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The Mental Health Clustering Tool for people with severe intellectual disability
- Authors:
- RADHAKRISHNAN Vishwa, SMITH Kevin, O'HARA Jean
- Journal article citation:
- Psychiatrist (The), 36(12), December 2012, pp.454-458.
- Publisher:
- Royal College of Psychiatrists
Payment by results is being extended to mental health services in the UK. To support its implementation in secondary mental health services, the DofH has developed the Mental Health Clustering Tool (MHCT) to assign patients to groups based on need and anticipated service use, rather than diagnosis. The authors examined 92% (117/127) of the patients in their community mental health learning disability team using the MHCT to discover whether it could capture their needs sufficiently well for assignment to a payment by results care cluster. A large proportion, 48%, of the sample was assigned to the variance cluster, Cluster 0, which is used when the needs of patients do not match any of the current 21 care clusters but a service will be provided. Clinicians’ ability to assign patients to clusters was primarily related to the absence of pervasive development disorder. Severity of intellectual disability alone did not appear to be associated with Custer 0 but aggression and agitation was more common in this cluster. It is concluded that the MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development and the authors suggest that until it is available it will not be possible to implement payment by results in mental health within learning disability services.
Can LETS make it better. A Stirling example
- Authors:
- MANLEY Catherine, ALDRIDGE Theresa
- Journal article citation:
- A Life in the Day, 4(4), November 2000, pp.3-10.
- Publisher:
- Emerald
This article explores the potential of Local Exchange Trading Schemes (LETS) to overcome some of the barriers to participating in meaningful activity for people with severe and enduring mental illness. The struggle for funding is considered to be the key barrier.
Factors enabling and hindering participation in leisure for people with mental health problems
- Authors:
- PIERIS Yvonne, CRAIK Christine
- Journal article citation:
- British Journal of Occupational Therapy, 67(6), June 2004, pp.240-247.
- Publisher:
- Sage
Using a qualitative design, semi-structured interviews were conducted with 10 participants with mental health problems living in the community, randomly selected from clients referred to a local assertive outreach service in South-East England. Initially, the data were analysed for content and the phrases, language and words used; subsequently, emerging themes were identified, which were confirmed by a second occupational therapist. The three themes arising from the data reported here were the number and range of occupations engaged in, the factors enabling participation in leisure and the factors hindering participation in leisure. The range of leisure occupations was similar to that noted in the literature. The main enabling factor was having an adequate network of people to provide support, while the main hindering factors were physical limitations, lack of finances and lack of transport. In the absence of paid employment, leisure was important to the clients. Occupational therapists need to recognise that enhancing the factors enabling participation in leisure and assisting clients to overcome the factors hindering participation in leisure will lead to the increased wellbeing of people with enduring mental health problems.
Strengths and weaknesses of self-help groups in mental health: the case of Grow
- Author:
- YIP Kam-Shing
- Journal article citation:
- Groupwork, 13(2), 2002, pp.93-113.
- Publisher:
- Whiting and Birch
Grow is a self-help movement of ex-mental health patients which is well established in Australia. Participant observation of two groups over six months suggested strengths, difficulties and weaknesses. The strengths concerned intense commitment to mutual aid among members, a great deal of sharing and an unusual form of rotating leadership. The difficulties centred on the unstable sources of finance and the unmanageable caseloads of workers. The weaknesses related to the quasi-religious ideology, which might have inhabited the expression and exploration of negative feelings.
Assertive community treatment of persons with severe mental illness
- Authors:
- STEIN Leonard I., SANTOS Alberto B
- Publisher:
- W.W. Norton
- Publication year:
- 1998
- Pagination:
- 286p.,bibliogs.
- Place of publication:
- New York
Practical text describing the assertive community treatment (ACT) approach to working with people with severe mental health problems in the United States. Contains chapters on: stigma and prejudice; origins of ACT; ACT research and dissemination; characteristics of the users; the continuous care strategy; the ACT team; treatment principles; daily programme operation; rural, diagnosed and homeless populations; and ACT financing and administration.
A fatal catalogue of missed opportunities
- Author:
- MAHONY Chris
- Journal article citation:
- Care Weekly, 3.3.94, 1994, p.7.
The Ritchie Report into how Christopher Clunis came to murder Jonathan Zito is critical of the services involved in Clunis' care. It also blames the government for inadequately funding care in the community.
The economic and social costs of mental illness
- Author:
- SAINSBURY CENTRE FOR MENTAL HEALTH
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 2003
- Pagination:
- 15p.
- Place of publication:
- London
The cost of mental illness in England adds up to £77.4 billion, twice as high as was previously estimated, when quality of life is considered alongside the costs of care and lost work. The figures are:: £12.5 billion for care provided by the NHS, local authorities, privately funded services, family and friends; £23.1 billion in lost output in the economy caused by people being unable to work (paid and unpaid); £41.8 billion in the human costs of reduced quality of life, and loss of life, amongst those experiencing a mental health problem. The costs of mental illness to businesses and to individuals dwarf the sums of money used in treating mental health problems. Some 39 per cent of working age adults with a mental health problem, for example, have no job. That represents a loss to the economy of £9.4 billion: more than the £6.5 billion the NHS spent on mental health services last year. Many of the costs of mental illness are hidden. For example, most people with mental health problems are looked after by relatives and friends on an unpaid basis. The value of this care is estimated at £3.9 billion.
The hidden costs of mental health
- Author:
- MIND
- Publisher:
- MIND
- Publication year:
- 2003
- Pagination:
- 33p.,tables.
- Place of publication:
- London
The report is largely based on a survey of people with mental health problems in Mind’s networks. It was designed to find out what types of care and treatment people with mental health problems did and didn’t get prescribed on the NHS, how much people were paying, and the affect that this was having on their lives. Almost one in five people who paid for un-prescribed care and treatment were spending more than £100 a month for treatment they felt they needed. And out of the 58 per cent who’d said they had missed out, 70 per cent felt the lack of treatment had hampered their recovery or ability to cope. Where care or treatment was prescribed by doctors, 45 per cent paid an average £37 a month (mostly for medication, complementary therapies, and counselling/therapy). 51 per cent of people paid an average £61 a month for un-prescribed care and treatment (mostly for complementary therapies and counselling/therapy). Despite a commitment from the Government in its national service framework four years ago to make mental health a priority, this report shows that people with mental health problems are not given equal status on the NHS and are often forced to foot the bill for their own treatment.
A survey of policy and practice on expenses and other payments to mental health service users and carers participating in service development
- Authors:
- RYAN Tony, BAMBER Carey
- Journal article citation:
- Journal of Mental Health, 11(6), December 2002, pp.635-644.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This article reports a survey of 75 organisations commissioning and providing secondary mental health services regarding their policies and practice in respect of payment to mental health services users and informal carers for expenses and their time when participating in the design, development, delivery and monitoring of services. A wide range of statutory and non-statutory organisations was invited to participate. Results indicate that there is a considerable desire to develop practice in this area and that the issue of payments is viewed as important in addressing user and carer participation. Significantly, many organisations employed unwritten policies based on custom and practice and were most likely to relate to basic expenses payments rather than payments for time given. A small number of organisations had developed robust policies and these usually included payment for time as well as expenses payments.
World health report 2001: mental health; new understanding, new hope
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2001
- Pagination:
- 178p.,tables.
- Place of publication:
- Geneva
This report examines the effectiveness of prevention, and the availability of, and barriers to, treatment. It deals in detail with service provision and planning. Finally, it outlines the politics that are needed to ensure that stigma and discrimination are broken down and that effective treatment and prevention are adequately funded.