A structured process for reviewing the operation of the Mental Health Act 2001 in an Irish mental health service

2013 ◽  
Vol 30 (2) ◽  
pp. 131-134
Author(s):  
M. Mulligan ◽  
T. Maher ◽  
J. V. Lucey
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Governance ◽  
University Hospital ◽  
Mental Health Act ◽  
Monitoring Tools ◽  
Monitoring Process ◽  
Governance Committee ◽  
Key Events

This paper provides a description of a structured template which allows review of the operation of the Mental Health Act 2001 at St Patrick's Mental Health Services (incorporating St Patrick's University Hospital, St Edmundsbury Hospital and Willow Grove Adolescent Unit). These structured processes were implemented to ensure rigorous monitoring of all clinical governance activities associated with adherence to the Mental Health Act (MHA) 2001. The paper describes in detail the information contained in the St Patrick's Mental Health Services dashboard for 2012. The dashboard displays the key performance indicators that are monitored and the paper describes how these were reviewed by the Hospital's Clinical Governance Committee on a weekly basis for the three approved centres. The dashboard has also been used by the Clinical Governance Committee to provide ongoing education and engagement with staff in order to improve the operation of the MHA 2001. The use of this structured monitoring process has allowed the hospital to measure adherence to the MHA 2001 and also to measure activities that impact directly on the care and treatment of patients detained under the Act. The use of structured monitoring tools (i.e. the dashboard) to review the operation of the MHA 2001 allows for coherent observation of key events and issues which can cause concern in terms of the operation of the Act.

scholarly journals Why Do Approved Mental Health Professionals Think Detentions under the Mental Health Act Are Rising and What Do They Think Should Be Done about It?

2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Online Survey ◽  
Social Risk ◽  
Social Risk Factors ◽  
Mental Health Act ◽  
The Impact

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.

scholarly journals Commission for Health Improvement and mental health Services

2004 ◽  
Vol 28 (7) ◽  
pp. 238-240 ◽  
Author(s):  
Femi Oyebode ◽  
Giles Berrisford ◽  
Liz Parry
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child Protection ◽  
Quality Care ◽  
Clinical Governance ◽  
Health Improvement ◽  
Service Failures ◽  
Governance Systems ◽  
Management Capacity

The Commission for Health Improvement (CHI) ceased to function at the end of March 2004. This provides the opportunity to review its contribution and achievements as a new body, the Commission for Healthcare Audit and Inspection (CHAI), takes over its functions∗. CHI recently published its assessment of mental health services (http://www.chi.nhs.uk/eng/news/2003/dec/11.shtml). The report is based on the 35 clinical governance reviews, in England and Wales, published between July 2001 and October 2003; two investigations into serious service failures; and a report on safeguarding arrangements for children in England and a self-audit of child protection arrangements. CHI concluded that mental health services lag behind acute health services in developing clinical governance systems and processes that promote high-quality care and continuous improvement. It specifically highlighted the shortages of psychiatrists and in-patient nurses, and the reliance on agency nurses and locum staff; the unsuitability of buildings and facilities; the pressures on in-patient beds; the lack of management capacity and poor information systems; and the low priority given to services for children and older people.

Transition from child to adult mental health services: a French retrospective survey

2016 ◽  
Vol 11 (5) ◽  
pp. 286-293 ◽  
Author(s):  
Aurélie Schandrin ◽  
Delphine Capdevielle ◽  
Jean-Philippe Boulenger ◽  
Monique Batlaj-Lovichi ◽  
Frédérick Russet ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Care Pathway ◽  
Small Sample ◽  
University Hospital ◽  
Retrospective Survey ◽  
Content Type ◽  
Adult Mental Health

Purpose Adolescents and young adults’ mental health problems are an important health issue. However, the current organisation of the care pathway is not robust enough and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) has been identified as a period of risk. The paper aims to discuss these issues. Design/methodology/approach A retrospective survey was conducted in Montpellier University Hospital concerning transitions organised between CAMHS and AMHS between 2008 and 2009. The aim was to assess if transitions met four criteria identified in literature as warranting an optimal transition. Findings In total, 31 transitions were included. Transition was accepted by AMHS in 90 per cent of cases but its organisation was rarely optimal. Relational continuity and transition planning were absent in 80 per cent of cases. The age boundary of 16 often justified the triggering of the transition regardless of patient’s needs. Discontinuity was observed in 48 per cent of transition cases, with an average gap of three months without care. Psychiatrists reported difficulties in working together. Finally, at the moment of the survey (one to three years later), 55 per cent of patients were lost to follow-up. Research limitations/implications This is a retrospective study on a small sample but it reveals important data about transition in France. Practical implications Transition process should include collaborative working between CAMHS and AMHS, with cross-agency working and periods of parallel care. Social implications Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU. Originality/value Data related to the collaboration between CAMHS and AMHS services are scarce, especially regarding the transition in France.

scholarly journals Commentary

2000 ◽  
Vol 6 (3) ◽  
pp. 235-237
Author(s):  
Robert Hale ◽  
Sebastian Kraemer
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Governance ◽  
National Service ◽  
Staff Support ◽  
National Service Framework ◽  
Service Framework

This is a timely and useful start to a major debate that should now be taking place in mental health services. The authors have successfully woven the need for staff support into the themes of clinical governance and the national service framework for mental health and other Government initiatives. While concentrating on the particular stresses of consultants, they recognise that other grades and other disciplines in the field also suffer.

scholarly journals Professional leadership for social work in state mental health services in Aotearoa New Zealand

2009 ◽  
Vol 21 (4) ◽  
pp. 103-108
Author(s):  
David McNabb
Keyword(s):  
Mental Health ◽  
Social Work ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Governance ◽  
Health Board ◽  
District Health ◽  
The Future ◽  
Professional Leadership

This paper recounts the changes in the New Zealand government-run health services over the past 15 years and the subsequent changes to social work leadership in mental health services. Drawing on two pieces of local research, the article will explore social work mental health leadership in New Zealand. The first piece of research investigates the views of social work professional leaders (PL) about their roles and the prospects for social work in mental health in the future. The second piece of research investigates a new type of professional leadership role in the mental health services of the Auckland District Health Board. Clinical governance is an emerging phenomenon in health services internationally that is aimed at advancing quality improvement. This paper links developments in social work professional leadership with the activities of clinical governance in mental health services. It concludes that there is evidence of an improvement to the leadership infrastructure and of the contribution of leaders to clinical governance in district health boards (DHBs). However, many challenges remain for social work leaders into the future.

Reorganization based on patient focused care programs, in the context of mental health services reform: Effects on patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 516-516
Author(s):  
J.-P. Bonin ◽  
M. Lavoie-Tremblay ◽  
A. Lesage ◽  
P. Miquelon ◽  
C. Briand
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Action Plan ◽  
University Hospital ◽  
Primary Health ◽  
Health Action ◽  
The Difference ◽  
The Government ◽  
Health Action Plan

BackgroundWHO (2001) suggested that the population should get easier and faster access to services improvements in the management of mental disorders in primary health care. In this context, the Government of Quebec (Canada) published in 2005 a Mental Health Action Plan, based on an organization into a hierarchy and some hospitals began to reorganize their mental health services into patient focused care programs.Aims of the studyThe presentation will focus on the effects on outpatients (N = 290) who were receiving mental health services from two hospitals in Montreal.MethodsAs part of a broader study on mental health services and patient outcomes, mental health services’ patients from a psychiatric hospital and a general university hospital in Montreal, were recruited to complete the Basis24, Euroqol, SF12 and other scales. A standard recruitment protocol was followed. All incoming patients at the outpatient clinics/programs during a typical week were considered eligible. This procedure was done before the reorganization of services, in 2006 (T1), and after the reorganization of services (T2; 2 years later), in 2008. We used T-test to assess the difference of a six-month evolution between the two-time measures.ResultsRespectively, 1057 (T1) and 557 (T2) participated to the project. Generally patients showed no significative differences between the two times in their symptoms, functioning and QOL. Only some marginal aspects changes in one site or another.ConclusionPatients were not very disturbed by changes and the new program were not fully implemented two years after T1.

scholarly journals Clinical governance in mental health services

1999 ◽  
Vol 23 (12) ◽  
pp. 715-717
Author(s):  
Jake Lyne
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Customer Satisfaction ◽  
Health Services ◽  
Clinical Outcomes ◽  
Clinical Audit ◽  
Clinical Governance ◽  
Audit Committees ◽  
Limited Impact ◽  
Department Of Health

Clinical audit has had a limited impact in the NHS because clinical outcomes and standards, while important to clinicians, have not received the investment required from NHS management which has been preoccupied with efficiency and customer satisfaction. With the advent of A First Class Service (Department of Health, 1998) the emphasis is changing and clinical audit committees and departments now have a central role.

scholarly journals Exploration of the views of healthcare professionals working in a mental health trust in England on pharmacists as future approved clinicians: early findings

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i24-i24
Author(s):  
B Adam ◽  
R N Keers
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Data Collection ◽  
Health Services ◽  
Mental Health Professionals ◽  
Healthcare Professionals ◽  
Mental Health Act ◽  
Key Skills ◽  
Health Trust ◽  
Views Of Healthcare Professionals

Abstract Introduction The 2007 amendment to the Mental Health Act (MHA) 1983 enabled various non-medical professionals to now qualify as approved clinicians (ACs); these included social workers, mental health and learning disability nurses, clinical psychologists and occupational therapists. [1–2] As ACs, these professionals can take on roles of clinical leadership whilst assuming responsibility for patients under the Act. Although mental health pharmacists have recognised specialist clinical roles and regularly work alongside these professionals in caring for patients, they are not presently permitted to practise as ACs. Aim This study sets out to investigate the views of healthcare professionals working in a mental health trust in England on this hitherto unexplored group of the mental health workforce as potential ACs. Methods Upon obtaining ethics approval, pharmacists, ACs and other experienced mental health professionals working in one mental health trust in England were approached via internal trust email to take part in a digitally audio recorded semi-structured interview to explore their views on pharmacists as potential ACs in future. A thematic analysis is being performed on the entire set of transcripts and an additional sentiment analysis will be applied to specific parts of the dataset. Results A total of 11 interviews were completed with 6 pharmacists, 4 medical ACs and 1 ‘other’ mental health professional thus far, with recruitment ongoing. Emerging themes included wide recognition among participants of highly valued key skills of pharmacists within mental health services provision, for instance their ability to access and appraise specialist literature as well as their analytical skills to apply expert knowledge to real-life cases. Participants identified unique challenges to pharmacists potentially becoming ACs in future, namely the traditional organisational structures whereby pharmacists are line managed and clinically supervised from within a pharmacy department which sits external to the clinical teams they typically work in, and the lack of pharmacists being fully embedded in interdisciplinary teams. Conclusion Since this is the first study of its kind to be conducted on a small cohort of participants working within one mental health trust in England, this qualitative study will likely highlight the need for further research to be carried out on the topic, such as data collection in several other NHS trusts as well as recruiting participants from the working group and other stakeholders involved in the most recent amendment of the Act. Whilst data collection and analysis are ongoing, initial findings help shed light on potential barriers and also possible solutions to these, as well as other opportunities for pharmacists wishing to assume higher leadership roles within mental health services in England. References 1. Barcham, C. Understanding The Mental Health Act Changes – Challenges And Opportunities For Doctors. BJMP. 2008;1 (2):13–17. 2. Oates, J., Brandon, T., Burrell, C., Ebrahim, S., Taylor, J. & Veitch, P. Non-medical approved clinicians: Results of a first national survey in England and Wales. International Journal of Law and Psychiatry. 2018;60:51–56.

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