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The mental health residential care study: classification of facilities and description of residents
- Authors:
- LELLIOTT Paul, AUDINI Bernard, KNAPP Martin, CHISHOLM Daniel
- Journal article citation:
- British Journal of Psychiatry, 169, August 1996, pp.139-147.
- Publisher:
- Cambridge University Press
The NHS is no longer a virtual monopoly provider of mental health residential care. This makes it difficult to assess the volume, range and adequacy of provision. In this study facilities providing residential care in eight districts were compared on levels of staffing, staff qualifications, and the characteristics of their residents. Results found that there was great variation between districts in the number of places available per unit of the population, especially in those with 24-hour waking cover. It is suggested that one consequence of the diversification in provision of mental health residential accommodation has been a relative reduction in the proportion of provision available to the most severely disabled, particularly those who pose a risk of acting violently.
Economic evaluation of early intervention (EI) services: phase IV report
- Authors:
- McCRONE Paul, PARK A-La, KNAPP Martin
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2010
- Pagination:
- 22p., bibliog.
- Place of publication:
- Canterbury
Using a 2006 model adapted during 3 previous research phases, Phase IV focuses on the economic impacts of early intervention services (EI) on vocational and employment outcomes of people with mental health problems, including psychoses, in the UK. The report also covers long-term outcomes of EI and the impact on costs associated with suicide and murder. Four findings are discussed. Firstly, EI reduced NHS health care, and wages costs of employment lost to mental health problems, with employment rates of 36% and 27% attributed to those in EI and standard care (SC), respectively. Costs of homicide are low, say these authors, with annual costs per person at £6 for those in EI compared with £80 for SC. Thirdly, suicide is estimated to occur in 1.3% EI and 4% SC patients, equating to annual savings of £957 per person. Finally, long-term outcomes associated with EI are dependent on readmission rates following EI discharge. They equate to costs savings of £36,632 over 8 years if rates remain constant. If rates gradually or immediately converge expected savings dip to £27,029 and £17,427, respectively. The increased work and decreased homicides and suicides recorded here reinforce earlier work that EI is beneficial to the UK’s mental health.
Mental health policy and practice across Europe
- Editors:
- KNAPP Martin, et al, (eds.)
- Publisher:
- Open University Press
- Publication year:
- 2007
- Pagination:
- 452p.
- Place of publication:
- Maidenhead
In much of Europe, it remains taboo to discuss the challenges that poor mental health raises for governments, societies and particularly for people with mental health problems themselves. This book maps the current state of policy, service provision and funding for mental health care across Europe, taking into account the differing historical contexts that have shaped both the development and delivery of services. A holistic approach is adopted that aims to assess the influence on mental health of environmental factors such as housing, poverty, employment, social justice and displacement. This title examines the legal rights of people with mental health problems; addresses the impact of stigma, social exclusion and discrimination; reviews the role of users and their families in the development of mental health services and policy; reflects on approaches to reform and on the future development of services; evaluates opportunities for the rehabilitation of people with mental health problems; discusses the financing and organisation of mental health systems; and, reflects on approaches to reform and the future development of services.
Private voluntary or public: comparative cost-effectiveness in community mental health care
- Authors:
- KNAPP Martin, et al
- Journal article citation:
- Policy and Politics, 27(1), January 1999, pp.25-41.
- Publisher:
- Policy Press
Two prominent features of mental health policy in the UK in recent years have been the rundown of hospital provision and the changing of the balance between public and other provider sectors. This article examines the cost, quality of care and outcome implications. Public, voluntary and private providers of mental health care are compared, based on a long-term study of people moving out of psychiatric hospitals in London. Costs are found to be the lowest in the private (for profit) sector, and highest in the NHS and consortium (NHS and voluntary sector partnership) sectors. However, quality of care indicators suggest that the lowest cost sector is performing least well, and the highest cost sectors offer the best quality. These are associated with some differences in user outcome.