Learning Disability Today, 10(5), June 2010, pp.20-21.
Publisher:
Pavilion
Place of publication:
Hove
The author reports that, for many project leads who are working on implementing local “Green Light” action plans to improve mental health support for people with learning disabilities, change is proving difficult and slow to achieve. Green Light is a service improvement toolkit centred on the National Service Framework (NSF) for mental health. It includes a self-assessment checklist to evaluate how well local areas are applying the NSF to meet the specific needs of people with learning disabilities who experience mental health problems. Green Light is designed to help local areas plan action to ensure that people with learning disabilities benefit from improvements in the same way as everyone else. To encourage and support the implementation of Green Light the Care Services Improvement Partnership funded a national programme: Green Light: Making It Happen. The author discusses the themes around the struggle to implement action plans that emerged: a lack of local data; capacity issues and competing priorities; the need to change practices; engagement issues; the challenge of change; and a lack of agreements and pathways. She goes on to consider what helps and list things that appear to have made a real difference in local areas. The New Horizons short briefings series beginning in the Spring of 2010 to inform and update local decision makers is welcomed but the author believes there is still a need for a new Green Light support programme.
The author reports that, for many project leads who are working on implementing local “Green Light” action plans to improve mental health support for people with learning disabilities, change is proving difficult and slow to achieve. Green Light is a service improvement toolkit centred on the National Service Framework (NSF) for mental health. It includes a self-assessment checklist to evaluate how well local areas are applying the NSF to meet the specific needs of people with learning disabilities who experience mental health problems. Green Light is designed to help local areas plan action to ensure that people with learning disabilities benefit from improvements in the same way as everyone else. To encourage and support the implementation of Green Light the Care Services Improvement Partnership funded a national programme: Green Light: Making It Happen. The author discusses the themes around the struggle to implement action plans that emerged: a lack of local data; capacity issues and competing priorities; the need to change practices; engagement issues; the challenge of change; and a lack of agreements and pathways. She goes on to consider what helps and list things that appear to have made a real difference in local areas. The New Horizons short briefings series beginning in the Spring of 2010 to inform and update local decision makers is welcomed but the author believes there is still a need for a new Green Light support programme.
Extended abstract:
Author
COLE Angela, GREGORY Margaret.
Title
Green Light for mental health: a service improvement toolkit.
Publisher
Foundation for People with Learning Disabilities, 2004
Summary
Green Light is a framework and self audit toolkit for improving mental health support services for people with learning disabilities, providing a picture of what services should be aiming to achieve, including quality outcomes, and a self assessment checklist, and aimed at Mental Health Local Implementation Teams and Learning Disability Partnership Boards.
Contents
Part A is a guide to the pack itself and to improving services and support for people with mental health problems who have learning disabilities. Section One introduces Green Light, telling users about the pack and what it's for and giving some ideas about getting the most benefit from the toolkit. Section Two is an easy to read summary designed primarily for use with and by people with learning disabilities. Section Three has two parts which, when added together, give an overall picture of what services should be aiming to achieve. The first gives the national policy context and highlights what the government expects of services in relation to people with mental health problems who have learning disabilities. The second is about quality outcomes for people with mental health problems who have learning disabilities and for their carers, from their own perspectives. Section Four creates a concrete picture of what needs to happen ‘out there' in the reality of services. It highlights key challenges for services in moving towards integrated mental health services for people with learning disabilities; explores what the national policy objectives actually look like in practice, i.e., accessible, integrated mental health support services, using examples from around the UK wherever possible. Section Five is about how to work out what needs to be sustained or changed locally. It introduces the self-assessment checklist and some ready-to-use survey tools which are found in Part B. The self-assessment checklist is at the core of the service improvement toolkit. There is guidance about getting information and evidence to underpin your local self-assessment, and about presenting findings to the Local Implementation Teams and Partnership Board. Part B – the toolkit – has four sections. Section One contains the self-assessment checklist and an action planning proforma. Section Two is a survey of in-patient experience Section Three is a survey of community support experiences. Section Four is a survey of carers' experiences. Throughout the guide there are quotations from the test sites and from people with mental health problems who have learning disabilities, which reinforce points in the text, and references to publications, resources and sources of information. These are listed at the end.
23 references
Subject terms:
learning disabilities, mental health problems, mental health services, social care provision, evaluation;
Advances in Mental Health and Learning Disabilities, 3(2), June 2009, pp.3-7.
Publisher:
Emerald
Green Light was developed to enable service providers to implement the National Service Framework for Mental Health (NSF MH), and asks how good your mental health services are for people with a learning disability. A multi-agency user and carer project in Hampshire has evaluated and improved the quality of existing service provision for adults with learning disabilities who also have a mental health problem.
Green Light was developed to enable service providers to implement the National Service Framework for Mental Health (NSF MH), and asks how good your mental health services are for people with a learning disability. A multi-agency user and carer project in Hampshire has evaluated and improved the quality of existing service provision for adults with learning disabilities who also have a mental health problem.
Subject terms:
learning disabilities, mental health problems, mental health services, quality assurance, evaluation;
Psychiatric Bulletin, 31(4), April 2007, pp.138-141.
Publisher:
Royal College of Psychiatrists
Assertive community treatment (ACT) was developed in the early 1970s as a means of coordinating the care of people with severe mental illness in the community. A Cochrane review of the effectiveness of ACT for the general adult population found that people receiving ACT were more likely to engage with services, and were less likely to be admitted to hospital. This article describes the development and operation of the learning disability assertive outreach team in Oxfordshire. This could be used as a framework for setting up similar teams for working with people with learning disability and mental health problems. The results of an audit comparing a period of assertive outreach care with standard community care are discussed.
Assertive community treatment (ACT) was developed in the early 1970s as a means of coordinating the care of people with severe mental illness in the community. A Cochrane review of the effectiveness of ACT for the general adult population found that people receiving ACT were more likely to engage with services, and were less likely to be admitted to hospital. This article describes the development and operation of the learning disability assertive outreach team in Oxfordshire. This could be used as a framework for setting up similar teams for working with people with learning disability and mental health problems. The results of an audit comparing a period of assertive outreach care with standard community care are discussed.
Subject terms:
learning disabilities, mental health problems, assertive outreach, community care, evaluation;
Journal of Applied Research in Intellectual Disabilities, 33(6), 2020, pp.1340-1347.
Publisher:
Wiley
Introduction: People with intellectual disability have a higher chance of developing mental disorders than the general population. Yet, few evidence‐based interventions exist. This article evaluates My Lifestory, a narrative intervention tailored to people with intellectual disability and depressive or trauma‐related complaints. Method: A quasi‐experimental research design was adopted with an experimental condition (My Lifestory) and a matched control condition (care as usual). Measurements took place before the intervention, at the end of the intervention and at follow‐up two months later. Measurements focused on psychiatric complaints, well‐being, life satisfaction, mastery, and purpose in life. Results: Participants in the intervention condition improved more in psychiatric complaints, well‐being, life satisfaction, and purpose in life, but not in mastery, than participants in the control condition. Effect sizes were large in the intervention condition and small in the control condition. Discussion: Despite some limitations, this study adds to the evidence base of this narrative intervention.
(Edited publisher abstract)
Introduction: People with intellectual disability have a higher chance of developing mental disorders than the general population. Yet, few evidence‐based interventions exist. This article evaluates My Lifestory, a narrative intervention tailored to people with intellectual disability and depressive or trauma‐related complaints. Method: A quasi‐experimental research design was adopted with an experimental condition (My Lifestory) and a matched control condition (care as usual). Measurements took place before the intervention, at the end of the intervention and at follow‐up two months later. Measurements focused on psychiatric complaints, well‐being, life satisfaction, mastery, and purpose in life. Results: Participants in the intervention condition improved more in psychiatric complaints, well‐being, life satisfaction, and purpose in life, but not in mastery, than participants in the control condition. Effect sizes were large in the intervention condition and small in the control condition. Discussion: Despite some limitations, this study adds to the evidence base of this narrative intervention.
(Edited publisher abstract)
Subject terms:
intervention, evaluation, adult social care, learning disabilities, mental health problems, depression, traumas;
Journal of Applied Research in Intellectual Disabilities, 33(5), 2020, pp.1005-1015.
Publisher:
Wiley
Background: In the Netherlands, Flexible Assertive Community Treatment (FACT) teams have been established for people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and mental health problems or challenging behaviour. Little is known yet about service users’ experiences with FACT. Method: An inductive grounded theory approach was used to explore how service users valued the treatment and their own functioning, and which factors were perceived as supportive. Semi‐structured interviews were held with 15 service users. Results: Most service users highly appreciated the contact with the staff and the practical and emotional support. Persistent involvement, availability and humanity, and respect for autonomy were distinguished as core values in the relationship with the staff. Most service users experienced improvement in time and attributed this to intrapersonal changes and/or less stress in life. Conclusions: From the perspective of service users with MID/BIF, FACT appears to have an added value.
(Edited publisher abstract)
Background: In the Netherlands, Flexible Assertive Community Treatment (FACT) teams have been established for people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and mental health problems or challenging behaviour. Little is known yet about service users’ experiences with FACT. Method: An inductive grounded theory approach was used to explore how service users valued the treatment and their own functioning, and which factors were perceived as supportive. Semi‐structured interviews were held with 15 service users. Results: Most service users highly appreciated the contact with the staff and the practical and emotional support. Persistent involvement, availability and humanity, and respect for autonomy were distinguished as core values in the relationship with the staff. Most service users experienced improvement in time and attributed this to intrapersonal changes and/or less stress in life. Conclusions: From the perspective of service users with MID/BIF, FACT appears to have an added value.
(Edited publisher abstract)
Advances in Mental Health and Intellectual Disabilities, 10(3), 2016, pp.185-198.
Publisher:
Emerald
Purpose: The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical Behaviour Therapy programme, the “I Can Feel Good” programme (Ingamells and Morrissey, 2014) designed for individuals with intellectual disabilities (ID) and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper.
Design/methodology/approach: The training was delivered for staff working with individuals with ID in a UK medium-secure psychiatric hospital and was attended by nursing staff. The workshop consisted of six modules: “Introduction to the programme”, “Mindfulness”, “Managing feelings”, “Coping in Crisis”, “People skills” and “Application and summary”. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training.
Findings: The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant.
Originality/value: This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with ID. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members.
(Publisher abstract)
Purpose: The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical Behaviour Therapy programme, the “I Can Feel Good” programme (Ingamells and Morrissey, 2014) designed for individuals with intellectual disabilities (ID) and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper.
Design/methodology/approach: The training was delivered for staff working with individuals with ID in a UK medium-secure psychiatric hospital and was attended by nursing staff. The workshop consisted of six modules: “Introduction to the programme”, “Mindfulness”, “Managing feelings”, “Coping in Crisis”, “People skills” and “Application and summary”. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training.
Findings: The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant.
Originality/value: This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with ID. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members.
(Publisher abstract)
Subject terms:
evaluation, staff, training, learning disabilities, emotions, mental health problems, therapies;
Purpose – The purpose of this paper is to present results from an evaluation of the experience of a move to independent living for people with mental health needs or a learning disability. The discussion focuses on the shift in organisational culture from providing care within a hostel setting to supporting people in their own tenancies.
Design/methodology/approach – The evaluation was underpinned by a participatory action research design. A total of ten co-researchers with experience of using services or as carers were recruited. Qualitative data was obtained from “before” and “after” interviews with residents, staff and relatives.
Findings – Widespread satisfaction was expressed with people's new homes. Many residents were found to be increasingly independent. There was some evidence of concerns regarding the pace and process of change and the introduction of new practices to promote independence.
Research limitations/implications – The timing of the evaluation limited the opportunity for comprehensive “before” and “after” data collection. The involvement of co-researchers required considerable time and support although the experience of those involved was positive.
Practical implications – Learning from this evaluation emphasises the importance of support and preparation for staff as well as residents, in moving from hostel to independent living.
Social implications – This study highlights the advantages of a participatory design in evaluating a major change in service delivery.
Originality/value – This paper raises important issues about organisational change. It contributes to wider debates regarding the implementation of personalisation and recovery-focused agendas.
(Publisher abstract)
Purpose – The purpose of this paper is to present results from an evaluation of the experience of a move to independent living for people with mental health needs or a learning disability. The discussion focuses on the shift in organisational culture from providing care within a hostel setting to supporting people in their own tenancies.
Design/methodology/approach – The evaluation was underpinned by a participatory action research design. A total of ten co-researchers with experience of using services or as carers were recruited. Qualitative data was obtained from “before” and “after” interviews with residents, staff and relatives.
Findings – Widespread satisfaction was expressed with people's new homes. Many residents were found to be increasingly independent. There was some evidence of concerns regarding the pace and process of change and the introduction of new practices to promote independence.
Research limitations/implications – The timing of the evaluation limited the opportunity for comprehensive “before” and “after” data collection. The involvement of co-researchers required considerable time and support although the experience of those involved was positive.
Practical implications – Learning from this evaluation emphasises the importance of support and preparation for staff as well as residents, in moving from hostel to independent living.
Social implications – This study highlights the advantages of a participatory design in evaluating a major change in service delivery.
Originality/value – This paper raises important issues about organisational change. It contributes to wider debates regarding the implementation of personalisation and recovery-focused agendas.
(Publisher abstract)
Subject terms:
independent living, mental health problems, learning disabilities, housing, hostels, evaluation, mental health services;
Partners for Inclusion is a voluntary organisation that provides support for adults with learning disabilities and mental health problems. It has adopted a person-centred approach to supporting people with ‘high’ or ‘complex’ support needs in order to provide services based on individual needs, wants and desires. This report presents the findings of an evaluation aiming to measure the progress made in the 4 years since the service was last evaluated. Specifically, it aimed to address: whether people are living the life they choose; whether people are living in the place that makes sense for them now; in what ways people’s lives have changed since receiving a service from Partners for Inclusion; and the experiences of staff who work for Partners for Inclusion. The research included a total of 50 interviews with individuals who receive services, support staff, family members, friends, and other professionals. The findings show that, for some people, lives have changed in significant ways since receiving support from Partners for Inclusion. However, further work is needed in areas of social inclusion, such as participating in education and employment. In common with other person-centred organisations, the staff often experience lone working with a resultant reduction in collegial support. A number of recommendations are provided in the areas of: personalisation; creating opportunities; and organisational capacity.
Partners for Inclusion is a voluntary organisation that provides support for adults with learning disabilities and mental health problems. It has adopted a person-centred approach to supporting people with ‘high’ or ‘complex’ support needs in order to provide services based on individual needs, wants and desires. This report presents the findings of an evaluation aiming to measure the progress made in the 4 years since the service was last evaluated. Specifically, it aimed to address: whether people are living the life they choose; whether people are living in the place that makes sense for them now; in what ways people’s lives have changed since receiving a service from Partners for Inclusion; and the experiences of staff who work for Partners for Inclusion. The research included a total of 50 interviews with individuals who receive services, support staff, family members, friends, and other professionals. The findings show that, for some people, lives have changed in significant ways since receiving support from Partners for Inclusion. However, further work is needed in areas of social inclusion, such as participating in education and employment. In common with other person-centred organisations, the staff often experience lone working with a resultant reduction in collegial support. A number of recommendations are provided in the areas of: personalisation; creating opportunities; and organisational capacity.
Subject terms:
learning disabilities, mental health problems, person-centred care, social inclusion, staff management, voluntary organisations, evaluation;
International Journal of Geriatric Psychiatry, 9(4), 1994, pp.259-272.
Publisher:
Wiley
Aims to clarify some of the concepts and terminology of health system evaluation; to draw on published literature to exemplify these concepts; and to discuss some of the implications of routinely evaluating a system rather than scientifically evaluating particular interventions or programmes. Concludes by arguing that the evaluation of psychiatric services for elderly persons is best achieved by the construction of relatively simple models from an array of complex knowledge.
Aims to clarify some of the concepts and terminology of health system evaluation; to draw on published literature to exemplify these concepts; and to discuss some of the implications of routinely evaluating a system rather than scientifically evaluating particular interventions or programmes. Concludes by arguing that the evaluation of psychiatric services for elderly persons is best achieved by the construction of relatively simple models from an array of complex knowledge.
Subject terms:
intervention, learning disabilities, mental health problems, mental health services, older people, performance evaluation, evaluation;
British Journal of Social Work, 21(2), April 1991, pp.157-172.
Publisher:
Oxford University Press
Reports on a follow-up survey of group homes and other independent living schemes, and the characteristics of their residents, to establish how far residents' needs were being met.
Reports on a follow-up survey of group homes and other independent living schemes, and the characteristics of their residents, to establish how far residents' needs were being met.
Subject terms:
independence, hostels, learning disabilities, mental health problems, community care, evaluation, group homes;