Participation is on everyone’s agenda at the moment, and statutory agencies are conscious of the need to hear a wide range of voices. Some voices, however, are more powerful than others. This research project carried out in Bradford supports the view that statutory agencies do not adequately hear minority voices within groups such as the South Asian community. Academics from Bradford University supported four community members to research participation issues in their communities, focusing on culture and place of origin, sexuality, mental health and disability.
Participation is on everyone’s agenda at the moment, and statutory agencies are conscious of the need to hear a wide range of voices. Some voices, however, are more powerful than others. This research project carried out in Bradford supports the view that statutory agencies do not adequately hear minority voices within groups such as the South Asian community. Academics from Bradford University supported four community members to research participation issues in their communities, focusing on culture and place of origin, sexuality, mental health and disability.
Subject terms:
mental health problems, participation, sexuality, South Asian people, Asian people, communities, disabilities;
In 1995, Home-Link, an interagency initiative, was set up in the East Riding of Yorkshire to provide permanent housing and low level, practical support to people with enduring mental health problems. The service offered ongoing individual tenancy support and also aimed to encourage a mutual support network by housing users within walking distance of each other. Outlines an evaluation, undertaken by the Centre for Housing Policy, University of York, which found that Home-Link represented a successful model for providing support to people with mental health problems in the community.
In 1995, Home-Link, an interagency initiative, was set up in the East Riding of Yorkshire to provide permanent housing and low level, practical support to people with enduring mental health problems. The service offered ongoing individual tenancy support and also aimed to encourage a mutual support network by housing users within walking distance of each other. Outlines an evaluation, undertaken by the Centre for Housing Policy, University of York, which found that Home-Link represented a successful model for providing support to people with mental health problems in the community.
Subject terms:
housing, mental health problems, needs, quality of life, social networks, community care, evaluation;
Direct payments increase the choice and control that people have over the support they receive. The take-up of direct payments by people experiencing mental health problems has been extremely low in most parts of the country. This project, New Directions, was undertaken by the Health and Social Care Advisory Service and draws on a range of discussions with over 250 service users and staff in order to identify what needs to happen for direct payments to be successfully implemented. Service users, carers and professionals require straightforward, accurate and accessible information about direct payments which is specific to mental health. Both service users and professionals can be confused about the distinction to access to an assessment for receipt of direct payments and access to services, where the threshold may be much higher and based largely on clinical considerations. This can affect take-up. Mental health users require specific advocacy and practical support to facilitate access to and use of direct payments. The absence of a streamlined process integrated with the Care Programme Approach adds to the sense of direct payments being a burden rather than an opportunity. Ways to increase take-up by people from black and minority ethnic communities include developing resources and approaches, including outreach and direct support services specific to those communities.
Direct payments increase the choice and control that people have over the support they receive. The take-up of direct payments by people experiencing mental health problems has been extremely low in most parts of the country. This project, New Directions, was undertaken by the Health and Social Care Advisory Service and draws on a range of discussions with over 250 service users and staff in order to identify what needs to happen for direct payments to be successfully implemented. Service users, carers and professionals require straightforward, accurate and accessible information about direct payments which is specific to mental health. Both service users and professionals can be confused about the distinction to access to an assessment for receipt of direct payments and access to services, where the threshold may be much higher and based largely on clinical considerations. This can affect take-up. Mental health users require specific advocacy and practical support to facilitate access to and use of direct payments. The absence of a streamlined process integrated with the Care Programme Approach adds to the sense of direct payments being a burden rather than an opportunity. Ways to increase take-up by people from black and minority ethnic communities include developing resources and approaches, including outreach and direct support services specific to those communities.
Subject terms:
mental health problems, social care provision, user views, access to information, access to services, advocacy, black and minority ethnic people, decision making, direct payments;
The Shaping Our Lives project, working in partnership with Black User Group (London), Service User Action Group (Wakefield), Ethnic Disabled Group Emerged (Manchester) and an alliance of user groups in Waltham Forest (London), looked at the application in practice of on-going work about what service users meant by 'user-defined outcomes'. Both the research and the development projects covered a range of experiences - including those of older people, mental health users, minority ethnic communities and disabled people and involving 66 users in all.
The Shaping Our Lives project, working in partnership with Black User Group (London), Service User Action Group (Wakefield), Ethnic Disabled Group Emerged (Manchester) and an alliance of user groups in Waltham Forest (London), looked at the application in practice of on-going work about what service users meant by 'user-defined outcomes'. Both the research and the development projects covered a range of experiences - including those of older people, mental health users, minority ethnic communities and disabled people and involving 66 users in all.
Subject terms:
mental health problems, older people, outcomes, physical disabilities, service users, user participation, user views, advocacy, black and minority ethnic people;
The Disability Discrimination Act 1995 has focused the attention of health and social care employers on the issue of discrimination within the workforce. Describes a small exploratory study which asked a range of mental health professionals, who have also used mental health services, about their experiences as members of this workforce and their recommendations for change.
The Disability Discrimination Act 1995 has focused the attention of health and social care employers on the issue of discrimination within the workforce. Describes a small exploratory study which asked a range of mental health professionals, who have also used mental health services, about their experiences as members of this workforce and their recommendations for change.
Subject terms:
mental health problems, mental health professionals, mental health services, service users, staff, user views, community mental health services, disability discrimination, discrimination;
People with physical impairments who also have mental health support needs have tended to be overlooked by both policy-makers and those commissioning services. The majority of respondents said they had difficulty accessing mental health services because of their physical impairments. The majority also had difficulty using physical disability services because of inadequate recognition of mental health needs and negative attitudes amongst staff towards mental health issues. In-patient experiences were often characterised by inaccessible physical environments and a lack of assistance for even simple things. There was a lack of understanding of the assistance that people needed, and staff were often too busy to provide it. Medication required for a physical condition was commonly withdrawn on admission to a psychiatric ward and was not always available when needed. This caused considerable distress, particularly when the medication was required for the control of pain. Community mental health services were appreciated when needs relating to physical impairment as well as mental health were addressed. However, this was unusual. Staff were often unfamiliar with needs relating to physical impairment and this could be associated with unhelpful attitudes. There was commonly poor or no communication between mental health and physical disability services. Many respondents found that services accessed because of physical impairment ignored mental health issues; some staff had negative reactions to such needs. Medication given for mental health needs often had an impact on physical impairment, but most people said they had not been warned about these potential effects. 'Talking treatments' received the highest rating of any service, but it was often difficult to find an accessible and, within the private sector, affordable therapist or counsellor. When people were asked what they wanted from mental health and physical disability services, they said they wanted to be seen as "a whole person", with attention paid to both mental health needs and those relating to physical impairment. They wanted services and professionals to communicate and work together, and easy access to flexible services which could address individual needs. Above all, they wanted to be listened to and treated with respect.
People with physical impairments who also have mental health support needs have tended to be overlooked by both policy-makers and those commissioning services. The majority of respondents said they had difficulty accessing mental health services because of their physical impairments. The majority also had difficulty using physical disability services because of inadequate recognition of mental health needs and negative attitudes amongst staff towards mental health issues. In-patient experiences were often characterised by inaccessible physical environments and a lack of assistance for even simple things. There was a lack of understanding of the assistance that people needed, and staff were often too busy to provide it. Medication required for a physical condition was commonly withdrawn on admission to a psychiatric ward and was not always available when needed. This caused considerable distress, particularly when the medication was required for the control of pain. Community mental health services were appreciated when needs relating to physical impairment as well as mental health were addressed. However, this was unusual. Staff were often unfamiliar with needs relating to physical impairment and this could be associated with unhelpful attitudes. There was commonly poor or no communication between mental health and physical disability services. Many respondents found that services accessed because of physical impairment ignored mental health issues; some staff had negative reactions to such needs. Medication given for mental health needs often had an impact on physical impairment, but most people said they had not been warned about these potential effects. 'Talking treatments' received the highest rating of any service, but it was often difficult to find an accessible and, within the private sector, affordable therapist or counsellor. When people were asked what they wanted from mental health and physical disability services, they said they wanted to be seen as "a whole person", with attention paid to both mental health needs and those relating to physical impairment. They wanted services and professionals to communicate and work together, and easy access to flexible services which could address individual needs. Above all, they wanted to be listened to and treated with respect.
Subject terms:
medication, mental health problems, mental health services, multiple disabilities, physical disabilities, unmet need, access to services, acute psychiatric care, commissioning, communication, counselling;
This research is about the involvement in risk assessment and management of mental health service users considered by professionals to pose a potential risk to other people. The research was carried out due to concerns that the voices of these service users are not being heard in research, policy or practice. Many service users were aware that they could pose a risk to other people when experiencing psychosis and they wanted help to reduce the chances of this happening. Full and frank discussion of risk to others was difficult for many professionals. Some people could not be asked to participate in the study because they did not know they were considered to be a risk to other people. Reasons for talking about risk to others included the user's right to know what is written about them, and increased trust between user and professional, with the potential for collaborative risk management. Reasons against talking about risk to others included increasing stigma and distress; this prompted disengagement from services, and fears for personal safety. Levels of agreement between service users and professionals about risk and how to respond to it ranged from full agreement to very little or none. Service user involvement in risk assessment and management was variable and depended upon individual professional initiative. Few professionals were undertaking systematic risk assessment or risk management plans. Some service users influenced the support they received but, generally, users' main role was to accept or reject what was offered. Professionals had less room to accommodate user views where the risks were considered too high. Little use was made of advocates, and users were not provided with a full picture of the different supports available. Medication and supported housing emerged as key issues for potential tension and disagreement between service users and professionals. Serious gaps and inaccuracies were sometimes found in information held about service users that potentially put themselves and others at risk.
This research is about the involvement in risk assessment and management of mental health service users considered by professionals to pose a potential risk to other people. The research was carried out due to concerns that the voices of these service users are not being heard in research, policy or practice. Many service users were aware that they could pose a risk to other people when experiencing psychosis and they wanted help to reduce the chances of this happening. Full and frank discussion of risk to others was difficult for many professionals. Some people could not be asked to participate in the study because they did not know they were considered to be a risk to other people. Reasons for talking about risk to others included the user's right to know what is written about them, and increased trust between user and professional, with the potential for collaborative risk management. Reasons against talking about risk to others included increasing stigma and distress; this prompted disengagement from services, and fears for personal safety. Levels of agreement between service users and professionals about risk and how to respond to it ranged from full agreement to very little or none. Service user involvement in risk assessment and management was variable and depended upon individual professional initiative. Few professionals were undertaking systematic risk assessment or risk management plans. Some service users influenced the support they received but, generally, users' main role was to accept or reject what was offered. Professionals had less room to accommodate user views where the risks were considered too high. Little use was made of advocates, and users were not provided with a full picture of the different supports available. Medication and supported housing emerged as key issues for potential tension and disagreement between service users and professionals. Serious gaps and inaccuracies were sometimes found in information held about service users that potentially put themselves and others at risk.
Subject terms:
medication, mental health problems, mental health services, management, risk, risk assessment, risk management, severe mental health problems, stereotyped attitudes, stress, supported housing, user participation, user views, assessment;
There is a widespread view that low self-esteem is a risk factor for a broad range of psychological and behavioural problems. However, neither public discussion nor decisions to invest in prevention and treatment have been strongly informed or guided by hard evidence, either about the effects or the causes of low self-esteem. This review of the available research evidence, by Nicholas Emler (London School of Economics) aimed to fill this gap.
There is a widespread view that low self-esteem is a risk factor for a broad range of psychological and behavioural problems. However, neither public discussion nor decisions to invest in prevention and treatment have been strongly informed or guided by hard evidence, either about the effects or the causes of low self-esteem. This review of the available research evidence, by Nicholas Emler (London School of Economics) aimed to fill this gap.
Subject terms:
literature reviews, mental health, mental health problems, personality development, prevention, psychology, self-concept, self-esteem, treatment, therapy and treatment, conduct disorders, costs;
A significant number of older people have a serious mental health problem which is not a form of dementia related to their age. Many are accommodated in long-stay psychiatric wards and homeless persons hostels. An exploratory study based in Edinburgh finds that few community care plans consider the special needs of this group or how they might be provided with more suitable housing.
A significant number of older people have a serious mental health problem which is not a form of dementia related to their age. Many are accommodated in long-stay psychiatric wards and homeless persons hostels. An exploratory study based in Edinburgh finds that few community care plans consider the special needs of this group or how they might be provided with more suitable housing.
Subject terms:
homeless people, homelessness, hostels, housing, local government, long stay care, long term care, mental health problems, nursing homes, needs, older people, patients, psychiatric care, social care provision, care planning, community care plans;
Black ethnic minority people discharged from psychiatric hospitals and their carers are inadequately catered for by aftercare services; their housing needs though pressing are also often hidden, according to a new study. The survey of 101 discharged people, conducted by a team from the School of Sociology and Social Policy of Leeds University, found many poorly prepared for return to the community, with widespread experience of poverty, unemployment, racial harassment and social isolation.
Black ethnic minority people discharged from psychiatric hospitals and their carers are inadequately catered for by aftercare services; their housing needs though pressing are also often hidden, according to a new study. The survey of 101 discharged people, conducted by a team from the School of Sociology and Social Policy of Leeds University, found many poorly prepared for return to the community, with widespread experience of poverty, unemployment, racial harassment and social isolation.
Subject terms:
housing, mental health problems, needs, hospital discharge, poverty, racial harassment, racism, surveys, unemployment, black and minority ethnic people, discrimination;