Search results for ‘Subject term:"mental health problems"’ Sort:
Results 1 - 10 of 15
Employment advice in primary care: a realistic evaluation
- Authors:
- PITTAM Gail, et al
- Journal article citation:
- Health and Social Care in the Community, 18(6), November 2010, pp.598-606.
- Publisher:
- Wiley
In 2007 the Richmond Fellowship, a national mental health charity, received a grant to provide four employment advisers to work with GP surgeries. The goal was to help people with mental health problems gain work or retain their current employment. In this study an evaluation framework was applied to address the question of what works, for whom and in which contexts through interviews with key stakeholders including 22 clients of the project, five primary health care staff and the four employment advisers. The interventions that retain clients found most helpful were careers guidance and developing strategies to negotiate and communicate with employers. These appeared to help individuals to take control, broaden their horizons and move forward. For regaining clients, the most important interventions were help with interview skills, CV writing and assertiveness training. Employment outcomes were considerably higher for the retained clients than for the regained clients. The authors suggest that it could be more effective for retain and regain services to be delivered through different care pathways to avoid diluting the services offered and consequently reducing their effectiveness.
A five-year evaluation of the effectiveness of person-centred counselling in routine clinical practice in primary care
- Authors:
- GIBBARD Isabel, HANLEY Terry
- Journal article citation:
- Counselling and Psychotherapy Research, 8(4), December 2008, pp.215-222.
- Publisher:
- Wiley
Counselling is the recommended treatment for individuals with mild to moderate mental health problems of recent onset. In this evaluation of a primary care counselling service offering person-centred counselling, the Core Outcome Measure (CORE-OM) was administered at referral and at the beginning and end of therapy. A pre-post therapy effect size for 697 individuals over a 5 year period was 1.2. This compares with a waitlist (between referral and pre therapy) effect size of 0.24 for 382 individuals over a three year period. The results indicate that person-centred counselling is effective for clients with common mental health problems, such as anxiety and depression. Effectiveness is not limited to individuals with mild to moderate symptoms of recent onset, but extends to people with moderate to severe symptoms of longer duration.
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.
Using realistic evaluation to evaluate a practice-level intervention to improve primary healthcare for patients with long-term mental illness
- Authors:
- BNYNG Richard, REDFERN Sally, NORMAN Ian
- Journal article citation:
- Evaluation, 11(1), January 2005, pp.69-93.
- Publisher:
- Sage
Mental Health Link - a facilitated programme - aimed to develop systems within primary care and links with specialists to improve care for patients with long-term mental illness. A process evaluation based on Pawson and Tilley’s Realistic Evaluation complemented a randomized controlled trial. This article describes the method developed for this ‘realistic evaluation’, the mechanisms behind the integration of linked specialist workers and discusses practical and theoretical issues arising from the use of the realistic evaluation framework as a way of explaining the results of trials and service development. Retrospective interviews identified the important outcomes and were used to construct ‘Context-Mechanism-Outcome’ configurations. The 12 case studies represented what had happened. A second-level analysis using analytic induction developed ‘middle range theories’ designed to be of value to those developing care elsewhere. The intervention was successful in stimulating productive joint working, through case discussions, but often failed to ensure a review of progress.
Counselling in primary care: a review of the practice evidence
- Author:
- HEMMINGS Adrian
- Journal article citation:
- British Journal of Guidance and Counselling, 28(2), May 2000, pp.233-252.
- Publisher:
- Taylor and Francis
Describes the level of mental health problems that are encountered in primary health care. Describes the limitations of using randomised control trials (RCTs) in evaluating effectiveness of psychological therapies in primary health care and reviews the literature on research carried out in more naturalistic circumstances.
Developing practice and evidence for counselling in primary care: the agenda
- Author:
- MELLOR-CLARK John
- Journal article citation:
- British Journal of Guidance and Counselling, 28(2), May 2000, pp.253-266.
- Publisher:
- Taylor and Francis
Counselling in primary care has developed rapidly over the last few years and now appears to be a widespread provision. Yet ad hoc, unregulated development, coupled with radical changes within the National Health Service environment, presents an array of challenges to continued development. This paper reviews and summarises the contributions of all the authors to this special symposium, and in so doing attempts to set out a development agenda for both evidence and practice as a practical yield from the rich insights and experiences offered.
The impact of primary care counselling on psychiatric symptoms
- Authors:
- GORDON Kenneth, GRAHAM Carolyn
- Journal article citation:
- Journal of Mental Health, 5(5), December 1996, pp.515-523.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The work of three primary care counsellors was assessed over a one year period, in which clients were offered a brief intervention, under supervision of a clinical psychologist. Results suggested that clients were referred with significant mental health problems, and that counselling was effective in reducing psychiatric symptomatology. However, some of the more severely disturbed clients needed to be referred on to specialist teams, and while it can produce cost savings in some areas, counselling may therefore also create new demands on secondary care. Concludes that general practice counselling is valuable, but should be seen as an expansion of the range of mental health care, rather than an alternative to existing specialist services.
An evaluation of Wolverhampton's social prescribing service: a new route to wellbeing
- Authors:
- MASSIE Rachel, AHMAD Nahid
- Publisher:
- University of Wolverhampton. Institute for Community Research and Development
- Publication year:
- 2019
- Pagination:
- 31
- Place of publication:
- Wolverhampton
An independent evaluation of Wolverhampton social prescribing pilot service, which was launched in 2017 by the Clinical Commissioning Group in collaboration with Wolverhampton Voluntary Sector Council. The evaluation found that the service, which provides a link between primary care services and voluntary and community organisations for those with non-clinical issues, is highly regarded. A total of 676 referrals were received between May 2017 and December 2018. The most common reasons for referral were loneliness and low-level mental health conditions. Link workers made onward referrals to over 150 groups and services. Participants reported a positive impact on mental health, wellbeing, confidence, self-esteem, and even physical health for those who had been referred. The report estimates that Return on Investment means that for every £1 spent on the social prescribing intervention, there will be a saving of £0.15 for primary care services. The researchers recommended further awareness-raising activities, quarterly progress reports and better communication to service users around the nature of the service and wider access, as well as improved data capture. (Edited publisher abstract)
Training general practitioners in cognitive behavioural therapy for panic disorder: randomized-controlled trial
- Authors:
- HEATLEY Charles, RICKETTS Tom, FORREST Julie
- Journal article citation:
- Journal of Mental Health, 14(1), February 2005, pp.73-82.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Cognitive Behavioural Therapy (CBT) is an effective treatment for panic disorder and other common mental health problems, however its availability in British General Practice is limited. Work is needed to identify ways to improve access to patients in primary care. This research is a pilot study to measure the effectiveness of a training programme in CBT for GPs for the treatment of panic disorder. Randomized-controlled trial. GPs were randomized to early or late entry into a training programme in CBT, consisting of formal teaching and clinical supervision. Outcome measures were: knowledge of panic disorder using a multiple-choice questionnaire; evidence of ability to assess and plan management of patients with panic disorder using responses to role-played consultations; assessment of change in practice by analysis of patient records. GPs significantly increased their ability to assess and plan management of panic disorder. There was no significant increase in knowledge. There was evidence for an increased use of CBT techniques with recruited patients. Training and clinical supervision in CBT led to a change in GP behaviour in the management of panic disorder. Further development could lead to greater availability of effective psychological management of other mental health problems.
Side by side
- Authors:
- NEIRA-MUNOZ Edmundo, WARD Derek
- Journal article citation:
- Health Service Journal, 13.8.98, 1998, pp.26-27.
- Publisher:
- Emap Healthcare
A specialist mental health worker liaising with general practices can reduce pressure on children's services. Reports on a pilot study.