Adult mental health services in the NHS should be improved to provide person-centred care that tackles the stigma associated with mental illness, says NICE.
People with mental health issues should have access to mental health services when they need them, and should be actively involved in shared decision-making and supported in self-management.
This latest NICE guidance, together with a quality standard, comes on the back of government calls to improve patient experience of using mental health services in the NHS.
Developed together, the guidance (231 pages long) and quality standard (31 pages long) aim to ensure users of mental health services have the best possible experience of care from the NHS. The standard has the following 15 quality statements, which are a slimmed down version of the recommendations from the guideline:
- People using mental health services, and their families or carers, feel optimistic that care will be effective.
- People using mental health services, and their families or carers, feel they are treated with empathy, dignity and respect.
- People using mental health services are actively involved in shared decision-making and supported in self-management.
- People using community mental health services are normally supported by staff from a single, multidisciplinary community team, familiar to them and with whom they have a continuous relationship.
- People using mental health services feel confident that the views of service users are used to monitor and improve the performance of services.
- People can access mental health services when they need them.
- People using mental health services understand the assessment process, their diagnosis and treatment options, and receive emotional support for any sensitive issues.
- People using mental health services jointly develop a care plan with mental health and social care professionals, and are given a copy with an agreed date to review it.
- People using mental health services who may be at risk of crisis are offered a crisis plan.
- People accessing crisis support have a comprehensive assessment, undertaken by a professional competent in crisis working.
- People in hospital for mental health care, including service users formally detained under the Mental Health Act, are routinely involved in shared decision-making.
- People in hospital for mental health care have daily one-to-one contact with mental healthcare professionals known to the service user and regularly see other members of the multidisciplinary mental healthcare team.
- People in hospital for mental health care can access meaningful and culturally appropriate activities 7 days a week, not restricted to 9am to 5pm.
- People in hospital for mental health care are confident that control and restraint, and compulsory treatment including rapid tranquillisation, will be used competently, safely and only as a last resort with minimum force.
- People using mental health services feel less stigmatised in the community and NHS, including within mental health services.
Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE, said:
The aim of this quality standard and guidance is to improve the experience for people using adult mental health services in the NHS. This area is still, sadly, associated with stigma and embarrassment, despite 1 in 4 people in the UK suffering with a mental health problem at some stage in their lives. I am sure this guidance and accompanying standard will be helpful aids to all those working in this field.
Links
Service user experience in adult mental health: improving the experience of care for people using adult NHS mental health services (PDF). NICE, 14 Dec 2011.
Quality standard for service user experience in adult mental health (PDF). NICE, 145 Dec 2011.
Go to the NICE website for the patient and carers version of this guideline, implementation tools and documents for commissioners.
There’s an interesting blog on the King’s Fund website about this new NICE guideline:
Can we be aspirational about quality standards for mental health when resources are so tight?
Joanna Goodrich
22 December 2011
http://www.kingsfund.org.uk/blog/nice_mental_health.html
Cheers,
The Mental Elf
NICE have now published the ‘comments and responses’ document that accompanies this guideline. It contains all of the comments made by stakeholders about the guidance and the responses from NICE:
http://www.nice.org.uk/nicemedia/live/13260/58038/58038.pdf
Cheers,
The Mental Elf
Based on my recent experiences with mental health professionals, it would appear that some services have a long way to go before they can meet these expectations. I agree with the above comment about resources too. How can the expectations even be met when the service is so stretched.
There’s a good summary of this guidance in the BMJ today from Tim Kendall and colleagues:
http://www.bmj.com/content/344/bmj.e1089
Cheers,
The Mental Elf