Search results for ‘Subject term:"mental health problems"’ Sort:
Results 1 - 10 of 15
How can the benefits of personal budgets for people with mental illness be sustained after the payments stop?
- Authors:
- CLEWETT Naomi, et al
- Journal article citation:
- Research Policy and Planning, 31(2), 2014/15, pp.105-126.
- Publisher:
- Social Services Research Group
One aim of mental health social work is to promote recovery and independence for people accessing services. Personal budgets, which can now be requested by all mental health service users in England, can enable service users to achieve these outcomes. This paper addresses the lack of evidence on service user understandings of the purpose and duration of their personal budget, and their experiences of personal budgets ending. The research draws on interviews with 53 mental health service users and 28 practitioners. The results identify how different factors affect the sustainability of the outcome: the type of outcome identified, how far service user and practitioner understanding of outcomes are shared, and the ability to continue activities after the budget ends. The article highlights learning for practitioners and policy makers on improving the sustainability of outcomes achieved through personal budgets, and improving service user experiences of their endings. (Edited publisher abstract)
Stability and change: a 7- to 8-year follow-up study of mental health problems in Norwegian children in long-term out-of-home care
- Authors:
- HAVNEN Karen Skaale, BREIVIK Kyrre, JAKOBSEN Reidar
- Journal article citation:
- Child and Family Social Work, 19(3), 2014, pp.292-303.
- Publisher:
- Wiley
The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long-term out-of-home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre-placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre-placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow-up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care. (Publisher abstract)
A systematic review of studies examining effectiveness of therapeutic communities
- Authors:
- MAGOR-BLATCH Lynne E., et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 35(4), 2014, pp.168-184.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes. Design/methodology/approach: A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues. Findings: Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed. Research limitations/implications: Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts. Practical implications: Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances. Originality/value: The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes. (Publisher abstract)
Evaluation of the MEAM pilots: update on our findings
- Authors:
- BATTRICK Tim, et al
- Publisher:
- FTI Consulting
- Publication year:
- 2014
- Pagination:
- 40
- Place of publication:
- London
Reports on the findings of a two year evaluation of three service pilots which aimed to improve the coordination of local support to individuals suffering from multiple needs such as, homelessness, substance misuse, mental health problems and offending. The three pilots were in Cambridgeshire, Derby and Somerset. The findings are discussed in relation to client wellbeing and service use costs. The study also discusses the concept of survirorship bias and how this can result in programmes appearing more or less successful than they actually are. The evaluation highlights the considerable wellbeing improvements and financial savings that a more coordinated approach can deliver, including one pilot which reduced service use costs by 26.4% over the study period. Appendices include details of service use and unit costs. (Edited publisher abstract)
Effects of the child–perpetrator relationship on mental health outcomes of child abuse: it's (not) all relative
- Authors:
- KISER Laurel J., et al
- Journal article citation:
- Child Abuse and Neglect, 38(6), 2014, pp.1083-1093.
- Publisher:
- Elsevier
The present study was conducted to better understand the influence of the child–perpetrator relationship on responses to child sexual and physical trauma for a relatively large, ethnically diverse sample of children and youth presenting for clinical evaluation and treatment at child mental health centres across the United States. This referred sample includes 2,133 youth with sexual or physical trauma as their primary treatment focus. Analyses were conducted to ascertain whether outcomes were dependent on the perpetrator's status as a caregiver vs. non-caregiver. Outcome measures included psychiatric symptom and behaviour problem rating scales. For sexual trauma, victimization by a non-caregiver was associated with higher posttraumatic stress, internalizing and externalizing behaviour problems, depression, and dissociation compared to youth victimized by a caregiver. For physical trauma, victimization by a non-caregiver was also associated with higher posttraumatic symptoms and internalizing behaviour problems. The total number of trauma types experienced and age of physical or sexual trauma onset also predicted several outcomes for both groups, although in disparate ways. These findings are consistent with other recent studies demonstrating that perpetration of abuse by caregivers results in fewer symptoms and problems than abuse perpetrated by a non-caregiving relative. Thus, clinicians should not make a priori assumptions that children and adolescents who are traumatized by a parent/caregiver would have more severe symptoms than youth who are traumatized by a non-caregiver. Further exploration of the role of the perpetrator and other trauma characteristics associated with the perpetrator role is needed to advance our understanding of these findings and their implications for clinical practice. (Edited publisher abstract)
Assertive community treatment and associations with substance abuse problems
- Authors:
- van VUGT Maaike D., et al
- Journal article citation:
- Community Mental Health Journal, 50(4), 2014, pp.460-465.
- Publisher:
- Springer
This study examined the associations between substance abuse problems in severely mentally ill patients, outcome and Assertive Community Treatment (ACT) model fidelity. In a prospective longitudinal study, ACT model fidelity and patient outcomes were assessed in 20 outpatient treatment teams using the Health of the Nation Outcome Scales, Camberwell Assessment of Needs short appraisal schedule and measures of service use. Five hundred and thirty severely mentally ill patients participated in the study. Substance abuse problems were assessed three times during a 2-year follow-up period. This study found that among patients with severe mental illness, patients with an addiction problem had more serious psychosocial problems at baseline. Substance abuse problems showed improvement over time, but this was not associated with ACT model fidelity. The study indicates that investment by teams to improve a patient’s psychosocial situation can lead to improvements on substance problems. (Publisher abstract)
The impact of sexual abuse committed by a child on mental health in adulthood
- Authors:
- ALLEN Brian, et al
- Journal article citation:
- Journal of Interpersonal Violence, 29(12), 2014, pp.2257-2272.
- Publisher:
- Sage
Numerous research studies document the negative mental health outcomes associated with the experience of childhood sexual abuse. In addition, factors such as one’s relationship with the perpetrator and the severity of the abuse predict the likelihood of future mental health problems. Less attention, however, has focused on the age of the perpetrator, and recent years have seen an increased interest in children who display sexual behaviour problems. College students completed measures of mental health functioning and retrospective reports of maltreatment histories. Participants were categorised as abused by an adult (n = 48), teenager (n = 39), or another child (n = 37), and non-abused (n = 219). Victims of abuse, regardless of perpetrator age, displayed higher levels of mental health problems than non-abused participants. There were no differences between the abused groups on any of the mental health outcomes; however, individuals who were abused by other children were less likely to label their experiences as abuse. (Edited publisher abstract)
Exploring primary care activities in ACT teams
- Authors:
- VANDERLIP Erik R., et al
- Journal article citation:
- Community Mental Health Journal, 50(4), 2014, pp.466-473.
- Publisher:
- Springer
People with serious mental illness often receive inadequate primary and preventive care services. Federal healthcare reform endorses team-based care that provides high quality primary and preventive care to at risk populations. Assertive community treatment (ACT) teams offer a proven, standardised treatment approach effective in improving mental health outcomes for the seriously mentally ill. Much is known about the effectiveness of ACT teams in improving mental health outcomes, but the degree to which medical care needs are addressed is not established. The purpose of this study was to explore the extent to which ACT teams address the physical health of the population they serve. ACT team leaders were invited to complete an anonymous, web-based survey to explore attitudes and activities involving the primary care needs of their clients. Information was collected regarding the use of health screening tools, physical health assessments, provision of medical care and collaboration with primary care systems. Data was analysed from 127 team leaders across the country, of which 55 completed the entire survey. Nearly every ACT team leader believed ACT teams have a role in identifying and managing the medical co-morbidities of their clientele. ACT teams report participation in many primary care activities. ACT teams are providing a substantial amount of primary and preventive services to their population. The survey suggests standardisation of physical health identification, management or referral processes within ACT teams may result in improved quality of medical care. ACT teams are in a unique position to improve physical health care by virtue of having medically trained staff and frequent, close contact with their clients. (Edited publisher abstract)
The cost effectiveness of employment support for people with disabilities: final detailed research report
- Authors:
- GREIG Rob, et al
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2014
- Pagination:
- 121
- Place of publication:
- Bath
The final report from a two year study on employment support for people with mental health problems or learning disabilities. The study focused on three areas: the cost effectiveness or value for money of current models of employment support, whether outcomes varied for different models used, and if outcomes were affected by approaches of commissioners to implementing local employment strategies. The report summarises the findings of a scoping review, findings from national and local data collection on the quality and effectiveness of employment support, and findings from in-depth field work visits to 11 sites to see local commissioners implemented employment strategies. Five Theories of Change identified from the field visits are discussed: shifting culture, employment outcomes, strategic direction, developing the market and performance management. They were seen as aspects that needed to be in place to delivery cost effective outcomes. (Edited publisher abstract)
Employment support for disabled people: investigating the relationship between investment and outcomes: research findings
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2014
- Pagination:
- 4
- Place of publication:
- London
This briefing summarises the findings of research on the cost effectiveness of different service models and commissioning approaches to employment support for people with mental health problems or learning disabilities. The study analysed national data and in addition analysed cost and outcome data from 70 different sites and also carried out fieldwork visits to six sites. Data analysis included an analysis of costs per job outcome (securing new jobs, retaining jobs or moving into self employment). Good evidence was also found to support Individual Placement and Support (IPS) in mental health services and supported employment in learning disabilities services were the most effective ways of supporting people. The study also identified five different organisational or system 'conditions' that were most likely to be found in successful cost effective services.