This guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed. In this guideline, self-harm is defined as intentional self-poisoning or injury, irrespective of the apparent purpose. The guideline does not cover repetitive, stereotypical self-injurious behaviour (such as head banging). This guideline includes recommendations on: information and support; consent and confidentiality; safeguarding; involving family members and carers; psychosocial assessment and care by mental health professionals; risk assessment tools and scales; assessment and care by healthcare professionals and social care practitioners; assessment and care by professionals from other sectors; admission to and discharge from hospital; initial aftercare after an episode of self-harm; interventions for self-harm; supporting people to be safe after self-harm; safer prescribing and dispensing; training and supervision.
(Edited publisher abstract)
This guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed. In this guideline, self-harm is defined as intentional self-poisoning or injury, irrespective of the apparent purpose. The guideline does not cover repetitive, stereotypical self-injurious behaviour (such as head banging). This guideline includes recommendations on: information and support; consent and confidentiality; safeguarding; involving family members and carers; psychosocial assessment and care by mental health professionals; risk assessment tools and scales; assessment and care by healthcare professionals and social care practitioners; assessment and care by professionals from other sectors; admission to and discharge from hospital; initial aftercare after an episode of self-harm; interventions for self-harm; supporting people to be safe after self-harm; safer prescribing and dispensing; training and supervision.
(Edited publisher abstract)
Subject terms:
service provision, assessment, self-harm, mental health problems, prevention;
This guidance highlights the problems in assessing and managing pain in an ever increasing older population. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. The first iteration of this guideline was published in 2007. But there has been a proliferation of literature and research since then, so this is a a revised set of guidelines based on a systematic review to examine the evidence for the effectiveness of pain assessment strategies in older people with or without cognitive function. The objectives of the review included: exploring the attitudes and beliefs of older people with pain about the assessment of their pain and interactions with carers; evaluating the effectiveness of the assessment of function as a measure of pain in older people; evaluating the effectiveness of self-assessment to quantify pain in older people and determining if changes in pain assessment strategy are required for people with cognitive impairment, mental health or psychological problems. These guidelines provide a range of tools which demonstrate good validity and reliability for clinical practice in assessing pain in older people.
(Original abstract)
This guidance highlights the problems in assessing and managing pain in an ever increasing older population. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. The first iteration of this guideline was published in 2007. But there has been a proliferation of literature and research since then, so this is a a revised set of guidelines based on a systematic review to examine the evidence for the effectiveness of pain assessment strategies in older people with or without cognitive function. The objectives of the review included: exploring the attitudes and beliefs of older people with pain about the assessment of their pain and interactions with carers; evaluating the effectiveness of the assessment of function as a measure of pain in older people; evaluating the effectiveness of self-assessment to quantify pain in older people and determining if changes in pain assessment strategy are required for people with cognitive impairment, mental health or psychological problems. These guidelines provide a range of tools which demonstrate good validity and reliability for clinical practice in assessing pain in older people.
(Original abstract)
Subject terms:
pain, assessment, older people, mental health problems, systematic reviews;
ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
Publisher:
Royal College of Physicians
Publication year:
2007
Pagination:
13p.
Place of publication:
London
Pain is under-recognised and under-treated in older people, and the assessment of pain is particularly challenging in the presence of severe cognitive impairments, communication difficulties or language and cultural barriers. This guidance sets out the key components of assessing pain in older people, together with a range of practical scales that can be used with different groups, including those with cognitive or communication impairment. It aims to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. It describes the background and methodology used, key components of an assessment of pain, and types of scale used to assess pain. It also provides a summary of recommendations in the full guidelines covering: pain awareness, pain enquiry, pain description, pain location and intensity, communication, assessment in people with impaired cognition/communication, cause of pain, and re-evaluation. It notes that the basic guidelines should be a routine part of the training and care provision of all healthcare professionals. The appendices include the guideline development process, an algorithm for the assessment of pain in older people, a pain map, and examples of pain scales.
Pain is under-recognised and under-treated in older people, and the assessment of pain is particularly challenging in the presence of severe cognitive impairments, communication difficulties or language and cultural barriers. This guidance sets out the key components of assessing pain in older people, together with a range of practical scales that can be used with different groups, including those with cognitive or communication impairment. It aims to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. It describes the background and methodology used, key components of an assessment of pain, and types of scale used to assess pain. It also provides a summary of recommendations in the full guidelines covering: pain awareness, pain enquiry, pain description, pain location and intensity, communication, assessment in people with impaired cognition/communication, cause of pain, and re-evaluation. It notes that the basic guidelines should be a routine part of the training and care provision of all healthcare professionals. The appendices include the guideline development process, an algorithm for the assessment of pain in older people, a pain map, and examples of pain scales.
Subject terms:
mental health problems, older people, pain, assessment, communication;
The author describes why there is a need to replace the Deprivation of Liberty Safeguards (DoLs) and explains how proposals from the Law Commission will be cheaper and more manageable than the system currently in place
(Edited publisher abstract)
The author describes why there is a need to replace the Deprivation of Liberty Safeguards (DoLs) and explains how proposals from the Law Commission will be cheaper and more manageable than the system currently in place
(Edited publisher abstract)
Subject terms:
Deprivation of Liberty Safeguards, law, costs, assessment, mental health problems, mental capacity, decision making;
Royal College of Psychiatrists; British Psychological Society
Publication year:
2011
Pagination:
310p., CD ROM
Place of publication:
London
The published version of the full evidence-based clinical guideline on common mental health disorders: identification and pathways to care (Clinical Guideline 123), commissioned by the National Institute for Health and Clinical Excellence (NICE). This guideline aims to help clinicians and service commissioners in providing and planning high-quality care for people with a common mental health disorder, while emphasising the importance of the experience of care for them and their families and carers. It covers depression and anxiety disorders, including phobias, obsessive compulsive disorders and post traumatic stress disorders. The first three chapters provide a summary of the clinical practice and research recommendations, a general introduction to guidelines and the topic, and to the methods used to develop the guideline. Chapter 4 to Chapter 7 cover provide the evidence that underpins the recommendations. These chapters cover: access to healthcare; assessment; risk assessment and outcome monitoring; systems for organising and developing local care pathways. The final chapter provides a summary of the recommendations. The guideline is relevant to those providing primary, community and secondary care, and other healthcare professionals who have direct contact with and make decisions concerning the care of adults with common mental health disorders. It is also relevant for, though doesn't cover the work of, social services.
The published version of the full evidence-based clinical guideline on common mental health disorders: identification and pathways to care (Clinical Guideline 123), commissioned by the National Institute for Health and Clinical Excellence (NICE). This guideline aims to help clinicians and service commissioners in providing and planning high-quality care for people with a common mental health disorder, while emphasising the importance of the experience of care for them and their families and carers. It covers depression and anxiety disorders, including phobias, obsessive compulsive disorders and post traumatic stress disorders. The first three chapters provide a summary of the clinical practice and research recommendations, a general introduction to guidelines and the topic, and to the methods used to develop the guideline. Chapter 4 to Chapter 7 cover provide the evidence that underpins the recommendations. These chapters cover: access to healthcare; assessment; risk assessment and outcome monitoring; systems for organising and developing local care pathways. The final chapter provides a summary of the recommendations. The guideline is relevant to those providing primary, community and secondary care, and other healthcare professionals who have direct contact with and make decisions concerning the care of adults with common mental health disorders. It is also relevant for, though doesn't cover the work of, social services.
Subject terms:
mental health problems, risk assessment, access to services, assessment, anxiety, depression;
The presence of mental disorder may, for some people, be a barrier to necessary physical health care if the person lacks capacity. This guidance refers specifically to the situation where the person refuses to attend hospital in a situation where others think that such attendance for physical health reasons is necessary. The guidance emphasises the need to carry out a proper assessment of capacity; the need to take account of the views of the individual and other with an interest; and the need to base interventions on an analysis of the risks and benefits, including the risk of not intervening. A flow chart shows the decisions that can be made mental health and incapacity law. Case study examples are also provided.
The presence of mental disorder may, for some people, be a barrier to necessary physical health care if the person lacks capacity. This guidance refers specifically to the situation where the person refuses to attend hospital in a situation where others think that such attendance for physical health reasons is necessary. The guidance emphasises the need to carry out a proper assessment of capacity; the need to take account of the views of the individual and other with an interest; and the need to base interventions on an analysis of the risks and benefits, including the risk of not intervening. A flow chart shows the decisions that can be made mental health and incapacity law. Case study examples are also provided.
Subject terms:
medical treatment, mental capacity, mental health law, mental health problems, assessment, compulsory treatment, decision making;
This guide sets out good practice in relation to making direct payments more accessible to people with mental health problems. It is intended to support the efforts that all local authorities, primary care trusts, mental health trusts and non-statutory providers of mental health services and support will wish to make to ensure that direct payments become a standard option within mental health services. This guide is specifically about the payments that are made to individuals who have been assessed as needing social care services in order that they can make their own arrangements to meet their needs. The number of people receiving direct payments is currently a key performance assessment framework indicator (AO/C51) for local authorities.
This guide sets out good practice in relation to making direct payments more accessible to people with mental health problems. It is intended to support the efforts that all local authorities, primary care trusts, mental health trusts and non-statutory providers of mental health services and support will wish to make to ensure that direct payments become a standard option within mental health services. This guide is specifically about the payments that are made to individuals who have been assessed as needing social care services in order that they can make their own arrangements to meet their needs. The number of people receiving direct payments is currently a key performance assessment framework indicator (AO/C51) for local authorities.
Extended abstract:
Author
GREAT BRITAIN . Department of Health.
Title
Direct payments for people with mental health problems: a guide to action.
Publisher
Great Britain. Department of Health, 2006
Summary
This guide sets out good practice in relation to making direct payments more accessible to people with mental health problems. It is intended to support the efforts that all local authorities, primary care trusts, mental health trusts and non-statutory providers of mental health services and support will wish to make to ensure that direct payments become a standard option within mental health services and is specifically about the payments made to individuals who have been assessed as needing social care services in order that they can make their own arrangements to meet their needs.
Context
The number of people receiving direct payments is currently a key performance assessment framework indicator (AO/C51) for local authorities.
Method
Contents
Sections explain what direct payments are and how they came about. Disabled people led a campaign as a means of achieving the choice and control necessary for independent living. They were originally introduced at the discretion of local authorities for disabled people of working age in April 1997, for older people in 2000, and for carers, parents of disabled children and for 16 and 17 year olds in 2001. The purpose of this guide to action is explained and policy on moving towards independent living and promoting recovery and inclusion outlined.
Detailed guidance on implementing direct payments within mental health service is given and the whole system approach explained. Making direct payments accessible to people who might use them, and necessary staff training and procedures, are discussed. Direct payments in practice are then summarised. People who are eligible to use mental health services (and carers eligible to receive carers' services) can expect to: have a clear statement of the needs for which they are eligible to receive services; be given the maximum possible choice and control in how their eligible needs are met; be offered the option of direct payments at every assessment and review meeting or have a clear statement of the reasons if they are excluded from receiving direct payments; be provided with adequate information about direct payments and sufficient time in order to be able to make an informed choice whether to use them or not; be given the details of people who can support them to consider and use direct payments; be able to use a mixture of direct payments and provided services if they choose; and be able to stop using direct payments at any time and return to using a provided service.
In order to achieve this, action is required from managers and care co-ordinators . Managers need to consider the following: promote direct payments as a standard option within the CPA, and ensure it is included within CPA training; promote the values of independent living and recovery as core to the provision of services, to support a positive and pro-active approach to direct payments; work with the local authority scheme, the support service, service user and carer groups and practitioners to achieve a straightforward and co-ordinated process for considering, applying for and accessing support to manage direct payments; ensure that adequate information and training is provided to those who might wish to use direct payments and all care co-ordinators; ensure that all teams understand their responsibilities in respect of offering direct payments; make specific information available in appropriate formats/languages to all those who might wish to consider or use direct payments to meet their social care needs.
This should be consistent with but additional to the direct payment schemes generic information; record levels of direct payment uptake by people with mental health problems to inform future planning and set current targets; and, where appropriate, work with commissioners to ensure adequate budget setting/flexibility.
Assessors/care co-ordinators need to consider the following: assess people's eligible needs and record them clearly before beginning the process of discussing how those needs might be met; support those they work with to build their future around their aspirations and abilities, and work through risk assessment procedures to minimise risks to an acceptable level wherever possible; always check whether or not a person is excluded from receiving direct payments; offer the option of direct payments to all those who are eligible to receive them at every assessment and review; ensure that all people eligible to receive mental health services are made aware of how to access information and support to consider and/or use direct payments; and be fully aware of DH's guidance, the local authority direct payments policy and the operation of their local authority's scheme/s, and of how to get support and advice for themselves about direct payments.
Sources of further information and resources are given.
28 references
Subject terms:
local authorities, mental health problems, mental health services, service uptake, assessment, direct payments;
Hoarding and self-neglect are estimated to be a factor in 20% of social workers' cases when working with older people or adults with mental health issues. This guide introduces the patterns of self-neglect and how challenging they can be to identify. It offers practical and applicable tools and solutions for all professionals involved in working with people who self-neglect. It includes tips for assessment and decision-making in the support process, and updates following the implementation of the Care Act 2014, which deemed self-neglect a safeguarding matter.
(Edited publisher abstract)
Hoarding and self-neglect are estimated to be a factor in 20% of social workers' cases when working with older people or adults with mental health issues. This guide introduces the patterns of self-neglect and how challenging they can be to identify. It offers practical and applicable tools and solutions for all professionals involved in working with people who self-neglect. It includes tips for assessment and decision-making in the support process, and updates following the implementation of the Care Act 2014, which deemed self-neglect a safeguarding matter.
(Edited publisher abstract)
Subject terms:
safeguarding adults, obsessive compulsive disorders, older people, mental health problems, self-neglect, service provision, assessment, decision making, adult social care;
Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.224-236.
Publisher:
Emerald
Purpose: The paper is a review, for the general adult mental health practitioner, of the issues to consider when managing a mental health presentation of a person with intellectual disability (PWID). The paper aims to discuss these issues.
Design/methodology/approach: A neurodevelopmental model is outlined to assist practitioners in unravelling the wide range of potential factors relevant to intellectual disabilities (IDs). This includes an emphasis on complexity and interdisciplinary formulation within an individual’s context, and implications of the current policy changes.
Findings: In practice, managing the mental health of PWID can be challenging within usual mainstream services; there is more to consider than is usual for the general population.
Originality/value: The paper provides general mental health practitioners with a framework for a greater depth of understanding of the issues involved in the management of people with intellectual disability (ID). This includes discussion of the current policy context in ID, and some of its limitations.
(Publisher abstract)
Purpose: The paper is a review, for the general adult mental health practitioner, of the issues to consider when managing a mental health presentation of a person with intellectual disability (PWID). The paper aims to discuss these issues.
Design/methodology/approach: A neurodevelopmental model is outlined to assist practitioners in unravelling the wide range of potential factors relevant to intellectual disabilities (IDs). This includes an emphasis on complexity and interdisciplinary formulation within an individual’s context, and implications of the current policy changes.
Findings: In practice, managing the mental health of PWID can be challenging within usual mainstream services; there is more to consider than is usual for the general population.
Originality/value: The paper provides general mental health practitioners with a framework for a greater depth of understanding of the issues involved in the management of people with intellectual disability (ID). This includes discussion of the current policy context in ID, and some of its limitations.
(Publisher abstract)
Subject terms:
models, adults, assessment, learning disabilities, mental health problems, mental health professionals, professional role, psychiatry, treatment;
GREAT BRITAIN. Department of Health, PUBLIC HEALTH ENGLAND, NHS ENGLAND
Publishers:
Great Britain. Department of Health, Public Health England, NHS England
Publication year:
2016
Pagination:
61
Place of publication:
London
Drawing the available evidence, this resource provides practice advice to help mental health nurses to improve the physical health and wellbeing of people living with mental health problems. It builds on work to ensure parity of esteem between mental and physical health by giving equal attention to the physical health of people with mental health problems as is given to the general population, thus reducing health inequalities. The document focuses on how to deal with some of the main risk factors for physical health problems. It focuses on eight key areas for action: smoking, obesity, improving levels of physical activities, alcohol and substance misuse, sexual and reproductive health, medicine optimisation, dental and oral health, and reducing falls. Each area discussed incIudes information on why mental health nurses need to take action, activities to achieve change, examples of good practice and a review of the evidence base for practice. The publication is relevant for mental health nurses working both in inpatient settings and in the community and focuses on adults with mental health problems.
(Edited publisher abstract)
Drawing the available evidence, this resource provides practice advice to help mental health nurses to improve the physical health and wellbeing of people living with mental health problems. It builds on work to ensure parity of esteem between mental and physical health by giving equal attention to the physical health of people with mental health problems as is given to the general population, thus reducing health inequalities. The document focuses on how to deal with some of the main risk factors for physical health problems. It focuses on eight key areas for action: smoking, obesity, improving levels of physical activities, alcohol and substance misuse, sexual and reproductive health, medicine optimisation, dental and oral health, and reducing falls. Each area discussed incIudes information on why mental health nurses need to take action, activities to achieve change, examples of good practice and a review of the evidence base for practice. The publication is relevant for mental health nurses working both in inpatient settings and in the community and focuses on adults with mental health problems.
(Edited publisher abstract)
Subject terms:
mental health problems, health care, access to services, risk, nurses, mental health professionals, assessment, prevention, intervention, good practice;