Dual diagnosis initiatives, particularly those related to training, have largely focused on working age adults. Professionals working with older people need to identify whether dual diagnosis is present and provide effective assessment and treatment, but they often lack knowledge, skills and confidence in working with this group. This paper describes the development and preliminary evaluation of a 5-day course designed to meet the needs of staff working with older people who have a dual diagnosis. The course was designed to provide Level 1 (‘core’) and Level 2 (‘generalist’) competencies for staff working in mental health of older adults (MHOA) services. The training was intended for practitioners in a variety of clinical roles. It was taught using a range of methods including didactic presentations, small group discussions, videos, exercises, role-play, homework and clinical supervision. Evaluation of the course involved a short battery of self-report questionnaires aiming to assess changes to knowledge, confidence and attitudes which were completed prior to and on completion of training. The students' perceptions of the quality of the programme were also obtained. The evaluation indicated that significant changes were achieved in knowledge and confidence after the course. Although there were some changes in attitudes these did not reach significance.
Dual diagnosis initiatives, particularly those related to training, have largely focused on working age adults. Professionals working with older people need to identify whether dual diagnosis is present and provide effective assessment and treatment, but they often lack knowledge, skills and confidence in working with this group. This paper describes the development and preliminary evaluation of a 5-day course designed to meet the needs of staff working with older people who have a dual diagnosis. The course was designed to provide Level 1 (‘core’) and Level 2 (‘generalist’) competencies for staff working in mental health of older adults (MHOA) services. The training was intended for practitioners in a variety of clinical roles. It was taught using a range of methods including didactic presentations, small group discussions, videos, exercises, role-play, homework and clinical supervision. Evaluation of the course involved a short battery of self-report questionnaires aiming to assess changes to knowledge, confidence and attitudes which were completed prior to and on completion of training. The students' perceptions of the quality of the programme were also obtained. The evaluation indicated that significant changes were achieved in knowledge and confidence after the course. Although there were some changes in attitudes these did not reach significance.
Subject terms:
mental health problems, mental health services, older people, substance misuse, training, attitudes, dual diagnosis;
There is growing recognition of the public health needs of the increasing numbers of older people with mental health problems and substance misuse. Policy guidance directed at both mental health and substance misuse services has repeatedly highlighted the need to prevent clients from ‘falling through the net’ between services, and this has led to an increase in localised responses with the intention of ensuring that treatment options are available for this client group. This paper describes the development and implementation of one particular dual diagnosis strategy in an inner city area in London. The dual diagnosis strategy was designed to improve the detection, treatment and health outcomes for older people with dual diagnosis who are referred to mental health of older adults (MHOA) services, and to champion excellence within the MHOA Directorate. A needs assessment highlighted that the majority of staff were unlikely to have the specialist skills, knowledge, confidence or competence required for working with this group. This led to the commissioning of training to address this. In addition, 3 care pathways were created to allow seamless transition between services, thus enabling older adults with dual diagnosis to receive the care that they require.
There is growing recognition of the public health needs of the increasing numbers of older people with mental health problems and substance misuse. Policy guidance directed at both mental health and substance misuse services has repeatedly highlighted the need to prevent clients from ‘falling through the net’ between services, and this has led to an increase in localised responses with the intention of ensuring that treatment options are available for this client group. This paper describes the development and implementation of one particular dual diagnosis strategy in an inner city area in London. The dual diagnosis strategy was designed to improve the detection, treatment and health outcomes for older people with dual diagnosis who are referred to mental health of older adults (MHOA) services, and to champion excellence within the MHOA Directorate. A needs assessment highlighted that the majority of staff were unlikely to have the specialist skills, knowledge, confidence or competence required for working with this group. This led to the commissioning of training to address this. In addition, 3 care pathways were created to allow seamless transition between services, thus enabling older adults with dual diagnosis to receive the care that they require.
Subject terms:
mental health problems, mental health services, older people, substance misuse, training, care pathways, dual diagnosis;
In February and March 2010, the Royal College of Psychiatrists held hearings, hosted a one-day seminar and invited written submissions to gather the views of more than 50 contributors, including psychiatrists, psychologists, social workers, commissioners, trust chief executives, academics, health economists, carers, and medical directors, on the future of UK mental health services. The enquiry considered the need for service redesign in mental healthcare. It aimed to identify areas for future service development that reflect the needs and aspirations of users of mental health services, those who care for them, and also the people who deliver those services. The recommendations provided in this report relate to the following areas: creating efficiencies and improving productivity through redesigned services and care pathways; consultant expertise at the beginning of the pathway; standardised outcomes; investing to save through the development of family mental healthcare; out-of-area treatments; mental health of older people; in-patient care; statutory and voluntary sector partnerships; housing; employment and mental health; substance misuse; relationship between physical and mental health; psychological therapies; and peer support.
In February and March 2010, the Royal College of Psychiatrists held hearings, hosted a one-day seminar and invited written submissions to gather the views of more than 50 contributors, including psychiatrists, psychologists, social workers, commissioners, trust chief executives, academics, health economists, carers, and medical directors, on the future of UK mental health services. The enquiry considered the need for service redesign in mental healthcare. It aimed to identify areas for future service development that reflect the needs and aspirations of users of mental health services, those who care for them, and also the people who deliver those services. The recommendations provided in this report relate to the following areas: creating efficiencies and improving productivity through redesigned services and care pathways; consultant expertise at the beginning of the pathway; standardised outcomes; investing to save through the development of family mental healthcare; out-of-area treatments; mental health of older people; in-patient care; statutory and voluntary sector partnerships; housing; employment and mental health; substance misuse; relationship between physical and mental health; psychological therapies; and peer support.
Subject terms:
housing, joint working, mental health problems, mental health services, needs, older people, outcomes, planning, substance misuse;
The Excellence Network is Community Care's new honours programme which recognises innovative practice. This article profiles six teams that judges felt demonstrated excellence in partnership working. The teams are: The Bridge Substance Misuse Service in Birmingham; Gateway in Poole, which aims to bridge the gap between social and mental health services; East Cambridgeshire Children's Team; Aberdeenshire Autism Service; the Reprovisioning Project Team in Melrose, Scotland which developed a new community based service to meet the needs of former nursing home residents with physical and complex disabilities; and the Meadows Centre for Excellence which joins social care rehabilitation, primary care trust intermediate care and voluntary sector services to provide seamless support for people over 50 in Stoke on Trent.
The Excellence Network is Community Care's new honours programme which recognises innovative practice. This article profiles six teams that judges felt demonstrated excellence in partnership working. The teams are: The Bridge Substance Misuse Service in Birmingham; Gateway in Poole, which aims to bridge the gap between social and mental health services; East Cambridgeshire Children's Team; Aberdeenshire Autism Service; the Reprovisioning Project Team in Melrose, Scotland which developed a new community based service to meet the needs of former nursing home residents with physical and complex disabilities; and the Meadows Centre for Excellence which joins social care rehabilitation, primary care trust intermediate care and voluntary sector services to provide seamless support for people over 50 in Stoke on Trent.
Subject terms:
joint working, mental health services, older people, primary care, social care provision, substance misuse, autism, community health care;
Contains chapters on: a history of mental health in Northern Ireland; mental health policy in the Republic of Ireland; mental health social work and the law in Northern Ireland; mental health social work and the law in the Republic of Ireland; community care and the social inclusion of individuals with psychiatric disabilities in Northern Ireland; deinstitutionalisation in the Republic of Ireland; mental health social work and addictions in the Republic and Northern Ireland; and mental health social work and older people.
Contains chapters on: a history of mental health in Northern Ireland; mental health policy in the Republic of Ireland; mental health social work and the law in Northern Ireland; mental health social work and the law in the Republic of Ireland; community care and the social inclusion of individuals with psychiatric disabilities in Northern Ireland; deinstitutionalisation in the Republic of Ireland; mental health social work and addictions in the Republic and Northern Ireland; and mental health social work and older people.
Subject terms:
law, mental health problems, mental health services, older people, social policy, social work history, social care provision, substance misuse, community care, deinstitutionalisation;
Exploration by a series of expert groups on the Health Improvement Programme, the cornerstone of the white paper 'The new NHS: modern and dependable'. Contains papers on: the national perspective; approaches to health improvement programmes (HIPs); healthcare needs assessment and HIPs; organisational commitment and stakeholder involvement in implementation; HIP implementation in general practice; changing clinical behaviour; local government and HIPs; HIPs and the public; setting and monitoring clinical standards; assessment of performance and health outcomes; a US perspective on clinical quality; medical schools, universities and HIPs; new therapies and technology; coronary heart disease; equity in mental health; substance misuse; minority ethnic health; child health; older people's health; and strengths, weaknesses and the way forward in current approaches.
Exploration by a series of expert groups on the Health Improvement Programme, the cornerstone of the white paper 'The new NHS: modern and dependable'. Contains papers on: the national perspective; approaches to health improvement programmes (HIPs); healthcare needs assessment and HIPs; organisational commitment and stakeholder involvement in implementation; HIP implementation in general practice; changing clinical behaviour; local government and HIPs; HIPs and the public; setting and monitoring clinical standards; assessment of performance and health outcomes; a US perspective on clinical quality; medical schools, universities and HIPs; new therapies and technology; coronary heart disease; equity in mental health; substance misuse; minority ethnic health; child health; older people's health; and strengths, weaknesses and the way forward in current approaches.
Subject terms:
local government, mental health services, NHS, needs, needs assessment, older people, primary care, quality assurance, substance misuse, assessment, black and minority ethnic people, children, general practitioners, health care, health education, heart diseases;
Aims to improve unit cost estimates for health and social services. Includes sections on services for: elderly people; people with mental health problems; people with learning difficulties; services for children and families; and substance misusers. Also provides a breakdown of costs of health care staff in the community and in hospitals.
Aims to improve unit cost estimates for health and social services. Includes sections on services for: elderly people; people with mental health problems; people with learning difficulties; services for children and families; and substance misusers. Also provides a breakdown of costs of health care staff in the community and in hospitals.
Subject terms:
learning disabilities, looked after children, mental health problems, mental health services, NHS, older people, social care, social care provision, social care staff, social workers, substance misuse, care homes, child care, community care, community health care, cost effectiveness, costs, health care, health professionals;
Explores the approved social worker's role in contemporary mental health practice. Combines a description of various aspects of multi disciplinary working, with accounts of clinical signs and syndromes, set against the possibilities and challenges inherent in the ASW's duties. Includes chapters on: law, policy and practice; psychiatry, diagnosis and treatment; severe mental health problems; disturbances in children and young people; people with learning difficulties; culture and diversity; substance misuse; dangerousness, suicide and homicide; ethical issues; and developing a psychotherapeutic approach to approved social work.
Explores the approved social worker's role in contemporary mental health practice. Combines a description of various aspects of multi disciplinary working, with accounts of clinical signs and syndromes, set against the possibilities and challenges inherent in the ASW's duties. Includes chapters on: law, policy and practice; psychiatry, diagnosis and treatment; severe mental health problems; disturbances in children and young people; people with learning difficulties; culture and diversity; substance misuse; dangerousness, suicide and homicide; ethical issues; and developing a psychotherapeutic approach to approved social work.
Subject terms:
law, learning disabilities, mental health problems, mental health services, homicide, older people, psychiatry, severe mental health problems, substance misuse, treatment, therapies, therapy and treatment, approved social workers, black and minority ethnic people, children, dangerous offenders, diagnosis, ethics;
Sets out the theoretical and research basis for cognitive behavioural social work practice, and includes case examples. Subsequent chapters use a case study approach to bring together material from practitioners and academics to provide an evidence based perspective. Includes chapters on: direct clinical work with children; intervention to protect the child; treating children who fail to thrive; children with severe learning difficulties; behavioural work in residential care; working with young offenders; adult probationers and the STOP programme; working with carers using the birthday exercise; learning theory, addiction and counselling; behavioural work, crisis intervention and mental health call out; intervention in group care for older people; the prevention and management of elder abuse; and education for effective practice.
Sets out the theoretical and research basis for cognitive behavioural social work practice, and includes case examples. Subsequent chapters use a case study approach to bring together material from practitioners and academics to provide an evidence based perspective. Includes chapters on: direct clinical work with children; intervention to protect the child; treating children who fail to thrive; children with severe learning difficulties; behavioural work in residential care; working with young offenders; adult probationers and the STOP programme; working with carers using the birthday exercise; learning theory, addiction and counselling; behavioural work, crisis intervention and mental health call out; intervention in group care for older people; the prevention and management of elder abuse; and education for effective practice.
Subject terms:
intervention, mental health problems, mental health services, older people, probation, prevention, severe learning disabilities, social work education, social work methods, social work theories, substance misuse, young offenders, child development, child neglect, child protection, children, counselling, crisis intervention, elder abuse, evidence-based practice;
Presents a comprehensive assessment of the mental health needs of Londoners and shows that these are greater than in other parts of the country. Provides strong evidence that these needs are not being met adequately by current mental health services, and demonstrates that they are working beyond their capacity to cope. Includes sections on: the sociodemographic context; special areas of need for mental health services; mental health services for older people; child and adolescent services in London; substance misuse services; HIV/AIDS related mental health services; mentally disordered offenders; the homeless in London; services in primary care; black and minority ethnic people; levels of in-patient and residential provision; structure and functioning of services; and costs.
Presents a comprehensive assessment of the mental health needs of Londoners and shows that these are greater than in other parts of the country. Provides strong evidence that these needs are not being met adequately by current mental health services, and demonstrates that they are working beyond their capacity to cope. Includes sections on: the sociodemographic context; special areas of need for mental health services; mental health services for older people; child and adolescent services in London; substance misuse services; HIV/AIDS related mental health services; mentally disordered offenders; the homeless in London; services in primary care; black and minority ethnic people; levels of in-patient and residential provision; structure and functioning of services; and costs.
Subject terms:
HIV AIDS, homeless people, homelessness, mental health problems, mental health services, mentally disordered offenders, needs, older people, primary care, social policy, substance misuse, young people, alcohol misuse, black and minority ethnic people, children, demographics, drug misuse, financing;