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Including families and carers: an evaluation of the Family Liaison Service on inpatient psychiatric wards in Somerset, UK
- Author:
- STANBRIDGE Roger
- Journal article citation:
- Mental Health Review Journal, 17(2), 2012, pp.70-80.
- Publisher:
- Emerald
National mental health policies for working age adults and older people recommend the development of working partnerships between people who use mental health services, their families and carers and professionals. In Somerset, a Family Liaison Service has been developed aiming to improve communication between staff and families. In this model, a member of staff, with systemic family therapy training and experience in working with families, is employed to work alongside psychiatric ward staff to jointly hold meetings with families as part of the assessment and admissions process. The aim of this article is to describe the development of the Family Liaison Service and report on evaluation of its progress. Evaluation data was collected in 3 ways: audit data collected on the number of meetings offered and conducted; feedback from families using the service; and a survey of staff experience. The findings suggest that, although there is still progress to be made, considerable success has been achieved in embedding the service on inpatient units with a substantial increase in meetings held between staff and families. Feedback from families is positive and staff report increased confidence in engaging with families and carers.
The effect of service setting on treatment outcome: a comparison between cognitive behavioural approaches within primary and secondary care
- Authors:
- FORTUNE Lorna, et al
- Journal article citation:
- Journal of Mental Health, 14(5), October 2005, pp.483-498.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Within the National Health Service (NHS) there has been an increasing emphasis on the integration of mental health services within primary care. This study compares a hospital-based and a primary care-based CBT service, to investigate if the setting of treatment affected participants' rate of recovery and levels of satisfaction. 52 participants who received CBT treatment for a range of psychological problems in either setting were compared using a non-randomized, quasi-experimental, design. A range of psychological measures were taken at baseline and over the first six treatment sessions, and rate of change in psychological symptoms and satisfaction were compared. Both groups demonstrated improvement over the period of the study but the participants from the primary care group showed a more rapid rate of recovery during the first six sessions, and received briefer treatment. Such differential rates of treatment change were not attributable to group differences in terms of chronicity or severity. The primary care group also reported significantly higher levels of satisfaction. The authors conclude the setting of treatment might impact on patients' outcome, with primary care patients responding more rapidly than those seen in secondary care. Providing a service in primary care might also increase patient compliance with treatment. Further research is needed to investigate longer term outcome, as well as enhancing how well findings can be generalized.
The impact of a state hospital closure on local jails: the Kansas experience
- Author:
- SEVERSON Margaret E.
- Journal article citation:
- Community Mental Health Journal, 36(6), December 2000, pp.571-587.
- Publisher:
- Springer
In 1990, Kansas' mental health reform legislation began transferring fiscal support for the delivery of mental health services from hospitals to community based services. Kansas jails were studied to assess the impact of the closure of the state hospital on the jail system. Though a relationship between the hospital closure and incarceration rates could not be substantiated, the results of this study provide a rare over-view of the extent of and problems associated with the incarceration of people with mental health problems in a predominantly rural US state.
A qualitative analysis of the views of in-patient mental health service users
- Authors:
- GOODWIN Isabel, et al
- Journal article citation:
- Journal of Mental Health, 8(1), February 1999, pp.43-54.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This study examines the views of patients of adult in-patient psychiatric services in a large, rural county in England. The emergent themes extracted from the comments made by the patients reflect what appear to be most important issues for in-patient service users. The 13 themes identified are presented with illustrative comments, and discussed in relation to the methodology used and the issues of the intransigence and power of psychiatric institutional systems. Finally, the challenge of pursuing more humane and caring practices within psychiatric institutions is considered and means of achieving and monitoring this are discussed.
Informal caregiving to older adults hospitalized for depression
- Authors:
- MORROW-HOWELL N.L., PROCTOR E.K.
- Journal article citation:
- Aging and Mental Health, 2(3), August 1998, pp.222-231.
- Publisher:
- Taylor and Francis
This study addresses the following questions: what are the caregiving needs stemming from functional dependency of older adults hospitalised for depression and discharged at home; who are the informal caregivers, and what assistance do they provide; and how adequate is this informal care? On a sample of depressed older adults, in-hospital information was collected from medical records and discharge planners; and one-month post-discharge, a telephone interview was completed. Finds that despite high levels of involvement, concerns remain about the adequacy of the care informal caregivers are able to provide in the face of such need. Increased attention should be paid to the topic of informal caregiving to older adults with depression.
Preventing violence on mental health wards
- Authors:
- WARREN Jonathan, BEADSMOORE Alan
- Journal article citation:
- Nursing Times, 20.8.97, 1997, pp.47-48.
- Publisher:
- Nursing Times
The findings reported in this article form part of a two-year study on the quality and effectiveness of acute mental health in-patient care by the Sainsbury Centre for Mental Health.
Dual diagnosis patients in community or hospital care: One-year outcomes and health care utilization and costs
- Authors:
- TIMKO Christine, et al
- Journal article citation:
- Journal of Mental Health, 15(2), April 2006, pp.163-177.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This American study evaluated the effectiveness and cost-effectiveness of community- and hospital-based acute residential treatment for dually disordered patients, and whether moderately-ill patients benefited more from community care, and severely-ill patients from hospital care. Two hundred and thirty patients with dual substance use and psychiatric disorders were randomly assigned to community or hospital acute care programs that had the same level of service-intensity. They were followed for 1 year (80%) using the Addiction Severity Index. Patients' health care utilization was assessed from charts, VA databases, and health care diaries; costs were assigned using methods established by the VA Health Economics Resource Center. Patients had better substance use outcomes when they were initially assigned to community rather than to hospital acute care. Patients assigned to hospital care had shorter index stays, but these index stays were more costly than were the longer index stays of patients assigned to community care. Patients assigned to hospital care also had more mental health follow-up outpatient visits, and more costly mental health follow-up stays, over the study year. The authors concluded that cost savings may be achieved without loss of benefit to all but the most decompensated dually disordered patients by shifting the locus of acute treatment from hospital to community care.
Community care for long-stay psychiatric patients: need- or policy-driven
- Authors:
- GARROD Neil, VICK Sandra
- Journal article citation:
- Health and Social Care in the Community, 7(6), December 1999, pp.502-507.
- Publisher:
- Wiley
Describes an economic analysis undertaken as part of an evaluation of mental health services in Clwyd. Cost data were collected in both the hospital setting and subsequent community care settings. Results found little significant difference in care effectiveness, but cost estimates showed that old long-stay patients cost more to care for in the community than the new long-stay patients, whilst in hospital they had cost less. Concludes that the cost of care is substantially affected by non-needs-driven policy decisions as well as by direct patient needs.
A critical appraisal of violent incident measures
- Author:
- BOWERS Len
- Journal article citation:
- Journal of Mental Health, 8(4), August 1999, pp.339-349.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Instrumentation for the recording of violence incidents in psychiatric wards for the purpose of research remain rudimentary and underdeveloped. This article provides a critical review of the currently available research tools. All have potentially fatal handicaps which have not been identified in previous reviews, the most serious of which is the conflation of severity of a violent incident with the outcome in terms of injury.
From efficacy to effectiveness in community mental health services. PRiSM Psychosis Study 10
- Authors:
- THORNICROFT Graham, et al
- Journal article citation:
- British Journal of Psychiatry, 173, November 1998, pp.423-427.
- Publisher:
- Cambridge University Press
The PRiSM Psychosis Study investigated the outcomes of community mental health services for epidemiological representative cases of psychosis in London. The results presented in the other studies are interpreted. Concludes that the evidence supports a community-orientated rather than a hospital-orientated approach and there is little difference between the community mental health team models.