Tackling culture change to transform mental health services

Mandip Kaur for the King’s Fund Blog | 16th March 2017

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Traditionally, mental health services are delivered by Children and Adolescent Mental Health Services (CAMHS) up until the age of 16 or 18 – or when a young person leaves school or college – at which point they’re expected to transition to adult mental health services. It’s long been recognised that this is a poor boundary for service transition, often having a further detrimental effect on mental health.

Forward Thinking Birmingham delivers mental health services for children and young people aged up to 25, combining the expertise of Birmingham Children’s Hospital, Worcester Health and Care Trust, Beacon UK, The Children’s Society and The Priory Group. The partnership’s vision is that Birmingham should be the first city where mental health problems are not a barrier to young people achieving their dreams. The transformational changes to the service were driven by the need to address disjointed and fragmented care provision, complicated service models, long waiting lists and rising demand. The service operates a ‘no wrong door’ policy and aims to provide joined-up care, focusing on individual needs, with improved access and choice for young people.

Read the full blog post here

Integrated collaborative care teams to enhance service delivery

Henderson J.L. et al. (2017) BMJ Open. 7:e014080

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Introduction: Among youth, the prevalence of mental health and addiction (MHA) disorders is roughly 20%, yet youth are challenged to access evidence-based services in a timely fashion. To address MHA system gaps, this study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges. A rapid, stepped-care approach geared to need in a youth-friendly environment is expected to result in better youth MHA outcomes. Moreover, the ICCT approach is expected to decrease service wait-times, be more youth-friendly and family-friendly, and be more cost-effective, providing substantial public health benefits.

Read the full protocol here

Does more mental health treatment and less stigma produce better mental health?

Two articles published this week shine a revealing light on how the general public views mental health care and its practitioners | The Conversation

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Mental health problems continue to carry a heavy stigma. People who experience them are often feared, excluded, shamed and discriminated against. Overcoming that stigma is a high priority, not least because it’s a barrier to engaging people in treatments that might help them.

People suffering from mental health problems are not the only ones to experience the stigma of mental illness, however. Those who treat them sometimes share the burden. Just as the shadow of death falls on workers in the funeral industry, psychiatric stigma casts a shadow on the public image of mental health professionals.

Psychiatrists in particular have been concerned they are held in low esteem by the public and within the medical profession. This negative view of the field has significant consequences, such as making it difficult to recruit students into psychiatric training. The chronic under-funding of mental health research and treatment arguably reflects the same devaluation.

Read the full blog post here

Using patient-reported outcome measures to improve service effectiveness for supervisors

Fullerton, M. et al. Child and Adolescent Mental Health. Published online:
24 January 2017

Background: Patient-reported outcome measures (PROMs) are recommended by healthcare systems internationally, but there are a number of barriers to implementation. The aim of this research was to examine the impact of training supervisors in using PROMs on clinical practice, given the importance of leadership when changing behaviour.
Method

Conclusions: Findings are in line with the growing body of evidence that training child mental health staff to use PROMs may be associated with changes in attitudes, self-efficacy and use of PROMs.

Read the full abstract here

The other one in four – how financial difficulty is neglected in mental health services

The other one in four – how financial difficulty is neglected in mental health services | The Money and Mental Health Policy Institute

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This report assesses the extent to which mental health services recognise and respond to this relationship between financial difficulty and mental health problems. The publication explores where there are gaps in existing provision and where better coordination could improve services for people with mental health problems who are experiencing financial difficulty.

Plan to Transform Mental Health Service

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The Prime Minister has this week announced a comprehensive plan that aims to transform mental health services with a particular focus on children and young people.

Speaking at the Charity Commission in London, she addressed the stigma attached to mental health stating that the Government aims to “transform the way we deal with mental health problems right across society, at every stage of life.”

Secretary of State for Health Jeremy Hunt has also announced new suicide prevention measures which includes initiatives to better support people at risk of self-harm.

The announcement from the Prime Minister included key areas that will impact on children and young people:

  • The Government will launch a major thematic review into Children and Adolescent Mental Health Services (CAMHS) across the country to find out what is, and what isn’t, working.
  • Every secondary school will receive ‘mental health first aid’ training and extra training for teachers in order to better support students experiencing mental health problems.
  • The Government aims to strengthen the links between schools and local NHS mental health staff.
  • The Government will be investing in new digital tools for mental health alongside the suicide prevention strategy.

Read more:
Prime Minister unveils plans to transform mental health support:  Department of Health

Mental health reforms to focus on young people, says PM: BBC

Funds for mental health must reach the front line if Prime Minister’s vision is to be realised:  The King’s Fund

Improving the mental health of children and young people

Reports to support commissioners in improving the mental health and wellbeing of children and young people. | Public Health England

These reports describe the importance of mental health and wellbeing among children and young people and the case for investment in mental health. They also summarise the evidence of what works to improve mental health among children and young people in order to inform local transformation of services.

The mental health of children and young people in England

The mental health of children and young people in London

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Image source: http://www.gov.uk