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Ethnicity and access to an inner city home treatment service: a case-control study
- Authors:
- BOOKLE Matthew, WEBBER Martin
- Journal article citation:
- Health and Social Care in the Community, 19(3), May 2011, pp.280-288.
- Publisher:
- Wiley
Evidence suggests that people from black and minority ethnic groups are more likely to be diagnosed with a mental health problem and are disproportionately represented in mental health inpatient services. The aim of this study, undertaken in a large inner London borough, was to establish whether people of black ethnic origin had equal access to home treatment in a mental health crisis. The researchers selected a random sample of 240 inpatient episodes and compared them with a sample of 77 home treatment episodes over a 12 month period, comparing the circumstances and characteristics of people using the home treatment team and inpatient services. The study found no association between ethnicity and the likelihood of receiving home treatment as opposed to a hospital admission whilst in a mental health crisis, although the findings showed that when admitted to hospital people from black ethnic groups experienced significantly longer admissions than people of white British origin. The authors suggest that further research is required for the early discharge function of home treatment teams to evaluate whether this aspect of care is experienced differently by different ethnic groups.
Intensive home treatment, admission rates and use of mental health legislation
- Authors:
- FORBES Naida F., CASH Helen T., LAWRIE Stephen M.
- Journal article citation:
- Psychiatrist (The), 34(12), December 2010, pp.522-524.
- Publisher:
- Royal College of Psychiatrists
An intensive home treatment team was launched when adult community mental health services were reconfigured in a redesign of the mental health service in Midlothian (a semi-rural area near Edinburgh) which included closure of a local adult in-patient ward. The aim of this study was to examine the effect of introducing a home treatment team on the rates of in-patient care and compulsory treatment in the local area. The results of the study showed that rates of admission to hospital and duration of hospital stay were unchanged, but that there was an increase in episodes of detention under the Mental Health (Care and Treatment) (Scotland) Act 2003 in the year following the team's introduction. The authors discuss the results and their implications.
Does additional care provided by a consumer self-help group improve psychiatric outcome? A study in an Italian community-based psychiatric service
- Authors:
- BURTI Lorenzo, et al
- Journal article citation:
- Community Mental Health Journal, 41(6), December 2005, pp.705-720.
- Publisher:
- Springer
This study compares the two-year clinical and social outcome, the use of services and the direct costs of patients of the South-Verona Community Psychiatric Service who were members of a self-help group, with those who were not. Use of services and costs in the two years before the baseline were compared with those occurring two years after the baseline. Self-help subjects decreased their use of hospital stay as to number of admissions and days in hospital, with a reduction of costs; they were more satisfied as to work/education while non self-help matches presented an increase of unmet needs. Clinical and social outcome showed no significant difference. The findings suggest that consumer participation may possibly enhance the effects of psychiatric treatment on outcome.
Hospital manager's review
- Authors:
- CURRAN Christopher, GRIMSHAW Catherine
- Journal article citation:
- Open Mind, 100, November 1999, pp.28-29.
- Publisher:
- MIND
Compulsory detention under the 1983 Mental Health Act raises important issues relating to the civil liberty of the individual concerned. Hospital managers are the formal detaining authority under the 1983 Mental Health Act, and the Act permits a patient to request a review of their detention. This article reviews the legal responsibilities of the hospital manager.
Human rights in mental health services: good practice guide
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2017
- Pagination:
- 74
- Place of publication:
- Edinburgh
This guide explains how and where human rights impact on the provision of mental health care and how staff can best ensure that the key rights are respected. It is aimed at staff in hospital and community teams in Scotland and has been written in consultation with mental health care practitioners, users of services, and patients’ relatives who have direct experience of adult acute settings. It looks at each of the rights set out in the Rights in Mind pathway to patients’ rights in mental health services. There is a section for each stage, covering patient’s rights in the community, hospital admission, hospital care, and hospital discharge. The guide also sets out overarching rights that apply across all of these stages. Short case studies are included to illustrate different scenarios. The guide can be used both as a reference guide and as an improvement resource to help staff reflect on their policies and practice. (Edited publisher abstract)
Is integrated care associated with service costs and admission rates to institutional settings? An observational study of community mental health teams for older people in England
- Authors:
- WILBERFORCE Mark, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(11), 2016, pp.1208-1216.
- Publisher:
- Wiley
Objectives: To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the service costs of community mental health and social care provision; (ii) rates of mental health inpatient and care home admission. Methods: An observational study of service use and admissions to institutional care was undertaken for a prospectively-sampled cohort of patients from eight CMHTs in England. Teams were chosen to represent ‘high’ or ‘low’ levels of integrated working practice and patients were followed-up for seven months. General linear models were used to estimate service costs and the likelihood of institutional admission. Results: Patients supported by high integration teams received services costing an estimated 44% more than comparable patients in low integration teams. However, after controlling for case mix, no significant differences were found in the likelihood of admission to mental health inpatient wards or care homes between team types. Conclusions: Integrated mental health and social care teams appeared to facilitate greater access to community care services, but no consequent association was found with community tenure. Further research is required to identify the necessary and sufficient components of integrated community mental health care, and its effect on a wider range of outcomes using patient-reported measures (Edited publisher abstract)
“Risky Business”: a critical analysis of the role of crisis resolution and home treatment teams
- Authors:
- RHODES Penny, GILES Sally J.
- Journal article citation:
- Journal of Mental Health, 23(3), 2014, pp.130-134.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: In 2000, the Department of Health for England recommended the creation of crisis resolution and home treatment teams (CRHTs) in order to reduce the number and length of psychiatric hospital admissions. Central to this was the role of gate-keeping all potential admissions. Aim: To examine the interface between crisis resolution and home treatment and other mental health services. Methods: Semi-structured interviews with mental health professionals (n = 25) at eight sites within one Strategic Health Authority region. Results: Despite wide variation in approach and provision, all teams were confronting common issues related to tensions at both ends of the service user trajectory – on initial assessment and on discharge. Conclusion: The CRHT model is likely to be most effective when there is low staff turnover, flexibility in inter-team working arrangements and senior practitioners have both acute and community experience. Rather than being seen primarily as gatekeeper to the acute service, it would be better to take a system approach and view the CRHT as a resource for clients awaiting discharge or seeking to avoid hospital admission that is equally available to both acute and community services. (Publisher abstract)
The balance of care: reconfiguring services for older people with mental health problems
- Authors:
- TUCKER S., et al
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.81-91.
- Publisher:
- Taylor and Francis
The belief that most older people, including those with complex needs, can, and would prefer to be, cared for in their own homes underpins community care policy in many developed nations. There is thus a common desire to avoid the unnecessary or inappropriate placement of older people in care homes or in hospital by shifting the balance of provision. This paper demonstrates the utility of a 'balance of care' approach to address these issues in the context of commissioners' intention to reconfigure services for older people with mental health problems in a defined geographical area of the North West of England. The findings suggest that, if enhanced community services were available, a number of people currently admitted to residential or hospital beds could be more appropriately supported in their own homes at a cost that is no greater than local agencies currently incur.
Inpatient provision for children and young people with mental health problems
- Author:
- FRITH Emily
- Publisher:
- Education Policy Institute
- Publication year:
- 2017
- Pagination:
- 33
- Place of publication:
- London
This report examines the state of child and adolescent mental health inpatient services in England. It explores the latest evidence and NHS data on admissions, quality of care, staffing and capacity of inpatient services – including geographical distribution and out of area placements. It also looks briefly at community alternatives to hospital admission and delayed discharge. It highlights five challenges in order to raise standards in young people’s mental health provision. These include: addressing workforce shortages, improving access to inpatient beds and reduce geographical disparity in access; and increasing the capacity of community mental health and social care support services to enable young people to be discharged from hospital sooner. (Edited publisher abstract)
Users' views of therapeutic community treatment: a satisfaction survey at the Cassel hospital
- Authors:
- CHIESA Marco, PRINGLE Pamela, DRAHORAD Carla
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 24(2), Summer 2003, pp.127-141.
- Publisher:
- Emerald
Explores the experience of 85 patients through the systematic survey of their views following their inpatient stay at the Cassel Hospital. Patients who had been resident for treatment for at least 6 weeks were invited to complete the Cassel Satisfaction Questionnaire. Data was examined through a separate quantitative and qualitative approach. Results show that although patients were generally satisfied with the treatment they received, their negative experiences and criticisms highlighted important deficiencies in specific aspects of the treatment programme in the areas of the transitional phase of treatment (admission and discharge), nursing organisation and adequate provision of aftercare.