scholarly journals Expenditure on mental health care by English health authorities: A potential cause of inequity

2000 ◽  
Vol 177 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Jonathan Bindman ◽  
Gyles Glover ◽  
David Goldberg ◽  
Daniel Chisholm
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Expenditure ◽  
Local Level ◽  
Regression Modelling ◽  
Health Authorities ◽  
London Health ◽  
Mental Health Expenditure ◽  
Deprived Areas

BackgroundThe York resource allocation formula includes a calculation of the amount needed to purchase mental health services equitably in each health authority in England. However, the amount which is actually spent on services is at the discretion of the authority.AimsTo compare expenditure on mental health services with allocation, and test the hypothesis that differences between them are to the disadvantage of services in deprived areas.MethodA comparison of routine expenditure and allocation data, and linear regression modelling of the ratio of expenditure to allocation.ResultsThe ratio of expenditure to allocation varies widely. Relative underspending occurs more frequently in deprived areas, although not in the four inner-London health authorities.ConclusionsThe intentions of the York formula are not achieved in practice. The implications of the formula for mental health should be made explicit to health authorities, and shortfalls in mental health expenditure relative to allocation should be justified at a local level.

scholarly journals Homicide inquiries

2000 ◽  
Vol 24 (1) ◽  
pp. 6-10 ◽  
Author(s):  
George Szmukler
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Authority ◽  
Trust Management ◽  
Poor Performance ◽  
Medical Director ◽  
Political Influences ◽  
Deprived Areas

We recently had a homicide inquiry in our trust. The events around the release of the report made for a demoralising experience. The visible pain in the families of the victim and the perpetrator caused by the tragedy was heart-rending. As Medical Director, I also saw at first hand the powerful impact on the members of the team involved, my colleagues in general, the trust management and the health authority, all of whom strive to provide effective mental health services in one of the most deprived areas in the country. There were also political influences, especially the need to be seen not to tolerate poor performance. Allusions to disciplinary issues were not infrequent. We all found it very disturbing. I was forced to think a lot about homicide inquiries and became increasingly struck by a growing number of internal contradictions. I started making notes to help order my thoughts. I offer for discussion some conclusions using this inquiry (Scotland et al, 1998) as an example.

scholarly journals Mental health services: results of a survey of English district plans

1989 ◽  
Vol 13 (2) ◽  
pp. 77-78 ◽  
Author(s):  
D. Kingdon
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Strategic Plan ◽  
Substantial Proportion ◽  
Short Term ◽  
Health Authorities ◽  
Comprehensive Service ◽  
Initial Reading

In November 1987, I wrote to the ‘Planning Officer (Mental Health)’ of the 192 English Health Authorities requesting a copy of the section of their 1984 Strategic Plan dealing with mental health and any recent update. A checklist of information to be analysed was drawn up on the basis of an initial reading of the plans. This contained a substantial proportion of the elements for a comprehensive service listed by Hirsch (1988) and by MIND (1983). Replies were received from 137 (71%) of the health authorities. Of these, 127 (67%) sent planning documents, ten wrote saying that their plans were under review and therefore unavailable, or “meaningless”. Strategies were sent dated 1983 (2), 1984/5 (63), 1986 (11) and 1987/8 (45). Planning reports and Short Term Programmes were also sent which meant that four (3%) provided information updated to 1988, 74 (58%) to 1987, 16 (13%) to 1986, 17 (13%) to 1985, 15 (12%) to 1984, with one giving details relating to 1983 only.

scholarly journals Australia's National Mental Health Strategy

2002 ◽  
Vol 180 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Harvey Whiteford ◽  
Bill Buckingham ◽  
Ronald Manderscheid
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Hospitals ◽  
Limited Evidence ◽  
Health Report ◽  
Independent Evaluation ◽  
Health Strategy ◽  
National Mental Health ◽  
Mental Health Expenditure

BackgroundAustralia commenced a 5-year reform of mental health services in 1993.AimsTo report on the changes to mental health services achieved by 1998.MethodAnalysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.ResultsMental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.ConclusionsMajor structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.

scholarly journals Improved investment in mental health services: value for money?

2008 ◽  
Vol 192 (2) ◽  
pp. 88-91 ◽  
Author(s):  
David Goldberg
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Local Level ◽  
Health Staff ◽  
Central Control ◽  
Front Line ◽  
Mental Health Staff ◽  
The Past ◽  
Local Initiatives

BackgroundThis paper examines what has been achieved in the specialist mental health services by the vastly increased health expenditures that the National Health Service (NHS) has enjoyed in the past 5 years.AimsTo describe the way money has been spent in specialist mental health services and examine why problems remain after such admirable changes to already available resources.MethodChanges in staff employed by mental health services, where the extra staff are deployed, and patterns of expenditure within the whole service and within community mental health teams are examined.ResultsSome of the new expenditure has been well spent, and has produced improvements in the service. However, one must also take account of the costs of the greatly increased numbers of managers, who impose two sorts of costs: that of their own salaries, and the opportunity costs of front-line staff having to attend meetings and write reports rather than seeing patients. Throughout the rest of the NHS, money has been wasted on needless reorganisations, on consultant and general practitioner contracts, and on information technology that has so far failed to deliver tangible advantages.ConclusionsThe emphasis on central control undermines local initiatives and wastes resources. Some central control is inevitable, but policies need to be developed in collaboration with clinicians. At local level, expenditure by primary care trusts and mental health trusts also needs to be scrutinised by committees that should include representatives of front-line mental health staff.

scholarly journals Resources available to develop mental health services

1992 ◽  
Vol 16 (8) ◽  
pp. 490-492
Author(s):  
John Mahoney
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Authority ◽  
Working Group ◽  
Psychiatric Services ◽  
Good Practices ◽  
Health Authorities ◽  
Audit Commission ◽  
Local Services

The Audit Commission has drawn attention to local champions of change in mental health services. Good Practices in Mental Health (GPMH) (1985) has highlighted a district which has overcome some of the myths about the impossibility of transforming the service, and recently the Institute of Health Services Management (IHSM) Working Group (1991) has entered the debate with “good psychiatric services can be developed in areas where managers are determined to introduce improved services”. The Audit Commission singled out Torbay Health Authority, GPMH highlighted Exeter Health Authority, and the IHSM Working Group have listed 12 exemplary health authorities (including Torbay and Exeter) where good local services have been developed.

scholarly journals Η αξιολόγηση της πρωτοβάθμιας φροντίδας υγείας ως δομικού συστατικού του υγειονομικού συστήματος της Κύπρου

2002 ◽  
Author(s):  
Πέτρος Μάτσας
Keyword(s):  
Mental Health ◽  
Job Satisfaction ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Special Reference ◽  
Primary Health ◽  
Health Authorities

The main aim of the present study is the evaluation of the Primary Health Care in Cyprus provided by the Health Authorities in the island. More particularly the specific objectives of the said research project are as follows: a) evaluation of primary healthcare in general practice; special reference as made to the job satisfaction of the General Practitioner as well as the satisfaction felt by the patients served by the health system (patients’ satisfaction). b) evaluation of primary health care within the mental health services in Cyprus; Special reference again is made to the job satisfaction of the psychiatric staff as well as the satisfaction felt or experience by the patients visitors served by the Mental Health Services. c) evaluation of the services provided by the School Health Services of the Ministry of Health. The present research was basically based on a qualitative approach employing questionnaires as the methodological instrument. The research findings have revealed the essential weaknesses inherent in the current primary Health Care System of Cyprus and pertinent suggestions and proposals have been made in a way that a productive utilization of the said findings can be made by the Health Authorities of Ministry of Health with a new to the amelioration of the existing health System.

scholarly journals Impact of COVID-19 Pandemic in Public Mental Health: An Extensive Narrative Review

2021 ◽  
Vol 13 (6) ◽  
pp. 3221
Author(s):  
Vicente Javier Clemente-Suárez ◽  
Eduardo Navarro-Jiménez ◽  
Manuel Jimenez ◽  
Alberto Hormeño-Holgado ◽  
Marina Begoña Martinez-Gonzalez ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Public Mental Health ◽  
Narrative Review ◽  
Primary Sources ◽  
Web Pages ◽  
Health Crisis ◽  
Use Of Technology ◽  
Health Authorities

The Coronavirus Disease 2019 (COVID-19) pandemic has surprised health authorities around the world producing a global health crisis. This research discusses the main psychosocial stressors associated with COVID-19 in the literature, and the responses of global public mental health services to these events. Thus, a consensus and critical review were performed using both primary sources, such as scientific articles and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. The method was a systematic literature review (SLR) of the available literature regarding mental health services during the COVID-19 pandemic to conduct the present narrative review. Different stressors are identified in this pandemic, from psychophysiological, confinement, to social and work. Depending on the level of severity and the country of origin, various interventions have been applied that mark different ways of returning to normality and preparing new interventions. This new stressor has a direct impact on the mental health of the population, provoking governments, and health services to become more flexible, innovate and adapt to the changing situation. The use of technology and mass media could be an important tool in this aim. Independent of this, preparing the general population for possible future waves of the pandemic is currently the best measure to mitigate more serious effects on the mental health of the population.

scholarly journals Mind the gap: the interface between child and adult mental health services

2005 ◽  
Vol 29 (8) ◽  
pp. 292-294 ◽  
Author(s):  
Swaran P. Singh ◽  
Navina Evans ◽  
Lester Sireling ◽  
Helen Stuart
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Full Time ◽  
Adult Mental Health ◽  
Adult Services ◽  
Health Authorities ◽  
Audit Commission ◽  
The Uk

Adolescents with mental health problems are poorly served by mental health services, since responsibility for care often falls between child and adult services. Within the UK, there is no consensus on how service boundaries should be delineated. Some services use an age cut-off at some point between 16 and 18 years, whereas others consider child services to be appropriate only for those in full-time education. The Audit Commission (1999) reported that nationally 29% of health authorities commissioned child and adolescent mental health services for young people before their 16th birthday only, although adult services were not considered suitable for those under 17 years old. The report highlighted the poor development of adolescent services and their inadequate links with other agencies, including adult mental health services.

scholarly journals Facilitating moves into the community: a new mental health services initiative

1991 ◽  
Vol 15 (10) ◽  
pp. 654-654
Author(s):  
Rosalind Ramsay
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mentally Ill ◽  
District Health ◽  
Consultant Psychiatrist ◽  
Department Of Health ◽  
Health Authorities ◽  
The Government

Stephen Dorrell, the government Health Minister, has criticised the current “gross misallocation” of resources for patients with mental illness. The Department of Health estimates that more than half the district health authorities' budget of £1.5 billion for mental health services is still being channelled into the 90 remaining large specialist mental hospitals. There are now only 40,000 patients in such institutions. However, according to government calculations, a total of 2¼ million people in this country have a mental illness which is “serious enough” for them to need consultant psychiatrist care. All those sufferers from mental illness living in the community must make do with the remaining DHA budget. In other words, 98% of the mentally ill are supported by less than half the total resources allocated by districts for mental health services.

More Deprived Areas Need Greater Resources for Mental Health

2003 ◽  
Vol 37 (4) ◽  
pp. 437-444 ◽  
Author(s):  
Melanie Abas ◽  
Jane Vanderpyl ◽  
Elizabeth Robinson ◽  
Peter Crampton
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Patient Care ◽  
Community Mental Health Services ◽  
Economic Deprivation ◽  
Area Index ◽  
Bed Days ◽  
The Relationship ◽  
Deprived Areas

Objective: This study set out to investigate the relationship in New Zealand between the newly developed small area index of socio-economic deprivation, NZDep96, and measures of psychiatric bed utilisation. It aims to contribute to the debate on resource allocation and to estimate the distribution of beds required in relation to levels of deprivation. Method: A cohort study of 872 persons admitted to the psychiatric in-patient unit within Counties Manukau, involving 1299 episodes of in-patient care between 1998 and 2000. The annual period prevalence of admission and the rate of total occupied bed days were calculated for the different deciles of deprivation, standardized for age and gender. Results: There was a three-fold gradient in admission prevalence and in total occupied bed days between persons living in the most and least deprived areas. Conclusions: Mental health services need to be organized and funded in ways that take account of the high use of in-patient care among those living in deprived areas. Further research is required to explore the relationship between socio-economic deprivation and use of community mental health services.

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