Integrated model of health and social care
Functional mental health problems.
Psychotherapy or psychological therapies
Patient and Public Involvement Forum (PPI)
Community Psychiatric Nurses (CPN).
Child and adolescent mental health services (CamHS)
Community mental health team (CMHT).
Crisis and intensive home treatment team
Low secure mental health services.
Primary care mental health services.
Psychiatric intensive care (PICU).
Secondary Mental Health Services.
Counselling/psychology services.
Residential and nursing homes.
Care Programme Approach (CPA).
Deprivation of Liberty Safeguards (DOLS)
Independent Mental Capacity Act (IMCA).
National Service Frameworks (NSF).
Mental health <= o:p>
An individual’s ability to manage and cope with the stress and
challenges of life and to manage any diagnosed mental health problems as pa=
rt
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 aged 18 – 65
Adults over 65 years old.
Assessment <= o:p>
A process to identify the needs of an individual and evaluate the im=
pact
of those needs on their daily living and quality of life.
Commissioning <= o:p>
The process by which commissioners decide which services to purchase=
and
which provider to purchase them from.
Crisis <= o:p>
A mental health crisis is a sudden and intense period of severe ment=
al
distress.
Integrated model of health and social care
Health and social care professionals (social workers) working togeth=
er
in health and social care professional teams to provide seamless care.
A financial system which aims to provide a transparent, rules-based
system for paying NHS trusts. It will reward efficiency, support patient ch=
oice
and diversity and encourage activity for sustainable waiting time reduction=
s.
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.
GP practices and groups of practices being given more control over
purchasing local services for their patients.
Group work, using psychological therapy techniques, to address mental and emotional problems such as anxiety, depression, trauma, severe stress.<= o:p>
Rehabilitation <= o:p>
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&n=
bsp;
Personal care for vulnerable people, including individuals with spec=
ial
needs which stem from their age or physical or mental disability and childr=
en
who need care and protection.
Social inclusion <= o:p>
The state whereby vulnerable or disadvantaged groups are able to acc=
ess
all of the activities and benefits available to anyone living in the commun=
ity.
Co=
nsent
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.
Ea=
rly
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 si=
gns.
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 chan=
ce
we have of stopping a relapse or reducing the severity of a relapse.=
Me=
ntal
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.
Re=
lapse
A relapse occurs when a person is affected a=
gain
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. F=
or
example, if someone who had problems with alcohol were to give up alcohol a=
nd
then later start drinking again, this drinking might be considered a relaps=
e.
Ri=
sk
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 informat=
ion
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, r=
isk
to family, risk to children and risk of exploitation.
Se=
lf
Harm
Self harm is the term used to describe someo=
ne
who deliberately harms him/herself. Self harm is often how people deal with
very strong emotions and feelings of distress.
Se=
lf
Help
It takes courage to speak out, especially if=
you
are experiencing a mental health problem. Some people find it useful talkin=
g to
family and friend, or may also think about an independent organization. The=
re
are many organizations that offer a range of information and advice as well=
as
treatments and therapies, in the statutory, voluntary and independent secto=
rs.
Organic illness <= o:p>
Illness affecting memory and other functions that is often associated
with old age. Dementia, including Alzheimer’s Disease, is an organic
mental illness.
De=
mentia
Dementia
Dementia is the gradual loss of a personR=
17;s
memory, characterised by deterioration in brain function. People may also h=
ave
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 organ=
ic
disturbance (dementia) even though physical performance is impaired.
Depression <= o:p>
Depression is one of the most common mental =
health
problems. A negative mood state which involves a feeling of sadness. A seve=
re
depression can require treatment. Depression can frequently coexist with and
complicate other physical illnesses.
An=
xiety
Anxiety is the term used to describe experie=
nces
such as chronic fear, tension and panic attacks. Sleepless nights and recur=
ring
thoughts are common, as well as nausea, palpitations, dizziness and difficu=
lty
in breathing. Anxiety is one of the most common mental health problems.
Sc=
hizophrenia
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. Peo=
ple
with a diagnosis of schizophrenia usually experience delusions (false belie=
fs)
hallucinations (hearing voices or seeing things) and/or thought disorder
(thoughts become jumbled up); feelings of paranoia are also common.
Psychosis&n=
bsp;
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 psycho=
tic
when they are experiencing hallucinations or delusions. It is common for pe=
ople
with schizophrenia or manic depression to experience psychosis.
This is a mental state that is characterised by the individual havin=
g 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 f=
alse
beliefs not consistent with the culture or subculture to which the individu=
al
belongs
Thought disorder: disorder=
ed
thinking in form and content, making odd connections between words, using w=
ords
in an odd way leading to speech that is often difficult to follow=
Negative symptoms: apathy, =
poor
motivation, social decline.
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. Individ=
uals
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 diagnosi=
s of
mental ill health who also misuses substances.
Le=
arning
Disability
Learning disability includes the presences o=
f :
a significantly reduced ability to understand new or complex information, to
learn new skills
Ma=
nia
Mania is a symptom of bipolar disorder or ma=
nic
depression. People often feel over excited are overactive physically and can
rapidly change their ideas (also known as scattered or tangential thoughts)=
.
Ma=
nic
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.
Pe=
rsonality
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...'
Po=
stnatal
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 b=
eing
able to cope or look after the baby.
Ph=
obias
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 wha=
tever
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 sp=
aces
and agoraphobia (fear of leaving the security of the home).
Po=
st
Traumatic Stress Disorder PTSD
People with PTSD often relive experiences th=
rough
nightmares and flashbacks, have problems sleeping and feel detached from
reality.
Se=
asonal
Affective Disorder or SAD
Seasonal affective disorder, or SAD, is a fo=
rm
of depression some people get consistently during autumn and winter seasons,
where there is less daylight. People often want to sleep for long periods w=
hen
they have seasonal affective disorder.
Ea=
ting
Disorders
People who have an eating disorder find their
life becomes centered on food.
An=
orexia
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.=
Bu=
limia
Bulimia may go unnoticed as appearance remai=
ns
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 followe=
d by
self-induced vomiting and abuse of laxatives.
St=
aff groups
Commissioners <= o:p>
Team of people who purchase (mental) health care services from provi=
ders
such as AWP for the local community.
County council <= o:p>
Councils are directly elected local bodies which had a duty to promo=
te
the economic, social and environmental well-being of their areas. They do t=
his
individually and in partnership with other agencies, by commissioning and
providing a wide range of local services.
Foundation Trusts <= o:p>
NHS Foundation Trusts are a new type of NHS Trust in
Independent sector <= o:p>
Voluntary, charitable and private care providers.
Primary care trusts have responsibility for commissioning specialist
services working closely with social services.
A junior doctor either a GP or psychiatry trainee. They are responsi=
ble
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 <= o:p>
Patients – people who need health and social care for their me=
ntal
health problems. They may be individuals who live in their own homes, are
staying in care, or are being treated in hospital.
Carers <= o:p>
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 overviews the work of an NHS organisation. There is a for=
um
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 heal=
th
law/ the Mental Health Act, which enables them to carry out Mental Health A=
ct
assessments with other professionals.
Advocate An advoc=
ate
is a person you can turn to for information, advice and other help to get t=
he
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 pe=
ople
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 h=
ave
the support of someone in addition to staff. For these reasons, many
service-users prefer to use trained, independent advocates.
Care coordinator <= o:p>
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 t=
he
services that you receive and be involved in reviewing your 'care' through =
the
Care Programme Approach (CPA). This ensures that you receive the support th=
at
is most helpful to you.
A formal patient is a person who is detained
under the Mental Health Act 1983.
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 independ=
ent
panel responsible for hearing a person’s application to be discharged=
and
for ensuring the Act is used appropriately in their organisation.
Occupational Therapists <= o:p>
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.
Psychotherapy uses talking therapies to help
patients help themselves. It is based on a variety of 'talking treatments'
including cognitive, behavioural, psychoanalytic and psychodynamic therapie=
s.
To receive this service, you would need to be referred by your Care
Coordinator. They are often based at Community Mental Health Centres
Social workers are part of a team of mental
health professionals and, like CPN’s; they also have specialist knowl=
edge
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.
Em=
ergency
Duty team Out of hour’s service, provided by community care for people
experiencing a mental health crisis
Se=
rvices
Child and adolescent mental health services (CamHS)
Individual and family work helping children and young people under t=
he
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 assessm=
ent,
treatment and care to people in their own homes and other community setting=
s.
The team should include nurses, psychiatrists, social workers, clinical
psychologists and occupational therapists, with ready access to other thera=
pies
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 da=
ys a
week and may visit individuals daily or even more frequently providing an
alternative to inpatient care.
Day hospital <= o:p>
A hospital where patients receive day care only, continuing to live =
at
home. A person would typically attend for several hours during the day, rat=
her
than just attending a specific session as part of their programme of treatm=
ent
and care.
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.<= o:p>
Primary care mental health services
Services provided by family doctors, dentists, pharmacists, optometr=
ists
and ophthalmic medical practitioners together with district nurses and heal=
th
visitors, with administrative support.
Services could include:
• counselling services based in GP practices
• psycho-educational groups
• psychological therapies provided by graduate mental health wor=
kers
• 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 acu=
te
phase of illness
Secondary Mental Health Services
These are specialist mental health services provided usually by a Me=
ntal
Health Trust. Services include support and treatment in the community as we=
ll
as a range of inpatient services. Individuals are referred into these servi=
ces
by their General Practitioners and usually have serious mental illness.
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 commu=
nity
setting, at times suited to the service user rather than focused on service
providers’ convenience.
Inpatient services <= o:p>
Services provided, often by the NHS, where the patients/service users
are accommodated on a ward and receive treatment there from specialist heal=
th
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 counselli=
ng
is a one to one activity but it may also be carried out in groups.
Outpatient services <= o:p>
Medical care on a same-day basis in a hospital or clinic.
Residential care refers to nursing homes and residential care homes =
that
provide around the clock care for vulnerable adults and older adults who ca=
n no
longer be supported in their own homes, are staying in care, or are being c=
ared
for in hospital. Homes may be run by local councils or independent
organisations.
Anti psychotic&n=
bsp;
Drugs used to ameliorate the symptoms of psychosis and schizophrenia.
These can be oral or by intra muscular injection and include older type dru=
gs
e.g. Stelazine and newer drugs with possibly fewer side effects such as
Risperidone and Amisulpiride.
Anti Depressants =
Anti depressants aim to tr=
eat
the symptoms of depression and can help people experiencing depression to f=
eel
more motivated and energetic.
This is the main way by which care is co-ordinated and delivered to
individuals by secondary care services. It means that all individuals invol=
ved
in the care will discuss the care with the user of the mental health servic=
es
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-ordina=
tor
who will also ensure there are regular reviews.
Is the main Act of Parliament setting out the rights of people recei=
ving
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 assessme=
nts
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 wit=
hin
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
Independent Mental Capacity Act (IMCA)
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 Nation=
al
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
CQC (Carer Quality Commission) The Care Quality Commission is the independent regulator of health and
social care in
They regulate health and =
adult
social care services, whether provided by the NHS, local authorities, priva=
te
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 incr=
ease
their self-esteem.
Bibliotherapy
The use of books as a means of providing psychological therapy
Co=
gnitive
Behavioural Therapy
Cognitive behavioural therapy or CBT involves
working with people to help them change their emotions, thoughts, and behav=
iours.
Co=
mputerised
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 therapeut=
ic
setting to resolve their difficulties. The therapist encourages dialogue
between the participants to help improve communication between them.=
Psychotherapy Psychoth=
erapy
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 a=
nd
distress.
Talking Treatments Talking
treatments describe a number of therapies available, including counseling,
Cognitive behavioral therapy and self – help