Best practices for the administration of Behavioral Health Rehabilitation Services (Wrap Around) in Pennsylvania: Six basic problems and their solutions.

This chapter provides information and advice to audiences at the practice, program management, and governance levels concerned with “evidence-based programs and practices” in Native Communities. The authors emphasize a defense of culture-based knowledge and practice because the systematic attempt to impose an “evidence-based” mandate on providers of behavioral health services in Native Communities has not been an incentive to incorporate scientifically tested information about interventions. The approach recommended here respects and accommodates culture-based knowledge, ways of knowing, and practice in Native Communities while facilitating the uptake of science-based knowledge.

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Mental health rehabilitation services in Ireland: vision and reality

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700011460 ◽

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.

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