Faith, Hope and Parity: Faith, Hope and Parity Deconstructing Mental Health Services


Faith, Hope and Parity: Faith, Hope and Parity Faith In services There to help Will meet our needs Will be accessible In the people who deliver them They are well trained Will treat us with respect Have our interests at heart


Faith, Hope and Parity: Faith, Hope and Parity Hope Identify cause Scientific approach Exclude all possible causes for experiences Understand context of experiences Socially culturally Provide services based on best evidence NICE guidelines as a starting point Offer choice – statutory or independent sector?


Faith, Hope and Parity: Faith, Hope and Parity Parity Quick and fair access to treatment Equal access to services for all including devalued groups Services built on sound values Service user as partner in care Respect for diversity


Faith, Hope and Parity: Faith, Hope and Parity NHS is almost 60 years old Born: 6th July 1948 to “promote the establishment in England and Wales of a comprehensive healthcare system designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness……..”


Faith, Hope and Parity: Faith, Hope and Parity 1st free, comprehensive healthcare system in Western society 1000 voluntary agency run hospitals and 540 LA run hospitals came under state control GP practices, previously only available to those who had insurance made available to all Competing values and pressure groups


Faith, Hope and Parity: Faith, Hope and Parity Prior to 1947: No agreed definitions of ‘specialist’ No minimum standards No way of checking skills and competencies required for the job e.g. GP’s often carried out both medical and surgical procedures in local hospitals


Faith, Hope and Parity: Faith, Hope and Parity Psychiatry and Mental Health Gods and Demons Those who the Gods destroy, they first make mad (Euripides) >5ooo BC. Madness (epilepsy and depression) often linked to judgement and punishment by devils and demons. Conditions linked to animals e.g. wolf-madness, black-dog (depression). Ancient Greeks. Psychic conflict, human condition driven by guilt, pride, ambition, shame etc Christianity: work of the devil, unclean spirit etc Drapetomania: 1851 USA (Samuel Cartwright) compulsive desire to run away


Faith, Hope and Parity: Faith, Hope and Parity Treatment: Water, thought to be effective for depression Priests, effective for possession, depression and epilepsy (often the same as possession) Drapetomania – amputation of the toes Psychoanalysis, Freud et al Prolonged sleep, insulin therapy etc Pharmacology Default position, admission (asylum?) at times of crisis and medication


Faith, Hope and Parity: Faith, Hope and Parity Treatment Rivalries between approaches Anti-psychiatry movement and development of social theories, Szasz, Laing, Cooper etc Medical Model, classification of illness, Bio-psychosocial model – integration and collaboration NICE guidelines


Faith, Hope and Parity: Faith, Hope and Parity Mental Health variously described as: “a national disgrace” (Bevan, 1958), “scandalous” (Crossman, 1969) Joseph (1973) described an “alliance of indifference” between managers and medics


Faith, Hope and Parity: Faith, Hope and Parity Services based on skills and competencies needed to deliver best or evidence based practice (not based on professional groups) Workers who are equipped to seek out the evidence and develop research methodologies Workers and organisations who are prepared to work together for the benefit of service users and their families and carers


Faith, Hope and Parity: Faith, Hope and Parity 10 Essential Shared Capabilities Quality Audit Tool for Education International implementation study including USA (Stuart), Singapore (Arthur), New Zealand (Potter), Hong Kong, Scotland (Forrest) and England (McGonagle) Supervision (Butterworth) Informed the Increasing access to psychological therapies national survey Influenced the New Ways of Working for AHP’s National Report Informed the PSI National Survey


Faith, Hope and Parity: Faith, Hope and Parity Dual Diagnosis (Hughes) Development of good practice guidelines for dual diagnosis education and training Development and evaluation of education and training programme for dual diagnosis National implementation through National Institute for Mental Health (England) (NIMHE) CAMHS (Gale) Development and evaluation of Education and Training module for Graduate Workers in Primary Care


Faith, Hope and Parity: Faith, Hope and Parity National Education and Training Framework for Mental Health (Baguley and Allcock) (going through gateway) New Ways of Working for Allied Health Professional Education and Training Report (Baguley and Melton) (going through gateway) Increasing Access to Psychological Therapy: National Survey of Education and Training Provision (Baguley, Alexander, Scott, Turpin and Hope). Report on behalf of DH to go to Treasury as part of DH submission to Comprehensive Spending Review


Faith, Hope and Parity: Faith, Hope and Parity Primary Care (Rushforth) Development of blended learning materials (Book and CD Rom) for primary care staff (Rushforth and Myles) Violence, Abuse and Mental Health (Itzin) Systematic Review: Extreme pornography Effects (Itzin) DH Strategy on Women's Health (Itzin and Owen) DH/HO Policy: Tackling the health and mental health effects of domestic and sexual violence (Itzin)


Faith, Hope and Parity: Faith, Hope and Parity Patient Outcomes (Baguley, Butterworth, Brooker and Hughes) Lecturer Competencies Recruitment to Professional Training (Owen and Baguley) Mental Health and Criminal Justice (including prisons) (Brooker and Sirdifield) Clinical Academic Careers (Butterworth, Jackson and Bell)


Faith, Hope and Parity: Faith, Hope and Parity Only academic institution involved in developing new QAA process Quality Audit Tool 10 ESC Education and Training Framework


Faith, Hope and Parity: Faith, Hope and Parity Work with NICE to develop implementation strategy for NICE guidelines on Dementia Care (Baguley) Work with Mental Health Foundation on report on services for older people (Baguley and McGonagle)


Faith, Hope and Parity: Faith, Hope and Parity Current Work: Acute in-patient care Review Education and Training for Care Programme Approach across England (Gurnay, Baguley and McGonagle) Evaluate NWW for Acute in-patient care (Alexander, Baguley and Middleton)