1,721,073 research outputs found
Survival and its discontents: the case of British psychiatry
No full textSub-divisions of labour in health settings are common and medical dominance and encroachment from competitors are well known. This article considers this general picture but in specific relation to mental health work in Britain and its particular features of recent contestation. British psychiatric orthodoxy has faced challenges to its legitimacy for over a century. However, since the 1980s, in the wake of de-institutionalisation and a new shared service commitment to ‘recovery’, these challenges have taken new shape. They are explored by considering: the current ambit of mental health care; the sub-division of labour in specialist mental services; recent governmental expectations of the mental health workforce; and the contested legacy of theory and practice in mental health work. The conclusion is that the profession is not under immediate threat of collapse but that its fate may now rest on whether a biomedical or a biopsychosocial model of practice predominates in routine service deliver
Risk, trust and mental health services
No full textBackground: strictly “mental health” should, as its name suggests, be about health, yet there is now a global discourse about “mental health” which actually alludes mainly to the clinical, organizational and legal aspects of managing mental disorder. Indeed, “mental health” law deals with the conditions under which people diagnosed with mental disorder can be lawfully compelled to accept treatment. This paradoxical use of language requires further examination.Aims: the paper aims to problematize the taken for granted notion of “mental health services”.Method: it draws upon general sociological work on “risk” and “trust”. The trustworthiness of ordinary language accounts and professional codifications are considered before examining the sociological implications of the controversy about the abuse of psychiatry. The risks to and from patients in routine mental health work, and the betrayal of trust as both a normal part of care and its corruption in mental health work are outlined.Conclusions: the paper concludes that “mental health services” are a myth in as much as they are mostly concerned with mental disorder and control (at least to the bulk of identified patients which form the focus of their activity
Innovation in mental health services: what are the key components of success?
Full text linkBackground: Service development innovation in health technology and practice is viewed as a pressing need within the field of mental health yet is relatively poorly understood. Macro-level theories have been criticised for their limited explanatory power and they may not be appropriate for understanding local and fine-grained uncertainties of services and barriers to the sustainability of change. This study aimed to identify contextual influences inhibiting or promoting the acceptance and integration of innovations in mental health services in both National Health Service (NHS) and community settings. Methods: A comparative study using qualitative and case study data collection methods, including semi-structured interviews with key stakeholders and follow-up telephone interviews over a one-year period. The analysis was informed by learning organisation theory. Drawn from 11 mental health innovation projects within community, voluntary and NHS settings, 65 participants were recruited including service users, commissioners, health and non-health professionals, managers, and caregivers. The methods deployed in this evaluation focused on process-outcome links within and between the 11 projects. Results: Key barriers to innovation included resistance from corporate departments and middle management, complexity of the innovation, and the availability and access to resources on a prospective basis within the host organisation. The results informed the construction of a proposed model of innovation implementation within mental health services. The main components of which are context, process, and outcomes. Conclusions: The study produced a model of conducive and impeding factors drawn from the composite picture of 11 innovative mental health projects, and this is discussed in light of relevant literature. The model provides a rich agenda to consider for services wanting to innovate or adopt innovations from elsewhere. The evaluation suggested the importance of studying innovation with a focus on context, process, and outcomes. <br/
Health and social care diversity among individuals with longstanding physical and psychological health problems: Pooled repeated cross sectional analyses
No full textThis paper examines differences in health-and-social care utilisation for individuals with physical and/or mental health problems. Logistic regression models are used to determine disparity in the percentage of General Household/Lifestyle Survey participants with physical compared to mental health problems receiving disability benefits or health care services between 2000 and 2011. Our findings of a relative underutilisation of secondary health care combined with a relative overutilization of out-of-work benefits by individuals with mental health problems is novel to the field of rehabilitative health care. These results provide evidence for the previously suspected disparity in health care utilisation of individuals with mental health problems and indicate problems in labour force integration. The findings support the political call for a 'parity of esteem', which, in Britain, was enshrined in the Health and Social Care Act of 2012.</p
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