Understanding the NHS
Tony White, John Black in The Doctor's Handbook, Part 2, 2018
Mental health services can be provided through a GP, other primary care services, or through more specialist care. This includes counselling and other psychological therapies, community and family support, or general health screening. For example, people suffering bereavement, depression, stress or anxiety can get help from primary care or informal community support. If they need more involved support, they may be referred for specialist care. Specialist care is usually provided by mental health trusts or local council social services departments. Services range from psychological therapy to specialised medical and training services for people with severe mental health problems. About two in every thousand people need specialist care for conditions such as severe anxiety problems or psychotic illness.
Guidelines for working with mental health–substance use
David B Cooper in Developing Services in Mental Health–Substance Use, 2018
In 2007, the updated clinical guidelines for drug dependence were published (known as the ‘Orange Guidelines’).8 This sets out clear and evidence-based guidance for the effective treatment of drug dependency (mainly focused on opiate dependency) including assessment, prescribing and detoxification. Within the Orange Guidelines, there is a section specifically for people with additional mental health problems, as well as drug dependency. It is acknowledged that people with drug dependency may also have mental health problems, and that they require high quality, person-focused integrated care with mental health services. People with sufficient levels of risk or severity of mental health problems should be under the Care Programme Approach,2 usually led by mental health services. However, local arrangements may mean that substance use service may care coordinate. Because of the high prevalence of mental health problems, substance use services should ensure that all people using the service receive a comprehensive assessment that includes their mental health needs, and ensures that where these needs are identified steps are taken to address them working jointly and flexibly with mental health services
Mental health
Liam J. Donaldson, Paul D. Rutter in Donaldsons' Essential Public Health, 2017
An important aim of mental health services is recovery. For many people, this does not mean complete recovery, free of mental disorder. Instead, recovery is about building a capability for mental well-being, as well as controlling the symptoms of mental disorder. Recovery is generally considered to have three elements: agency, opportunity and hope. Agency is to do with gaining a sense of control over one’s life, with meaning and a positive sense of self. Opportunity is to do with building a life beyond illness. Hope lies in a belief that one can still pursue hopes and dreams, even with ongoing illness. Helping patients to achieve these central aims in life requires mental health services not only to provide diagnosis and medical treatment, but also to provide practical support in areas such as getting patients back into work.
Who’s Logging on? Differing Attitudes about Online Therapy
Published in Journal of Technology in Human Services, 2020
Lena M. Knechtel, Cynthia A. Erickson
The participants were asked a series of yes or no questions to assess how much previous experience they had with both online and face-to-face therapy. Prior to answering these questions, definitions were provided for the participants. “Therapy” was defined as mental health services provided by a licensed professional. “Face-to-face therapy” was defined as therapy provided in person by a licensed professional. “Online therapy” was defined as therapy provided online through the use of instant messaging, text messaging, email, or video conferencing software by a licensed professional. A sample of these questions includes Have you previously been in face-to-face therapy? If yes, approximately how many hours have you spent in face-to-face therapy, total? Have you previously heard of online therapy? Are you currently in online therapy? Are you currently considering online therapy?
Occupation brings hope: Occupational therapy for people who are homeless
Published in World Federation of Occupational Therapists Bulletin, 2020
For an occupational therapist, based within a charity and working alongside support workers supporting people who are homeless, making a referral to mental health services to gain a multidisciplinary team (MDT) approach to care can prove challenging. The NHS Long Term Plan (NHS, 2019) recognises that MDT working is preferable when working with individuals with complex health need in order to ensure health, wellbeing and care needs are met. People who have conditions including anxiety, depression, post traumatic stress disorder and psychosis are supported frequently by the charity. Often, on referral to mental health services, the response is that the person should be re-referred when they are housed. Housing can provide a foundation upon which a person can address their mental health, but what about the people whose mental health affects their ability to manage living in a house? Occupations involved in managing a home, such as domestic activities of daily living including cooking, cleaning, and paying bills, can feel overwhelming for some. Talking therapies, such as counselling and cognitive behavioural therapy, are available via self or professional referral to specialist mental health services, although access to a phone is required. Often, homeless people lose phones, have them stolen or sell them in order to get money to address basic needs.
Psychiatric inpatient cost of care before and after admission at a residential subacute step-up/step-down mental health facility
Published in Journal of Medical Economics, 2019
Irina Kinchin, Alex M. T. Russell, Komla Tsey, Jon Jago, Thomas Wintzloff, Carla Meurk, Christopher M. Doran
Although step-up/step-down care services are proliferating, only a few have been evaluated1,12,13, with most of the evaluations being reported in the grey literature14,15. A systematic literature review that examined clinical and cost-effectiveness of acute and subacute residential mental health services found that most studies of acute residential units demonstrated clinical improvements equal to those of inpatient units and similar readmission rates, as well as cost benefits1. According to the same review, the evidence for subacute residential units was lacking, as the number and quality of studies with subacute units was limited and not sufficient to evaluate their effectiveness. The present study aims to examine the cost of a subacute step-up/step-down residential mental health service and inpatient cost-offsets associated with the service and contribute to the sparse evidence base.
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