Centre for Mental Health

A study published in the British Journal of Psychiatry has shown there has been an 11.5% reduction in average levels of discrimination. The study of England’s Time to Change anti-stigma programme provides the first evidence that it is possible to change the way the public treat people with mental health problems, but that a long term focus is needed to ensure that discrimination is removed from all areas of people’s lives.

The study found that discrimination when getting and keeping a job decreased significantly between 2008 and 2010, and a survey of employers shows improved knowledge of common mental health problems and more policies in place to support people with mental health problems in the workplace in 2010 compared to 2006. Read more on the Time to Change website.

The Joint Commissioning Panel for Mental Health (JCP-MH) has launched commissioning guides for perinatal mental health services, rehabilitation services and public mental health services.

The JCP-MH is a collaboration between 17 leading organisations. It will publish 18 guides for commissioners by June 2013.

In May 2012, the Armed Forces Partnership hosted a user-led event focusing on injured veterans’ healthcare needs and experiences, and those of their families. This brought together veterans with those responsible for the commissioning and provision of their health and care services, with the aim of placing veterans’ voices at the heart of the design of health and social care services. Read the report here.

The Youth Justice System is currently failing children in care and care leavers and there should be more effort to prevent the unnecessary criminalisation of these vulnerable young people, the Justice Committee has concluded. It makes a series of recommendations including:
-A statutory threshold to enshrine in legislation the principle that only the most serious and prolific young offenders should be placed in custody;
-Devolving the custody budget to enable local authorities to invest in effective alternatives to custody; and
-More action to reduce the number of young people who breach the terms of their community sentences and the number of young black men in custody.

Read more here

A new report Violence against People with Disability in England and Wales: Findings from a National Cross-Sectional Survey, finds that people with disability are at increased risk of being victims of domestic and non-domestic violence, and of suffering mental ill health when victimized. The authors say: "The related public health and economic burden calls for an urgent assessment of the causes of this violence, and national policies on violence prevention in this vulnerable group." Read more here.

The NICE guideline on common mental disorders (PDF) was published back in May 2011, which means that it only included evidence published up until the end of 2010. This is a fast moving field, so NICE have now put out an evidence update, which focuses on new evidence published from Sept 2010 to Oct 2012.

The Mental Elf blog concludes that this update does not highlight any important new evidence that will impact on the recommendations in the current NICE guidance, but it does flag up some high quality research that managers, commissioners and health professionals may like to look at in more detail.

Read more on the Mental Elf blog here.

Mortality among mental health service users aged 19 and over in England was 3.6 times the rate of the general population in 2010/11, according to Health and Social Care Information Centre (HSCIC) figures released this week.

People in contact with specialist mental health services had a higher death rate for most causes of death, especially mental and behavioural disorders and diseases of the nervous system such as Alzheimer's disease

However a much higher level of mortality (considering people between the ages of 19 and 74) also occurred for lifestyle - related diseases, including:

-Nearly four times the general population rate of deaths from diseases of the respiratory system (at 142.2 per 100,000 service users, compared with 37.3 per 100,000 in the general population).

-Just over four times the general population rate of deaths from diseases of the digestive system (at 126.1 per 100,000, compared with 28.5 per 100,000 in the general population).

-2.5 times the general population rate of deaths from diseases of the circulatory system (at 254.0 per 100,000 compared with 101.1 per 100,000 in the general population).

Read more on the NHS Information Centre website here

The Department of Health has published the fifth annual report on the Independent Mental Capacity Advocacy (IMCA) service which also provides an overview of the last five years.

It provides statistical information on the continued increase in referrals to this statutory advocacy service and makes recommends to clinical commissioning groups and local authorities about its use for those who lack capacity.

The Mental Capacity Act 2005 created this service to empower and safeguard people who do not have the capacity to make certain important decisions. The Act also introduced a legal duty on NHS bodies and local authorities to refer eligible people towards the IMCA service and consider their views.

The role of the IMCA is to represent and support people when critical decisions are going to be made on their behalf about provision of health or social care services. This is vital where someone is unable to make decisions themselves and do not have family or friends who could represent them.

During the fifth year there was a 9% increase in referrals from the previous year. The numbers have more than doubled in five years.

Download the report here.

The Department for Education and The Early Intervention Foundation Consortium have signed a contract which will see the creation of an independent Early Intervention Foundation (EIF) – one of the key recommendations of Graham Allen’s Early Intervention report.

The Foundation is being set up by a consortium of organisations which includes 4Children, The Local Government Association and Achievement for All 3As. The organisations will support the new Foundation in its infancy before handing over responsibility to the Foundation’s trustees and management once it is established as a charity in its own right, in the summer.

The annual figures from the Youth Justice Board have been released in Youth Justice Statistics 2011/12. The report shows that the number of children entering the criminal justice system for the first time is falling but that there has been a 17 per cent rise in the number of times restraint was used against children aged 10 to 17 in custody in England and Wales.

Alistair Campbell has written a new blog for the King's Fund website: A better future for mental health care: acceptance, choice and dignity, as an ambassador for Time to Change.

Fitness for work: the Government response to ‘Health at work – an independent review of sickness absence’ is the Government's response to the independent review of the sickness absence system by Dame Carol Black.

The report highlights the support that healthcare professionals and GPs in particular, require in helping individuals back to work and supports the recommendations of the review that fit note guidance is in need of revision and GP knowledge and awareness of the benefit system requires improvement. Download the report here.

The Second Reading of the Mental Health (Discrimination) (No. 2) Bill took place in the House of Lords on 18 January 2013. You can read the transcript of the debate on TheyWorkForYou.com here.

The IAPT programme to increase the availability of psychological treatments for depression and anxiety disorders within NHS services in England has completed its first three years. This report details the origins of the programme and highlights progress and successes after the first three full financial years of roll-out. It also outlines future requirements, particularly in meeting the financial commitments to 2015 and political commitments, together with plans to meet them.

Understanding how the market in mental health works is critical – both for the development of future and the implementation of current policy. Ensuring clinical commissioning groups (CCGs) have a clear understanding of the way in which the market currently operates in the mental health sector will be central to developing effective commissioning arrangements.

The Department of Health commissioned the NHS Confederation’s Mental Health Network and Mental Health Strategies to produce an analysis of the current landscape for mental health service provision in England.

The QIPP collection on NHS Evidence is a resource to share examples of successful good ideas with colleagues in the NHS. There are now more than 120 examples of best practice quality and productivity examples available that have the potential to save the NHS over £1.9 billion.

Visit the QIPP collection to find examples of best practice or to submit an example.

The Strategy "Together for Mental Health" sets out the Welsh Government's vision for 21st century mental health services and is the first mental health and wellbeing strategy for Wales covering people of all ages. The Strategy reinforces the legal framework put in place by the Mental Health Measure and its accompanying Regulations and Codes of Practice.

The Delivery Plan sets out a three-year programme of improvement, cranking up the progress required for service delivery. Download the Strategy and the Delivery Plan here.

The CJA has produced a short briefing paper for Police and Crime Commissioners covering subjects across the criminal justice system including re-offending, resettlement and restorative justice. It discusses mental health in the criminal justice system and calls on the new commissioners to act as champions for liaison and diversion services. Download a copy here.

This research is the first national study dedicated to examining the psychological health and wellbeing of Jobseeker’s Allowance (JSA) claimants.

People who started a JSA claim in the first quarter of 2011 had worse mental health than people of working age in the population as a whole. After standardising the JSA claimant cohort to the age and sex profile of the general population, 14.7 per cent were found to have a level of symptoms almost certain to warrant treatment. This is nearly twice the rate for the general population (8.5 per cent).More than a fifth (22.6 per cent) of the cohort had a CMD like anxiety or depression. In the months after a claim commenced the average mental health of men in this cohort remained poor, while that of women improved. Read more on the DWP website here.

This paper by Vihdya Alakeson is part of a broader programme of work with PCT clusters in the north west of England to help support them for roll out of personal health budgets in 2014. It draws on the learning of pilot sites in the region and nationally to outline the 10 features of an effective personal health budget process within NHS continuing healthcare.

Participants in the latest survey of community mental health services said they are treated with dignity and respect by the health or social care worker they had seen most recently. However, some would have liked more support in getting help with aspects of day-to-day living.

The vast majority of participants said that they:

• were treated with respect and dignity, were listened to carefully and had trust and confidence in the health or social care worker they had seen most recently.
• could ‘always’ contact their care co-ordinator/lead professional if they had a problem and that their care co-ordinator/lead professional organised their care and services ‘very well’.

However, over a third of participants who had physical health needs said that they would have liked more support from a member of staff at their mental health service but didn’t get it.

The survey results also suggest that a considerable proportion of respondents who needed help would have liked more support in some aspects of day-to-day living such as:

• caring responsibilities.
• finding or keeping work.
• finding or keeping their accommodation.
• financial advice or benefits.

The Department of Health has launched a new cross-government strategy ‘Preventing suicide in England’. This all-age suicide prevention strategy builds on the 2002 strategy. Progress has been made in reducing the already relatively low suicide rate.

But there are new challenges to be addressed and at a time when we have economic pressures on the general population, it is particularly timely to revisit the approach we're taking.

The Mental Health Foundation, in collaboration with Hafal and Bipolar UK, has launched a new self-management booklet, Take Control, to ensure people with serious mental health problems are able to take more control of their lives.

The guide is a product of the highly successful self-management courses which ran throughout Wales and supports participants in setting goals for themselves and using their Care and Treatment Plan to achieve them. To date over 600 people with a long-term mental health diagnosis have been trained to utilise key skills and tools to look after themselves and help others.

This consultation is seeking views on options for distributing funding to local authorities for Independent Mental Health Advocate (IMHA) services and the Armed Forces’ compensation disregard.

From April 2013 the statutory duty and funding for commissioning IMHA services will transfer to local authorities. These services are currently commissioned by PCTs. Funding for these new local authority duties will be provided through a Department of Health grant. This consultation runs until 5pm on Friday 7 September 2012.

People between the ages of 18 and 74 inclusive with serious mental illness have a mortality rate three times higher than the general population, new data from the Health and Social Care Information Centre (HSCIC) show. This is the first time such figures have been calculated by linking mortality data to the Mental Health Minimum Dataset (MHMDS) – the dataset that contains record-level data about NHS services delivered to over one million people with serious mental health problems.

A new study from the University of Central Lancashire reveals that understanding the role of advocacy is critical to ensuring people get the support they need from mental health services.

The right to be heard looks at the quality of Independent Mental Health Advocacy (IMHA) services, used by people who have been detained under the Mental Health Act. It found that when people get access to these advocacy services they really appreciate them but there are specific problems for access for black and minority ethnic communities, and older people.

The Mental Elf reports how a new health atlas reveals the variations in social care spending on mental health services across England. The report, from Health Mandate, shows that while mental health spending accounts for over 10% of the health budget, local authorities allocate just 4% of additional social care funding from PCTs to mental health services. Visit The Mental Elf for further information.

Following 39 clients, the results show statistically significant increases in individual wellbeing and provide important information on how the shape and cost of wider service use changes as people engage with coordinated interventions.

In two of the three pilot areas there was a reduction in costs to the criminal justice system. In Cambridgeshire this reduction was large enough to offset the other costs incurred as people got the help they needed, resulting in an overall cost reduction. The total cost of service use in the first year increased in the other two areas.

Download the full evaluation.

Clinical commissioning groups and local authorities must ensure that they uphold the rights of people detained under the Mental Health Act as they take up new responsibilities, according to a report published today by the Mental Health Alliance.

A new report from New Philanthropy Capital, Troubled Families, highlights three areas where additional funding is needed to support families: early intervention, long-term support for the most vulnerable, and support for parents with mental health problems. It also highlights effective interventions in each of these areas.

The Department of Health has published the third edition of its Long Term Conditions Compendium, which includes a chapter on longterm conditions and mental health and unexplained symptoms.

The General Social Care Council (GSCC) has launched a research report, Targeted inspections of Approved Mental Health Professionals (AMHP) courses in England (2011-12). The inspections were Undertaken between March 2011 to February 2012 and covering all 22 approved courses in England, the inspections ensure that providers continue to meet regulatory requirements and produce graduates who are competent to be appointed and undertake the AMHP role.

This clinical guideline offers evidence-based advice on the care and treatment of adults who have common mental health disorders, with a particular focus on primary care. It brings together advice from existing guidelines and combines it with new recommendations on access to care, assessment and developing local care pathways for common mental health disorders. Common mental health disorders include depression, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, post‑traumatic stress disorder and social anxiety disorder. Download the guidelines as a word document or as a PDF from the NICE website.

A new report, commissioned by the Department of Health, presents views from leaders (working as NHS commissioners, providers of NHS services and from local authorities) on the barriers that prevent improvements in access, experience and outcomes for black and minority ethnic (BME) service users.

NICE has published an update on its 2010 Guidance on Delirium, Delirium: diagnosis, prevention and management, which highlights new research, including the potential benefits of introducing a risk assessment tool. Around 20% of people on medical wards in hospital are affected by delirium.

The Social Care Institute for Excellence has published a briefing that offers an overview of the different models of working between health and social care services at the strategic, commissioning and operational level.

The health system in the UK is struggling to care for the rising number of people who have two or more chronic illnesses, argues the authors of a study published in The Lancet this week. The authors propose that generalist clinicians who "can oversee all the problems" and provide personalised care would better serve people with multiple conditions.

In a new report, Out of trouble: Families with complex problems, a guide for funders, New Philanthropy Capital highlights the cost of troubled families. Estimating that the 120,000 most troubled families cost society up to £9bn every year, NPC argues that early intervention is key and that services should be provided before problems are entrenched.

The Department of Health is working with other government departments to develop a strategy on long term conditions and is inviting comments via a new long term conditions website, where you can have your say.

This report by the think tank Civitas focuses on the evidence base for what works in drug rehabilitation, with a particular focus on criminal justice issues. It concludes that the evidence does not conclusively support one particular treatment, but suggests that a diverse range of quality treatments are necessary.

The report recognises that it is only in a few cases where drug addiction is the primary motivator for crime and that in most cases successful interventions must address multiple needs, including those relating to mental health, housing or access to employment or training. Read the report here.

The National Institute for Health and Clinical Excellence has published an evidence update to its guidelines, Depression in adults with a chronic physical health problem.

This briefing paper sets out the policy context around tackling homelessness and addressing the mental health needs of homeless people. It also examines what considerations need to be made when planning, designing and delivering mental health services for homeless people and highlights examples of good practice.

Researchers at the University of Toronto have reviewed the psychosocial and pharmacologic treatment of depression in patients with cancer, reports The mental elf. While depression is at least three times as common in patients with cancer compared to the rest of the population, it was found that there is insufficient evidence to recommend first line treatment for depression for cancer patients.

This strategy sets out Government proposals to cut down alcohol fuelled violence and disorder and reduce the number of people drinking to damaging levels. It includes commitments to introduce a minimum unit price for alcohol; consult on a ban on the sale of multi-buy alcohol discounting; introduce stronger powers for local areas to control the density of licensed premises; and pilot sobriety schemes to challenge alcohol-related offending. View the strategy on the Home Office website here.

The Department of Health has published its final report of an evaluation of the youth justice liaison and diversion pilot scheme. The report notes that there was universal support for making diversion a more systematic or compulsory element within police practice, and makes 11 eleven policy, practice and research recommendations, including integrating diversion scheme with existing services.

The Royal College of Psychiatrists has published four guides to help current and future commissioners plan and deliver high quality mental health services. The guides describe what good quality, modern mental health services should look like and bring together scientific evidence, patient and carer experience and viewpoints, and examples of best practice.

• Guidance for commissioners of primary mental health care services
• Guidance for commissioners of liaison mental health services to acute hospitals
• Guidance for commissioners of dementia services
• Guidance for commissioners of mental health services for young people making the transition from child and adolescent to adult services