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Article
Publication date: 1 March 2007

Neill Simpson, Margaret Whoriskey and Michael McCue

Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations…

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Abstract

Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations are responding to the spectrum of mental health needs by working in partnership to improve quality. This article describes this system and the key organisations, and presents some findings of the National Overview Report of services undertaken by NHS Quality Improvement Scotland.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 1
Type: Research Article
ISSN: 1753-0180

Keywords

Book part
Publication date: 21 October 2008

Ethel G. Nicdao, Seunghye Hong and David T. Takeuchi

Objective: Our study examines the association between social support and use of mental health services in Asian American men and women. Specifically, we report on the association…

Abstract

Objective: Our study examines the association between social support and use of mental health services in Asian American men and women. Specifically, we report on the association between types of social support and types of health services used (general medical care and specialty mental health care).

Method: We use data from the National Latino and Asian American Study, a nationally representative survey of the US household population of Latino and Asian Americans. Our present study is based on data from the sample of Asian Americans (N = 2,095).

Results: Overall, our findings suggest that Asian Americans use general medical care services more than specialty mental health care. Our findings also showed variations in levels of social support, and the use of health services among different Asian subgroups (Vietnamese, Filipino, Chinese, and Other Asian) and nativity status (US-born versus foreign-born Asians). Specific types of social support influenced the use of specialty mental health care services, while other types of social support inhibited use of specialist services.

Conclusion: Compared to using generalist services, Asian Americans demonstrated lower rates of using specialist services. Our results emphasize the importance of considering other social factors to explain between group differences as well as factors contributing to the underutilization of specialty mental health services by Asian Americans.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

Article
Publication date: 1 March 2007

Owen Barr

In 2002, a Review of Mental Health and Learning Disability in Northern Ireland was launched, which reported during 2005‐6 and produced a framework for future learning disability…

Abstract

In 2002, a Review of Mental Health and Learning Disability in Northern Ireland was launched, which reported during 2005‐6 and produced a framework for future learning disability and mental health services. This article will address three broad areas: first, it will provide an overview of the current structure of health and social services within Northern Ireland and summarise how these structures are expected to change within the next few years. Second, it will outline the key policy objectives in relation to the health of people with learning disabilities, giving particular attention to individuals among this population who develop mental health problems. Third, it will consider some key challenges that may lie ahead if the recently stated policy objectives are to be realised.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 1
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 1 March 1984

RONALD W. MANDERSCHEID

The U.S. mental health service delivery system consists of a broad array of inpatient and ambulatory services operated under governmental, corporate, nonprofit, and…

Abstract

The U.S. mental health service delivery system consists of a broad array of inpatient and ambulatory services operated under governmental, corporate, nonprofit, and entrepreneurial auspices. Granted this complex mixture of control patterns, a primary question to be addressed by this paper is the degree to which this set of services can be conceptualized as a system at any level of social organization beyond a single control point for a subset of services. This paper will also explore the utility of systems formulations, including cybernetic processes, for addressing the question of whether mental health services can be controlled and directed to such a degree that they act in concert across different control points. Reference will be made to exogenous systems, such as public and private reimbursement programs, that may influence control processes. Some directions for future research will also be explored.

Details

Kybernetes, vol. 13 no. 3
Type: Research Article
ISSN: 0368-492X

Article
Publication date: 2 March 2012

Ashok Roy and Sabyasachi Bhaumik

Needs led person centred services are the hallmark of high quality intellectual disability services. Commissioning mechanisms such as Payment by Results (PbR) have been…

Abstract

Purpose

Needs led person centred services are the hallmark of high quality intellectual disability services. Commissioning mechanisms such as Payment by Results (PbR) have been established in acute health services. An outcome focussed version of PbR will be implemented nationally from 2012 in an incremental manner in mental health services for adults and older people. Though intellectual disability services are currently excluded, it is proposed that needs led approaches would improve the quality and efficiency of specialist intellectual disability services. This paper aims to suggest that this approach could be the key to commissioning and designing personalised pathways of care.

Design/methodology/approach

Health needs are scoped and care pathways are defined as primarily consisting of Needs, Interventions and Outcomes. The mandated cluster groups to be used for PbR in adult mental health and older people's services are extended to cover the non overlapping needs of people with intellectual disability to provide an integrated framework of health needs usually met by specialist services. A framework of interventions is suggested and components of “assessment” and “therapeutic” activities are outlined. An outcome framework is described. A case example illustrates the application of these components to design a care pathway to provide a personalised, needs led service.

Findings

It is possible to use the principles underlying PbR to commission personalised services of high quality, improved efficiency and thus greater value.

Originality/value

The principles underlying PbR can be used to commission personalised pathways of care in intellectual disability services at a time when this approach is being extended to mental health services nationally.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 6 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 1 September 2007

Raghu Raghavan and Fozia Waseem

Children and young people with learning disabilities and mental health problems from black and minority ethnic communities face barriers in accessing services. This paper…

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Abstract

Children and young people with learning disabilities and mental health problems from black and minority ethnic communities face barriers in accessing services. This paper describes a mapping of services used by young people with learning disabilities and mental health problems from Pakistani and Bangladeshi communities. Overall the participants accessed primary health care services through their GPs, had contact with Social Services for support and benefits and the voluntary sector for culturally appropriate services. Most participants did not access statutory child or adult mental health services, or professionals such as psychologists or behaviour nurse specialists. Families reported key barriers such as lack of awareness of services, language difficulties in communication and lack of culturally sensitive services.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 3
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 1 November 2005

Hannah Cinamon and Richard Bradshaw

In the last four years health services in public sector prisons in England have undergone a period of rapid reform and modernisation. Before this, prisoners' health care was…

Abstract

In the last four years health services in public sector prisons in England have undergone a period of rapid reform and modernisation. Before this, prisoners' health care was characterised by over‐medicalisation, isolation from the NHS, and lack of education and training for health care staff. As part of this process of reform, responsibility for funding and commissioning these services has moved from the Prison Service to the National Health Service (NHS). The results so far seem encouraging. Services are better funded, standards have improved and there is significant progress in developing a strong partnership between the key partners ‐ the Prison Service and the NHS ‐ at national and local levels. These reforms address human rights and the aim of the Prison Health Unit, that prisoners should be able to expect their health needs to be met adequately by services that are broadly equivalent to services on offer in the community. Some learning points for other countries are considered. An equivalent strategy for the modernisation of public sector prisons in Wales is being developed by the Welsh Assembly Government.

Details

The British Journal of Forensic Practice, vol. 7 no. 4
Type: Research Article
ISSN: 1463-6646

Keywords

Article
Publication date: 1 April 2000

Janice Robinson and Siân Griffiths

New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement…

Abstract

New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement, social exclusion and regeneration. Early signs of synergy indicate that social services have a key role to play in shaping the public health agenda and in acting as a bridge between the NHS and the wider local authority.

Details

Journal of Integrated Care, vol. 8 no. 2
Type: Research Article
ISSN: 1476-9018

Article
Publication date: 1 April 1999

Geraldine Holt and Theresa Joyce

Changes have occurred in the pattern of services for people with learning disabilities and mental illness and/or challenging behaviour over recent years, with the development of a…

Abstract

Changes have occurred in the pattern of services for people with learning disabilities and mental illness and/or challenging behaviour over recent years, with the development of a variety of service models across the UK. In SE London, residential services are based predominantly on a supported housing model and the strong philosophical premise that people should not be excluded from a community residential service because they have complex physical, behavioural or mental health needs. Local services, therefore, are supporting individuals with a wide range of need. This paper describes the development of specialist mental health and challenging needs services in support of this model. The issues raised are outlined, together with a list for action and priorities to overcome the difficulties encountered, including the maintenance of an effective infrastructure.

Details

Tizard Learning Disability Review, vol. 4 no. 2
Type: Research Article
ISSN: 1359-5474

Article
Publication date: 1 October 1996

Andrew Rust

This Case Study gives an account of the factors that led up to the joint commissioning unit (JCU) within the health and social services scene in Shropshire; analyses the concept…

Abstract

This Case Study gives an account of the factors that led up to the joint commissioning unit (JCU) within the health and social services scene in Shropshire; analyses the concept of strategic joint commissioning; and describes the role of the JCU and how it works.

Details

Journal of Integrated Care, vol. 4 no. 5
Type: Research Article
ISSN: 1476-9018

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