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 Development of Mental Health Services

1986 ◽  
Vol 10 (7) ◽  
pp. 180-181
Author(s):  
Ian B. Cookson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Social Services ◽  
Health Authority ◽  
Regional Health Authority ◽  
Regional Health ◽  
Voluntary Organisations

In the Mersey Regional Health Authority it has been decided that closure of at least one large mental illness hospital will take place within some 10 years and may be complete by 1992. To facilitate this the region has provided funding for every long-stay patient who might be discharged to the care of voluntary organisations or Social Services Departments and joint assessments of patients have been undertaken by the Health Service and Social Services staff.

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 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 Objective predictors of outcome in forensic mental health services—a systematic review

CNS Spectrums ◽  
2016 ◽  
Vol 21 (6) ◽  
pp. 430-444 ◽  
Author(s):  
Ottilie Sedgwick ◽  
Susan Young ◽  
Mrigendra Das ◽  
Veena Kumari
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Length Of Stay ◽  
Health Services ◽  
Clinical Judgment ◽  
Poor Performance ◽  
Self Report ◽  
Forensic Mental Health ◽  
Predictors Of Outcome

This systematic review aimed to examine whether neurobiological methods, or other methods independent of clinical judgment, have been investigated to assist decision making in forensic mental health services and, if so, whether this may be a useful strategy for predicting outcomes. OVID-Medline, Embase, and PsychInfo (inception–January 2015) were searched, limiting to English and human studies, using terms relating to “predict,” “outcome,” “psychiatry,” and “forensic” to identify primary research articles reporting on predictors of outcome in forensic mental health services not reliant on clinical judgment/self-report. Fifty studies investigating demographic, neuropsychological/neurophysiological, and biological predictors were identified, reporting on 3 broad outcomes: (i) inpatient violence, (ii) length of stay, (iii) reoffending. Factors associated positively, negatively, and showing no relationship with each outcome were extracted and compiled across studies. Of various demographic predictors examined, the most consistent associations were between previous psychiatric admissions and inpatient violence; a more “severe” offense and a longer length of stay; and young age and reoffending. Poor performance on tests of cognitive control and social cognition predicted inpatient violence while a neurophysiological measure of impulsivity showed utility predicting reoffending. Serum cholesterol and creatine kinase emerged as biological factors with potential to predict future inpatient violence. Research in this field is in its infancy, but investigations conducted to date indicate that using objective markers is a promising strategy to predict clinically significant outcomes.

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.

Hotlines and Mental Health Services

Crisis ◽  
1998 ◽  
Vol 19 (1) ◽  
pp. 4-5
Author(s):  
Mary Frances Seeley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services
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