Search results

The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding.

This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures.

Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care.

The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.

Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers.

Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings.

None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration.

Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care.

This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

Prisoners are supposed to receive health care that is equivalent to that provided in the community. There is a high prevalence of mental ill health in prisons, and prisoners tend to have complex needs. Prison mental health care has received only limited attention until recently. The impact of the new in ‐reach teams appears to have been positive, but primary mental health care is weak across the prison estate and the vast majority of prisoners with mental health problems still receive little or no service. The development of prison mental health care has not been evidence‐based and there has been no policy implementation guidance that compares to that provided for reforms in services for the wider community. There is no model for prison mental health care and the role of the prison mental health practitioner is not well defined, nor is the health care workforce prepared for the task.

Care management has developed in a variety of forms. This diary study explores differences in the approach taken to care management in three distinct social service settings: community‐based older people's teams, hospital social work teams also for older people and community‐based teams for adults with mental health problems. Conclusions are drawn both for social care and for health services developing case management for people with long‐term conditions.

This article summarises what the Department of Health's (2005) Delivering Race Equality (DRE) agenda in mental health services set out to achieve and the background to this. The article then provides commentary on the Central and North West London NHS Foundation Trust's experiences while acting as one of the 18 focused implementation sites (FIS) created as part of the Department of Health's five‐year Delivering Race Equality Action Plan and highlights the recommendations that developed out of this work and have national application.

Peer support workers (PSWs) are individuals with lived experience of mental health difficulties, who apply this to support and inspire others in their recovery. The role of PSWs is relatively new within the forensic health-care service. Although there has been little time for these roles to develop, PSWs have successfully integrated into community teams. Despite perceived benefits of having these workers within a multi-disciplinary team (MDT), the views held by mental health professionals in forensic services have not yet been studied. The purpose of this research is to develop an understanding of the experiences of staff working with PSWs in a community forensic team and the impact this has on them.

Structured, individual interviews were conducted with eight mental health professionals, from a variety of disciplines, used across two community teams within forensic services. The data was examined according to thematic analysis.

The data indicated general positive attitudes held by professionals surrounding the working with PSWs, including the themes “providing alternative perspectives”, “unique relationships” and “hope”. Yet, themes concerned around “role ambiguity”, “boundaries” and “the impact on PSWs” also arose.

This study provides insight into the attitudes held by members of an MDT of working with PSWs. Although seemingly positive, the lack of clarity around the role of the PSW is problematic.

To the best of the authors’ knowledge, this is the first study to explore the employment of PSWs in the context of UK forensic settings, highlighting the benefits and challenges of such from the perspective of staff.

Pre- and post-immigration trauma and stress make refugees a particularly vulnerable group in terms of mental health and well-being. The purpose of this paper is to describe a listening project undertaken in Plymouth, UK, which sought the views of 17 service users (n=12) and staff (n=5) from four local support organisations, for people with refugee and asylum seeker status and those with diverse cultural backgrounds. Aims of the project were to expand Western-centric understandings regarding beneficial support and the promotion of good mental health and well-being in this population.

Responses were subjected to thematic analysis, co-conducted with a service user. Participants were asked about their personal understandings of mental health and well-being and what supports or hinders well-being.

The findings enabled the development of a model incorporating 10 threads which support and 9 holes that can hinder well-being.

The relatively small numbers of participants compared with the numbers of asylum seekers and refugees in Plymouth may not be fully representative of the general population in Plymouth and the UK.

Despite increasing cultural diversity within the UK population, available mental health services exist mainly as developed from a Western psychological model of mental distress and treatment. This research provides services with a more informed understanding of mental health for asylum seekers and refugees. As such it is of value towards future service design in Plymouth and the UK. Findings also contributed to a successful funding bid to set up a peer-led support project in the city.

The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting.

The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety.

Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services.

Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model.

It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model.

People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission.

Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.

This article describes the approach to modernisation of adult mental health day services taken in Sandwell, which retains a building‐based element to provide for attachment and belonging, while developing community‐based models that promote social integration and recovery.