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Mental health in Scotland: improving the physical health of those with a mental illness
- Author:
- SCOTLAND. Scottish Government
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2008
- Pagination:
- 36p.
- Place of publication:
- Edinburgh
The Scottish Government is undertaking a consultation on the draft report, Improving the Physical Health of those with Mental Illness. Among other issues the draft report covers and includes: the evidence base on the need for change, aspects of care management, proposals for review of performance, and steps to ensuring equity and other dimensions. The report also makes six recommendations for forward attention and action to bring about early change and improvement.
An evaluation of the statement of fitness for work: qualitative research with general practitioners: research summary
- Authors:
- FYLAN Beth, CAVENEY Lauren
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2011
- Pagination:
- 3p.
- Place of publication:
- London
The Statement of Fitness for Work (Fit note) replaced the old medical certificates in England, Wales and Scotland on 6 April 2010. It aims to give individuals and employers access to information about when and how someone who is sick might return to work. This report summary explores GPs’ views of the change over to the Fit note system, how they prepared to use the fit note and use it during consultations with patients, and their views on their role in sickness certification. Forty five in-depth, semi-structured interviews with a purposive sample of GPs in England, Scotland and Wales were conducted. Findings suggest that the fit note was a useful consultation tool that GPs can use to keep their patients in work and to return them to work. However, a range of barriers were identified that GPs experienced to returning patients to work using the fit note. These include: low GP self-efficacy to use the fit note; the patient’s age; the local economic and labour market conditions; GPs’ reluctance to damage their relationship with patients; and the patient’s own agenda, for example their motivation to return to work, and their illness perceptions. GPs believed that there was a role for other agencies in helping remove non-medical barriers to their patients working, such as lack of skills or problems with their employers.
An evaluation of the statement of fitness for work: qualitative research with general practitioners
- Authors:
- FYLAN Beth, CAVENEY Lauren
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2011
- Pagination:
- 66p., bibliog.
- Place of publication:
- London
The Statement of Fitness for Work (Fit note) replaced the old medical certificates in England, Wales and Scotland on 6 April 2010. It aims to give individuals and employers access to information about when and how someone who is sick might return to work. This report explores GPs’ views of the change over to the Fit note system, how they prepared to use the fit note and use it during consultations with patients, and their views on their role in sickness certification. Forty five in-depth, semi-structured interviews with a purposive sample of GPs in England, Scotland and Wales were conducted. Findings suggest that the fit note was a useful consultation tool that GPs can use to keep their patients in work and to return them to work. However, a range of barriers were identified that GPs experienced to returning patients to work using the fit note. These include: low GP self-efficacy to use the fit note; the patient’s age; the local economic and labour market conditions; GPs’ reluctance to damage their relationship with patients; and the patient’s own agenda, for example their motivation to return to work, and their illness perceptions. GPs believed that there was a role for other agencies in helping remove non-medical barriers to their patients working, such as lack of skills or problems with their employers.
Stressful life-events exposure is associated with 17-year mortality, but it is health-related events that prove predictive
- Authors:
- PHILLIPS Anna C., DER Geoff, CARROLL Douglas
- Journal article citation:
- British Journal of Health Psychology, 13(4), November 2008, pp.647-657.
- Publisher:
- Wiley
Despite the widely-held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life-events exposure and death. The present analyses examined the association between overall life-events stress load, health-related and health-unrelated stress, and subsequent all-cause mortality. This study employed a prospective longitudinal design incorporating time-varying covariates. Participants were 968 Scottish men and women who were 56 years old. Stressful life-events experience for the preceding 2 years was assessed at baseline, 8-9 years and 12-13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time-varying covariates were applied. Results were adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure. Overall life-events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17-year mortality. Health-related event numbers and impact scores were strongly predictive of mortality. This was not the case for health-unrelated events. The frequency of life-events and the stress load they imposed were associated with all-cause mortality. However, it was the experience and impact of health-related, not health-unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.
Unemployment, mortality and the problem of health related selection: evidence from the Scottish and England and Wales (ONS) Longitudinal Studies
- Authors:
- CLEMENS Tom, BOYLE Paul, POPHAM Frank
- Journal article citation:
- Health Statistics Quarterly, 43, Autumn 2009, pp.7-13.
- Publisher:
- Office for National Statistics
Testing whether unemployment causes health deterioration is complicated because failing health may increase the probability of unemployment. In some previous studies of unemployment and mortality a ‘wear-off’ period is used to exclude any deaths occurring in the first few years after employment status was observed. It is assumed that selection effects will wear-off during this period. In this article the effectiveness of using wear-off periods is tested. Using data from the Scottish Longitudinal Study and the England and Wales Longitudinal Study, logistic regression models were used for estimating the odds of death in a given time period after the 1991 Census for those aged 35–64 in 1991. The odds ratios for the different economic positions (in work, unemployed, retired, permanently sick and other inactive) were compared, as well as the changes in risk associated with cumulatively increasing the length of wear-off prior to follow-up. No evidence was found of health related selection for the unemployed in 1991. This observation was consistent across both studies. This suggests that the use of the five year wear-off period in many studies of mortality and unemployment may be an ineffective and unnecessary technique for mitigating the effects of health-related selection.
Sick, tired and caring: the impact of unpaid caring on health and long term conditions
- Author:
- CARERS SCOTLAND
- Publisher:
- Carers Scotland
- Publication year:
- 2011
- Pagination:
- 11p.
- Place of publication:
- Glasgow
This report describes the results of a survey of 68 carers across Scotland. The survey investigated: the nature of the self-reported levels of ill health amongst carers; the prevalence of long term conditions; and the impact of primary health in supporting carers’ health and well-being. The survey found that 96% of respondents said that caring had impacted negatively on their health, with 27% rating their health as poor or very poor. The level of long term illness or disability was 57%, more than twice the level of the general population. Many respondents had more than 1 long term conditions: 45% suffered from significant illness including diabetes, depression and fibromyalgia or have had cancer; 68% experienced physical problems such as joint, hip, back or neck pain; 13% had respiratory problems including asthma and COPD; 11% had neurological problems including epilepsy, stroke or acquired brain injury; and 34% had high blood pressure or heart problems. More than half the respondents (54%) said they felt isolated and could not meet friends and family or take part in leisure or social activities. Almost half reported that their conditions had started after they began caring. Of those whose condition predated their caring role, a quarter said that their condition had worsened since they took on their caring role. Almost all (91%) said that their GP knew that they were a carer, but, despite this improved identification, 73% said that their GP had offered little or no help. A number of recommendations are provided.
The SHARP study: findings of a controlled study of the effects of housing and neighbourhood change on health and well-being
- Authors:
- KEARNS Ade, et al
- Publisher:
- Scotland. Scottish Government Social Research
- Publication year:
- 2008
- Pagination:
- 4p.
- Place of publication:
- Edinburgh
The SHARP (Scottish Health, Housing and Regeneration Research Project) study was carried out to investigate the links between housing and regeneration, and health and well-being. It involved interviewing a national sample of social sector tenants who were rehoused into newly built, general purpose housing developed and let by Registered Social Landlords across Scotland (the intervention group). Participants were interviewed before they moved, and again 2 years after they moved. Data were also collected by postal survey one year after the move, and in-depth qualitative interviews were conducted at 2 points in time. The tenants who moved were compared to a control group of people living in the same area as the new house, but who were not themselves due to be rehoused from their existing home. Data were collected on housing and neighbourhood conditions, physical and mental health, use of health and other services, and a range of social and community outcomes, including community cohesion. SHARP also examined whether rehousing within a regeneration area (Social Inclusion Partnership) provided additional residential or health gains. Key findings are presented.
SHARP survey findings: physical health and health behaviour outcomes
- Authors:
- KEARNS Ade, et al
- Publisher:
- Scotland. Scottish Government Social Research
- Publication year:
- 2008
- Pagination:
- 55p.
- Place of publication:
- Edinburgh
The Scottish Health, Housing and Regeneration Project (SHARP) study is a longitudinal study of the health and social effects on tenants of moving into new-build socially rented housing. The primary aim was to investigate the impacts of being rehoused in new-build socially rented property on housing conditions, neighbourhood and social outcomes, and the health and wellbeing of tenants. Three waves of household surveys were conducted. Waves 1 and 3 involved face-to-face interviews with 334 households who had been rehoused (the intervention group) and 389 households who were not rehoused (the control group) . Wave 2 was a postal survey involving only the intervention group. This report presents the results relating to physical health and health behaviour outcomes. Physical health outcomes did not markedly improve for the intervention group over the 2 year period of study, thus rehousing itself did not deliver significant health gains in this respect. There were reductions in the incidence of common symptoms and in wheezing in the past year among the intervention group, but these were also experienced by the control group to similar extent. Although positive outcomes were experienced by the intervention group in respect of a reduction in the incidence of local accidents, and a slight improvement in physical functioning, these findings were not statistically significantly from the changes in the control group.
Housing as health capital: how health trajectories and housing paths are linked
- Authors:
- SMITH Susan J., et al
- Journal article citation:
- Journal of Social Issues, 59(3), 2003, pp.501-525.
- Publisher:
- Wiley
This article explores the relationships between housing and health inequalities. It locates housing within a network of health resources that can either promote well-being or increase susceptibility to disease. Housing thereby contributes to the accumulation, or depletion, of the health capital of individuals and communities. Qualitative interviews were carried out in areas of Scotland, Northern England and Greater London with people with health problems to help specify the links between health capital, on the one hand, and the network of resources, environments, events, institutions, and social relations comprising the housing system, on the other. The findings show that although owner-occupation had demonstrable health benefits, the emotional stress of difficulties of maintaining a home in that sector can also be damaging to health.
Housing allocations and medical priority in Scotland
- Authors:
- MASON Steve, BRITAIN Amanda
- Publisher:
- Stationery Office/Great Britain. Scottish Office. Central Research Unit
- Publication year:
- 1998
- Pagination:
- 114p.,bibliog.
- Place of publication:
- Edinburgh
Report of a research study arising from concerns that housing allocation to people with health problems was poorly coordinated, subjectively executed and inadequately monitored in Scotland. Uses six Scottish local authority areas as a basis for the study. Contains sections on: a context for medical priority; information, advice and support; application, assessment and the determination of priority; allocation and rehousing; and appeals, monitoring and review.