MENTAL HEALTH COMMISSION

 

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GENERAL NOTE

This part of the website contains papers and presentations which Commissioners have written or given in an individual capacity. Any views expressed are those of the authors, and they should not be taken to express Commission policy.                                                                                                                    

 
 

OFFICIAL REPORTS AND PUBLICATIONS

  

 

Independent Review of Health and Social Services Care in Northern Ireland (Appleby Report)

Northern Ireland's health and social care services would benefit both from large increases in spending and tougher incentives to improve efficiency, according to an independent study published on 31 August 2005.

The Appleby report which was commissioned in December 2004 by the Northern Ireland Department of Finance and Personnel and carried out by King's Fund Chief Economist Prof John Appleby, highlights three areas where improvements could be made:

·         A real increase in spending from £2.7 billion in 2002/3 to £6 billion by 2022/23 to take into account growing needs for health and social care in Northern Ireland

·         Efficiency improvements to reduce the performance gap between Northern Ireland and the UK as a whole especially in the following areas - waiting times, drug costs, and costs for hospital operations.

Ministers should consider incentives being used in the English NHS such as introducing greater patient choice, hospital payment systems tied to the work they do and devolving some purchasing to General Practitioners.

 

A Strategic Framework for Adult Mental Health Services, Bamford Review (June 2005)

 

This first report from the Bamford Review set out a vision for adult mental health services for the next 15 to 20 years. June 2005.

267 pages. Pdf format.

 
 

 

LAW

  

 

Connecting Mental Health and Human Rights, Davidson et al., NIHRC (2003)

Authors: Gavin Davidson, Maura McCallion and Michael Potter.

Northern Ireland Human Rights Commission, December 2003.

An excellent review of human rights issues involved in mental health law, policy and practice in Northern Ireland. (Pdf format).

 

 

MEDICINE, PSYCHIATRY, PSYCHOLOGY & NURSING

  

Costing the hospital-based process of resettling people with learning disability in the community, Hughes et al., Irish Journal of Psychological Medicine (2003)

Authors: Damien Hughes, Maria McGinnity, John Kell, Oscar Donnelly, Michael Donnelly.

Irish Journal of Psychological Medicine, June 2003, Vol 20 No 2: 41-44.

The study describes and costs the input provided by a hospital based multi-disciplinary team into the resettlement of adults with learning disabilities from long stay wards in Muckamore Abbey Hospital in Northern Ireland between 1996 and 1999.

Approximately 55% of people resettled in the community during the study period did so with a modest degree of input from hospital staff. For 18% resettlement proved to be a demanding and prolonged process, requiring intensive input from hospital staff. Financial costs of the resettlement process ranged from approximately £1,500 to £8,000, with an average of £3,400 for each person.

 

Psychiatric services in Ireland: North and South, Webb et al., Irish Journal of Psychological Medicine (2002)

 

Authors: Marcus Webb, Roy McClelland, Glenda Mock.

Irish Journal of Psychological Medicine, March 2002;Vol 19 No 1: 21 - 26.

A descriptive account of mental illness services in Ireland, North and South, over recent decades. The article refers to policies, development and operation of the services, with figures relating to hospital admissions, human resources and costs in Northern Ireland and the Republic of Ireland. The paper points to the need for more detailed comparisons, which would require more rigorous, systematic health services research.

 

 

 

SOCIAL WORK

  

Mental Health Social Work and the Troubles in Northern Ireland: A study of practitioner experiences, Campbell & McCrystal, Journal of Social Work (2005)

Authors: Campbell J. and McCrystal P.

Journal of Social Work (2005), 173-190. Sage Publications.

During the last decade increasing attention has been paid to the impact of the Troubles on social work in Northern Ireland. In this paper, the authors describe the first survey used to test some of the assumptions which exist in the literature.

The findings reveal a workforce with complex religious and national identities and many of the respondents have experienced relatively high levels of troubles-related incidents whilst carrying out their duties in a variety of organizational and geographical settings. High proportions of respondents received minimal agency support and training to equip them to deal with Troubles-related problems faced by them during this period.

The authors conclude that the profession and employing agencies should pay greater attention to past and present effects of the troubles on social work practice and develop appropriate strategies for supporting, training and resourcing staff in this neglected area.

Dilemmas in the Case Manager's Role: Implementing Involuntary Treatment in the Community, Brophy et al., Psychiatry, Psychology and the Law (2003)

Authors: Brophy, L., Campbell, J. and Healy, B.

Psychiatry, Psychology and the Law (2003) 10 (1), 154-163.  Australian Academic Press.

Frontline non-medical practitioners in mental health services are frequently working as case managers with involuntary clients in the community who are subject to community treatment orders (CTOs). In this work they often experience tensions between the various legal and organisational expectations of their role, their professional orientation and wider understandings of social justice and consumer rights. This paper reviews literature on the purpose and efficacy of CTOs before discussing the current, limited role of the case manager within the Mental Health Review Board (MHRB) process in Victoria. In the concluding sections, it is argued that a more involved function for the case manager may enhance the decision-making process of mental health review tribunals.

Co-authored by a leading Northern Irish academic.

 

The Experience and Practice of Approved Social Workers in Northern Ireland, Manktelow et al., British Journal of Social Work (2002)

 

Authors: Manktelow R.; Hughes P.; Britton F.; Campbell J.; Hamilton B.; Wilson G.

British Journal of Social Work, Vol. 32, Number 4, June 2002, pp. 443-461(19). Oxford University Press.

This article reports on the first extensive survey of Approved Social Worker (ASW) activity under the Mental Health (Northern Ireland) Order 1986.

The study revealed that two-thirds of ASWs had experience of acting as an applicant in compulsory hospital admission during the past two years. Nearly half (42 per cent) of these ASWs had reported experience of between one and five admissions and one-tenth had completed over twenty admissions in the two-year period. In only a small minority of cases did joint face-to-face assessment with the General Practitioner (doctor) take place; nearly half of ASWs reported difficulties in obtaining transport; and only one-fifth of ASWs had experience of acting as a second approved social worker. Half of ASWs reported experience of guardianship, either as applicant or in making the recommendation. Both service users and carers reported a lack of understanding about the role of the ASW and complained about the lack of alternative resources that ASWs could use to prevent hospital admissions. These findings are discussed and a number of recommendations are proposed for improvements to approved social worker practice.