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Services for people with complex psychosis: towards a new understanding

  • Tom Edwards (a1), Rob Macpherson (a2), Martin Commander (a3), Alan Meaden (a3) and Sridevi Kalidindi (a4)...
Summary

This paper describes the need for commissioners and service providers to consider the development of a whole-system approach to providing rehabilitation services for patients with complex psychosis, in the context of the current economic pressures and emergence of a competitive market in this area of mental health. The practical and organisational arrangements for the management of risk with such services are described, taking into account the varying provision of rehabilitation services across the UK and considering how these can be developed against the care clustering system and interfaces with other mental health services.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Tom Edwards (thomas.edwards@dwmh.nhs.uk)
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Declaration of interest

None.

Footnotes
References
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1 Killaspy, H. The ongoing need for local services for people with complex mental health problems. Psychiatr Bull 2014; 38: 257–9.
2 Killaspy, H, Marston, L, Omar, RZ, Green, N, Harrison, I, Lean, M, et al. The service quality and clinical outcomes: an example from mental health rehabilitation services in England. Br J Psychiatry 2013; 202: 2834.
3 Craig, TKJ, Garety, P, Power, P, Rahaman, N, Colbert, S, Fornells-Ambrojo, M, et al. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 2004; 329: 1067–71.
4 Morgan, C, Lappin, J, Heslin, M, Donoghue, K, Lomas, B, Reininghaus, U, et al. Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study. Psychol Med 2014; 44: 2713–6.
5 Department of Health. Mental Health Policy Implementation Guide. Department of Health, 2001.
6 Holloway, F. The Forgotten Need for Rehabilitation in Contemporary Mental Health Services. A Position Statement from the Executive Committee of the Faculty of Rehabilitation and Social Psychiatry, Royal College of Psychiatrists. Royal College of Psychiatrists, 2005.
7 Firn, M. Assertive outreach: has the tide turned against the approach? Ment Health Pract 2007; 10: 24–7.
8 Ritchie, J, Dick, D, Lingham, R. The Report of the Inquiry into the Care and Treatment of Christopher Clunis. HMSO, 1994.
9 Priebe, S, Frottier, P, Gaddini, A, Kilian, R, Lauber, C, Martínez-Leal, R, et al. Mental health care institutions in nine European countries, 2002 to 2006. Psychiatr Serv 2008; 59: 570–3.
10 Singleton, N, Meltzer, H, Gatward, R. Psychiatric Morbidity Among Prisoners in England and Wales. Department of Health, 1998.
11 Priebe, S, Badesconyi, A, Fioritti, A, Hansson, L, Kilian, R, Torres-Gonzales, F, et al. Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. BMJ 2005; 330: 123–6.
12 Department of Health. Partnerships in Action – New Opportunities for Joint Working between Health and Social Services. A Discussion Document. HMSO, 1998.
13 Fakhoury, WKH, Priebe, S. The process of deinstitutionalization: an international overview. Curr Opin Psychiatry 2002; 15: 187–92.
14 Department of the Environment, Transport and the Regions. Supporting People – Policy into Practice. DETR, 2001.
15 Cameron, A, Macdonald, G, Turner, W, Lloyd, L. The challenges of joint working: lessons from the Supporting People Health Pilot evaluation. Int J Integr Care 2007; 7: 110.
16 Rose, D, Muijen, M. Nursing doubts. Health Serv J 1997; 107: 34–5.
17 Monahan, J. Mental disorder and violent behaviour: perceptions and evidence. Am Psychologist 1992; 47: 511–21.
18 Blumenthal, S, Lavender, T. Violence and Mental Disorder: A Critical Aid to the Assessment and Management of Risk. Jessica Kingsley Publishers, 2000.
19 Commander, M, Rooprai, D. Survey of long-stay patients on acute psychiatric wards. Psychiatrist 2008; 32: 380–3.
20 Cowan, C, Meaden, A, Commander, M, Edwards, T. In-patient psychiatric rehabilitation services: survey of service users in three metropolitan boroughs. Psychiatrist 2012; 36: 85–9.
21 Keown, P, Weich, S, Bhui, KS, Scott, J. Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988–2008: ecological study. BMJ 2011; 343: d3736.
22 Centre for Mental Health. Pathways to Unlocking Secure Mental Health Care. CMH, 2011.
23 Ryan, T, Pearsall, A, Hatfield, B, Poole, R. Long term care for serious mental illness outside the NHS: A study of out of area placements. J Ment Health 2006; 13: 425–9.
24 Chukwama, J. Low secure versus locked rehabilitation units: a reflection. J Psychiatr Intensive Care 2015; 11: 73–7.
25 Royal College of Psychiatrists. Royal College of Psychiatrists' Statement on Mental Health Payment Systems (formerly Payment by Results) (Position Statement PS01/2014). Royal College of Psychiatrists, 2014.
26 Kalidindi, S, Killaspy, H, Edwards, T. Community Psychosis Services: The Role of Community Mental Health Rehabilitation Teams (Faculty Report FR/RS/07). Royal College of Psychiatrists, 2012.
27 Sood, L, Owen, A. A 10-year service evaluation of an assertive community treatment team: trends in hospital bed use. J Ment Health 2014; 23: 323–7.
28 UK700 Group. Intensive versus standard case management for severe psychotic illness: a randomised trial. Lancet 1999; 353: 2185–9.
29 Killaspy, H, Bebbington, P, Blizard, R, Johnson, S, Nolan, F, Pilling, F, et al. The REACT study: randomised evaluation of assertive community treatment in North London. BMJ 2006; 332: 815–9.
30 Mortimer, AM, Shepherd, CJ, Fadahunsi, A, Jones, A, Kumar, P, Gangaram, P. Assertive outreach: mirror-image study with contemporaneous controls. Psychiatrist 2012; 36: 245–8.
31 van Veldhuizen, JR. FACT: a Dutch version of ACT. Comm Ment Health J 2007; 43: 421–33.
32 Lawton-Smith, S. Supervised Community Treatment (Briefing Paper 2). Mental Health Foundation, 2010.
33 Burns, T, Rugkåsa, J, Molodynski, A, Dawson, J, Yeeles, K, Vazquez-Montes, M, et al. Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial. Lancet 2013; 381: 1627–33.
34 Curtis, D. OCTET does not demonstrate a lack of effectiveness for community treatment orders. Psychiatr Bull 2014; 38: 36–9.
35 Owen, A, Sood, L. Comment: OCTET does not prove community treatment orders are ineffective. Lancet Psychiatry 2015; 2: 373–5.
36 Mustafa, FA. The OCTET trial, community treatment orders and evidence-based practice. Psychiatr Bull 2014; 38: 197.
37 Rawala, M, Gupta, S. Use of community treatment orders in an inner-London assertive outreach service. Psychiatr Bull 2014; 38: 13–8.
38 Killaspy, H, Meier, R, Mitchell, S, Harrison, C, Kalidindi, S, Edwards, T, et al. Guidance for Commissioners of Rehabilitation Services for People with Complex Mental Health Needs. Joint Commissioning Panel for Mental Health, 2012.
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BJPsych Bulletin
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Services for people with complex psychosis: towards a new understanding

  • Tom Edwards (a1), Rob Macpherson (a2), Martin Commander (a3), Alan Meaden (a3) and Sridevi Kalidindi (a4)...
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