Improving access to primary care risks fuelling demand unless a system-wide view taken, says Nuffield Trust

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This new report, based on a workshop in March 2014, sets out to inform the development of 20 pilots (in England) of the Prime Minister’s Challenge Fund, to improve access to primary care.   The report focuses on the debate around unintended consequences of extending (e.g. longer opening hours) or broadening (e.g. phone or online consultations) access – will [read the full story…]

We don’t know if general health advice improves physical health for patients with serious mental illness

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For me, one of the most infuriating aspects of health care is the relegation of mental health problems, and mental health services, as secondary to physical health. There are a myriad of examples of this, from the classic stigma that people with mental health problems receive compared to those with physical health problems (fantastically illustrated [read the full story…]

Health Professionals’ views on care pathways for adults with learning disabilities

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The health inequalities of people with learning disabilities are well documented in the literature, with increased risks for many physical and sensory health issues as well as mental health issues and responses from health services have often been poor, as documented in the Michael Report. In recent years, the healthcare pathways approach has been introduced [read the full story…]

Bridging the gap: low intensity collaborative care for patients with recent cardiac events can improve mental health and quality of life

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There are many interfaces in mental health services, such as the one between physical and mental health. Where there are interfaces, there are inevitably gaps for patients to fall through. Consequently opportunities are missed to treat mental health problems in those with physical health problems. There is mounting evidence for the effectiveness of Collaborative Care (CC) [read the full story…]

Reasonable adjustments in primary care for people with learning disabilities

Good health care is dependent on cooperation between health care professionals and support workers in order to maximise care, health and functioning for people with learning disabilities

UK law requires public services to make reasonable adjustments for disabled people following the Disability Discrimination Act (1995) and the Equality Act (2010), which does not cover Northern Ireland. For people with physical disabilities these have predominantly focused on the environment, whilst for people with a learning disabilities it requires more commonly clear explanations and [read the full story…]

Why do GPs over prescribe benzodiazepines? Synthesis of qualitative studies

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Benzodiazepines are used to treat insomnia, anxiety and chronic back pain due to their sedative and muscle relaxing effects. They’ve got a sting in the tail though and can cause memory disruption, loss of coordination and dependence if used long term. It’s therefore recommended that other treatments, such as psychological interventions, are tried first and [read the full story…]

Off to a good start. Are self-help interventions effective for people with comorbid physical and mental health problems?

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The ideal treatment for common mental health problems in those with chronic physical illness would have to be reliable, easy to deliver, inexpensive and accessible by a group of people whose physical impairment may affect treatment adherence. NICE guidelines (CG90 Depression; the treatment and management of depression in adults) recommend self-help interventions (SHIs) based on [read the full story…]

Black patients’ first contact with mental health services is more likely to be coercive

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It is well documented that there are differences in how patients are treated, depending on their ethnicity. Previous inquiries in the UK have suggested that the NHS is institutionally racist (Blofeld et al, 2003). Some groups, for example those from African Caribbean or Aboriginal descent, experience more coercive care and poor outcomes, including higher doses of [read the full story…]

Suicide in primary care: findings of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

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The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness was established in its current form at Manchester University in 1996. From 1991, prior to the move to Manchester, research in this area had been managed within the Royal College of Psychiatrists.  The NCISH has established an outstanding national and international reputation [read the full story…]

Is there ‘parity of esteem’ in shared decision making between physical and mental health?

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Current health and social care policies determine that people who use services should have choice and control over their care and support. This is particularly important for people with mental health problems who are managing their mental health and designing support in preventative ways to avoid crisis. One way for mental health service practitioners to [read the full story…]