Search results

New public health policies present social services with new opportunities and challenges. A shared public health and social care agenda is emerging around health improvement, social exclusion and regeneration. Early signs of synergy indicate that social services have a key role to play in shaping the public health agenda and in acting as a bridge between the NHS and the wider local authority.

In 2002, a Review of Mental Health and Learning Disability in Northern Ireland was launched, which reported during 2005‐6 and produced a framework for future learning disability and mental health services. This article will address three broad areas: first, it will provide an overview of the current structure of health and social services within Northern Ireland and summarise how these structures are expected to change within the next few years. Second, it will outline the key policy objectives in relation to the health of people with learning disabilities, giving particular attention to individuals among this population who develop mental health problems. Third, it will consider some key challenges that may lie ahead if the recently stated policy objectives are to be realised.

This Case Study gives an account of the factors that led up to the joint commissioning unit (JCU) within the health and social services scene in Shropshire; analyses the concept of strategic joint commissioning; and describes the role of the JCU and how it works.

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Despite differences in political approaches and institutional frameworks, health and social services in all European Union (EU) Member States face similar challenges, notably the need to adjust to demographic ageing and to changing employment and family patterns. This article takes a closer look at some of those issues (drivers) that are likely to have significant implications for the future of the sector. On this basis, three diverging “integrated visions” for health and social services are presented. The first vision is a “best guesstimate” and assumes that current developmental targets, for example, on reducing cardiovascular disease, are generally met. The second vision is a “problem‐plagued” view of health and social services, where targets are missed and the current level of service generally stays the same or deteriorates. Finally, the third vision presents a more “visionary” picture of health and social services where services are largely transformed from what is known today. All “integrated visions” have been constructed from existing health‐care scenarios as well as the drivers identified earlier. The paper is rounded off with an account of some of the policy measures being implemented by the European Commission and Member States in addressing several of the areas highlighted as important for the future of the sector.

Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their interplay with mental healthcare system lacks evidence in the European panorama. This study aims to gather information on the characteristics and the involvement of social services supporting young people approaching transition.

A survey of 16 European Union countries was conducted. Country respondents, representing social services’ point of view, completed an ad hoc questionnaire. Information sought included details on social service availability and the characteristics of their interplay with mental health services.

Service availability ranges from a low of 3/100,000 social workers working with young people of transition age in Spain to a high 500/100,000 social workers in Poland, with heterogeneous involvement in youth health care. Community-based residential facilities and services for youth under custodial measures were the most commonly type of social service involved. In 80% of the surveyed countries, youth protection from abuse/neglect is overall regulated by national protocols or written agreements between mental health and social services, with the exception of Czech Republic and Greece, where poor or no protocols apply. Lack of connection between child and adult mental health services has been identified as the major obstacles to transition (93.8%), together with insufficient involvement of stakeholders throughout the process.

Marked heterogeneity across countries may suggest weaknesses in youth mental health policy-making at the European level. Greater inclusion of relevant stakeholders is needed to inform the development and implementation of person-centered health-care models. Disconnection between child and adult mental health services is widely recognized in the social services arena as the major barrier faced by young service users in transition; this “outside” perspective provides further support for an urgent re-configuration of services and the need to address unaligned working practices and service cultures.

This is the first survey gathering information on social service provision at the time of mental health services transition at a European level; its findings may help to inform services to offer a better coordinated social health care for young people with mental health disorders.

The purpose of this paper is to develop a case definition of integrated health and social services initiatives that serve older adults, and will provide characteristics to aid in the identification of such initiatives. The case definition is intended to ease the identification of integrated health and social care initiatives.

A limited search was undertaken of both scientific and gray literature that documented and/or examined integrated health and social services initiatives. In addition, literature on well-documented and generally accepted integrated healthcare and social services models that reflect collaborations from healthcare and social services organizations that support older adults was also used to develop the case definition.

The case definition is as follows: healthcare organizations from across the continuum of care working together with social services organizations, so that services are complementary and coordinated in a seamless and unified system, with care continuity for the patient/client in order to achieve desired health outcomes within a holistic perspective; the initiatives comprise at least one healthcare organization and one social care organization; and these initiatives possess 18 characteristics, grouped under 9 themes: patient care approach; program goals; measurement; service and care quality; accountability and responsibility; information sharing; culture; leadership; and staff and professional interaction.

A limitation of this study is that the characteristics are based on a limited literature search. The quality of some of the literature both gray and published was not definitive: information on how they undertook the literature search was not provided; exclusion and inclusion criteria were not included; and there was insufficient detail on the design of the studies included. Furthermore, the literature reviews are based on integrated initiatives that target both seniors and non-senior’s based services. The cross-section of initiatives studied is also different in scale and type, and these differences were not explored.

The case definition is a useful tool in aiding to further the understanding of integrated health and social care initiatives. The number of definitions that exist for integrated health and social care initiatives can make it confusing to clearly understand this field and topic. The characteristics identified can assist in providing greater clarity and understanding on health and social care integration.

This study provides greater coherence in the literature on health and social care integration. It aids in better framing the phenomenon of healthcare and social services integration, thereby enhancing understanding. Finally, the study provides a very useful and concrete list of identifying characteristics, to aid in identifying integrated health and social care initiatives that serve older adults.

This paper reviews the NHS Plan from the perspective of the Government’s wider programme of “modernising” public services. Although broadly focussed, particularly highlights older people. Two dimensions of modernisation are identified. The NHS Plan is seen to be patient‐cited – rather than citizen‐centred. Argues further, that, if the economic, social and environmental causes of ill health are to be addressed more generally and if citizens are to be enabled to live in healthy, sustainable communities, planning for health services should logically be subordinate to planning for health. Health improvement plans should, therefore, be integrated within the wider community strategies for which local authorities are to have lead responsibility. Similarly, as ill health is recognised to be an important aspect of poverty, inequality and social exclusion, there is a strong case for the integration of the regional offices of the NHSE within the wider structure of regional governance. Finally, the personal social services should ensure that the values of social work and social care are not displaced by medical and nursing models which, historically, have shown little understanding of community development processes.

The modernisation of mental health day services has been shaped by concerns about the social exclusion of people with enduring mental health problems. Initiatives have emphasised the use of mainstream facilities and an individualised approach. In contrast, service users have sought to safeguard opportunities for peer support in safe places. This participatory action research brought together service users, staff and others involved, to explore how these different views could be transformed into modernised services. The research took place in an outer London borough from 2003‐2007, using varied methods to explore social networking, including a visual method, action research groups and individual interviews. The research was designed and adapted to enable the involvement of people with different capacities and interests. Each stage generated findings for local modernisation, pointing to the importance of a safe space, service user knowledge of social and recreational activities and how self‐help groups develop and thrive. The final reconfiguration of local services reflected these research outcomes. Credible and useful outcomes can be achieved from collaborative research, allowing time and creating opportunities to shape interpretations of policy. Emerging initiatives are more likely to reflect service user perspectives and receive their support.

The purpose of this paper is to examine three recent papers on mental health services and social inclusion.

A search was carried out for recent papers on mental health and social inclusion. The author selected three papers that each spoke to a similar theme, from slightly different angles, and that seemed to advance understanding of how social inclusion might be supported to a greater degree in mental health services.

One paper vividly describes some of the blocks to social inclusion, and what that can feel like from a service user perspective, and also points to ways for peer workers to support service users’ social inclusion. A second paper illustrates how mental health professionals and peer workers can choose to stand up for people’s human rights despite lack of organisational support for such actions. The third paper describes pioneering co-designed work to build dedicated support for social inclusion alongside mental health services.

All three papers highlight the ongoing need for better support for social inclusion in mental health services across different countries. They also show how such support can be implemented and even made more mainstream. This raises hope for wider progress in mental health services becoming real enablers of social inclusion.