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Importance of specialisation in psychiatric services. Commentary on... How did we let it come to this?
- Author:
- KILLASPY Helen
- Journal article citation:
- Psychiatrist (The), 36(10), October 2012, pp.364-365.
- Publisher:
- Royal College of Psychiatrists
In his editorial (ibid, pp.361-363), George Lodge makes a plea for continuity of care, making a case that the increased specialisation of mental healthcare over recent years has led to fragmentation of patient care. This response argues that continuity of care is not a straightforward concept and its relationship to clinical outcome is not established. Three arguments are presented: difficulties with the concept of continuity of care; specialisation as a reason for celebration; and ensuring efficiency in service delivery. It concludes that the increased specialisation of mental healthcare reflects an evolving evidence base that has increased our understanding of mental illness and the treatments and delivery systems that are most effective. In other words, specialisation is the sign of a progressive field.
Implementing recovery oriented evidence based programs: identifying the critical dimensions
- Authors:
- FARKAS Marianne, et al
- Journal article citation:
- Community Mental Health Journal, 41(2), April 2005, pp.141-158.
- Publisher:
- Springer
In the decades of the 1990s many mental health programmes and the systems that fund these programs have identified themselves as recovery-oriented. A program that is grounded in a vision of recovery is based on the notion that a majority of people can grow beyond the catastrophe of a severe mental illness and lead a meaningful life in their own community. First person accounts of recovery and empirical research have led to a developing consensus about the service delivery values underlying recovery. The emphasis on recovery-oriented programming has been concurrent with a focus in the field on evidence-based practices. The authors propose that evidence based practices be implemented in a manner that is recovery compatible. Programme dimensions for evidence based practice, such as programme mission, policies, procedures, record keeping and staffing should be consistent with recovery values in order for a program to be considered to be recovery-oriented. This article describes the critical dimensions of such value based practice, regardless of the service the recovery oriented mental health programmes provide (e.g., treatment, case management, rehabilitation). The aim of this first attempt at conceptualizing recovery-oriented mental health programmes is to both provide direction to those involved in programme implementation of evidence based mental health practices, as well as providing a stimulus for further discussion in the field.
Demonstrating the effectiveness of housing support services for people with mental health problems: a review: briefing
- Author:
- NATIONAL HOUSING FEDERATION
- Publisher:
- National Housing Federation
- Publication year:
- 2011
- Pagination:
- 6p.
- Place of publication:
- London
Housing Associations and other support providers deliver services to help people improve their mental health, maximise independence, sustain their accommodation and participate in community life. This includes meeting specific mental health needs through specialist accommodation and support. In order to use housing support more effectively in care pathways, there is a need for a more robust and powerful evidence base of the effectiveness of housing support. This research review aims to identify outcome measures that can be used to examine the effectiveness of housing related support for people with mental health problems. It reviews the effectiveness measures already available and in use and considers the development of an evaluation methodology that could become the benchmark for future research and evaluation. It recommends that a pilot exercise to test possible evaluative measures is conducted. A robust service evaluation method should: have clear service objectives; understand and record the process of service delivery; give a voice to service users; and test service outcomes against standardised and validated measures of mental well-being, quality of life and cost-effectiveness.
How evidence-based practices contribute to community integration
- Authors:
- BOND Gary R., et al
- Journal article citation:
- Community Mental Health Journal, 40(6), December 2004, pp.569-588.
- Publisher:
- Springer
Since the groundbreaking work of the Robert Wood Johnson Conference in 1998 identifying six evidence-based practices (EBPs) for people with severe mental illness (SMI), the mental health field has moved in the direction of re-examination and redesign of service systems. Surprisingly, one area that has not been fully explicated is the role that EBPs play in promoting community integration. In this paper, the authors explain how community integration is a unifying concept providing direction and vision for community mental health for people with SMI. As one crucial aspect of the recovery process, community integration clarifies the link between EBPs and recovery. We propose an alternate view, grounded in the empirical literature, to the assertion by Anthony, Rogers, and Farkas that EBP research has rarely demonstrated a positive impact on recovery related outcomes.
The evolution of systems of care for children's mental health: forty years of community child and adolescent psychiatry
- Authors:
- PUMAARIEGA Andres J., WINTERS Nancy C., HUFFINE Charles
- Journal article citation:
- Community Mental Health Journal, 39(5), October 2003, pp.399-425.
- Publisher:
- Springer
Over the past 20 years, child and adolescent community mental health has evolved conceptually, clinically, and scientifically towards the community-based systems of care model. This model asserts important values and principles, including the centrality of the child and family in the care process, the integration of the efforts of disparate agencies and interveners into a contextual approach, and the importance of serving children with serious disturbances in their homes and communities. The article reviews the evolution of the community-based systems of care model, its evidence-base, its application in practice, and the challenges it faces in today's human services environment
Practical guidelines for the community treatment of markedly impaired patients
- Authors:
- TEST Mary Ann, STEIN Leonard I.
- Journal article citation:
- Community Mental Health Journal, 36(1), February 2000, pp.47-59.
- Publisher:
- Springer
A sound technology does not yet exist for successfully treating in the community those patients traditionally treated by public mental hospitals and aftercare programmes. The current article attempts to advance this technology by presenting practical guidelines based on the empirical work of the writers and others. Recommendations include a focus on the teaching of coping skills, and in vivo site of treatment, and assertive approach, and use of variety of social learning techniques. Staffing and monetary needs for community treatment are also discussed.
The national service framework: a scaffold for mental health
- Author:
- TYRER Peter
- Journal article citation:
- British Medical Journal, 16.10.99, 1999, pp.1017-1018.
- Publisher:
- British Medical Association
The National Service Framework for Mental Health is part of the programme to establish better quality and reduce unacceptable variations in the NHS. The author of this article asserts that implementation is key to determining whether the framework is a support or a gallows.
The European WHO mental health programme and the World Health Report 2001: input and implications
- Author:
- RUTZ Wolfgang
- Journal article citation:
- British Journal of Psychiatry, 183(7), July 2003, pp.73-74.
- Publisher:
- Cambridge University Press
The World Health Report 2001, subtitled Mental Health: New Understanding, New Hope, has so far been presented in many member states at meetings with governmental participation and it continues to play a crucial role. It focuses on decentralisation and the need to establish community-based mental health services, giving the mentally vulnerable access to treatment at home, and utilising their social networks, existential identity and psychological environment. It focuses on the need for individual and societal empowerment, and public education about mental health, as well as the education of mental health professionals, family doctors, families and the social sector. It underlines the extreme and still increasing burden of depression and suicide and the need for inter-disciplinary teamwork. It advocates national mental health development, evidence-oriented research and awareness-raising activities.
Effective community mental health services for people with serious mental illness: a critical review
- Author:
- HALL Pauline
- Journal article citation:
- Mental Health and Learning Disabilities Care, 3(9), May 2000, pp.299-303.
- Publisher:
- Pavilion
Government policy demands that the majority of people with mental illness are cared for in the community. Yet the implementation of this policy remains controversial and variable in outcome. Reviews the literature on recent developments in community mental health care, and the evidence for their relative effectiveness.