This report aims to better understand the priorities and lessons for improving mental health services in established and emerging Integrated Care Systems (ICSs) and makes recommendations that reflect the opportunities and challenges in doing so. It is recognised that further lessons and priorities will emerge as more ICSs are established across the country.
Tighter working partnerships between health professionals and police services are likely to improve the care of people who come into contact with police during mental health crises | National Institute for Health research
People experiencing severe mental health episodes can present with extreme and unpredictable behaviour posing a danger to themselves and members of the public. Police are often the first to respond in these challenging situations.
New models are emerging of mental health staff working with police. This NIHR-funded review found limited UK-relevant evidence of mixed quality. Studies showed different models in use, from police and mental health staff responding to incidents together to health staff in police control rooms providing support and advice. There was little evidence on which approaches work best, but some research suggested a reduction in formal detentions although there were few outcome data reported.
Research shows potential for improving health outcomes for individuals in crisis by ensuring they are diverted to appropriate services, and in helping direct the appropriate use of police and NHS resources.
Making the right choices: Using data-driven technologies to transform mental healthcare | Reform
This report examines the current landscape of data-driven technologies and their applications in mental healthcare, highlighting areas where these tools offer the most potential for the NHS and its patients. It discusses what makes mental health different from other areas of health, and the implications this has for the application of data-driven tools. It examines barriers to implementation, and proposes ways to move forward.
The National Institute for Care and Health Excellence should make guidelines and protocols machine-readable to inform Clinical Decision Support Systems used in mental healthcare. This would make the guidelines more accessible to frontline practitioners and enable the guidelines to be continuously improved in accordance with up-to-date clinical evidence.
In order to improve understanding of mental health conditions, NHS Digital should develop a repository using data held by NHS organisations to help researchers securely identify suitable participants for mental health research studies and assess the feasibility of research projects at early stages. Similar governance frameworks to the Scottish Health Research Register should be employed.
NHSX should require all healthcare providers to design interoperable systems and ensure data portability. This would allow data generated from technologies such as wearables and sensors to be transferred across platforms.
Filling the chasm: reimagining primary mental health care | Centre for Mental Health
This report explores local initiatives which bridge the gap between primary care and secondary care mental health services, supporting people have more complex needs, don’t meet secondary care thresholds, or present with multiple or medically unexplained symptoms.
It finds that primary care services in many areas of England have developed a number of different approaches to addressing mental health needs that other services do not meet. The report describes promising approaches in eight local areas.
The report calls on NHS England to make primary mental health care a central strand of the long-term NHS plan, due to be published later this month. The NHS needs to identify effective models of primary mental health care and invest in local services to help them meet the needs of their communities. The report also calls on Health Education England to invest in the workforce for primary mental health care.
The report identified some key elements for future primary care developments:
Identifying the opportunities for prevention and promotion of mental health – including in the perinatal period; with children and young people; and through providing information and resources
Maximising social interventions for mental health – moving away from anti-depressants and therapy as the only solutions, improving awareness of community resources
Culture change – embracing the holistic approach – valuing social support and linking to physical health initiatives
Empowering the person – moving ‘from patient to person’ – enabling people to make their own decisions about what they need to focus on, addressing social factors and causes of mental health problems
Bridging the gap between primary and secondary care – co-locating services, employing senior staff to provide consultancy and supervision
This tool and supporting guidance have been developed to support mental health trusts in securing learning through reviewing the deaths of patients who are currently or have recently been under their care | Royal College of Psychiatrists (RCPsych)
The Royal College of Psychiatrists (RCPsych) has drawn up national guidance, which is made up of a Care Review Tool and guidance on how to use it, for the first time at the request of NHS England.
The guidance focuses on patients with severe mental illness and on four ‘red-flag’ scenarios, including where concerns have been raised by families and carers or where patients have experienced psychosis or had an eating disorder. To ensure any opportunities for learning are not missed, trusts are also encouraged to review a sample of other patients’ deaths, such as those with dementia.
The Tool has been developed to look at care at different phases of a patient’s contact with services, and ensures that good care is able to be recognised, judged and recorded in the same detail as problematic care. The object of the structured judgement review method is to look for strengths and weaknesses in the process of the patient’s care and treatment, to provide information about what can be learned when care goes well, and to identify gaps, problems or difficulties in the care received by the patient.
The tool allows explicit judgements around a patient’s care to be made, with a score given for each phase of care. The aim of this tool is to make it possible for Trusts to screen all deaths of patients in contact with mental health services and, through thematic analysis of a number of completed forms, to:
Determine areas of good care that can be recognised and further developed
AHSN | May 2018 | Improving the Physical Health of People with Serious Mental Illness
Bradford District Care Foundation Trust, has developed a template to support healthcare professionals to identify patients with conditions including high blood pressure, diabetes and cardiovascular problems. The template improves the quality of health checks for people with a serious mental illness (SMI) who are at risk of dying prematurely due to preventable physical conditions.
Potential cost savings in the Yorkshire and Humber region alone are estimated to be £11.3 million over the next 10 years. The AHSN piloted an initial rollout across two Mental Health Trusts and two Clinical Commissioning Groups (CCGs). It has also supported organisations nationally to trial or implement the template.
The template is available through the SystmOne, EMIS and RIO web platforms and has been used by 74 CCGs. An eLearning module produced by the AHSN went live in January 2017 (Source: AHSN).
Equally Well: A new collaborative to support the physical health of people with a mental illness | via Centre for Mental Health
In October 2016, the Academy of Medical Royal Colleges published the report ‘Improving the physical health of adults with severe mental illness: essential actions’The report outlined the changes that were needed to make a sustained impact on the physical health of people living with a mental illness. It highlighted that coordinated national effort would be needed to bring good practice to scale and support further innovation and improvement across the country.
Equally Well is an initiative from New Zealand which seeks to promote and support such collaborative action to improve physical health among people with a mental illness.
Now in the UK, the Centre for Mental Health, Kaleidoscope and Rethink Mental Illness are working together with support from the Royal College of GPs and the Royal College of Psychiatrists to create an Equally Well collaborative in this country.
The Beyond Places of Safety fund will focus on improving urgent mental healthcare in local areas | Department of Health
The Department of Health has launched a £15 million fund to better support people at risk of experiencing a mental health crisis.
The Beyond Places of Safety scheme aims to improve support services for those needing urgent and emergency mental healthcare. This includes conditions such as psychosis, bipolar disorder, and personality disorders that could cause people to be a risk to themselves or others.
In 2015, the government committed five years of extra funding for children and young people’s mental health services (CYPMHS). All areas of England were required to submit plans outlining how they will improve their services by 2020.
This POSTnote describes some of the new models of CYPMHS and examines the challenges to their effective implementation.
The Office for National Statistics estimates that nearly one in four Children and Young People (CYP) show some evidence of mental ill health.
It is estimated that between £70-100 billion is lost each year in the UK due to poor
New models of CYP mental health services are currently being developed across the
country to suit the unique needs of local areas. They include whole-system, schoolsbased, community-based and other models, and involve integrating services from across the statutory and voluntary sectors.
Issues with implementing new service models include data monitoring, recruiting
and retaining staff and funding.