Showing posts with label schizophrenia. Show all posts
Showing posts with label schizophrenia. Show all posts

Friday, 10 October 2014

WMHD II c/o LSE: Investing in crisis care for people with schizophrenia makes moral and economic sense

“When someone has a mental health crisis, it is distressing and frightening for them as well as the people around them. Urgent and compassionate care in a safe place is essential – a police cell should never need to be used because mental health services are not available. For me, crisis care is the most stark example of the lack of equality between mental and physical health.” 
(The Rt Hon Norman Lamb MP, Care and Support Minister)
There is a strong moral and economic case for investing in innovative approaches that support people with schizophrenia to live independently in the community. Crisis resolution and home treatment teams and crisis houses can help reduce the need for expensive hospital admissions with some studies suggesting that the costs of care can be reduced by up to 30% through these service models. There is a clear potential for Clinical Commissioning Groups to make better use of their resources by investing in home treatment teams and crisis houses as approaches to crisis resolution.
My source: The London School of Economics and Political Science, Health and Social Care blog email

Hodges' model in recovery ...
Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

Wednesday, 10 July 2013

Computer-based 'avatar' therapy promising for persecutory auditory hallucinations

A study in the British Journal of Psychiatry has reported symptom reductions among patients hearing voices, who developed computerised 'avatars' of the voices and then engaged in dialogue with them. When compared with treatment as usual during a randomised trial, the therapy group showed mean reductions in scores for auditory hallucinations and for the omnipotence and malevolence of the voices. The researchers conclude: 'Patients who are able to sustain a dialogue with their persecutor feel much more in control.'
BJP June 2013, 202:428-433
Source:
http://www.mental-health-forum.co.uk/news-blog.html

In addition see and listen to:

BBC Radio 4: http://www.bbc.co.uk/news/health-23141916

Sunday, 16 June 2013

Mental Health at NWHealthHack Knutsford - Prof. Lewis (thanks)

NWHealthHack began with several briefings. These were all excellent in providing both technical and health care insights before projects were pitched in 60 seconds.

Prof. Shôn Lewis set the health agenda in the context of mental health. I'm really grateful to Prof. Lewis to be able to share two slides here. The first speaks volumes not only in the research spend across health care domains but the disability-adjusted life year (DALY):

Over the past 25+ years I'm aware of the change within community mental health nursing. I can summarise this as follows:
  • 1985 one of six new community psychiatric nurses - CPNs
  • Early 1990s newly built community mental health resource centers
  • Mid-late 1990s CPNs criticised for not meeting the needs of the enduring mentally ill
  • Early 2000s early intervention services, role of psychosocial interventions
  • Mid-late 2000s reduction and closure of mental health day hospitals
  • Early 2010s former community mental health resource centers turned to primary care (mental health)
I have mentioned here previously about the need to put the 'mental'' into public - health and the need to put mental health literacy on the map. It will be interesting to watch what happens now that this has landed in a very 'local' way within Local Authorities. Prof. Lewis reviewed the situation in mental health conjoining serious mental illness, services and self-care, making a critical point for those readers working in community mental health teams. This should also give pause for thought for those (like me) working in related services:
Prof. Lewis also shared an app - ClinTouch and reflections on the professional's response to the apps potential and the findings in practice. It's never easy being open to what is new and being ready as a consequence to re-invent yourself. If that's a problem for individuals then for professional groups and multidisciplinary teams it's an even greater challenge. ...

Friday, 16 November 2012

Conceptual Reflections on Schizophrenia - Hodges' model

A decade ago I was studying the Psychosocial Interventions for Psychosis (COPE) pathway part-time at Manchester University. The student body was interprofessinal made up of nurses, psychologists, occupational therapists, nurses and if memory serves me right people from the voluntary (third) sector. What I learned then left me wondering where I had been all those years since qualifying (lost in IT....).

There are many universities now delivering this curriculum, presenting the very latest research. The lecturers are frequently the researchers themselves, working in ongoing multicenter trials studying  various aspects of the treatment and care management of psychosis.

This is why it is very alarming to hear of the lack of progress not just within in-patient care as per the findings of the Schizophrenia Commission, but the delivery of care for these individuals and their families across the health and social care system. Of course, as a former student and holder of a PG(Dip.) I am not at present practising these skills formally.

In the h2cm table that follows I have highlighted some of the main concepts across the care domains of Hodges' model:

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

beliefs, perception, attention, anxiety, stress, vulnerability, pleasure, feedback, motivation, mood, therapies, therapeutic relationship, communication, assets, cognitive triad, perception, delusions, hallucinations, positive and negative symptoms, person-centered care, existing coping strategies, mental health assessment, literacies (3Rs, emotional, health), salience, attention, attribution, meaning, creativityphysical health, weight, fitness, side effects, medication, atypical antipsychotics, evidence,
genetics, research, diagnosis, (cognitive) information processing, dual diagnosis, risk, models of care, recovery, hierarchy of clinical evidence, care processes - assessment, care planning, access to interventions, audio recording of sessions, protocols, DSM IV
clinical supervision, social attitudes - family, friends, community, stigma, myth, media, carers, familes, social relationships, network, self help groups, survivors,
www.hearing-voices.org/
activities, daily routine, 'value' of a diagnosis - pros & cons (discuss), community centers, clinical supervision, positive risk management, employment, social history of mental health, social psychiatry, stories,education - schools & community,
'community care', housing
mental health history, institutional vs. community care, mental health law, autonomy, consent, capacity, best interests, equity
mental health services, early intervention, access, POLICY, antipsychiatry, equity, governance, data gathering, statistics, reporting, outcomes, services,
secure provision, early intervention, crisis intervention, DSM V, commissioning,
funding for mental health, education and training, sickness - welfare benefits - 'incapacity' review 'return to work'

The relative position of concepts above does not indicate priority.



Thursday, 15 November 2012

Schizophrenia Commission - Recommendations


100 years since Eugen Bleuler coined the term, schizophrenia remains a stigmatised and misunderstood illness. Today a report is published on one of the largest ever reviews of the condition in England. We’d like to tell you about it - and how sharing a picture with your friends can help spread the message…

An independent inquiry

In November last year, Rethink Mental Illness launched the Schizophrenia Commission. Chaired by Professor Sir Robin Murray, this expert panel heard evidence from people with schizophrenia and psychosis, families, professionals, leaders of NHS and social services, academics, policy makers and journalists. Recommendations arising from their inquiry, released today, call for a radical overhaul of the current system of care.

The message that comes through loud and clear is that people are being badly let down by the system in every area of their lives    Robin Murray – Commission Chair
 

The commission found that

  • Only 10% of people with schizophrenia are being offered potentially life-transforming talking therapies such as CBT
  • Mental health hospital wards are often such appalling places they make patients worse rather than better
  • 1 in 3 people affected say they can't get quick access to services when they need it - and many don't know where to go for help
  • Major concerns remain about the lack of efficacy and side effects of anti-psychotic drugs, which can lead to rapid weight gain, diabetes, and heart disease
We need more people to understand the realities of living with schizophrenia. Share our infographic today so the public know more about what the illness is - and isn’t.

The messageThe report suggests priority actions that directly affect services for people with schizophrenia. Key recommendations include:

  • A complete overhaul of inpatient units including more widespread use of community based “recovery houses”
  • A redirection of funding from secure units into early intervention services, which save the taxpayer money and prevent people reaching crisis point
  • More research on the causes and treatment of schizophrenia and psychosis including the development of better drugs with fewer side effects
  • The elimination of poor prescribing by psychiatrists and the right to a second opinion on medication for patients
  • Extending access to psychological therapies and assertive physical health interventions
  • A stronger focus on prevention, including clear warnings about the risks of cannabis
  • Greater partnership with people with psychosis - valuing their experiences and making their preferences and goals central to their recovery
  • Action to meet the needs of all marginalised groups, especially those from African and Caribbean communities
  • A better deal for long-term carers who should be treated as partners, not problems
Read the commission’s report and their full 42 recommendations
See what commissioners themselves say about the recommendations and clinical practice by reading their blogs.

You can help
Do you want more people to understand what schizophrenia is? Help combat the myths surrounding the illness. Please share our infographic on Facebook and Twitter.

Thanks in advance for your support.
Rethink Mental Illness


My source: Pam Pinder c/o
http://www.jiscmail.ac.uk/lists/psychiatric-nursing.html
and various media twitter and BBC Radio 4.


Do check the infographic link in the above text.
The next post will provide a conceptual reflection on the above using Hodges' model.