Posts Tagged health services

Productivity and Lean in the Delivery of Mental Health Services

Health ServicesThe scale of the potential productivity challenge in mental health was highlighted in the King’s Fund report published at the end of 2010. Whilst the scale of the productivity opportunities are vast, the problems of realising them are equally vast.

Whilst it is possible to make improvements within an organisation’s own sphere of influence, the real productivity gains are only realised when organisations work together. For Mental Health this normally means working across health and social care boundaries and will often involve the third sector as well. No one should under-estimate the challenges this presents, particularly when the relationships between organisations are strained.

Shifting the setting of where care occurs, and indeed strengthening community based options, means changes to commissioning models and that affects the distribution of funding and often resources, for example moving a secondary care clinicians into a community setting to enable them to provide outreach support rather than staffing in-patient facilities causes the need for change in the funding structure of two and possibly more organisations. Read the rest of this entry »

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Who’s Who In Mental Health Service – GPs, Psychiatrists, Psychologists, CPNs And Allied Therapists

Health ServicesWhen a person is experiencing psychological or emotional difficulties (hereafter called “mental health problems”), they may well attend their GP. The GP will interview them and based on the nature and severity of the persons symptoms may either recommend treatment himself or refer the person on to a specialist. There can seem a bewildering array of such specialists, all with rather similar titles, and one can wonder as to why they’ve been referred to one specialist rather than another. In this article I give an outline of the qualifications, roles and typical working styles of these specialists. This may be of interest to anyone who is about to, or already seeing, these specialists.

The General Practitioner

Although not a mental health specialist, the GP is a common first contact for those with mental health problems. A GP is a doctor who possesses a medical degree (usually a five-year course) and has completed a one-year “pre-registration” period in a general hospital (six-months on a surgical ward and six-months on a medical ward as a “junior house officer”). Following this a GP has completed a number of six-month placements in various hospital-based specialities – typical choices include obstetrics and gynaecology, paediatrics, psychiatry and/or general medicine. Finally, a year is spent in general practice as a “GP registrar” under the supervision of a senior GP. During this period, most doctors will take examinations to obtain the professional qualification of the Royal College of General Practitioners (“Member of the Royal College of General Practitioners”, or MRCGP). Others qualifications, such as diplomas in child health, may also be obtained. Read the rest of this entry »

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Beyond the Community Mental Health Service Improvement Act

Health ServicesAs demand for mental health and addictions treatment grows, insurance coverage must be preserved and expanded. It’s critical that we preserve the guarantee of Medicaid coverage for low income, disabled Americans. Commercial parity must be passed; Medicare parity must follow; and if we accept what research is teaching us–that addictions are chronic, relapsing conditions that require ongoing monitoring and management, just like diabetes, asthma, and yes like mental illnesses–then we must act. We must lead the fight to restore eligibility for social security disability for people with addiction disorders.

Data collected by non-profit organizations documents increased demand and increased numbers of uninsured. States reallocated their general fund mental health dollars to the Medicaid match. And now state plans to cover the uninsured are floundering. This leaves large numbers of individuals with treatable mental illnesses in our overburdened emergency rooms and without access to the services that can engage them, treat them, and return them to work.

We’re denying our economy productive taxpayers. We’re wasting human lives. We must introduce and champion a federal funding stream to cover the mental health and addictions treatment costs of the uninsured. Read the rest of this entry »

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