scholarly journals Lessons from and for Japan on service delivery

2005 ◽  
Vol 29 (8) ◽  
pp. 309-311 ◽  
Author(s):  
Peter Kennedy
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Mental Hospital ◽  
Community Care ◽  
Quality Care ◽  
Chronic Schizophrenia ◽  
Mental Hospitals ◽  
Good Quality Care

On a recent visit to Japan, I saw some good quality care of patients with chronic schizophrenia in a rural mental hospital. The Japanese staff were keen to hear about community care alternatives being developed in Britain. However, being a strong protagonist of community care, who has managed the closure of three English mental hospitals, I found myself recommending caution. There are lessons for Japan from the mistakes we have made; and there may be lessons for us in the ways Japan manages delivery of its mental health services.

scholarly journals Provision of mental health services in Nigeria

2008 ◽  
Vol 5 (2) ◽  
pp. 32-34 ◽  
Author(s):  
Olufemi Olugbile ◽  
M. P. Zachariah ◽  
O. Coker ◽  
O. Kuyinu ◽  
B. Isichei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Urban Areas ◽  
Mental Healthcare ◽  
African Countries ◽  
Grass Roots ◽  
The Past ◽  
Trained Personnel

Nigeria, like other African countries, is short of personnel trained in mental healthcare. Efforts to tackle the problem have often focused on increasing the numbers of psychiatrists and nurses in the field. These efforts, over the past 20 years, have not appeared to have greatly improved service delivery at the grass roots. Most of the specialist centres where such highly trained personnel work are in urban areas and for a large part of the population access to them is limited by distance and cost.

scholarly journals Understanding health and care expenditure by setting – who matters to whom?

2020 ◽  
pp. 135581962093672
Author(s):  
Jenny Shand ◽  
Stephen Morris ◽  
Manuel Gomes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Hospital Care ◽  
Service Use ◽  
Community Care ◽  
Mental Health Service Use ◽  
Total Expenditure ◽  
System Perspective

Objective To assess service use and associated expenditure across a range of care settings in one local authority in London, United Kingdom. Methods An analysis of linked electronic health and council records of adults living in the borough of Barking and Dagenham, east London, for the financial year 2016/17. Unit costs were applied to individual service use to provide expenditure at an individual and population level for five settings of care. Population and expenditure volumes were compared for 32 possible combinations of service use. Results The total expenditure for the cohort (114,393 residents) for 2016/17 was £180.1 million. Almost half (47%) of total expenditure was incurred by community care, social care and mental health services, with hospital care and primary care incurring, respectively, 35% (£63.3 m) and 18% (£32.6 m). The two most common combinations in terms of total population volume and expenditure were primary and hospital care, and primary, hospital and community care. Primary care was present in all combinations. Mental health service use accounted for just over a tenth of all expenditure in the borough, but using mental health services substantially increased mean expenditure per patient. Conclusions A whole system perspective across all settings of care improves understanding of service user patterns. Setting-level analysis remains important, particularly for mental health users.

A systematic review of current approaches to managing demand and waitlists for mental health services

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kerry A. Thomas ◽  
Annelise M. Schroder ◽  
Debra J. Rickwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Clinical Effectiveness ◽  
Research Literature ◽  
Inclusion Criteria ◽  
Content Type

Purpose Timely access to effective treatment is a primary goal for mental health services; however, when demand exceeds available resources, services may place clients on a waitlist or restrict services. This paper aims to identify approaches used by mental health services to manage service demand and waitlists. Design/methodology/approach A review of research literature between 2009 and 2019 was conducted using the Medline, PsycINFO, CINAHL, Embase and Cochrane databases. Articles were screened and assessed against inclusion criteria and the methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings In total, 20 articles were located that met the inclusion criteria. Five demand management approaches were identified, namely, walk-in models, triage processes, multi-disciplinary care, patient-led approaches and service delivery changes. Research limitations/implications This review identifies effective approaches that services can consider adapting to their local setting; however, further research is needed to demonstrate the clinical effectiveness of services provided under these models. Originality/value This review makes a valuable contribution to mental health care service delivery by detailing the strategies that services have adopted to manage demand and, where available, comparative outcomes with traditional service delivery models.

The balanced care model for global mental health

2012 ◽  
Vol 43 (4) ◽  
pp. 849-863 ◽  
Author(s):  
G. Thornicroft ◽  
M. Tansella
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Mental Health System ◽  
Community Care ◽  
Care Model ◽  
Adult Mental Health ◽  
High Resource

BackgroundFor too long there have been heated debates between those who believe that mental health care should be largely or solely provided from hospitals and those who adhere to the view that community care should fully replace hospitals. The aim of this study was to propose a conceptual model relevant for mental health service development in low-, medium- and high-resource settings worldwide.MethodWe conducted a review of the relevant peer-reviewed evidence and a series of surveys including more than 170 individual experts with direct experience of mental health system change worldwide. We integrated data from these multiple sources to develop the balanced care model (BCM), framed in three sequential steps relevant to different resource settings.ResultsLow-resource settings need to focus on improving the recognition and treatment of people with mental illnesses in primary care. Medium-resource settings in addition can develop ‘general adult mental health services’, namely (i) out-patient clinics, (ii) community mental health teams (CMHTs), (iii) acute in-patient services, (iv) community residential care and (v) work/occupation. High-resource settings, in addition to primary care and general adult mental health services, can also provide specialized services in these same five categories.ConclusionsThe BCM refers both to a balance between hospital and community care and to a balance between all of the service components (e.g. clinical teams) that are present in any system, whether this is in low-, medium- or high-resource settings. The BCM therefore indicates that a comprehensive mental health system includes both community- and hospital-based components of care.

School-Based Mental Health

2017 ◽  
Author(s):  
Mia Everett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Children And Adolescents ◽  
Social Stigma ◽  
Quality Care ◽  
Assessment Tools ◽  
Health Crisis ◽  
School Based ◽  
Educational Advocacy

The majority of children and adolescents in need of mental health services do not receive adequate care. Barriers to quality care include limited financial resources, social stigma, and a paucity of appropriately trained clinicians. The deleterious effects of untreated childhood mental illness have been well documented. School-based child and adolescent psychiatrists are on the front line of managing this public health crisis. Approximately 75% of mental health services for children and adolescents are provided in educational settings. The success of school-based mental health programs is contingent upon effective collaboration between the practitioner, caregiver, child/adolescent, and educator. In this chapter, a case is used to illustrate salient features of school-based psychiatric practice, including assessment tools, interventions, educational advocacy, and logistical considerations. The practice of public psychiatry in school-based settings should optimally adhere to the principles of recovery, resilience, and cultural competence.

scholarly journals Profile: Vanessa Cameron – 36 years at the Royal College of Psychiatrists

2016 ◽  
Vol 40 (6) ◽  
pp. 341-345
Author(s):  
Rob Poole ◽  
Catherine A. Robinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
21St Century ◽  
Royal College ◽  
Chief Executive ◽  
Continuous Change ◽  
Mental Hospitals

On 16 December 2016, Vanessa Cameron retires as Chief Executive of the Royal College of Psychiatrists. She started working there in September 1980 and in 1984 she became Secretary of the College, the role that preceded chief executive. The College was formed in 1971, so Vanessa has been present for most of its lifetime. It has been a period of continuous change that has seen psychiatry leave the old mental hospitals, expand considerably in the late 1990s and early part of the 21st century, and come under huge pressure more recently. Although she has never worked within mental health services, Vanessa has been at the heart of British psychiatry for 36 years. She was awarded an MBE in the 2013 New Year's Honours list for services to psychiatry.

WHAT DO PEOPLE WANT FROM SPECIALIST MENTAL HEALTH SERVICES AND CAN THIS BE MEASURED IN ROUTINE SERVICE SETTINGS?

2000 ◽  
Vol 28 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Media Coverage ◽  
Community Care ◽  
Public Image ◽  
Routine Practice ◽  
Service Users ◽  
Measurement Instruments ◽  
Routine Service

The level of public satisfaction with mental health services is low. This is evident in adverse media coverage and the Government's view that community care has failed. Some components of a comprehensive mental health service are in disrepair and others are missing altogether. Surveys of those who use services show that many are dissatisfied with the care they receive. One of the actions that services must take to improve their effectiveness, acceptability and public image is to understand better what people want from the services they use. Surveys of service users have identified what these issues are. It is now important that these factors are incorporated into measurement instruments that can be used in routine practice settings. This paper summarizes what service users have indicated that they want from services, lists the desirable attributes of instruments that might measure these factors, and gives brief descriptions of four instruments that meet some aspects of the specification.

scholarly journals Does community care work? A model to evaluate the effectiveness of mental health services

2008 ◽  
Vol 2 (1) ◽  
pp. 10 ◽  
Author(s):  
Emiliano Monzani ◽  
Arcadio Erlicher ◽  
Antonio Lora ◽  
Piergiorgio Lovaglio ◽  
Giorgio Vittadini
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Community Care ◽  
Care Work

Examining Models of Mental Health Service Delivery in the Emergency Department

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.

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