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Crisis and intensive home treatment team
Low secure mental health services
Mental health
An individual’s ability to manage and cope with the stress and
challenges of life and to manage any diagnosed mental health problems as part
of leading their normal everyday life
Acute
A disorder or symptom that develops suddenly. Acute conditions may or
may not be severe and they are usually of short duration.
Adults of working age
Adults aged 18 – 65
Older adults / older people
Adults over 65 years old.
Assessment
A process to identify the needs of an individual and evaluate the impact
of those needs on their daily living and quality of life.
Commissioning
The process by which commissioners decide which services to purchase and
which provider to purchase them from.
Crisis
A mental health crisis is a sudden and intense period of severe mental
distress.
Integrated model of health and social care
Health and social care professionals (social workers) working together
in health and social care professional teams to provide seamless care.
Payment by results (PBR)
A financial system which aims to provide a transparent, rules-based
system for paying NHS trusts. It will reward efficiency, support patient choice
and diversity and encourage activity for sustainable waiting time reductions.
Payment will be linked to activity and adjusted for the mix of types of
patients and/or treatment episodes. The system will aim to ensure a fair and
consistent basis for hospital funding rather than being reliant principally on
historic budgets and the negotiating skills of individual managers. Instead of
being commissioned through block agreements as previously, providers will be
paid for the activity that they undertake.
Practice based commissioning
GP practices and groups of practices being given more control over
purchasing local services for their patients.
Psycho-educational groups
Group work, using psychological therapy techniques, to address mental
and emotional problems such as anxiety, depression, trauma, severe stress.
Rehabilitation
A programme of therapy and re-enablement designed to restore
independence and confidence and reduce disability. The programme may include
occupational therapy to help with domestic and vocational skills that people
will need when they return to living independently.
Social care
Personal care for vulnerable people, including individuals with special
needs which stem from their age or physical or mental disability and children
who need care and protection.
Social inclusion
The state whereby vulnerable or disadvantaged groups are able to access
all of the activities and benefits available to anyone living in the community.
Consent
to treatment
If you are an informal patient, in most cases
you have the right to refuse any treatment you do not wish. When deciding, you
are entitled to get full information about the treatment, its purpose and
possible side-effects. Care may be given to people who are informal patients
without their consent if health workers assess that it is an emergency.
Early
Warning Signs
Before a relapse happens we often experience
changes in the ways in which the usual symptoms of our illness, or changes in
the way we behave, think or feel. These changes are what we call warning signs.
The early warning signs of mental illness differ from person to person, but
could include depression, anxiety, and irritability, disturbed patterns of
sleep or eating. The earlier we can identify warning signs, the better chance
we have of stopping a relapse or reducing the severity of a relapse.
Mental
Health Act Review Tribunal
The Mental health Act Review Tribunal is an
independent panel of people that decide if a person should be subject to the
Mental Health Act.
Relapse
A relapse occurs when a person is affected again
by a condition that affected them in the past. This could be a medical
condition such as depression, bipolar disorder or an addiction to a drug. For
example, if someone who had problems with alcohol were to give up alcohol and
then later start drinking again, this drinking might be considered a relapse.
Risk
Assessment
This is a record of any risks that are
associated with a patient. This can feel daunting and uneasy for some people
and can be a difficult area to discuss. Usually, this will contain information
about any known risks that are apparent to the professionals who are working
with you. It generally covers areas such as risk to self, risk to public, risk
to family, risk to children and risk of exploitation.
Self
Harm
Self harm is the term used to describe someone
who deliberately harms him/herself. Self harm is often how people deal with
very strong emotions and feelings of distress.
Self
Help
It takes courage to speak out, especially if you
are experiencing a mental health problem. Some people find it useful talking to
family and friend, or may also think about an independent organization. There
are many organizations that offer a range of information and advice as well as
treatments and therapies, in the statutory, voluntary and independent sectors.
Organic illness
Illness affecting memory and other functions that is often associated
with old age. Dementia, including Alzheimer’s Disease, is an organic mental
illness.
Dementia
Dementia
Dementia is the gradual loss of a person’s
memory, characterised by deterioration in brain function. People may also have
difficulty concentrating, be confused, anxious or agitated. The most common
form of dementia is Alzheimer’s Disease. The main symptoms of dementia are
progressive memory loss, disorientation and confusion.
Functional mental health problems
A term for any mental illness in which there is no evidence of organic
disturbance (dementia) even though physical performance is impaired.
Depression
Depression is one of the most common mental health problems. A negative
mood state which involves a feeling of sadness. A severe depression can require
treatment. Depression can frequently coexist with and complicate other physical
illnesses.
Anxiety
Anxiety is the term used to describe experiences
such as chronic fear, tension and panic attacks. Sleepless nights and recurring
thoughts are common, as well as nausea, palpitations, dizziness and difficulty
in breathing. Anxiety is one of the most common mental health problems.
Schizophrenia
Schizophrenia is a term used to describe a
complex illness, which affects a person’s ability to separate real and unreal
experiences. It is most common in people between the ages of 15 and 25 but it
can also start later in life. Some people have just one experience of
schizophrenia (or episode), while others have a longer lasting illness. People
with a diagnosis of schizophrenia usually experience delusions (false beliefs)
hallucinations (hearing voices or seeing things) and/or thought disorder
(thoughts become jumbled up); feelings of paranoia are also common.
Psychosis
Psychosis is the term used to describe when a person isn’t able to
distinguish between what is real and what isn’t. Mental health professional
will assess someone as being psychotic when they are experiencing hallucinations
or delusions. It is common for people with schizophrenia or manic depression to
experience psychosis.
This is a mental state that is characterised by the individual having a
number of symptoms which may include:
Hallucinations
Probably the most common hallucinations are hearing voices or seeing thing that
don’t exist but some people experience other kinds of hallucinations. These may
be auditory (hearing things), olfactory (smelling) visual (seeing things) or
gustatory (tasting). Hallucinations are common symptoms of schizophrenia.
Delusions
having false beliefs not consistent with the culture or subculture to
which the individual belongs
Thought disorder
disordered thinking in form and content, making odd connections between
words, using words in an odd way leading to speech that is often difficult to
follow
Negative symptoms
apathy, poor motivation, social decline.
Paranoid Psychosis
A psychotic state in which the predominant features are delusional
beliefs that the individual is being persecuted in some way.
Psychoses can be caused by stress and alcohol or drug abuse. Individuals
who experience a psychotic episode can recover and have no further problems.
Dual Diagnoses
Dual diagnosis is the term used to describe a person with a diagnosis of mental
ill health who also misuses substances.
Learning
Disability
Learning disability includes the presences of :
a significantly reduced ability to understand new or complex information, to
learn new skills
Mania
Mania is a symptom of bipolar disorder or manic
depression. People often feel over excited are overactive physically and can
rapidly change their ideas (also known as scattered or tangential thoughts).
Manic
Depression
Manic depression, also known as bipolar
disorder, is characterized by mood swings-periods of deep depression and of
overactive or excited
behaviour, known as ‘mania’. Theses severe highs and lows may occur directly
after each other or they can be separated by longer periods of time.
Personality
disorder
Personality disorder is defined in the Mental
Health Act 1983 as ... ' a persistent disorder or disability of mind...which
results in abnormal aggressive or seriously irresponsible conduct...'
Postnatal
Depression
Women may experience a wide range of symptoms
including feeling low and unhappy most of the time, acute anxiety,
irritability, sleeplessness, tiredness and a loss of enjoyment of desire to do
anything. These symptoms may be made worse by feelings of guilt about not being
able to cope or look after the baby.
Phobias
A phobia is an irrational and uncontrollable
fear of an object or situation that most people can face without anxiety. A
person with a phobia has feelings of intense panic when confronted with whatever
it is that frightens them and will go to great lengths to avoid the causes of
the distress. An example of phobias are claustrophobia (fear of enclosed spaces
and agoraphobia (fear of leaving the security of the home).
Post
Traumatic Stress Disorder PTSD
People with PTSD often relive experiences through
nightmares and flashbacks, have problems sleeping and feel detached from
reality.
Seasonal
Affective Disorder or SAD
Seasonal affective disorder, or SAD, is a form
of depression some people get consistently during autumn and winter seasons,
where there is less daylight. People often want to sleep for long periods when
they have seasonal affective disorder.
Eating
Disorders
People who have an eating disorder find their
life becomes centered on food.
Anorexia
Nervosa
Anorexia is characterised by not
eating. In some cases, a person becomes malnourished to the point of
starvation. Someone experiencing anorexia will cut down on food and fluid and
may avoid eating with others. People’s perception of their own body size
becomes distorted.
Bulimia
Bulimia may go unnoticed as appearance remains
the same and the person seems to cope normally with his or her life. However
eating is chaotic and involves long periods of bingeing alone often followed by
self-induced vomiting and abuse of laxatives.
Staff groups
Commissioners
Team of people who purchase (mental) health care services from providers
such as AWP for the local community.
County council
Councils are directly elected local bodies which had a duty to promote
the economic, social and environmental well-being of their areas. They do this
individually and in partnership with other agencies, by commissioning and
providing a wide range of local services.
Foundation Trusts
NHS Foundation Trusts are a new type of NHS Trust in England. They have
been created to devolve decision-making from central Government control to
local
organisations and communities so they are more responsive to the needs and wishes of
their local people.
Independent sector
Voluntary, charitable and private care providers.
Primary Care Trust (PCT)
Primary care trusts have responsibility for commissioning specialist
services working closely with social services.
SHO (Senior House Officer)
A junior doctor either a GP or psychiatry trainee. They are responsible
for the day to day medical care of inpatients under the supervision of their
Consultants.
Psychotherapy or psychological therapies
Treatment of mental and emotional problems – such as anxiety, depression
or trauma – by psychological methods. Patients talk to a therapist about their
symptoms and problems with the aim of learning about themselves.
Service users
Patients – people who need health and social care for their mental
health problems. They may be individuals who live in their own homes, are
staying in care, or are being treated in hospital.
Carers
Relatives or friends who voluntarily look after individuals who are
sick, disabled, vulnerable or frail, on a part-time or full-time basis.
Patient and Public Involvement Forum (PPI)
An independent group set up by the Commission for Patient and Public
Involvement that reviews the work of an NHS organisation. There is a forum for each
NHS trust and primary care trust.
Approved Social Worker (ASW)
Same as social workers, but (ASW's) have undergone specific training in
mental health law/ the Mental Health Act, which enables them to carry out
Mental Health Act assessments with other professionals.
Advocate
An advocate
is a person you can turn to for information, advice and other help to get the
treatment and support you would like. This person can attend meetings with you
and help you to say what you want or can express your view for you. Many people
could act as your advocate – friends, relatives or a member of staff like a
nurse or a social worker. However, it can be difficult to say some things to
people who are close to you, like relatives, and sometimes people want to have
the support of someone in addition to staff. For these reasons, many
service-users prefer to use trained, independent advocates.
Care coordinator
A care coordinator is the name for the person responsible for
coordinating the care you receive when you are in the community. This is your
main contact person and tends to be a community psychiatric nurse, or CPN,
social worker or occupational therapist.
Community Psychiatric Nurses (CPN)
CPN's are part of a team of mental health professionals; they have
specialist knowledge about mental illness and are able to administer
medication. They act as Care Co-coordinators/ key workers to those who need
ongoing support, particularly in relation to the management of a mental
illness. If they are your Care Co-ordinator, they will co-ordinate the
services that you receive and be involved in reviewing your 'care' through the
Care
Programme Approach (CPA). This ensures that you receive the support that is most
helpful to you.
Formal Patient
A formal patient is a person who is detained under the Mental Health Act
1983.
Informal Patient
An informal patient is a person in hospital of his/her own free will.
Most people admitted to hospital are there on a voluntary basis.
Mental Health Act Manager
The Mental Health Act Manager is an independent
panel responsible for hearing a person’s application to be discharged and for
ensuring the Act is used appropriately in their organisation.
Occupational Therapists
These are therapists who assist individuals to develop the skills they
may need, to enable them to live independently. They are often based in
hospitals, but some are based at Community Mental Health Centres.
Psychotherapists
Psychotherapy uses talking therapies to help patients help themselves.
It is based on a variety of 'talking treatments' including cognitive, behavioural,
psychoanalytic and psychodynamic therapies. To receive this service, you would
need to be referred by your Care Coordinator. They are often based at Community
Mental Health Centres
Specialist registrar (SpR)
A registered
doctor who undergoes a training programme in a chosen specialty and is eligible
to apply for a consultant post.
Social Workers
Social workers are part of a team of mental health professionals and,
like CPN’s; they also have specialist knowledge about mental illness. They do
not administer medication. They act as Care Co-coordinators to those who need
ongoing support with their mental health difficulty, particularly in relation
to their social needs. If they are your Care Coordinator, they will co-ordinate
the services that you receive and be involved in reviewing your 'care' through
the Care Programme Approach (CPA). This ensures that you receive the support
that is most helpful to you.
Emergency Duty team
Out of hour’s service, provided by community care for people
experiencing a mental health crisis
Services
Child and adolescent mental health services
(CamHS)
Individual and family work helping children and young people under the
age of 18 who experience a mental health problem
Community mental health team (CMHT)
A team made up of a range of professions offering specialist assessment,
treatment and care to people in their own homes and other community settings.
The team should include nurses, psychiatrists, social workers, clinical
psychologists and occupational therapists, with ready access to other therapies
and expertise.
Crisis and intensive home treatment team
Services to manage/limit the crises suffered by mental health service
users and
support people to remain at home. They commonly operate 24 hours / seven days a
week and may visit individuals daily or even more frequently providing an
alternative to inpatient care.
Day hospital
A hospital where patients receive day care only, continuing to live at
home. A person would typically attend for several hours during the day, rather
than just attending a specific session as part of their programme of treatment
and care.
Early intervention service
Service for people experiencing their first episode of psychosis.
Research suggests that early detection and treatment will significantly
increase recovery.
Low secure mental health services
Intensive rehabilitation service for mentally-disordered offenders.
Primary care mental health services
Services provided by family doctors, dentists, pharmacists, optometrists
and ophthalmic medical practitioners together with district nurses and health
visitors, with administrative support.
Services could include:
• counselling services based in GP practices
• psycho-educational groups
• psychological therapies provided by graduate mental health workers
• access to
computerised psychological therapies
• in-reach to primary care by community mental health teams
Psychiatric intensive care (PICU)
Services to support mental health service users in a very severe acute
phase of illness
Secondary Mental Health Services
These are specialist mental health services provided usually by a Mental
Health Trust. Services include support and treatment in the community as well
as a range of inpatient services. Individuals are referred into these services
by their General Practitioners and usually have serious mental illness.
Assertive outreach Service
An active form of treatment delivery; the service can be taken to the
service users rather than expecting them to attend for treatment. Care and
support may be offered in the service user’s home or some other community
setting, at times suited to the service user rather than focused on service
providers’ convenience.
Inpatient services
Services provided, often by the NHS, where the patients/service users
are accommodated on a ward and receive treatment there from specialist health
professionals.
Counselling/psychology
services
Advice and psychological support from health professionals to help
people deal with personal difficulties. It is used to address a variety of
areas such as problems at school, work or in the family, and to help people to
deal with addictions and provide support during life crisis. Most counselling is a one to
one activity but it may also be carried out in groups.
Outpatient services
Medical care on a same-day basis in a hospital or clinic.
Residential and nursing homes
Residential care refers to nursing homes and residential care homes that
provide around the clock care for vulnerable adults and older adults who can no
longer be supported in their own homes, are staying in care, or are being cared
for in hospital. Homes may be run by local councils or independent organisations.
Anti psychotic
Drugs used to ameliorate the symptoms of psychosis and schizophrenia.
These can be oral or by intra muscular injection and include older type drugs
e.g. Stelazine and newer drugs with possibly fewer side effects such as
Risperidone and Amisulpiride.
Anti Depressants
Anti
depressants aim to treat the symptoms of depression and can help people
experiencing depression to feel more motivated and energetic.
Care Programme Approach (CPA)
This is the main way by which care is co-ordinated and delivered to
individuals by secondary care services. It means that all individuals involved
in the care will discuss the care with the user of the mental health services
and their family/friend/carer (as appropriate) to ensure all the users needs
are met. Once the package of care is agreed by the user and others a Care
Programme is drawn up and the individual responsible for delivering the care
identified. Delivery of the Care plan is co-ordinated by the Care Co-ordinator
who will also ensure there are regular reviews.
Mental Health Act 1983
Is the main Act of Parliament setting out the rights of people receiving
mental health services This is the legislation under which individuals can be
assessed and required to be admitted to hospital for assessment for 28 days
under section 2 or for treatment for 6 months under section 3. All assessments
are undertaken by a social worker and two medical practitioners, one of whom
will have special expertise in psychiatry. The Mental Health Act lays out a
number of duties and responsibilities.
Independent Mental Health Advocacy (IMHA)
IMHA
services provide an additional safeguard for patients who are subject to the
Mental Health Act, and are specialist advocates who are trained to work within
the framework of the Act. These services will not replace other advocacy
services currently available to patients, but are intended to operate in
conjunction with them.
Deprivation of Liberty Safeguards (DOLS)
The aim is to
implement the safeguards in April 2009. The safeguards are designed to protect
the interests of an extremely vulnerable group of service users and to:
- ensure people can be given the care they need in the least restrictive
regimes
- prevent arbitrary decisions that deprive vulnerable people of their liberty
- provide safeguards for vulnerable people
- provide them with rights of challenge against unlawful detention
- avoid unnecessary bureaucracy
Independent Mental Capacity Act (IMCA)
Overall, the
Act will provide a much clearer legal framework for people who lack capacity
and those caring for them by setting out key principles, procedures and
safeguards.
National Service Frameworks (NSF)
A set of quality standards for services issued by the Department of
Health.
setting out core standards for services
NICE (National Institute for Clinical excellence)
The National Institute for Health and Clinical Excellence (NICE) is the
independent organisation responsible for providing national guidance on the
promotion of good health and the prevention and treatment of ill health.
NICE produces guidance in three areas of health:
DoH (Department of Health)
The
Department of Health (DH) exists to improve the health and wellbeing of people
in England.
CQC (Carer Quality Commission)
The Care Quality Commission is the independent regulator of health and social
care in England. The aim is to make sure better care is provided for everyone,
whether that’s in hospital, in care homes, in people’s own homes, or elsewhere.
They regulate health and adult
social care services, whether provided by the NHS, local authorities, private
companies or voluntary organisations. And, protect the rights of people detained under the Mental Health Act.
Therapies
Art Therapy
Art therapy aims to support people’s recovery using art as a creative process
and a therapy to help people resolve emotional conflicts, be more aware about
themselves, develop social skills, reduce anxiety and increase their
self-esteem.
Bibliotherapy
The use of books as a means of providing psychological therapy
Cognitive
Behavioural Therapy
Cognitive behavioural therapy or CBT involves
working with people to help them change their emotions, thoughts, and behaviours.
Computerised Cognitive
Behavioural Therapy (CCBT)
This is a new method for delivering CBT via a
computer
Family Therapy
In some cases, it is useful for couples or families to work together in
a therapeutic setting to resolve their difficulties. The therapist encourages
dialogue between the participants to help improve communication between them.
Psychotherapy
Psychotherapy aims to help a person overcome a period of distress. A
qualified therapist will spend time helping the person to analyse his or her
past experiences to understand what may be the cause of their current feelings
of unhappiness and distress.
Talking Treatments
Talking treatments describe a number of therapies available, including
counseling, Cognitive behavioral therapy and self – help