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On or around the 31 March each year all psychiatric units in the UK undertake the Count Me In census. Now in its fourth year and with 100% of units in England taking part, the Count Me In census offers comprehensive but limited information on all people receiving inpatient psychiatric care. It also offers information on their ethnicity so that comparisons can be made between groups. It is an extraordinary achievement but this achievement has brought with it burdens. Though envisaged as a vehicle for introducing ethnic monitoring, the census is now expected to be a major tool of assessment and an aid to service development. But can this epidemiological survey deliver the information England needs to develop culturally competent services?

Two censuses, from 2010 and 2013, respectively, shed light on the trend in use of in-patient psychiatric care for people with learning disability or autism following the BBC documentary exposing abuse of patients at Winterbourne View. The purpose of this paper is to consider the implications of the detailed trends for future care for this group.

Published data from a recent (September 2013) census are compared with the re-analysis of a census undertaken by the Care Quality Commission in March 2010.

An overall 35 per cent reduction in numbers of in-patients is made up of larger falls in groups generally easier to discharge (older, female, in general as opposed to secure units). There is also substantial variation around the country.

There are some uncertainties about the comparability of the two censuses and the question of how complete enumeration was of people with learning disabilities in general mental illness beds.

The paper raise the question of whether the beds that are reducing fastest may be those most likely to be of value to a high quality and sustainable service in the long term.

While efforts to mainstream collection of ethnicity in routine health datasets have gathered pace since the Race Relations (Amendment) Act 2000, relatively little attention has focused on the capture of migrants, and data on asylum seekers and refugees are even more sparse. There is negligible coverage in the key datasets for primary and secondary care, and only a few of the new contract datasets to support the National Service Frameworks accord importance to the migrant population. Some of the communicable disease data collections record country of birth, but its incompleteness is a drawback. Given the growing size of the non‐UK‐born population and the accumulating evidence on the health and health care needs of the migrant population, country of birth merits a place alongside other access variables such as age, sex, ethnicity, socioeconomic status and place of residence in routine data collection. While record linkage studies offer some scope, and there is currently a focus on obtaining improved migration statistics in the forthcoming census and other data flows, health and social care sources remain a neglected area.

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.

This chapter intends to provide a reflexive discussion of the experience I loosely refer to as the ‘supervisory relationship breakdown’, which led me to withdraw from a Professional Doctorate in the penultimate year of completion. The event left an indelible impact upon me; a reminder of my blackness, the contrast between that and the ivory tower of academia and the emotional toil I endured as each incident unfolded, ultimately leading to my exit and the shattering of my emotional wellbeing. The term ‘supervisory relationship breakdown’ is a superficial reference to a complex entanglement of what I deemed to be dysconscious racism and attempts situated historically to control people of colour through education. I will explore how I as a black woman in academia believe I am perceived through a dysconscious racial lens, a lens shaped by a perception to maintain white privilege. I posit how a misalignment existed between who I am and who I was perceived to be by my doctoral supervisor. The space between this misalignment became filled with inequity, tension and oppression, culminating in the relationship breakdown. I present an ‘implosion’ of the relationship as a metaphor for the embodied affect having to withdraw from the doctorate had on me; it felt as though my ‘self’ – body, mind and spirit – were broken, in a state of collapse which I did not know how I would recover from. I conclude with support and renewed hope, I returned to academia and found an alternative approach for completing my doctorate.

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138 patients, 77 discharged and 61 current inpatients, treated over a six‐year period were included in the audit. Information on demographic and clinical variables was collected on a pre‐designed data collection tool and analysed using appropriate statistical methods. The median length of stay for the discharged group was 2.8 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. There was a ‘difficult to discharge long‐stay’ group which had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not predictive of the length of stay. Clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay, and there is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables. Common datasets and multi‐centre audits are needed to drive this.

This chapter aims to give an overview of key mental health policy and service provision, highlighting the need for specific attention to Black and minority ethnic children and young people. The focus is on mental health provision in the UK provided through the statutory sector and the voluntary and community sector, the issues raised are likely to have resonance across wider geographic locations. The themes examined include: the relevance of terminology regarding race and ethnicity and related impact on the planning and provision of services; the extent to which policy and commissioning of services give due focus and attention to the mental health of Black and minority ethnic children and young people; views young people themselves have contributed on the issue; and a case study illustrating work being undertaken to redress some of the imbalances encountered by young people in accessing appropriate support. The chapter argues that the supply chain to young people receiving support that is relevant and appropriate to their needs is a long and complex one. It is fundamental to take a holistic approach and consider how the components of this chain impact specifically on the mental health of children and young people from Black and minority ethnic communities.

Child and adolescent mental health services (CAMHS) – This term refers to all services that work with children and young people to address their behavioural and emotional wellbeing needs. The services may be provided by the National Health Service (NHS), local authority, school, private sector or charitable organisation and span early intervention support through to specialist treatment.

Care Quality Commission – The independent regulator of health and social care services in England.

Commissioning – The process by which health services are procured and should be based on an up-to-date assessment and understanding of needs of the target population.

Co-production – A process for planning and delivery of health and social care services that involves partnership working and power sharing between those responsible for the planning and provision of services, service users, their family members, carers and other citizens.

National Service Framework – Ten year programmes that, until the health and social care reforms started in 2010, defined standards of care in the NHS including measurable goals within set timeframes.

Population Needs Assessments – The collection and study of relevant data to understand and estimate current and future needs of a population in order to inform the planning of services that meet identified needs.

Voluntary and Community Sector – Also referred to as the Third Sector and encompassing a diverse range of organisations, services and groups that are seen as distinct from the public (also referred to as statutory) and private sectors.

Youth Information, Advice and Counselling Services (YIACS) – Most YIACS have charitable status and provide services to young people on a range of issues, a key feature associated with YIACS is the provision of holistic, young person centred support provided under one roof.

This paper explores issues surrounding the under‐representation of people from the Gujarati community in mental health statistics and services in the UK and asks why people from the Gujarati communities are less likely to seek assistance for mental health problems. It is well known that members of the African‐Caribbean community are over‐represented in mental health statistics, and this is attributed to factors such as racial discrimination, social adversity and stress of migration. However, members of the Gujarati community have also been exposed to these hardships, but are not similarly represented in the mental health statistics. The paper explores a selection of the key literature. Two questions are considered: first, whether this group genuinely has very good mental health (and if so why); and second, whether there are any factors that hold members of this community back from seeking help.