Mental health services

Background: NHS Direct is a new service that offers 24-hour advice from trained nurses. The National Service Framework for Mental Health and the National Strategy for Carers both mention NHS Direct as an important source of support for people with mental health problems. Aims: This paper reports findings from an evaluation of the Department of Health's NHS Direct mental health initiative.

The economic and social burden of dementia on society is the value of all the resources used to prevent, diagnose, treat, and generally cope with the illness. This article assess the overall resource implications of dementia in Ireland. Six main areas are covered in the cost analysis as follows: mortality and life years lost, in-patient acute care, in-patient psychiatric care, residential long-stay care, family care, and primary and social care in the community.

Specialist mental health services for older people have grown rapidly and successfully over the past two decades, aiming to offer services that are comprehensive, accessible, responsive, individualised, multidisciplinary, accountable, and systematic. As with all mental health problems, the burden falls on primary care (where minor morbidity often goes undetected) and specialist services tend to be reserved for those conditions and patients where diagnosis and management is problematic.

This article describes how Thurrock Council Social Services Department and South Essex Mental Health and Community Care NHS Trust launched a joint initiative to develop an integrated service strategy and implementation plan for older people's mental health services in Thurrock. The main principles of the approach were: service user and carer involvement, the active participation of mental health professionals working directly with service users and carers, representatives from all key agencies involved in the planning process.

This paper reports on a qualitative study analyzing service-user (SU) and carer perspectives on medication compliance and their experience of compulsory treatment. Eleven SUs and eight carers were interviewed. The research is set against the background of changes to mental health legislation in England, in the form of Supervised Community Treatment. This signals a change in community mental health practice and urges a reconsideration of concepts such as compliance, concordance and coercion.

Argues why the nearest relative role has important lessons for the roles of the nominated person and carer which will replace it in the next Mental Health Act.

Background: Patients with severe and enduring mental health problems are increasingly being cared for in the community. Whilst community services continue to develop it is recognized that family members and friends play an important role in the care process.

Aims: (i) to assess the level of service use and associated costs of carers, (ii) to compare service use to that pertaining in the general population, and (iii) to identify carer characteristics that are predictive of cost variations.

User or carer involvement is often seen as intrinsically worth while; but if such involvement is a good thing in itself, it would not matter whether changes resulted from it. However, most people argue for user or carer involvement because they think some useful change will follow as a consequence. Being involved can benefit users or carers both personally (for example, by empowering them or increasing their social contacts) and practically (for example, by enabling them to earn money or learn new skills).

Background: The prevention of suicide is a key aim for health care authorities and society in general and family members have a principal role in caring for suicidal people. However, the support needs of these essential family carers are relatively unknown. Aim: To explore the support needs of family members of suicidal people. Method: Eighteen participants were interviewed using a short topic guide. Transcripts were analysed using thematic analysis and confirmed by discussion. Findings: Family members of suicidal people have unmet needs (this was the main theme).

NHS teams should also make carers aware of statutory right to social services assessment and explain process. [Journal abstract]