the population attributable risk for some socioeconomic factors and some psychiatric disorders were found to be of the same order of magnitude. The suggestion that public health policy on suicide prevention should focus on lower risk, but higher prevalence, socioeconomic factors is discussed.

Journal article

Affective disorders, anxiety disorders and the risk of alcohol dependence and misuse

Authors:
LIANG Wenbin, CHIKRITZHS Tanya
Journal article citation:
British Journal of Psychiatry, 199(3), September 2011, pp.219-224.
Publisher:
Royal College of Psychiatrists

It remains unclear whether affective disorders and anxiety disorders increase the risk of alcohol dependence and alcohol misuse. This retrospective cohort study is based on data collected from the 2007 Australia Mental Health and Well-Being survey. Both Poisson and logistic regression models were used for multivariate analysis. There were 8841 participants in the MHW study of whom 342 had received a diagnosis of alcohol dependence at some time prior to the start of the study; full data was available and analysed for 336. Those with affective and anxiety disorders appeared to be at higher risk of alcohol misuse or dependence. For affective disorders the relative risk of alcohol dependence within five years was 5.46; for anxiety disorders it was 3.33. The authors conclude that common affective disorders and anxiety disorders may increase the risk of alcohol dependence and alcohol misuse among the Australian population.

Journal article

Emotional well-being and mental health of looked after children in England

Authors:
MCAULEY Colette, DAVIS Teresa
Journal article citation:
Child and Family Social Work, 14(2), May 2009, pp.147-155.
Publisher:
Wiley-Blackwell

This article examines the evidence on prevalence of mental health problems amongst looked after children in England. In previous national prevalence studies forty-five per cent of looked after children in England were found to have a diagnosable mental health disorder. In contrast, this is to one in 10 in the general population. Carers estimated that mental health problems were even more widespread. Children with mental health disorders were also more likely to have education, health and social issues. This paper discusses the findings and argues for early intervention along with inter-departmental and interdisciplinary approaches. The recent Child and Adolescent Mental Health Services Review clearly indicates that issues of access to appropriate and timely Child and Adolescent Mental Health Services remain. However, the introduction of evidence-based approaches is encouraging. Young people's views on the services they want and on what is important for emotional well-being and mental health are important considerations.

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