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The extent and impact of depression on BME older people and the acceptability, accessibility and effectiveness of social care provision: systematic map report 3
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, SHARIF Nadira, BROWN Walt, RUTTER Deborah
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2008
- Pagination:
- 86p., bibliog.
- Place of publication:
- London
Systematic maps aim to describe the existing research literature on a broad topic area and also highlight any gaps. This systematic map includes research on the experience of depression in various BME older populations and the use of services in the UK. In particular, it provides an overview of and access to research on: the main ethnic groups assessed for depression; the factors associated with the incidence of depression; the languages used by different BME communities to describe depression, and the meanings attached to depressive symptoms; the screening tools for depression used by healthcare and other professionals some types of interventions available to older BME people. Despite the coverage of broad issues on depression in BME older people, the map highlights considerable gaps particularly around the issue of social care provision.
Are the views of members of mental health user groups representative of those of 'ordinary' patients? A cross-sectional survey of service users and providers
- Authors:
- CRAWFORD Mike J., RUTTER Deborah
- Journal article citation:
- Journal of Mental Health, 13(6), December 2004, pp.561-568.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The lack of representativeness of service users who participate in user involvement initiatives has been cited as a major obstacle to efforts to develop patient-centred mental health services. Aims : To examine whether the views of active members of a local user group reflect those of "ordinary" patients in contact with mental health services and to compare their views with those of other local stakeholders. A cross-sectional survey in which participants were asked to rate the importance of different priorities for service development. Participants comprised 90 patients randomly selected from among those currently using mental health services, 10 members of the local mental health user group, 30 local service managers, 9 consultant psychiatrists and members of the local Trust Board. The views of members of the mental health user group were similar to those of the randomly selected sample of patients. All four items rated as priorities by a random sample of patients were also rated priorities by members of the group and the two items rated as low priorities by patients were the two lowest priorities of user group members. User group members tended to rate all options as being of greater priority (mean rating = 3.3) than the random sample of patients (mean rating = 2.9, F = 9.7, p = .02). While caution needs to be exercised before making assumptions about the generalizability of views of members of user groups, these results challenge the view that members of user groups differ from those of "ordinary" patients.
Internal vs. external care management in severe mental illness: randomized controlled trial and qualitative study
- Authors:
- RUTTER Deborah, et al
- Journal article citation:
- Journal of Mental Health, 13(5), October 2004, pp.453-466.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Case management is the encompassing model for managing people with severe mental illness, but models of case management vary. The aim was to compare the effectiveness of an integrated (internal) model of care management (in which the social worker is a member of the multidisciplinary healthcare team) against a brokerage model in which the care manager operates "externally" to the healthcare team. Patients with severe mental illness meeting a high threshold of need referred to a community team were randomized to a care manager newly appointed to the team, or to a care manager outside the team. Days spent in hospital were the primary outcome measure, and costs for patients in each arm were compared. Semi-structured qualitative interviews were employed to explore a sample of cases in each category; compare joint working practice in both models; and compare practice in London to that within a well-established integrated CMHT in Nottingham. The randomized trial of "internal" vs. "external" care management showed no significant differences in outcome or costs among 26 patients. However, the qualitative study revealed worker dissatisfaction with the brokerage model, and identified inefficiencies and duplication of effort. The brokerage model of case management should not be maintained.