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1 – 10 of over 1000Matt Fossey, Lauren Godier-McBard, Elspeth A. Guthrie, Jenny Hewison, Peter Trigwell, Chris J. Smith and Allan O. House
The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared…
Abstract
Purpose
The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals.
Design/methodology/approach
Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98).
Findings
Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern.
Research limitations/implications
There were a small number of survey respondents (n = 98). The sampling used an opportunistic framework that targeted commissioner and clinician forums. Using an opportunistic framework, the sample may not be representative. Additionally, multiple pairwise comparisons were conducted during the analysis of the survey responses, increasing the risk that significant results were found by chance.
Practical implications
A number of steps were identified that could be applied in practice. These mainly related to the importance of collecting and communicating data and co-production with commissioners in the design, development and monitoring of liaison psychiatry services.
Originality/value
This is the first study that has specifically considered the challenges associated with the commissioning of liaison psychiatry services.
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Gary Lamph and Claire Bullen-Foster
This paper aims to provide an insight into the design, development and delivery proposals for a first of its kind “Liaison Mental Health Training Programme”. In the UK, there has…
Abstract
Purpose
This paper aims to provide an insight into the design, development and delivery proposals for a first of its kind “Liaison Mental Health Training Programme”. In the UK, there has been a significant investment in Liaison Mental Health Services and an expansion of the workforce (NHS England, 2016). However, the complexity and varied presentations of patients who attend to acute physical health services now requires a dedicated strategy to address any skills deficit in the mental health liaison workforce and to support core competency development (DOH, 2016).
Design/methodology/approach
This paper provides an overview of preparations to develop a regional educational pilot programme using a three-phased model: Phase 1 – Review of policy and best practice guidelines; Phase 2 – Stakeholder Data Collection; and Phase 3 – Synthesis and Development.
Findings
An insight into the developmental processes undertaken to shape a core competency liaison mental health training programme is presented. Additionally, the authors provide insight into educational theory and an overview of the LMH Core Competency Curricula.
Practical implications
This paper provides the reader with an insight into our findings and a focussed core competency training model for those working within LMH services. This programme development was reviewed throughout by both those using LMH services and the LMH practitioners working within them, ensuring the curriculum proposed was endorsed by key stakeholders. The three-phased model has transferable benefits to other training development initiatives.
Originality/value
To the best of the authors’ knowledge, this training is the first of its kind in the UK and addresses the education of essential core competencies of a regional liaison mental health workforce. The collaboration of clinical and academic expertise and model of co-production makes this endeavour unique.
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This paper aims to give insight into the role of a liaison worker.
Abstract
Purpose
This paper aims to give insight into the role of a liaison worker.
Design/methodology/approach
This paper presents a first person account of someone in the role of Mental Health and Housing Liaison Officer.
Findings
The paper offers insight into a day in the life of a liaison worker, including information about how they work and communicate with clients and their various different situations.
Originality/value
The paper demonstrates that communication is central to delivering good and appropriate services for clients. Joint working between housing and mental health needs to become the norm, and a role such as this is the fore‐runner to what the author hopes will become part of every mental health service in the country.
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Nick Walsh, Tricia Handley and Ian Hall
The purpose of this paper is to address the serious problems that people with intellectual disability face in getting their healthcare needs met in general hospitals by improving…
Abstract
Purpose
The purpose of this paper is to address the serious problems that people with intellectual disability face in getting their healthcare needs met in general hospitals by improving the training of general hospital staff.
Design/methodology/approach
Review of recent developments in models of service provision including the development of intellectual disability liaison nurses and the RAID model in liaison psychiatry.
Findings
There is much scope for intellectual disability liaison nurses and liaison psychiatry services to work together in staff training in general hospitals. There is a clear strategic role for both services in convincing the management of general hospitals to implement such training using economic and quality arguments.
Originality/value
The authors suggest a new model of working to improve the healthcare outcomes of people with intellectual disabilities through effective training of staff in general hospitals.
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The purpose of this paper is to improve the health and criminal justice outcomes for people who come into contact with the criminal justice system. People with learning…
Abstract
Purpose
The purpose of this paper is to improve the health and criminal justice outcomes for people who come into contact with the criminal justice system. People with learning disabilities (LD) are particularly vulnerable to health and social inequalities within the criminal justice system.
Design/methodology/approach
Using examples from practice, this paper discusses some of the challenges and achievements experienced by a LD nurse employed within a liaison and diversion service within the North-West of England.
Findings
Whilst the specific functions of liaison and diversion practitioners are detailed by National Health Service (NHS) England (2014), complexities in communication, multi-disciplinary working and role recognition affect the embedment of the role in practice.
Research limitations/implications
The implications for practice are identified and recommendations for further research made. These seek to evaluate the impact of liaison and diversion services from the perspectives of LD nurses within liaison and diversion services, people with LD, their families and the wider multi-disciplinary team.
Originality/value
NHS England (2015) are in the process of evaluating of liaison and diversion services. This paper adds to the evaluation by discussing the experiences of a LD nurse within a liaison and diversion service through the inclusion of activity data and illustrative examples.
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Ian Cummins and David Edmondson
In his recent report, Lord Adebowale (2013) described mental health issues as “core police business”. The recent retrenchment in mental health and wider public services mean that…
Abstract
Purpose
In his recent report, Lord Adebowale (2013) described mental health issues as “core police business”. The recent retrenchment in mental health and wider public services mean that the demands on the police in this area are likely to increase. Mental health triage is a concept that has been adapted from general and mental health nursing for use in a policing context. The overall aim of triage is to ensure more effective health outcomes and the more effective use of resources. The purpose of this paper is to examine the current policy and practice in this area. It then goes on to explore the models of mental health triage that have been developed to try and improve working between mental health services and the police.
Design/methodology/approach
The paper outlines the main themes in the research literature regarding mental illness and policing, including a brief overview of section 136 MHA. It then examines recently developed models of triage as applied in these settings.
Findings
The models of triage that have been examined here have developed in response to local organisational, demographic and other factors. The approaches have two key features – the improved training for officers and improved liaison with mental health services.
Practical implications
Wider mental health training for officers and improved liaison with community-based services are the key to improving police contacts.
Social implications
The current pressure on mental health services has increased the role that the police have in responding to these sorts of emergencies. This situation is unlikely to change in the short term.
Originality/value
This paper contributes to the wider debate about policing and mental illness. It highlights the fact that section 136 MHA use has tended to dominate debates in this area to the detriment of a broader discussion of the police role.
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Sally Ashton and Christine Carter
Older people (those aged over 65) occupy a significant proportion of hospital beds, with many suffering from depression, delirium, dementia, anxiety and other conditions. The…
Abstract
Older people (those aged over 65) occupy a significant proportion of hospital beds, with many suffering from depression, delirium, dementia, anxiety and other conditions. The mainstreaming of mental health liaison teams within general hospitals is therefore to be welcomed. Sally Ashton and Christine Carter explain that the journey towards productive collaboration can take time, but the results are worth it.
Chrispen Madondo and Marc Van der Putten
The purpose of this study was to describe programs that aim at programs to divert people with a mental condition from the criminal justice system to mental health services are…
Abstract
Purpose
The purpose of this study was to describe programs that aim at programs to divert people with a mental condition from the criminal justice system to mental health services are being initiated, but reporting is limited and fragmented. This study described programs that aim at diverting persons with mental health conditions out of criminal justice systems to community mental health services, with the intention to inform research and practice.
Design/methodology/approach
A scoping review was used to map and synthesise diversion programs. Ten online data bases were searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used to direct the selection of sources. Research and evaluation publications and grey literature published from 2010 to 2021 in English language were included.
Findings
Eight distinct diversion programs were identified across 24 countries or territories covering five phases of the criminal justice process. Diversion programs included crisis intervention teams, the electronic linkage system, mobile crisis units, the criminal justice liaison program, problem-solving courts, the abstinence-based program, the community equivalence program and the forensic assertive community treatment program. Although distinct programs have the potential to form a system of diversion across the continuum of the criminal justice process, only two territories moved in that direction. Diversion programs reported overwhelmingly originated from high-income countries.
Practical implications
Stigma that labels people with mental health conditions as violent and dangerous need to be addressed. It is important to place diversion systems on national policy agendas and advocate for evidence-based interventions.
Originality/value
The study provides a blueprint on diversion systems to set a research agenda and develop a road map, tailored towards local contexts.
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Waqqas Khokhar, Katherine Williams, Oluwagbenga Odeyemi, Tracy Clarke, Catharine Tarrant and Andrew Clifton
Excess morbidity in people with enduring mental illness is well known. The promotion of healthier lifestyles and physical health monitoring has started to receive more attention…
Abstract
Excess morbidity in people with enduring mental illness is well known. The promotion of healthier lifestyles and physical health monitoring has started to receive more attention in recent years. Despite this, the British Society for Disability and Oral Health (BSDH) has highlighted extensive unmet needs for inpatients with mental illness who have poor levels of oral health and hygiene compounded by restricted access to dental services. An audit cycle of oral health and hygiene was completed at Heather Close Recovery Unit (HCRU), Mansfield in 2009 and 2010, with the aims to improve the oral healthcare of the patients at HCRU and to develop the multidisciplinary team's ability to promote, monitor and enable patients to look after their dental health. A total of 59 people were helped to fill in the questionnaire during two audit runs. Improvement in access to toothbrushes increased from 68% to 86%. There is also an improvement in knowledge of basic oral hygiene practice from 55% to 61%. The ideally recommended practice of brushing teeth twice daily increased from 29% to 38% in our patients. There was a little improvement in the number of patients registered with the dentist since the last audit. We believe that prevention and early intervention are keys to addressing dental health problems in psychiatric patients. The improvement in oral/dental healthcare of patients with chronic mental illness should be seen as part of the holistic recovery package. Effective liaison with community preventive dentistry teams can play a vital role in educating mental health practitioners and patients.
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