Service provision for men with antisocial personality disorder who make contact with mental health services

2009 ◽  
Vol 3 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Mike J. Crawford ◽  
Layth Sahib ◽  
Helen Bratton ◽  
Peter Tyrer ◽  
Kate Davidson
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Antisocial Personality Disorder ◽  
Service Provision ◽  
Antisocial Personality

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

scholarly journals Professionals’ perceptions of the establishment of a specialized brief therapy unit in a district psychiatric centre - a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hilde V. Markussen ◽  
Lene Aasdahl ◽  
Marit B. Rise
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Provision ◽  
Mental Health Problems ◽  
Brief Therapy ◽  
Longitudinal Research ◽  
Health Problems ◽  
Outpatient Clinics ◽  
Short Term Treatment

Abstract Background Increasing mental health problems and scarce treatment resources put pressure on mental health services to make innovations in service provision, such as developing differentiated services adapted to different needs. One innovation in differentiated service provision is brief or short-term treatment to patients with moderate mental health problems. Implementing a new unit in an organization usually faces many potential barriers and facilitators, and knowledge on how the professionals providing the services perceive the implementation of innovative approaches in mental health services is scarce. The aim of this study was therefore to explore the professionals’ perceptions of how the establishment of a specialized brief therapy unit had affected the organization, especially the everyday work in the outpatient clinics. Methods Eleven professionals, five men and six women, took part in individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Data was analyzed according to Systematic text condensation. Results The professionals’ experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were described as “forgotten”. (3) The establishment process had elucidated different views on treatment in the outpatient clinics - and had set off (4) a discussion regarding the criteria for prioritizing in mental health services. Conclusion Providing targeted treatment to patients with moderate mental health problems, while having a concurrent aim to solve broader problems in mental health services, entails a discussion regarding resource use and the appropriate level of treatment provision. Professionals should be more involved when innovative efforts are implemented, and the criteria for success must be conceptualized and evaluated. Longitudinal research on the implementation of innovative efforts in the services should include professionals’ and service users’ perspectives.

scholarly journals Security needs among patients referred for high secure care in Broadmoor Hospital England

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Kate Williams ◽  
Madhri Senanayke ◽  
Callum C. Ross ◽  
Rob Bates ◽  
Mary Davoren
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cohort Study ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Final Decision ◽  
Forensic Mental Health ◽  
Vulnerable Group ◽  
Secure Care

Background Security needs among patients referred to forensic mental health services have rarely been systematically studied. Aims To ascertain security needs among patients referred to a high secure hospital, Broadmoor High Secure Hospital, England. We also aimed to compare the security needs for those referred to mental illness services with those referred to personality disorder services in the hospital. Method A retrospective complete cohort study of all referrals to Broadmoor Hospital over a 2-year period was conducted. All referred patients (n = 204) were assessed for need for high secure care by two Broadmoor clinicians. The final decision on need for admission was taken by a multidisciplinary admission panel. Independent of the panel, researchers rated need for security using the DUNDRUM-1 triage security scale. Results Those admitted to Broadmoor Hospital had higher triage security scores than those declined (F = 4.209, d.f. = 1, P = 0.042). Referrals to the personality disorder pathway had higher security needs than those referred to the mental illness pathway high secure service (F = 6.9835, d.f. = 1, P = 0.0089). Overall security needs among referrals to Broadmoor were extremely high, both by comparison with previous needs identified in UK medium secure services and international medium and high secure services. Conclusions High secure patient cohorts represent a uniquely vulnerable group within mental health services, with extremely high security needs identified in this study. This has significant implications for services given the high levels of resources needed to provide therapeutically safe and secure care and treatment to this group.

scholarly journals Delaying the implementation of Payment by Results in mental health: the application of standardisation

2015 ◽  
Vol 20 (3) ◽  
pp. 156-165 ◽  
Author(s):  
Ruoxi Wang ◽  
Ian Shaw ◽  
Hugh Middleton
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Provision ◽  
Quality Data ◽  
High Quality Data ◽  
Treatment Pathways ◽  
Content Type ◽  
Clinical Level ◽  
Recent Reform

Purpose – The purpose of this paper is to explore the issues surrounding a long planned expansion of Payment by Results (PbR) into mental health services and to highlight the factors responsible for the delay. Design/methodology/approach – PbR relies upon “standardisation” of conditions and treatments. This depends upon a scheme of classification that can realistically predict resources required to execute treatment of any one case. Plans to fund NHS mental health services on the basis of tariffs derived in this way have been delayed, and a key reason is the lack of high-quality data. This would require effective “standardisation-to the-average” of both a system of classification and a repertoire of costed treatment pathways. This paper investigated the delay implementation by exploring the difficulties in applying standardisation principles to service provision and tariff calculation. Findings – The paper identified the fundamental difficulty with PbR’s implementation in applying “standardisation” to practice. This is defining the mental disorder that the patient is suffering and designing care pathways at clinical level considering the balance between practical applicability and conceptual/constructional validity. This is necessary to enable the calculation of a national tariff. The conceptual flaws of the Health of the Nation Outcome Scale led to the constructional shortcomings which compromised the credibility and validity of Mental Health Clustering Tool regarding making accurate classification in a standardised way. The validity and credibility of calculating a national tariff thus became contentious on the basis of this inaccurate clinical classification system. Originality/value – This paper explored the driving factors of delay in implementing PbR in mental health through connecting the recent reform with the fundamental assumptions of “standardisation-to the-average”, which provided another perspective to illustrate the current obstacles.

Mental health rehabilitation services in Ireland: vision and reality

2011 ◽  
Vol 28 (2) ◽  
pp. 69-75
Author(s):  
Atif Ijaz ◽  
Helen Killaspy ◽  
Frank Holloway ◽  
Fiona Keogh ◽  
Ena Lavelle
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
National Survey ◽  
Service Provision ◽  
Rehabilitation Services ◽  
Assertive Outreach ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
Specialist Rehabilitation

AbstractObjectives: The Irish national mental health policy document, A Vision for Change, included recommendations to develop specialist rehabilitation mental health services. This survey was conducted as part of a multicentre study to investigate current provision of mental health rehabilitation services in Ireland and factors associated with better clinical outcomes for users of these services. The aim was to carry out a detailed national survey of specialist rehabilitation services in order to describe current service provision.Method: A structured questionnaire was sent to consultant rehabilitation psychiatrists in all mental health catchment areas of Ireland that had any rehabilitation services to gather data on various aspects of service provision.Results: Twenty-six of the 31 mental health areas of Ireland had some form of rehabilitation service. Sixteen teams working in 15 of these areas fulfilled A Vision for Change criteria to be defined as specialist rehabilitation services and all 16 responded to the survey. The overall response rate was 73% (19/26). Most services lacked a full multidisciplinary team. Only one service had an assertive outreach team with acceptable fidelity to the assertive outreach model. Urban services were less well resourced than rural services.Conclusion: This is the first national survey to describe the provision of mental health rehabilitation services in Ireland. Although there has been an increase in the provision of consultant-led specialist rehabilitation services nationally, these services lack multidisciplinary input. There also appears to be a lack of planned provision of the facilities required to provide comprehensive rehabilitation services with unequal distribution of resources between urban and rural areas. This has potential cost implications for local mental health services in relation to ‘out of area treatment’ placements and perhaps more importantly to the overall quality of patient care.

More than being against it: Anti-racism and anti-oppression in mental health services

2012 ◽  
Vol 49 (2) ◽  
pp. 261-282 ◽  
Author(s):  
Simon Corneau ◽  
Vicky Stergiopoulos
Keyword(s):  
Mental Health ◽  
Social Justice ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Social Services ◽  
Service Provision ◽  
Alternative Healing ◽  
Health And Social Services ◽  
Alliance Building

Anti-racism and anti-oppression frameworks of practice are being increasingly advocated for in efforts to address racism and oppression embedded in mental health and social services, and to help reduce their impact on mental health and clinical outcomes. This literature review summarizes how these two philosophies of practice are conceptualized and the strategies used within these frameworks as they are applied to service provision toward racialized groups. The strategies identified can be grouped in seven main categories: empowerment, education, alliance building, language, alternative healing strategies, advocacy, social justice/activism, and fostering reflexivity. Although anti-racism and anti-oppression frameworks have limitations, they may offer useful approaches to service delivery and would benefit from further study.

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