Managed clinical networks – their relevance to mental health services

Holmes, Jeremy; Langmaack, Claus

doi:10.1192/pb.26.5.161

Cited by 4 publications

(4 citation statements)

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“…MCNs vary tremendously in size and levels of formality. Whilst some are mandated, have formally managed inter‐professional boundaries, and operate nationally; others are arranged on more informal bases and may be restricted to a relatively small locality or even a single NHS Trust (Holmes and Langmaack, 2002). Although subject to some criticism (NHS Confederation, 2001), MCNs have been embraced enthusiastically by those working with certain disease conditions (such as cancer) and in some parts of the UK – particularly Scotland where they have been formally integrated into the health system for some time (SEHD, 1999, 2002, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that MCNs might prove effective for improving mental healthcare in the UK and reducing disparities in access to care, treatment, and outcomes (Holmes and Langmaack, 2002). This is because current approaches to mental healthcare demonstrate a number of features which indicate that a more coordinated approach would be beneficial.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous research indicates that adherence to clinical guidelines in this area is poor (Edge, 2010a, Kendrick, 2000, Hegarty et al , 2009). Ability to articulate the anticipated benefits for service improvement and value for money is another key criterion for establishing MCNs (Holmes and Langmaack, 2002, SEHD, 2007). There is little evidence of analyses of current and future needs prior to such services being developed or service evaluation thereafter (Edge, 2010b).…”

Section: Discussionmentioning

confidence: 99%

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Can managed care networks improve perinatal mental healthcare for Black and minority ethnic (BME) women?

Edge

2011

Journal of Public Mental Health

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PurposePerinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.Design/methodology/approachResponding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.FindingsIn total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.Practical implicationsTaken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.Originality/valueThis paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks ha...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Can managed care networks improve perinatal mental healthcare for Black and minority ethnic (BME) women?

Edge

2011

Journal of Public Mental Health

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“…Initially, it was their potential to improve services for those suffering from chronic conditions such as cancer and coronary heart disease that raised interest [9]. Since then however, their usage in wider services including mental health has become apparent [10].…”

Section: Introductionmentioning

confidence: 99%