scholarly journals Community mental health teams for older people: variations in case mix and service receipt (II)

2014 ◽  
Vol 30 (6) ◽  
pp. 605-613 ◽  
Author(s):  
Mark Wilberforce ◽  
Sue Tucker ◽  
Christian Brand ◽  
Michele Abendstern ◽  
Rowan Jasper ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People ◽  
Case Mix

scholarly journals Community mental health teams for older people: variations in case mix and service receipt (I)

2014 ◽  
Vol 30 (6) ◽  
pp. 595-604 ◽  
Author(s):  
Sue Tucker ◽  
Mark Wilberforce ◽  
Christian Brand ◽  
Michele Abendstern ◽  
Anthony Crook ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People ◽  
Case Mix

Social Workers as Members of Community Mental Health Teams for Older People: What Is the Added Value?

2014 ◽  
Vol 46 (1) ◽  
pp. 63-80 ◽  
Author(s):  
Michele Abendstern ◽  
Susan Tucker ◽  
Mark Wilberforce ◽  
Rowan Jasper ◽  
Christian Brand ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People ◽  
Social Workers ◽  
Added Value

scholarly journals National trends and local delivery in old age mental health services: towards an evidence base. A mixed-methodology study of the balance of care approach, community mental health teams and specialist mental health outreach to care homes

2014 ◽  
Vol 2 (4) ◽  
pp. 1-480 ◽  
Author(s):  
David Challis ◽  
Sue Tucker ◽  
Mark Wilberforce ◽  
Christian Brand ◽  
Michele Abendstern ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People ◽  
Mental Health Problems ◽  
Care Home ◽  
Research Programme ◽  
Community Services ◽  
Care Homes ◽  
Care Home Staff ◽  
Mental Health Outreach

BackgroundThe rising number of older people with mental health problems makes the effective use of mental health resources imperative. Little is known about the clinical effectiveness and/or cost-effectiveness of different service models.AimsThe programme aimed to (1) refine and apply an existing planning tool [‘balance of care’ (BoC)] to this client group; (2) identify whether, how and at what cost the mix of institutional and community services could be improved; (3) enable decision-makers to apply the BoC framework independently; (4) identify variation in the structure, organisation and processes of community mental health teams for older people (CMHTsOP); (5) examine whether or not different community mental health teams (CMHTs) models are associated with different costs/outcomes; (6) identify variation in mental health outreach services for older care home residents; (7) scope the evidence on the association between different outreach models and resident outcomes; and (8) disseminate the research findings to multiple stakeholder groups.MethodsThe programme employed a mixed-methods approach including three systematic literature reviews; a BoC study, which used a systematic framework for choosing between alternative patterns of support by identifying people whose needs could be met in more than one setting and comparing their costs/outcomes; a national survey of CMHTs’ organisation, structure and processes; a multiple case study of CMHTs exhibiting different levels of integration encompassing staff interviews, an observational study of user outcomes and a staff survey; national surveys of CMHTs’ outreach activities and care homes. A planned randomised trial of depression management in care homes was removed at the review stage by the National Institute for Health Research (NIHR) prior to funding award.ResultsBoC: Past studies exhibited several methodological limitations, and just two related to older people with mental health problems. The current study suggested that if enhanced community services were available, a substantial proportion of care home and inpatient admissions could be diverted, although only the latter would release significant monies. CMHTsOP: 60% of teams were considered multidisciplinary. Most were colocated, had a single point of access (SPA) and standardised assessment documentation. Evidence of the impact of particular CMHT features was limited. Although staff spoke positively about integration, no evidence was found that more integrated teams produced better user outcomes. Working in high-integration teams was associated with poor job outcomes, but other factors negated the statistical significance of this. Care home outreach: Typical services in the literature undertook some combination of screening (less common), assessment, medication review, behaviour management and training, and evidence suggested intervention can benefit depressed residents. Care home staff were perceived to lack necessary skills, but relatively few CMHTs provided formal training.LimitationsLimitations include a necessary reliance on observational rather than experimental methods, which were not feasible given the nature of the services explored.ConclusionsBoC: Shifting care towards the community would require the growth of support services; clarification of extra care housing’s (ECH) role; timely responses to people at risk of psychiatric admission; and improved hospital discharge planning. However, the promotion of care at home will not necessarily reduce public expenditure. CMHTsOP: Although practitioners favoured integration, its goals need clarification. Occupational therapists (OTs) and social workers faced difficulties identifying optimal roles, and support workers’ career structures needed delineating. Care home outreach: Further CMHT input to build care home staff skills and screen for depression may be beneficial. Priority areas for further study include the costs and benefits for older people of age inclusive mental health services and the relative cost-effectiveness of different models of mental health outreach for older care home residents.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

scholarly journals Support workers in community mental health teams for older people: roles, boundaries, supervision and training

2017 ◽  
Vol 73 (7) ◽  
pp. 1657-1666 ◽  
Author(s):  
Mark Wilberforce ◽  
Michele Abendstern ◽  
Sue Tucker ◽  
Saima Ahmed ◽  
Rowan Jasper ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People ◽  
Supervision And Training ◽  
And Training

Towards integrated community mental health teams for older people in England: progress and new insights

2011 ◽  
Vol 26 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Mark Wilberforce ◽  
Val Harrington ◽  
Christian Brand ◽  
Sue Tucker ◽  
Michele Abendstern ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Older People
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