Search results for ‘Subject term:"mental health problems"’ Sort:
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End of life care for people with severe mental illness: the MENLOC evidence synthesis
- Authors:
- HANNIGAN Ben, et al
- Journal article citation:
- Health and Social Care Delivery Research, 10(4), 2022, p.234. Online only
- Publisher:
- National Institute for Health Research
- Place of publication:
- London
Background: People with severe mental illness have significant comorbidities and a reduced life expectancy. This project answered the following question: what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional diagnosis of advanced incurable cancer and/or end-stage lung, heart, renal or liver failure and who are likely to die within the next 12 months? Objectives: The objectives were to locate, appraise and synthesise relevant research; to locate and synthesise policy, guidance, case reports and other grey and non-research literature; to produce outputs with clear implications for service commissioning, organisation and provision; and to make recommendations for future research. Review methods: This systematic review and narrative synthesis followed international standards and was informed by an advisory group that included people with experience of mental health and end-of-life services. Database searches were supplemented with searches for grey and non-research literature. Relevance and quality were assessed, and data were extracted prior to narrative synthesis. Confidence in synthesised research findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluation and the Confidence in the Evidence from Reviews of Qualitative Research approaches. Results: One hundred and four publications were included in two syntheses: 34 research publications, 42 case studies and 28 non-research items. No research was excluded because of poor quality. Research, policy and guidance were synthesised using four themes: structure of the system, professional issues, contexts of care and living with severe mental illness. Case studies were synthesised using five themes: diagnostic delay and overshadowing, decisional capacity and dilemmas, medical futility, individuals and their networks, and care provision. Conclusions: A high degree of confidence applied to 10 of the 52 Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of Qualitative Research summary statements. Drawing on these statements, policy, services and practice implications are as follows: formal and informal partnership opportunities should be taken across the whole system, and ways need to be found to support people to die where they choose; staff caring for people with severe mental illness at the end of life need education, support and supervision; services for people with severe mental illness at the end of life necessitate a team approach, including advocacy; and the timely provision of palliative care requires proactive physical health care for people with severe mental illness. Research recommendations are as follows: patient- and family-facing studies are needed to establish the factors helping and hindering care in the UK context; and studies are needed that co-produce and evaluate new ways of providing and organising end-of-life care for people with severe mental illness, including people who are structurally disadvantaged. Limitations: Only English-language items were included, and a meta-analysis could not be performed. Future work: Future research co-producing and evaluating care in this area is planned. (Edited publisher abstract)
Implementing evidence-based supported employment in Sussex for people with severe mental illness
- Authors:
- van VEGGEL Rhonda, WAGHORN Geoffrey, DIAS Shannon
- Journal article citation:
- British Journal of Occupational Therapy, 78(5), 2015, pp.286-294.
- Publisher:
- Sage
Introduction The aim of this research was to evaluate a large-scale implementation of evidence-based supported employment for people with severe mental illness, at 17 locations throughout Sussex, England. Method A parallel group observational design was used to evaluate an implementation of the individual placement and support approach to supported employment. Three sites provided both a comparison pre-individual placement and support cohort (n = 140), and a new post-individual placement and support cohort (n = 107) as part of the individual placement and support implementation (n = 446). All individual placement and support sites involved community mental health teams forming partnerships with Southdown Supported Employment to co-locate an employment specialist into each mental health team. The primary outcome was the proportion of participants commencing competitive employment during the follow-up period. Results The new individual placement and support sites attained higher fidelity with respect to individual placement and support principles and practices (mean 97 of 125) than the pre-individual placement and support sites (mean 77 of 125). Significantly more individual placement and support participants commenced competitive employment than pre-individual placement and support participants (24.9% vs 14.3%). Individual placement and support participants experienced less delay before commencing their first job (153 vs 371 days), and when employed, worked more hours per week (24.3 vs 15.4 hours). Conclusion This implementation of individual placement and support in Sussex improved on the previous vocational services. Although progress is encouraging there is much room for improvement. More resources appear needed to support programme development, specifically to strengthen site-level management, training, technical support, fidelity assessment, programme monitoring, and outcome evaluation. (Publisher abstract)
Researchable questions to support evidence-based mental health policy concerning adult mental illness
- Authors:
- THORNICROFT G., et al
- Journal article citation:
- Psychiatric Bulletin, 26(10), October 2002, pp.364-367.
- Publisher:
- Royal College of Psychiatrists
This article aims to identify important gaps in completed research and to translate these gaps into researchable questions that can contribute to a debate about the future research agenda for general adult mental health in England. The authors conduct an expert assessment of a thematic review of commissioned research on adult mental health between 1992 and 2000 the Scoping Review of the Effectiveness of Mental Health Services, produced by the Centre for Reviews and Dissemination at the University of York and the Report of the Mental Health Topic Working Group (1999).
Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units
- Authors:
- PHILLIPS Prashant, JOHNSON Sonia
- Journal article citation:
- Psychiatric Bulletin, 27(6), June 2003, pp.217-220.
- Publisher:
- Royal College of Psychiatrists
Ward staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients. 264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with 'dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission. It appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.
Evidence-based social work practice with mentally ill persons who abuse alcohol and other drugs
- Author:
- O'HARE Thomas
- Journal article citation:
- Social Work in Mental Health, 1(1), 2002, pp.43-62.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mentalillness who also abuse alcohol and other drugs. Representative empirical literature is summarized within a framework that delineates the three major functions of evidence-based social work practice: assessment, intervention andevaluation. Assessment protocol, which incorporates the use of valid scales tocomplement the qualitative interview, is based on domain-specific research that outlines relevant psychosocial risk factors, and highlights those that are amenable to change. Intervention strategies are derived from the growing body ofcontrolled research findings, but flexibility in implementation is recommended to accommodate clients' individual needs and the vagaries of daily practice. Naturalistic evaluation methods are used to capitalize on the use of brief,valid process and outcome measures to augment individual qualitative evaluation and to aggregate data for programme evaluation. The implications of this integrated evidence-based strategy for social work practice are discussed.
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.
Public mental health: evidence, practice and commissioning
- Author:
- CAMPION Jonathan
- Publisher:
- Royal Society for Public Health
- Publication year:
- 2019
- Pagination:
- 233
- Place of publication:
- London
Based on a review of recent literature, this report summarises evidence around public mental health practice. Public mental health practice takes a population approach to mental health which includes three levels of mental disorder prevention and mental wellbeing promotion. The review covers: the impact of mental health problems and of mental wellbeing; risk factors for mental disorder and protective factors for mental wellbeing; groups at higher risk of poor mental health; effective interventions to treat mental disorder and to prevent associated impacts, preventing mental disorder from arising and promoting mental wellbeing; and economic savings of different public mental health interventions. It finds that despite the existence of cost-effective public mental health interventions, only a minority of people with a mental condition in England receive any treatment, receive interventions to prevent associated impacts or receive intervention to prevent mental conditions or promote mental wellbeing. It sets out a number of actions to improve coverage of evidence based interventions to reduce the population impact of mental disorder and promote population mental wellbeing. The report has been endorsed by the Association of Directors of Public Health, Faculty of Public Health, Health Education England, Local Government Association, Royal College of General Practitioners, Royal College of Psychiatrists and RSPH (Royal Society of Public Health). (Edited publisher abstract)
Rapid review of mental health in primary care: what aspects of primary care are effective in the prevention, recognition and management of mental health issues across the lifespan; for whom do they work, in what circumstances and why?
- Authors:
- BUNTING Brendan, et al
- Publisher:
- Public Health Agency
- Publication year:
- 2011
- Pagination:
- 283p., bibliog.
- Place of publication:
- Belfast
This rapid review of the literature looks at guidelines, standards and best practice for the effective provision of mental health services in primary care. The review used a defined search strategy to retrieve systematic reviews, meta-analysis or synthesis papers. A separate strategy was used to retrieve guidelines and standards. The main sections of the report cover the context and the current challenge presented by mental health in Northern Ireland; the review methodology; key principles of an ideal service model; synthesis of review level evidence; comparison of review level evidence and the key principles of an ideal model; and concluding comments. The findings and recommendations look at specific conditions separately, including: depression and anxiety; mental health and the Northern Ireland conflict; stigma; screening; suicide and self-harm; GAD; alcohol dependency and mental health; prevention; older people; dementia; and schizophrenia. This is one of a series of research reviews focussing on priorities identified through the Action Plan that supports the response to the Bamford Review Bamford Review of Mental Health and Learning Disability Recommendations in Northern Ireland.
Behind closed doors: acute mental health care in the UK: the current state and future vision of acute mental health care in the UK
- Authors:
- RETHINK, et al
- Publisher:
- Rethink
- Publication year:
- 2004
- Pagination:
- 23p.
- Place of publication:
- London
This report reveals that, despite some 650 national strategies, guidelines, frameworks and protocols issued by the government over the last five years, much still needs to be done to improve the harrowing conditions under which some of society’s most vulnerable people are treated. The report found that there are too many people in our psychiatric units, particularly those – like the psychiatric intensive care units (PICUs), that work with those most severely ill. The report shows, that there is a crisis in psychiatric in-patient care with wards over-crowded, treatment taking place in “bleakness and squalor” and staff left feeling demoralised and unsupported. The report also highlights developments that may improve this situation.
Treated as people: an overview of mental health services from a social care perspective, 2002-04
- Author:
- ROBBINS Diana
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 2004
- Pagination:
- 34p.
- Place of publication:
- London
Key messages from the report include the following. The use of Direct Payments in supporting the independence of mental health service users and their carers is very under-developed. Numbers receiving such payments have increased, but slowly and from a very low base. Organisational change is a necessary part of the reform of mental health services. But it can easily dominate activity and dilute good services. It requires clear focus and leadership, and attention to human resources, from management capacity to the caseloads of individual team members. Reports from the local teams (LITs) implementing the National Service Framework (NSF) for mental health include much encouraging news, and indications of progress in many areas. Some good work is reported in relation to work with carers: less, in relation to culturally appropriate services for black and ethnic minority service users. From inspections there is evidence of many good, individual services promoting and supporting the social care of service users. But the coordination which would make these initiatives work together as a coherent strategy against social exclusion is often lacking. At the same time, individual, often good services targeting the employment or accommodation of service users are currently inadequate to meet demand. Meeting these needs should be a priority for councils and their partners.