Community based teams can transform mental health services, says report
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《英国医生杂志》
Community based mental health teams are having far reaching effects on mental health services across the country, a new report says. But it warns that the teams need to be set up over a realistic period of time and be adequately resourced.
The report is the result of a two year study by the charity the Sainsbury Centre for Mental Health and the National Institute for Mental Health in England. It is a guide to establishing assertive outreach teams and crisis resolution teams based on the lessons learnt from new and existing teams across England.
Assertive outreach teams originated in the United States in the late 1970s and target people with severe mental illness living in the community, with whom conventional mental health services find it difficult to engage. Apart from improving engagement, they also aim to reduce the number of hospital admissions and offer a wide range of help—from assistance with medication and doing everyday tasks to guidance on education and employment.
Crisis resolution teams have existed in the United States, Australia, and the United Kingdom since the 1980s. Available 24 hours a day, seven days a week, they act as an alternative to hospital admission for people experiencing acute crises in their mental health. The teams normally work with people for three to four weeks and offer basic help with food, money, and dealing with distress.
Both types of team formed a major component of the Department of Health抯 national service framework for mental health in 1999 (BMJ 1999;319:940).
The report emphasises the importance of sufficient investment for successful implementation of the new service. The cost of the new teams must be covered in full; half funding will not achieve half the result, it says. Good project management is also important, it says.
Staff recruitment, especially of social workers, is a major obstacle to setting up the multi-disciplinary teams, as is the lack of recognition of the importance of good leadership, it adds.
More importantly the report shows how assertive outreach teams and crisis resolution teams have the ability to revolutionise the whole system of mental health care in a locality. They can change not only the structures of the services but the cultures and the attitudes in them, it says.
Angela Greatley, acting chief executive of the Sainsbury Centre for Mental Health, said: "Mental health services are undergoing massive changes. Assertive outreach and crisis resolution teams offer new ways of supporting people experiencing major mental health problems. But this change can only be achieved if they are implemented in full, over a realistic period of time, with the resources necessary for the job."(London Debashis Singh)
The report is the result of a two year study by the charity the Sainsbury Centre for Mental Health and the National Institute for Mental Health in England. It is a guide to establishing assertive outreach teams and crisis resolution teams based on the lessons learnt from new and existing teams across England.
Assertive outreach teams originated in the United States in the late 1970s and target people with severe mental illness living in the community, with whom conventional mental health services find it difficult to engage. Apart from improving engagement, they also aim to reduce the number of hospital admissions and offer a wide range of help—from assistance with medication and doing everyday tasks to guidance on education and employment.
Crisis resolution teams have existed in the United States, Australia, and the United Kingdom since the 1980s. Available 24 hours a day, seven days a week, they act as an alternative to hospital admission for people experiencing acute crises in their mental health. The teams normally work with people for three to four weeks and offer basic help with food, money, and dealing with distress.
Both types of team formed a major component of the Department of Health抯 national service framework for mental health in 1999 (BMJ 1999;319:940).
The report emphasises the importance of sufficient investment for successful implementation of the new service. The cost of the new teams must be covered in full; half funding will not achieve half the result, it says. Good project management is also important, it says.
Staff recruitment, especially of social workers, is a major obstacle to setting up the multi-disciplinary teams, as is the lack of recognition of the importance of good leadership, it adds.
More importantly the report shows how assertive outreach teams and crisis resolution teams have the ability to revolutionise the whole system of mental health care in a locality. They can change not only the structures of the services but the cultures and the attitudes in them, it says.
Angela Greatley, acting chief executive of the Sainsbury Centre for Mental Health, said: "Mental health services are undergoing massive changes. Assertive outreach and crisis resolution teams offer new ways of supporting people experiencing major mental health problems. But this change can only be achieved if they are implemented in full, over a realistic period of time, with the resources necessary for the job."(London Debashis Singh)