INFORMATION RESOURCES ON MENTAL HEALTH AND WELL-BEING
< Guidance on management of mental health problems | Themes >
Information for Commissioning of Mental Health Services
Introduction
Commissioning is the process by which PCTs identify the health needs of their population and make prioritised decisions to secure care to meet those needs within available resources. It includes longer term strategic planning, medium term planning and the shorter term agreement and performance management of service level agreements. The process should involve the public, engage clinicians, and be conducted on a whole system basis, informed by Health Equity Audits, and carried through with the full participation of other stakeholders including NHS Trusts, local authorities and the voluntary sector.
Because of the complexity of the approaches needed to promote mental health and provide support to those diagnosed with mental health problems there can be a temptation to deal with other priorities. This risk is exacerbated because mental health services lie outside the first phase of Payment by Results.
This section brings together key national guidance designed to help PCTs and local authorities understand how they can use their commissioning role to improve the mental health of the communities they serve.
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Back into work, back into Society: More social inclusion for people with mental health problems:
In March 2006 the government launched a new drive to help people with mental health problems get back on their feet and back into work.
Launching the guidance, Rosie Winterton, Health Minister, said:
"People who suffer from mental health problems remain one of the most excluded groups in society. Tackling inequalities and providing opportunities is a key objective for the government and these guidance documents will be a tool to help commissioners of mental health services provide better quality care so that people who have suffered from such problems are integrated more successfully.”
Four sets of new guidance were published for commissioners of services designed to better re-integrate people that have suffered with mental health problems into society. The guidance covers vocational services, day services, direct payments and women-only day services.
Vocational services for people with severe mental health problems: commissioning guidance
This guidance recognises that work is extremely important in maintaining mental health and promoting the recovery and well-being for those who have experienced mental health problems. However, people with mental problems have the lowest employment rate for any of the main groups of disabled people. This guidance provides commissioners of mental health services with a framework to commission evidence-based vocational services for people with severe mental health problems and provide the tools to monitor the effectiveness of such services.
Direct payments for people with mental health problems: a guide to action
Direct payments give recipients control over their own lives by providing an alternative to social care services provided by a local authority. Financial payments give people the flexibilty to look beyond ‘off-the-peg’ service solutions for certain housing, employment, education and leisure activities as well as for personal assistance to meet their assessed needs. This helps provide opportunities for independence, social inclusion and enhanced self-esteem.
This guide sets out good practice for making direct payments more accessible to people with mental health problems. It is intended to support the efforts of local authorities, primary care trusts, mental health trusts and non-statutory providers of mental health services who wish to ensure that direct payments become a standard option within mental health services.
From segregation to inclusion: Commissioning guidance on day services for people with mental health problems
Health and social care services have a key role in tackling the social exclusion experienced by people with mental health problems. The Social Exclusion Unit’s report on Mental Health and Social Exclusion highlighted the need to improve the health and wellbeing with mental health problems by improving access to mainstream community activities and enabling people to gain and retain employment.
Being able to access mainstream services such as colleges, or arts and sports activities can improve confidence and self-esteem. The opportunity to meet new people and create a network of friends plays a critical role in promoting well-being. Modern day services should provide an individualised and flexible service to meet the aspirations of of people with mental health problems and provide the necessary support to enable people to achieve them. A key aim for day services is to promote and facilitate social inclusion.
This guidance is designed to assist commissioners of mental health services in the refocusing of day services for working-age adults with mental health problems into community resources that promote social inclusion and promote the role of work and gaining skills in line with current policy and legislation.
Supporting women into the mainstream: Commissioning women-only community day services
Women-only community day services include a variety of services providing community based support to women to meet a range of needs (emotional, psychological, social and practical), enabling them to improve their mental health and access mainstream opportunities. Many women-only services are provided by the voluntary and community sector but the NHS and local authorities also provide a significant response to women’s mental health in day centres frequently offering women-only sessions in a mixed-sex environment.
In 2000, the NHS Plan made a commitment to the provision of a women-only day centre in every health authority by 2004, recognising the need to develop distinctive approachs for women. The implementation guidance for the Women’s Mental Strategy – Mainstreaming Gender and Women’s Mental Health – specified a range of approaches which would meet women’s needs within the context of mainstream services and establish a more flexible target for PCTs to have a women-only community day service in place by 2004. This remains a national priority for 2005/2006.
This best practice guidance is intended to support commissioners in delivering Section 6.1 of the implementation guidance on women-only community day services docetailing with the recommendations set out in the 'Mental health and social exclusion' report relating to day services.
Choosing Health: Supporting the physical health needs of people with severe mental illness
People diagnosed with severe mental illness are at increased risk of a range of physical illnesses and conditions, such as coronary heart disease, diabetes, infections, respiratory diseases and obesity.
This best practice document aims to help PCTs plan for, design and commission and monitor services that will deliver improved physical health and well-being for people living with severe mental illness.
It describes the necessary leadership for a successful physical healthcare programme, suggests who might be best placed to deliver the programme, outlines the roles and responsibilities of those involved and provides case studies, examples of outcomes and details of a range of promising practice that promotes physical healthcare and treatment and health promotion for people with severe mental illness.
Improving Services and Support for Older People with Mental Health Problems
The UK Inquiry into Mental Health and Well-Being in Later Life has published its final report, 'Improving Services and Support for Older People with Mental Health Problems'. The Inquiry is a UK-wide project set up in late 2003 with the aims of, raising awareness of mental health and well-being in later life, Involving and empowering older people, creating better understanding, influencing policy and planning, and improving services. The Inquiry has worked in two stages. Stage 1 focused on the promotion of good mental health and well-being in later life and stage 2 examined services and support for older people with mental health problems.
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