Community Mental Health Teams for People With Severe Mental Illnesses and Disordered Personality

Malone, Darren; Marriott, Sarah; Newton‐Howes, Giles; Simmonds, Shaeda; Tyrer, Peter

doi:10.1093/schbul/sbn164

Cited by 66 publications

(16 citation statements)

References 104 publications

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“…Initiated to address concerns over service fragmentation, poor interdisciplinary communication, decision making and negative service user experiences, the vision has been to provide a seamless service characterized by improved access, removal of gaps and effective care co‐ordination . Although implementation of integrated working has been marked by challenges and benefits, fewer deaths, lower levels of service user dissatisfaction with care and fewer hospital admissions have been reported …”

Section: Methodsmentioning

confidence: 99%

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Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Sweeney

Davies

McLaren

et al. 2015

Health Expectations

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BackgroundContinuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals.ObjectiveTo explore and compare mental health service users’ and professionals’ definitions of COC.MethodsUsing an exploratory, qualitative design, five focus groups with 32 service users each met twice. Data were analysed thematically to generate a service user‐defined model of COC. In a cross‐sectional survey, health and social care professionals (n = 184) defined COC; responses were analysed thematically. Service user and professional definitions were conceptually mapped and compared to identify similarities and differences.ResultsThere was crossover between the service user and professional derived models of COC. Both contained temporal, quality, systemic, staff, hospital and needs‐related elements of COC. Service users prioritized access, information, peer support and avoiding services; health professionals most frequently referred to staff, cross‐sectional and temporal COC. Service users alone identified service avoidance, peer support and day centres as COC elements; professionals alone identified cross‐sectional working.ConclusionsImportant similarities and differences exist in service user and professional conceptualizations of COC. Further research is necessary to explore these differences, prior to integrating service user and professional perspectives in a validated COC framework which could enable the development and evaluation of interventions to improve COC, informing policy and practice.

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Section: Methodsmentioning

confidence: 99%

“…22 Although implementation of integrated working has been marked by challenges and benefits, 23 fewer deaths, lower levels of service user dissatisfaction with care and fewer hospital admissions have been reported. 24…”

Section: Introductionmentioning

confidence: 99%

Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Sweeney

Davies

McLaren

et al. 2015

Health Expectations

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“…19 Changing the system is not just a pipe dream; the community practitioners are fighting back. The principles of good care can still be practised in the community mental health team, the unsung 'control' treatment in many studies that remains a highly cost-effective form of care 20,21 and the necessary flexibility to maintain continuity can be provided in a team structure that allows all elements of early intervention, assertive outreach, crisis resolution and recovery to be practised at appropriate times in the course of a patient's care.…”

Section: Need For Reorganisation Of Community Teamsmentioning

confidence: 99%

A solution to the ossification of community psychiatry

Tyrer

2013

Psychiatrist

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SummaryThe aim for seamless care that has long been the ultimate goal of good community psychiatry in the UK has disappeared, and there is now much needless argument over models of delivering care that ignore its main philosophy. It is argued that this ossification of care has not only made it ineffective, but has also promoted demoralisation and burn-out in the workforce, as the locus of control has shifted from clinician to managerial imperative. An initiative that can break up the opaque structures that hinder continuity of care is now available and a suggestion is made for a flexible, invigorated community care team system based on smaller catchment areas that allows a single team to combine the elements of assertive outreach, crisis resolution and early intervention with in-patient care.

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“…2 Community mental health team management was also shown to be superior compared to nonteam-based standard approaches using meta-analysis, 3 and superior in promoting greater acceptance of treatment. 4 However, generic community mental health teams have faced criticism of role limitations due to the development of specialist mental health teams. Irrespective of their strengths and weaknesses, it remains essential to implement the operational strategy of community mental health teams in accordance with the NHS Operating Framework Plan 2010-2015, as outlined in the 2010 White Paper.…”

Section: Primary and Secondary Care Dividementioning

confidence: 99%