AMCAT – Assessing Mental Capacity – The Assessment of Mental Capacity Audit Tool

Posted on March 31, 2010 by lancashirecarelibraryblog

The Assessment of Mental Capacity Audit Tool  Mental Health Foundation & SCIE

Click on the title above to access this toolkit and follow the links

About:

This site has been developed to help staff working in health and social care (including those in the private and voluntary sectors) as well as unpaid carers, to improve the way they assess mental capacity.

Mental capacity refers to the ability to make a decision. Visit our what is mental capacity page for more information.

The Assessment of Mental Capacity Audit Tool (AMCAT) is a simple online tool to help staff and others evaluate, reflect and learn about an assessment of mental capacity they have done. Audit an assessment using AMCAT.

Filed under: Acts - Mental Health, Assessment of Mental Capacity, social care | Tagged: , , , , , , | Comments Off

We Can Dream – Autism – Stories of four young people

Posted on March 31, 2010 by lancashirecarelibraryblog

We Can Dream  April 2009, Foundation for Peole with Learning Disabilities

Click on the title above to access the full-text of this report

Abstract:

We know that with the right support young people with autistic spectrum disorders can express creative ideas, dreams and hopes for their future. One way of doing this is to use person centred planning. Person centred planning is a way of planning all aspects of a person’s life. The person is at the centre of the planning process and with support decides who they would like to help them and who can help them make the plans possible. This approach is particularly useful at transition because it gives young people a chance to say what their hopes and dreams for the future are.

This booklet is for young people and their families, friends and supporters to read and talk about together. It is based on the stories of four young people. We hope it gives you good ideas about what to do when you leave full-time education. It is not always easy to bring about changes – but with careful planning, time and the right people to help, things can happen.

Lancashire Care staff can either click on the link above , or email: susan.jennings@lancashirecare.nhs.uk

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User Involvement – An evaluation of mental health service user involvement in the re-commissioning of day and vocational services

Posted on March 31, 2010 by lancashirecarelibraryblog

An evaluation of mental health service user involvement in the re-commissioning of day and vocational services, Sainsbury’s , Feb 2010

Click on the title above to access the full-text of this report

Abstract:

This is a Sainsbury Centre evaluation report on the process of involving people who use services in the re-commissioning of their day and vocational services.

This report provides insight into what worked during re-commissioning day and vocational services. Full of quotes from the people involved, it should help anyone wishing to embark on the re-commissioning of day and vocational services in their own area.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: user involvement, vocational rehabilitation | Tagged: , , , , , | Comments Off

Long term treatment of depression with selective serotonin reuptake inhibitors and newer antidepressants

Posted on March 31, 2010 by lancashirecarelibraryblog

Long term treatment of depression with selective serotonin reuptake inhibitors and newer antidepressants,  BMJ, 26th March 2010;340:c1468

Steven Reid, consultant psychiatrist, Corrado Barbui, lecturer in psychiatry

Department of Liaison Psychiatry, St Mary’s Hospital, London W2 1PF,  Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, 37134 Verona, Italy

Abstract:

The rise in the prescribing of antidepressants is largely accounted for by an increase in long term treatment.
Half of people with a diagnosis of major depression will go on to have a further episode, and risk of recurrence increases with each episode.
Evidence for the benefits of long term prescribing of antidepressants comes almost exclusively from secondary care settings.
Continuing antidepressant treatment roughly halves the absolute risk of relapse.
The increased risk of suicidal behaviour associated with selective serotonin reuptake inhibitors (SSRIs) is restricted to people aged under 25.
People with risk factors for relapse of depression should be advised to continue with SSRIs for at least 12 months and consider long term treatment.

 

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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Attitudes to mental illness 2010 research report

Posted on March 31, 2010 by lancashirecarelibraryblog

Attitudes to mental illness 2010 research report  , TNS UK for the National Mental Health Development Unit, Department of Health, 30th March 2010

Click on the title above to access the full-text of this report

Abstract:

The latest national statistics on Attitudes to Mental Illness produced by the Department of Health were released on 30 March 2010 according to the arrangements approved by the UK Statistics Authority.

Since March 1994, the Department of Health has placed a set of questions on TNS’s Face-to-Face Consumer Omnibus about public attitudes towards mental illness. From 1994 to 1997 the questions were asked on an annual basis and then every third year up until 2003.  

Since 2007 the survey has again been carried out annually. The surveys serve as a benchmark, enabling measurement of whether attitudes are improving or worsening over time. The questionnaire included a number of statements about mental illness. Respondents were asked to indicate how much they agreed or disagreed with each statement.

Key points from the report:

  • People are broadly sympathetic towards people with a mental illness.
  • However, some attitudes towards people with mental illness are worse compared to when the Department of Health first commissioned the poll in 1994 whilst a number have improved. Several attitudes that had worsened over the period up until 1997 have since improved.
  • Attitudes to a number of statements have changed between 2009 and 2010.
  • Opinions on some statements changed towards greater tolerance, for example:
  • - ‘Locating mental health facilities in a residential area downgrades the neighbourhood’ – agreement with this statement decreased from 21% to 18%.
  • Some opinions moved more in favour of integrating people with mental illness into the community, for example:
    - ‘Residents have nothing to fear from people coming into their neighbourhood to obtain mental health services’ – agreement with this statement increased from 62% to 66%.
  • On one item though, opinions moved less in favour of integration:
    - ‘Mental hospitals are an outdated means of treating people with mental illness’ – agreement with this statement fell from 37% in 2009 to 33% in 2010.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: Department of Health 2010, statistics, stigma | Tagged: , , , , , , , | Comments Off

Healthcare for Single Homeless People

Posted on March 30, 2010 by lancashirecarelibraryblog

Healthcare for Single Homeless People  22nd March 2010, Department of Health

Click on the title above to access the full-text of this report

Related documents

Abstract:

This paper presents the results of analysis aimed at better understanding the health needs and relative healthcare costs of people who are homeless or living in certain types of insecure or short-term accommodation. Using Hospital Episode Statistics combined with other data sources it is estimated that this client group use around 4 times more acute hospital services than the general population. For inpatient costs, the figure rises to 8 times when the client group is compared to the general population aged 16-64. The most common reasons for admission include toxicity, alcohol or drugs and mental health problems.

Different models for provision of primary care services to this client group are discussed and the barriers experienced in accessing mainstream primary care are set out. Four models of care are described, ranging from outreach services to a fully integrated primary and secondary care model. The current take-up of these models is discussed and ranges from one third of PCTs which provide no specialist homelessness primary care services to a group of PCTs which provide a specialist homelessness primary care service with registration. This will be partly explained by variation in need.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

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Group CBT prevents depression in at-risk adolescents

Posted on March 30, 2010 by lancashirecarelibraryblog

Group CBT prevents depression in at-risk adolescents, Evidence Based Mental Health 2010;13:16

Abstract:

Question:

What is the effect of a group cognitive behavioural programme in preventing depression in at-risk adolescents?

Patients:

316 adolescents (aged 13–17 years; mean age 14.8 years; 58.5% female) with current subsyndromal depressive symptoms, identified by a score of >20 on the Center for Epidemiological Studies Depression Scale or a prior episode of depression (DSM-IV) from which they were in remission for a minimum of 2 months, or both, plus at least one parent or carer with current or prior depressive episodes (either a major depressive episode within the previous 3 years or three or more major depressive episodes within the adolescent’s lifetime). Exclusions: diagnosis of bipolar 1 or schizophrenia (adolescent or parent); current mood disorder (DSM-IV); currently taking antidepressant medication or having received more than eight sessions of cognitive behavioural therapy (CBT).

Setting:

four US cities; August 2003–February 2006.

Intervention:

The group CBT prevention programme comprised eight weekly 90 min sessions for mixed sex groups of adolescents (mean group size 6.6). Sessions included cognitive restructuring techniques to challenge negative …

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: CAMHS, CBT Cognitive Behaviour Therapy, depression | Tagged: , , , , , , | Comments Off

Antidepressants combined with self-management of pain improves outcomes in people with comorbid pain and depression

Posted on March 30, 2010 by lancashirecarelibraryblog

Antidepressants combined with self-management of pain improves outcomes in people with comorbid pain and depression, Evidence Based Mental Health 2010;13:13

Abstract:

Question:

What is the effect of a combined pharmacological and behavioural intervention on depression and pain symptoms in people with musculoskeletal pain and comorbid depression?

Patients:

250 adults (mean age 55.5 years, 53% female) with depression and musculoskeletal pain in the hip, low back or knee persisting for 3 months or more despite using >2 different analgesics. Pain scores had to be at least of moderate severity, scoring >5 on the Brief Pain Inventory Score (BPI). Severity of depression had to be at least moderate, scoring >10 on the Patient Health Questionnaire-9 (PHQ-9). Exclusions included bipolar disorder, severe cognitive impairment, substance use disorder or schizophrenia.

Setting:

Six community based primary care clinics and five Veterans Affairs general medicine clinics, Indiana, USA; recruitment January 2005–June 2007.

Intervention

The intervention consisted of three steps. Step 1: 12 weeks of optimised antide press ant therapy, actively managed by a nurse care manager. Clinical response was assessed at 3 weeks and doses increased if a 5 point drop in the PHQ-9 score was …

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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Suicide and homelessness

Posted on March 30, 2010 by lancashirecarelibraryblog

Suicide and homelessness, Journal of Public Mental Health, 2009 Sep; 8 (3): 7-19

Adrian Bonner, Claire Luscombe

Centre for Health Service Studies, University of Kent, Canterbury CT2 7NY, UK
National Monitoring and Evaluation Scheme, The Salvation Army, UK

Abstract:

Suicide behaviour rates vary significantly between countries due to a range of cultural, behavioural and health-related factors. Gender and age-related factors also appear to be impor tant key determinants of vulnerability to suicide ideation and suicide completion. The homeless population is par ticularly at risk, due to multiple complex issues that relate to social exclusion, alcohol, drug, mental health and nutritional issues. Studying homeless people is problematic due to access, the transitory nature of their contact with statutary services, problems of self-repor t and recall in people – some of whom have mental health and cognitive issues. There is an increasing interest from practitioners and academic researchers in spiritual factors that appear to modulate the responses of an individual to the internal and external threats that underlie the motivation to end his or her life. Effective approaches to suicide prevention and crisis management require a good understanding of the interplay between this complex set of biological, psychological and social domains. These will be explored in the final section of this review. This paper, therefore, aims to provide a non-systematic review of the existing literature published in academic journals and relvant ‘grey literature’ and focuses on themes in the literature that will hopefully inform both policy and practice.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: alcohol, community mental health, Drugs & Substance Misuse, homeless, social care, suicide | Tagged: , , , , | Comments Off

Treating eating disorders: a review of the evidence

Posted on March 29, 2010 by lancashirecarelibraryblog

Treating eating disorders: a review of the evidence, Evidence Based Mental Health 2010;13:1-4

  • Rano Bhadoria
  • Kate Webb
  • John F Morgan

    • Dr J F Morgan, Yorkshire Centre for Eating Disorders, Newsam Centre, Seacroft Hospital, Leeds LS14 6WB, UK

    Abstract:

    The assessment and management of patients with eating disorders can cause significant anxiety for all involved in their care, particularly as many patients are ambivalent about treatment and may develop concerning physical complications. Anorexia nervosa has the highest standardised mortality rate of any psychiatric disorder and all eating disorders cause significant short and long term psychological and physical morbidity. In this article, we provide an overview of the current psychological, pharmacological and physical evidence based management of patients with eating disorders.

    Anorexia nervosa

    NICE guidelines1

    • ‘Most people with anorexia nervosa should be managed on an outpatient basis, with psychological treatment (with physical monitoring) provided by a healthcare professional competent to give it and to assess the physical risk of people with eating disorders.’

    • ‘People with anorexia nervosa requiring inpatient treatment should be admitted to a setting that can provide the skilled implementation of refeeding with careful physical monitoring in combination with psychosocial interventions.’

    • ‘Family interventions that directly address the eating disorder should be offered to children and adolescents with anorexia nervosa.’

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Eating Disorders | Tagged: , , , | Comments Off

    Anatomy of bipolar disorder and schizophrenia: A meta-analysis

    Posted on March 29, 2010 by lancashirecarelibraryblog

    Anatomy of bipolar disorder and schizophrenia: A meta-analysis, Schizophrenia Research, Volume 117, Issue 1, March 2010, Pages 1-12

    Ian Ellison-Wright, Ed Bullmore

    Brain Mapping Unit, University of Cambridge, Cambridge, UK

    Avon and Wiltshire Mental Health Partnership NHS Trust, Salisbury, UK

    Abstract:

    Recent genetic results have indicated that the two major, classically distinct forms of psychosis – schizophrenia and bipolar disorder – may share causative factors in common. However it is not clear to what extent they may also have similar profiles of brain abnormality. We used meta-analytic techniques to generate and compare maps of brain structural abnormality in the large samples of patients with both disorders that have been studied using magnetic resonance imaging.

    Method

    A systematic search was conducted for voxel-based morphometry studies examining gray matter in patients with schizophrenia or bipolar disorder. The anatomical distribution of the co-ordinates of gray matter differences was meta-analysed using Anatomical Likelihood Estimation.

    Results

    Forty-two schizophrenia studies including 2058 patients with schizophrenia and 2131 comparison subjects were compared with fourteen bipolar studies including 366 patients with bipolar disorder and 497 comparison subjects. In schizophrenia, there were extensive gray matter deficits in frontal, temporal, cingulate and insular cortex and thalamus, and increased gray matter in the basal ganglia. In bipolar disorder, gray matter reductions were present in the anterior cingulate and bilateral insula. These substantially overlapped with areas of gray matter reduction in schizophrenia, except for a region of anterior cingulate where gray matter reduction was specific to bipolar disorder.

    Implications

    In bipolar disorder studies there were consistent regional gray matter reductions in paralimbic regions (anterior cingulate and insula) implicated in emotional processing. Gray matter reductions in schizophrenia studies were more extensive and involved limbic and neocortical structures as well as the paralimbic regions affected in bipolar disorder.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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    Kolb’s experiential learning cycle as a framework – Studying the physical health care needs of people with learning disabilities

    Posted on March 29, 2010 by lancashirecarelibraryblog

    Exploring the physical health needs of people with learning disabilities: Facilitation student engagement in learning, using Kolb’s experiential learning cycle, Nurse Education in Practice, Volume 10, Issue 3, May 2010, Pages 115-118

    Mike Gibbs & Helena Priest

    School of Nursing and Midwifery, Keele University, Newcastle Road, st4 6qg, Staffs, United Kingdom

    Abstract:

    Using Kolb’s experiential learning cycle as a framework, this paper will describe the facilitation of an experiential learning journey by a small group of learning disability nursing students in the UK, studying the physical health care needs of people with learning disabilities. Highlighted are the problems faced by people with learning disabilities in accessing primary health care services and some of the policy drivers for these services. This is then followed by an account of an educational process designed both to support learning about physical health and to enhance engagement and motivation of learning disability nursing students.

    Lancashire care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Learning Disabilities, reflection | Tagged: , , , , | Comments Off

    Overcoming the challenges of evaluating dual diagnosis interventions in medium secure units

    Posted on March 29, 2010 by lancashirecarelibraryblog

    Overcoming the challenges of evaluating dual diagnosis interventions in medium secure units, The British Journal of Forensic Practice, Volume 12, Number 1 / February 2010, pgs 33-37

    Eleanor Swain, Sara Boulter, Nicola Piek

    North London Forensic Service, UK

    Abstract:

    This article outlines conventional dual diagnosis outcome measures and the challenges of using these measures to evaluate interventions in medium secure units. It suggests how these challenges can be overcome by using alternative outcome measures such as measures of motivation, stages of change, beliefs, knowledge, group satisfaction, therapeutic alliance or coping strategies.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Drugs & Substance Misuse, dual diagnosis, Forensic Mental Healthcare | Tagged: , , , , , | Comments Off

    Guiding students through reflective practice – Most Read Article

    Posted on March 28, 2010 by lancashirecarelibraryblog

    Guiding students through reflective practice – The preceptors experiences. A qualitative descriptive study, Nurse Education in Practice, Volume 9, Issue 3, May 2009, Pages 166-175

    Anita Duffy

    Lecturer/Course Co-ordinator, School of Nursing and Midwifery, Trinity College Dublin, 24, D’Olier St. Dublin 2, Ireland

    Abstract:

    Nurse Education in Ireland has experienced a significant change over the last 10 years. As a consequence staff nurses must be prepared to support student learning and enable student learners obtain an optimum educational outcome, thereby enriching the students’ clinical placement. ‘Reflective time’ has been included in the rostered year to enhance the consolidation of theory and practice. The nurse preceptor can facilitate students to reflect on their practice through guided reflection. This study presents the experiences of seven preceptors towards guiding student nurses through reflective practice in the clinical practice area.

    Methodology

    A qualitative descriptive research methodology was chosen to research this phenomenon. Semi-structured qualitative interviews were undertaken with a purposive sample of seven student nurse preceptors. All the interviews were transcribed verbatim and analysed using Burnard’s [Burnard, P., 1991. A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11(6), 461–466] 14-stage method of thematic analysis.

    Results

    Analysis of the data revealed that preceptors had little or no experience of using guided reflection within the preceptorship process. Factors, which contributed to these findings included the training and development of preceptors, the critical relationships within the preceptorship process, and the preceptors’ experiences of reflection in the past and present, not withstanding the anticipated future benefits of using guided reflection to aid student learning.

    Conclusion

    Guided reflection is a relatively new concept in Irish nursing with this study generating data on seven preceptors’ experiences of using guided reflection in the preceptorship process. The study caused the participants to deeply reflect on their own knowledge and understanding of guided reflection and how guided reflection has the potential to facilitate the development and maintenance of the student nurse/preceptor relationship.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Clinical Supervision, Mentorship, reflection | Tagged: , , , | Comments Off

    Description and Demonstration of CBT for ADHD in Adults – View Video Link

    Posted on March 28, 2010 by lancashirecarelibraryblog

    Description and Demonstration of CBT for ADHD in Adults. Cognitive and Behavioral Practice, Volume 17, Issue 1, February 2010, Pages 9-15

    Susan E. Sprich

    Click on the title to view the video link and download full-text of this article

    Abstract:

    ADHD in adulthood is a valid, prevalent, distressing, and interfering condition. Although medications help treat this disorder, there are often residual symptoms after medication treatment, and, for some patients, they are contraindicated. Compared to other disorders, such as mood and anxiety disorders, there are few resources available for clinicians wishing to conduct cognitive-behavioral treatment for this problem. The present manuscript provides a description of our cognitive-behavioral approach to treat ADHD in adulthood, which we have developed and tested in our clinic (Safren, Otto, et al., 2005), and for which detailed therapist and client guides exist (Safren, Perlman, Sprich, & Otto, 2005; Safren, Sprich, Perlman, & Otto, 2005). To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.

    Lancashire Care staff can either click on the link above and access the full-text and watch the video link or request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: adhd, CBT Cognitive Behaviour Therapy | Tagged: , , , , , | Comments Off

    Treatment of obsessions: A randomized controlled trial

    Posted on March 28, 2010 by lancashirecarelibraryblog

    Treatment of obsessions: A randomized controlled trial, Behaviour Research and Therapy
    Volume 48, Issue 4, April 2010, Pages 295-303    Maureen L. Whittal, Sheila R. Woody, Peter D. McLean, S.J. Rachman, Melisa Robichaud

    Abstract:

    This study tested Rachman’s cognitive behavioral method for treating obsessions not accompanied by prominent overt compulsions. The cognitive behavioral treatment was compared to waitlist control and an active and credible comparison of stress management training (SMT). Of the 73 adults who were randomized, 67 completed treatment, and 58 were available for one-year follow-up. The active treatments, compared to waitlist, resulted in substantially lower YBOCS scores, OCD-related cognitions and depression as well as improved social functioning. Overall, CBT and SMT showed large and similar reductions in symptoms. Pre–post effect sizes on YBOCS Obsessions for CBT and SMT completers was d = 2.34 and 1.90, respectively. Although CBT showed small advantages over SMT on some symptom measures immediately after treatment, these differences were no longer apparent in the follow-up period. CBT resulted in larger changes on most OCD-related cognitions compared to SMT. The cognitive changes were stable at 12 months follow-up, but the differences in the cognitive measures faded. The robust and enduring effects of both treatments contradict the long-standing belief that obsessions are resistant to treatment.

    Lancashire Care staf can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: CBT Cognitive Behaviour Therapy, OCD | Tagged: , , , , , | Comments Off

    Addressing offending risk in low secure mental health services for men: a descriptive review of available evidence

    Posted on March 28, 2010 by lancashirecarelibraryblog

    Addressing offending risk in low secure mental health services for men: a descriptive review of available evidence, British Journal of Forensic Practice, 2010 Feb; 12 (1): 38-47

    Nagi C; Davies J

    Abertawe Bro Morgannwg University Health Board
    Centre For Forensic and Family Psychology, University of Birmingham, UK
    Abertawe Bro Morgannwg University Health Board and Chiral
    School of Medicine, University of Swansea, UK

    Abstract:

    The topic of offender rehabilitation has been subject to much research over the past decade. Numerous meta-analytic reviews of offender treatment, particularly group treatment based on cognitive behavioural principles, have been reported. Together with the ‘triad of principles’ – risk, need and responsivity – they have formed the foundation upon which most offending behaviour interventions have developed. However, outcome data from existing programmes provides mixed evidence, and evidence for interventions for those in forensic mental health settings are still in their infancy. This paper critically considers the current evidence for the treatment of offending behaviour, and its application in forensic mental health settings, in order to inform development of such treatments in low secure mental health care. Most of the research focuses on non-mental health settings, and is largely what will be considered here. The paper concludes that low secure interventions need to capitalise on the evidence of ‘what works’ while revisiting key concepts such as ‘dose’ and responsivity in order to design appropriate treatments. Individual outcome evaluation needs to form part of development in this area.

     

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Forensic Mental Healthcare, rehabilitation | Tagged: , , , , , , , | Comments Off

    Sex & Dementia – Alzheimer’s Society

    Posted on March 27, 2010 by lancashirecarelibraryblog

    Sex & Dementia – Alzheimer’s Society  2008

    Click on the title to gain access to the full-text, pdf link is on the right hand side

    Abstract:

    Dementia causes many changes in people’s lives as time passes. One area in which there are often changes, but which is seldom discussed, is that of intimate relationships. This factsheet explains how dementia can affect the sexual feelings, desires and needs of people with dementia and their partners. It outlines some of the many ways in which sexual behaviour can change and suggests some ways for those with partners to adapt so that relationships remain loving and close.

    However much we hear about sex in the media, the reality is that it is not important for everyone. However, everyone is a sexual being, regardless of their age, ability or sexual preference, and has the right to express their sexuality without fear of disapproval. This is no less the case for people with dementia.

    Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

    Filed under: dementia, Patient Medication | Tagged: , , , , , , , , , | Comments Off

    Working towards Women’s Well-being – Unfinished business

    Posted on March 27, 2010 by lancashirecarelibraryblog

    Working towards Women’s Well-being – Unfinished business   National Mental Health Development Unit, 24th February 2010

    Click on the title above to access the full-text

    Abstract:

    Working towards Women’s Well-being presents clear evidence that some progress has been made in providing gender-specific and gender-sensitive mental health services to meet the needs of women. The report brings together an account of progress on implementation of the recommendations in the 2002 Department of Health report Women’s Mental Health: Into the Mainstream with examples of best practice on the ground to demonstrate this progress. These will have relevance to commissioners, service providers, service users, their carers and advocates.

    Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Equality & Diversity, gender identity, well-being | Tagged: , , , , , , | Comments Off

    Deprivation of Liberty Safeguards (DoLS) – New factsheets – Alzheimer’s Society

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Deprivation of Liberty Safeguards (DoLS)  March 2010, Alzheimer’s Society

    Click on the title above, pdf link on the right hand side

    Abstract:

    The Deprivation of Liberty Safeguards (DoLS), referred to as ‘safeguards’ in this factsheet, are part of the Mental Capacity Act (2005). They aim to protect people in care homes and hospitals from being inappropriately deprived of their liberty. The safeguards have been put in place to make sure that a care home or hospital only restricts someone’s liberty safely and correctly, and that this is done when there is no other way to take care of that person safely. (See Factsheet 460, Mental Capacity Act 2005 for more information about the act.)

    Who is affected?

    The safeguards apply to vulnerable people aged 18 or over in hospitals and care homes who are unable to make decisions for themselves but who are not detained under the Mental Health Act (1983). When someone is formally detained under this Act, the process is known as ‘being sectioned’. (See Factsheet 459, The Mental Health Act 1983 and guardianship, for more information.)

    Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Dols | Tagged: , , , , , | Comments Off

    Advance Decisions & Elderly – Factsheet from the Alzheimer’s Society

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Advance Decisions - March 2010, Alzheimer’s Society,

    Click on the title above to access the full-text, pdf link available on the right hand side

    Abstract:

    This factsheet explains what an advance decision is, and what it can and cannot do. It also provides practical advice and a form for drafting an advance decision.

    People who have dementia, or who are worried that they may develop it in future, are often concerned about how decisions about their medical treatment would be made if they lost the ability to decide for themselves. They may fear that they would be forced to receive life-sustaining or life-prolonging treatments long after they were able to achieve an acceptable or tolerable level of recovery, length of life or quality of life.

    The Mental Capacity Act 2005 gives people in England and Wales a statutory right to refuse treatment, through an ‘advance decision’. An advance decision allows a person to state what forms of treatment they would or would not like should they become unable to decide for themselves in the future.

    Lancashire care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Advance Decisions, dementia | Tagged: , , , , , , , , | Comments Off

    Patient restrictions: Are there ethical alternatives to seclusion and restraint?

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Patient restrictions: Are there ethical alternatives to seclusion and restraint? Kontio R; Välimaäki M; Putkonen H; Kuosmanen L; Scott A; Joffe G; Nursing Ethics, 2010 Jan; 17 (1): 65-76

    Abstract:

    The use of patient restrictions (e.g. involuntary admission, seclusion, restraint) is a complex ethical dilemma in psychiatric care. The present study explored nurses’ (n ¼ 22) and physicians’ (n ¼ 5) perceptions of what actually happens when an aggressive behaviour episode occurs on the ward and what alternatives to seclusion and restraint are actually in use as normal standard practice in acute psychiatric care. The data were collected by focus group interviews and analysed by inductive content analysis. The participants believed that the decision-making process for managing patients’ aggressive behaviour contains some in-built ethical dilemmas. They thought that patients’ subjective perspective received little attention. Nevertheless, the staff proposed and appeared to use a number of alternatives to minimize or replace the use of seclusion and restraint. Medical and nursing staff need to be encouraged and taught to: (1) tune in more deeply to reasons for patients’ aggressive behaviour; and (2) use alternatives to seclusion and restraint in order to humanize patient care to a greater extent.

     

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: ethics, Seclusion | Tagged: , , , | Comments Off

    ABI & Systematic Review – Pharmacotherapy for treatment of attention deficits after non-progressive acquired brain injury. A systematic review

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Pharmacotherapy for treatment of attention deficits after non-progressive acquired brain injury. A systematic review   Clinical Rehabilitation. London: Feb 2010. Vol. 24, Iss. 2; p. 110

    Manoj Sivan et al.

    Abstract:

    Objective: To systematically review the effectiveness of medications used to improve attention in people with non-progressive acquired brain injury.

    Design: A systematic review.

    Methods: MEDLINE, EMBASE, CINALH, PUBMED and PsychINFO databases were used to identify studies published between 1987 and 2008 meeting the following criteria: studies with subjects older than 18 years; diagnosis of new onset or previous acquired brain injury; medication given to improve attention and use of outcome to measure attention. Studies involving subjects in low arousal states or with neurogenerative conditions were excluded. The studies were categorized into three evidence levels: I — Randomized controlled trials; II — Prospective studies, controlled trials with methodological limitations; and III — Retrospective studies, clinical case series.

    Results: Forty-seven articles were identified on initial search. Twenty-six met the pre-specified criteria. Five articles were assessed as meeting the level I evidence criteria, 12 were level II studies and 9 were level III studies. Methylphenidate can improve information processing speed but not all attention aspects in some people after traumatic brain injury. There is weak evidence for use of dopamine agonists to improve neglect/inattention after stroke. There is little evidence on the frequency of adverse effects and long-term functional benefits.

    Conclusion: Although there is lack of robust evidence to recommend the routine use of medication to improve attention after traumatic brain injury and stroke, the existing evidence indicates potential for benefit in some patents and therefore further research is warranted.

    Lancashire Care staff can request the full-text of this paper,email: susan.jennings@lancashirecare.nhs.uk

    Filed under: ABI Acquired Brain Injury | Tagged: , , , , , | Comments Off

    Self-Harm & Peaks Unit at Rampton Hospital- Assessing the functions of self-harm behaviours for dangerous and severely personality disordered males in a high secure hospital

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Assessing the functions of self-harm behaviours for dangerous and severely personality disordered males in a high secure hospital, British Journal of Forensic Practice, 2010 Feb; 12 (1): 22-32

    Jen Gallagher, Kerry Sheldon

    Peaks Academic and Research Unit, Rampton Hospital, UK
    Institute of Mental Health, Nottingham, UK

    Abstract:

    The three aims of the study reported were to investigate the functions of self-harm in a population of patients detained in the Peaks Unit at Rampton hospital, to investigate the context and nature of this behaviour and to examine how staff respond to incidents of self-harm. The findings indicate that there may be some functions of self-harm specific to this population in addition to those found in other settings, namely expression of aggression and revenge. The context and nature of incidents were similar to those found in other secure settings. A range of staff responses were observed, and indicated high demand on staff time and resources. Limitations of the methods are discussed, with proposals for future research.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: Forensic Mental Healthcare, Personality Disorders, Self Harm, Self Harm Men | Tagged: , , , , , , , , | Comments Off

    Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder, European Psychiatry, Volume 25, Issue 1, January 2010, Pages 47-51

    İ. Özyıldırım, S. Çakır, O. Yazıcı

    Abstract:

    Objective

    In this study, we aimed to compare the clinical features and response patterns to the long-term prophylaxis of bipolar patients with or without psychotic features.

    Method

    The life charts of patients with bipolar I disorder were evaluated. Two hundred and eighty-one patients who suffer with bipolar disorder for at least 4 years and who had at least three mood episodes were included to the study. The patients whose all episodes are psychotic (psychotic group) and the patients who never experienced psychotic episode (non-psychotic group) were assigned as comparison groups. The clinical features and the response to long-term prophylaxis were compared across the groups.

    Results

    The psychotic group consists of 43 patients; non-psychotic group consists of 54 patients. The history of bipolar disorder among the first-degree relatives was remarkably more prevalent in non-psychotic group (p = 0.032). The predominance of manic/hypomanic episodes was significantly higher in psychotic group than non-psychotic group; and the rate of depressive episodes were higher in non-psychotic group than psychotic group (p = 0.013). Episodes were more severe (p < 0.001) and hospitalization rates were higher (p = 0.023) in psychotic group. The response to lithium monotherapy was better in non-psychotic group (p < 0.001).

    Conclusion

    The well identified psychotic subtype of bipolar patients may give important predictions about long term course and prophylaxis of bipolar disorder.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: bipolar, Psychosis, psychotic | Tagged: , , , | Comments Off

    Assessment of cognitive therapy skills for people with learning disabilities

    Posted on March 26, 2010 by lancashirecarelibraryblog

    Assessment of cognitive therapy skills for people with learning disabilities, Advances in Mental Health and Learning Disabilities, Volume 3, Number 4 / December 2009, pgs 25-30

    Dave Dagnan, Karen Mellor and Claire Jefferson

    Cumbria Partnership NHS Foundation Trust & Institute for Health Research, University of Lancaster, UK
    Calderstones NHS Trust, UK
    Cumbria Partnership NHS Foundation Trust, UK

    Abstract:

    There is increasing use of cognitive therapy with people with learning disabilities. This paper gives a detailed description of a clinically useful assessment approach that gives the therapist information that can be used to identify the appropriate approach to therapy.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: CBT Cognitive Behaviour Therapy, Learning Disabilities, psychological | Tagged: , , , , , , , , | Comments Off

    Re-examining concepts of occupation and occupation-based models: Occupational therapy and community development

    Posted on March 25, 2010 by lancashirecarelibraryblog

    Re-examining concepts of occupation and occupation-based models: Occupational therapy and community development,   Leanne L Leclair.   The Canadian Journal of Occupational Therapy. Feb 2010. Vol. 77, Iss. 1; p. 15 (7 pages)

    Abstract:

    Background. A growing body of literature supports the role of occupational therapists in community development. Using a community development approach, occupational therapists respond to community-identified occupational needs. They work to build local resources and capacities and self-sustaining programs that foster change within the community and potentially beyond. Purpose. The purpose of this paper is to highlight some key issues related to occupational therapy practice in community development. Key Issues. The definitions and classifications of occupation focus primarily on the individual and fail to elaborate on the shared occupations of a community. As well, occupation-based models of practice are not easily applied to occupational therapy practice in community development. Implications. In order for occupational therapy to articulate its role in community development, greater heed needs to be given to the definition and categorization of occupation, occupation-based models of practice, and their application to communities.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: community mental health, OT - Evidence Based OT, OT - Occupational Therapy | Tagged: , , , , , | Comments Off

    New updated CONSORT Statement, guidance for reporting randomised trials

    Posted on March 25, 2010 by lancashirecarelibraryblog

    New updated CONSORT Statement, guidance for reporting randomised trials

    Click on the link above to access the new 2010 statement and links to BMJ etc

    The CONSORT Statement is intended to improve the reporting of a randomized controlled trial (RCT), enabling readers to understand a trial’s design, conduct, analysis and interpretation, and to assess the validity of its results. It emphasizes that this can only be achieved through complete transparency from authors.

    Investigators and editors developed and revised the CONSORT (CONsolidated Standards of Reporting Trials) Statement to help authors improve reporting of two-parallel design RCTs by using a checklist and flow diagram. The most up-to-date revision of the CONSORT Statement is CONSORT 2010, which can be freely viewed and downloaded from this website. All previous versions of the CONSORT Statement are out-dated.

    Filed under: Consort Statement | Tagged: , , , , , | Comments Off

    2010 and beyond: Re-thinking Mental Health Policy in the UK

    Posted on March 25, 2010 by lancashirecarelibraryblog

    2010 and beyond: Re-thinking Mental Health Policy in the UK

    Click on the link above to access this website

    “Better mental health and wellbeing is vital for a healthy society. People with mental health problems are more likely to do other things that damage their health, such as have a poor diet, smoke or take drugs. So promoting good mental health is a key part of tackling many other health inequalities.”
    Phil Hope MP, Minister of State for Care Services, Department of Health, 22nd July 2009

    As a Collective Voice Representative l was given the opportunity to attend the recent “2010 and beyond: Re-thinking Mental Health Policy in the UK’ one day conference. The conference had a packed agenda, with a total of 12 speakers.  The key points from the day are summarised below.

    Professor Dame Carol Black, National Director, Health, Work and Wellbeing, started of the day discussing her national research on “A New Horizon for Mental Health Services in the UK”, focusing on the early intervention and recovery model at home and work, with recommendations of a ‘high profile’ mental health campaign with society.

    Anne Beales MBE, Director of Service User Involvement, from ‘Together’ gave a very informative and popular address. “Your agendas not Ours” was the theme, and how control should embody not only service formation but environmental support designed by Service Users and that services should be centric to all kinds of people, from older people to BAME groups.

    “Better Mental Health Services for BAME Communities”, by Polly Falconer, BME Mental Health Advocacy Manager and Patricia Chambers, BME Mental Health Service User Manager, Afiya Trust, opened our eyes to some fascinating points and statistics; including that one in two black men have suffered from mental health issues. They voiced that the BAME agenda is still immature within mental health policies and campaigning needs to be a priority.

    “Building a Coalition for Change” by Roger Catchpole, Training and Development Manager of ‘Young Minds’, discussed a major project in gathering information for mental health and young people. He spoke about the government having difficulty understanding how to deal with younger issues, problems with GP’s listening and A&E being a traumatic experience.  4PLEDGES is an Anti-stigma campaign set up to develop a “statement of need” for kids which hopes to have a Q&A with professionals & policy makers as well as training for staff on understanding the needs of children with mental health problems.

    Government policy in the next ten years will address the mental health workforce; Peter Kelly, Higher Occupational Health Psychologist from the Business Health Psychology Unit, Health and Safety Executive spoke on “Promoting Mental Wellbeing through Productive and Healthy Working Conditions: guidance for Employers”. He touched on some remedies and thoughts of how to challenge societal perceptions of mental health problems in the workplace.

    The closing keynote “A New Horizon in the Provision of Mental Wellbeing Services” by
    Bob Grove, Joint Chief Executive, Sainsbury Centre for Mental Health spoke about recovery and how medication is not always the answer but that the community will be the enabler of change to bring support to people affected by mental health issues.

    A longer report along with most presentations from the day will soon be available on the Collective Voice website: www.collectivevoicenw.org.uk

    Henri Rahman
    Collective Voice North West representative on the MHIP Steering Board

    Filed under: social care, well-being | Tagged: , , | Comments Off

    Changes in quality of life following cognitive-behavioral group therapy for panic disorder

    Posted on March 25, 2010 by lancashirecarelibraryblog

    Changes in quality of life following cognitive-behavioral group therapy for panic disorder, European Psychiatry, Volume 25, Issue 1, January 2010, Pages 8-14

     M. Rufer, R. Albrecht, O. Schmidt, J. Zaum, U. Schnyder, I. Hand, C. Mueller-Pfeiffer

    Abstract:

    Background

    Data about quality of life (QoL) are important to estimate the impact of diseases on functioning and well-being. The present study was designed to assess the association of different aspects of panic disorder (PD) with QoL and to examine the relationship between QoL and symptomatic outcome following brief cognitive-behavioral group therapy (CBGT).

    Method

    The sample consisted of 55 consecutively recruited outpatients suffering from PD who underwent CBGT. QoL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline, post-treatment and six months follow-up. SF-36 baseline scores were compared with normative data obtained from a large German population sample.

    Results

    Agoraphobia, disability, and worries about health were significantly associated with decreased QoL, whereas frequency, severity and duration of panic attacks were not. Treatment responders showed significantly better QoL than non-responders. PD symptom reduction following CBGT was associated with considerable improvement in emotional and physical aspects of QoL. However, the vitality subscale of the SF-36 remained largely unchanged over time.

    Conclusions

    Our results are encouraging for cognitive-behavior therapists who treat patients suffering from PD in groups, since decrease of PD symptoms appears to be associated with considerable improvements in QoL. Nevertheless, additional interventions designed to target specific aspects of QoL, in particular vitality, may be useful to enhance patients’ well-being.

    Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

    Filed under: CBT Cognitive Behaviour Therapy, panic disorder, well-being | Tagged: , , , , , , | Comments Off

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