- Testing the mental health components of existing vanguard sites must be a central part of the evaluation strategy for the new care models.
- Other local areas rolling out multispecialty community providers, primary and acute care systems and related care models should go further than the vanguard sites in four key areas:
- complex needs: enabling local integrated care teams to draw on and incorporate mental health expertise to support people with complex care needs
- long-term care: equipping primary care teams to address the wide range of mental health needs in general practice (including among people presenting primarily with physical symptoms)
- urgent care: strengthening mental health support for people using A&E departments and other forms of emergency care
- whole-population health: placing greater emphasis on promoting positive mental wellbeing in the population, in particular among children and young people, and during and after pregnancy.
- All sustainability and transformation plans should set out ambitious but credible plans for improving mental health and integrating mental health into new models of care.
There are varied antecedents to mental ill-health and often family groups play a part in the genesis, often multi-point, and maintenance of emotional discomfort.
A problem regarding treatment is that people internalise family dynamics and they become played out in different situations- the recapitulation of the family group.Often, removing oneself from toxic social and family dynamic can help enormously and this would complement psychological therapies allowing a person to recognise triggers to anxiety and depression.
I don't think it is possible to standardise treatment and care. in mental health settings. Individualised care, but with an overarching philosophy, understood by all is probably a way forward.
Do away with hierarchies e.g. psychiatrists et al v nurses.Mental health care is often referred to as biopsychosocial. Maybe best thought of as social psychobio. Not of course in every instance but research suggests, treatment hasn't advanced.
However, career pathways for many prominent mental health professionals have, without any significant advancement in service provision.
Academia is often cloistered. the objectives can become blurred and so not necessarily the improvement of treatment and care but an increased research output. Similar to clinical settings where individual and group professional advancement is prioritised over the sensitive delivery of healthcare.
An important consideration is our conceptualisation of 'mental health' - that there are widely differing care needs for someone with severe and enduring psychosis who is also physically ill and requiring self-management support vs. a person who is experiencing psychological distress and difficulty coping with a physical health challenge.
Clinical health psychology would typically work within an acute and/or primary care setting whereas clinical psychology per se sits more within mental health and associated services. There is a need for psychological services across this continuum of health and social care need, with liaison with OT, physio, social work etc colleagues.
Vice Chair, Faculty for Clinical Health Psychology, British Psychological Society
Some Vaguards are doing well and some STPs are doing well but one swallow doesn't make summer! All NHS leaders must be good, kind, caring and compassionate and with courage!
Sadly courage is something missing in NHS because of culture of bullying, harassment, victimisation and club culture and old boys network. In such a culture patients, staff and NHS suffer! When NHS suffers the nation suffers! This is Brexit!
Please wake up and let us transform Health and social care and let us get leadership, accountability, integration, workforce planning, governance, staff and patient engagement right and let us make the whole of NHS and social care safest and the best and the most vibrant in the world!
EXAMPLE: Living in Housing Association accommodation 'Supported Accommodation'?? subject to section 117 FREE aftercare??
Welfare Benefits:'Fit for Work' 45 questionnaire arrives to complete. (time scale) or ALL your Benefits will be withdrawn.
Welfare Benefits DLA/PIP another form: invited to interview by somebody with 'set questions' failure to 'turn up' NO AWARD.
MANY suffering from a 'severe mental illness' have become 'invisible to the system.
No Social Worker! despite Statutory Guidance 'Care Plan' at least once a year.
ACCOMMODATION; not able to keep the accommodation 'Habitable' .
RESULTS on the above.
HA takes 'severely Mentally Ill' to Court? why? No contact number with Social Services on this individuals file. FOUND GUILTY for NOT paying RENT, because their Welfare Benefits had 'STOPPED' because they were unable to complete a 45page Questionnaire. Housing Benefit 'STOPPED' paying their RENT.