Search results for ‘Subject term:"severe mental health problems"’ Sort:
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Specialisation and marginalisation: how the assertive community treatment debate affects individuals with complex mental health needs
- Authors:
- ROSEN Alan, KILLASPY Helen, HARVEY Carol
- Journal article citation:
- Psychiatrist (The), 37(11), 2013, pp.345-348.
- Publisher:
- Royal College of Psychiatrists
The growth of specialism in a field can be considered a healthy response to emerging evidence, technology and skills, yet it risks creating unhelpful barriers to collaborative working and fragmented patient pathways. Mental health services in England have experienced this tension in recent years through the national implementation of local specialist community teams that aim to reduce the need for in-patient admission through a focus on crisis resolution, early intervention and assertive community treatment (ACT). In response to the results of studies assessing its effectiveness, there has been disinvestment in ACT. This risks marginalising people with severe and complex mental health problems by depriving them and their families of the intensive support they need for successful community living, as well as discouraging researchers from undertaking further high-quality studies that can inform the intelligent evolution of the ACT model within different contexts.This editorial uses the example of assertive community treatment (originally developed in the USA) to explore the challenges of importing models of specialist care into different socioeconomic contexts and health systems at the international level. (Edited publisher abstract)
Assertive outreach: policy and reality
- Authors:
- SCHNEIDER Justine, et al
- Journal article citation:
- Psychiatric Bulletin, 30(3), March 2006, pp.89-96.
- Publisher:
- Royal College of Psychiatrists
This survey set out to profile the case-loads of assertive outreach teams in North East England, to discover whether they were reaching the people for whom they were meant. A survey of case-loads of 29 assertive outreach teams was carried out using the MARC-2, HoNOS and GAS instruments. Findings were compared with earlier surveys of the case-loads of community mental health teams in parts of the same region. The results found that clients of assertive outreach teams proved to be at the more severe end of the spectrum on almost every measure: 95% were deemed ‘psychotic’ and 30% had three or more admissions in the previous 2 years. Factors such as hospital admission, difficulty of maintaining contact with services, violence, risk of self harm, dual diagnosis and homelessness are discussed briefly. The authors conclude that assertive outreach teams in the North East are reaching the people they are meant to target. The effects of this shift on existing teams remain to be evaluated.
Using resources creatively to meet service users' employment support needs
- Authors:
- WOOD Steve, NORRISH Sylvia
- Journal article citation:
- A Life in the Day, 9(4), November 2005, pp.24-25.
- Publisher:
- Emerald
Vocational assessment is an important resource for people with long term mental health problems when they are considering employment options. However there are often long waiting lists to see a qualified occupational therapist providing this service. The authors argue that every community mental health team should have one member who is trained in vocational assessment, and describes a pilot project in Cardiff where a healthcare assistant was successfully trained to perform this role.
Copying clinic letters to psychiatric patients
- Authors:
- TAHIR Tayyeb A., BISSON Jonathan I., WILCOX Jodie
- Journal article citation:
- Psychiatric Bulletin, 29(9), September 2005, pp.327-329.
- Publisher:
- Royal College of Psychiatrists
This study assesses the views of patients and mental health professionals on the practice of copying clinical letters to patients. Patients and professionals from local community mental health teams were asked to complete a questionnaire regarding their views. The questionnaireswere completed by 51 patients and 40 mental health professionals. Significantly more patients (83%) than staff (37%) thought that copying letters to patients was a good idea . Many staff appeared concerned that copying letters to patients could result in breakdown of the therapeutic relationship, causing distress and anxiety. The study concludes that considerable work is needed for clinicians to feel comfortable in copying letters to patients.
Time-limited therapy in a Community Mental Health Team setting
- Author:
- CARTER Michael Fitzgerald
- Journal article citation:
- Counselling and Psychotherapy Research, 5(1), May 2005, pp.43-47.
- Publisher:
- Wiley
This study examines time limited therapy in a Community Mental Health Team (CMHT) setting. This work is directed towards CMHTs who are under pressure to focus on clients with serious mental illness as a priority as opposed to clients who might be deemed the 'psychologically distressed'. The development of CMHTs in the UK is described. Limited research on time-limited therapy in a CMHT setting is identifed. Results suggest that time-limited therapy has a positive impact on the mental health needs of clients referred to a CMHT by GPs. It is concluded that it is appropriate to justify the use of time-limited therapy in a CMHT-based setting. Suggestions for further research are made.
The impact of suicide on community mental health teams: findings and recommendations
- Authors:
- LINKE Stuart, WOJCIAK Jenny, DAY Samantha
- Journal article citation:
- Psychiatric Bulletin, 26(2), February 2002, pp.50-52.
- Publisher:
- Royal College of Psychiatrists
This study investigates the personal impact of patient suicides on the members of community mental health teams and the sources of support utilised for coping with adverse effects. Findings indicate that staff require skilled and dedicated support following a patient suicide in order to minimise its detrimental effects on personal, professional and team functioning.
Rapid report: how mental health social workers are responding to the coronavirus pandemic
- Author:
- THINK AHEAD
- Publisher:
- Think Ahead
- Publication year:
- 2020
- Pagination:
- 12
- Place of publication:
- London
This report looks at how mental health services, and the social workers within these teams, are responding to the coronavirus (COVID-19) pandemic. Based on a series of interviews with mental health social workers, the report explains the challenges services and professionals are facing and how mental health teams are transforming their work. Key findings show how services are reconfiguring roles to prepare for increased pressures, the challenges of digital contact with service users, the introduction of new forms of support for service users and the need to support staff welfare. The report also highlights examples of good practice from across the country. (Edited publisher abstract)
Acute mental health service use by patients with severe mental illness after discharge to primary care in South London
- Authors:
- RAMANUJ Parashar P., et al
- Journal article citation:
- Journal of Mental Health, 24(4), 2015, pp.208-213.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: To return the patients to primary care is arguably the desired service outcome for community mental health teams (CMHTs). Aims: To assess acute mental health service use (hospitalisation or Home Treatment Team) by people with severe mental illness following discharge to primary care. Method: Retrospective cohort study comparing receipt and duration of acute care by 98 patients in the two years following discharge to primary care from CMHT, with a cohort of 92 patients transferred to another CMHT. Results: The discharged group was significantly more stable on clinical measures. Fifty-seven (58.2%) patients were re-referred after median 39 weeks, with 35 (60.3%) in crisis. The difference in acute service use between discharged patients (27.9 days/patient) and transferred patients (31.7 days/patient) was not significant. Hospitalisation in the two years prior to discharge or transfer increased the odds of re-referral, subsequent acute service use and duration of input. Conclusions: The majority of the discharged patients were re-referred to mental health services. Although these were more stable, there was no difference from the transferred group on acute service use. Further support may be required in primary care to maintain stability. (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)
Crisis teams: systematic review of their effectiveness in practice
- Authors:
- CARPENTER Rebecca A., et al
- Journal article citation:
- Psychiatrist (The), 37(7), 2013, pp.232-237.
- Publisher:
- Royal College of Psychiatrists
Crisis resolution and home treatment teams (variously abbreviated to CRTs, CRHTTs, HTTs) were introduced to reduce the number and duration of in-patient admissions and better manage individuals in crisis. This systematic review explored whether CRTs: (a) affected voluntary and compulsory admissions; (b) treat particular patient groups; (c) are cost-effective; and (d) provide care patients value. Searches were carried out on the databases PubMed and PsycINFO (1998-present) as well as through searches of studies in recent reviews and scanning reference lists of articles found. The initial search of electronic databases produced 2169 abstracts. Four additional articles were also retrieved. Ultimately 37 articles met the final selection criteria and were reviewed. The results found crisis resolution teams appear effective in reducing admissions, although data are mixed and other factors have also influenced this. Compulsory admissions may have increased, but evidence that CRTs are causally related is inconclusive. There are few clinical differences between ‘gate-kept’ patients admitted and those not. Crisis resolution teams are cheaper than in-patient care and, overall, patients are satisfied with CRT care. The review concludes that high-quality evidence for CRTs is scarce, although they appear to contribute to reducing admissions. Patient-relevant psychosocial and longitudinal outcomes are under-explored. (Edited publisher abstract)