UK Mental Health Tsar Maps Out Way Ahead For Mental Health Reform

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Mental Health Reform

Professor Louis Appleby explains why improvements in community care must continue and sets out a new phase of reform in mental health services.

Tracing the development of community services from former institutional care to today's modern, specialised community teams and services such as home treatment, Professor Appleby sets out the case for the next stage of reform of community care reform.

Breaking down barriers - the clinical case for change, is the latest in a series of reports from National Clinical Directors or 'Tsars' and National Advisers focused on the clinical reasons for making changes to the ways that services are delivered.

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He calls for the breaking down of barriers that can prevent people from rebuilding their lives and looks at how the expansion in talking therapy services, as announced by Patricia Hewitt yesterday, along with the move to greater community care, will help to continue a process that requires all mental health professions to re-define their role in a modern service. Professor Louis Appleby said:

"We no longer rely on beds to help people with serious difficulties - and patients are given care that they prefer by specialist teams. "Eight years on from the publication of the National Service Framework, it is no exaggeration to say that this has been a period of unprecedented transformation. Large increases in funding and in numbers of staff have created the essential foundation for changing the way that care is delivered.

"There has been a major reshaping of front-line services around the needs of patients in the community. However, changes will not end there. "The next stage in the reconfiguration of mental health services will further strengthen care in the community - breaking down barriers in the way services are delivered. At the heart of these changes will be workforce reform, with the skills of staff more closely aligned to the needs of patients - modern treatments, a better quality of life, social opportunities and improved physical health."

There are now more than 700 specialised mental health teams across 60 mental health trusts which can identify and address problems earlier, provide home treatment as an alternative to hospital and engage patients who do not respond to traditional care. They are staffed by a range of professionals, so that patients get the best of nursing, clinical psychology and social care.

The report also features case studies of people who have been offered alternatives to traditional hospital-based mental health care. One example is the case of an early intervention team in Worcestershire helping Anthony, 24, to regain enough confidence to return to university in September. Early intervention teams provide a quick response to the 7,500 young people a year who suffer their first episode of psychosis.

Anthony's father Andrew said: "It's a shock when you're told your son has a problem. The reassurance that it is being managed in a structured way gives you confidence that things will improve. I don't think he would have progressed without the team's focus and structure. It's almost run like a business with milestones and six-monthly reviews which everyone is involved in. "It has also helped the family to cope better. We feel part of the team and feel included in Anthony's recovery."

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