ABSTRACT
"This paper discusses the advantages and disadvantages of case management systems for the co-ordination of care of people with long-term mental illness living in the community. Many of the principles are equally applicable to other client groups with long-term needs, e.g. elderly people or people with learning difficulties. Some of the historical background to the emergence of case management concepts is discussed, culminating in the recent White Paper on Community Care. The underlying concept of case management is examined, together with a number of fundamental questions concerning who should act as case managers, what kinds of training they will require, problems of inter- and intra-agency co-operation, and the empirical evidence regarding its effectiveness. It is concluded that case management could be an important element in a comprehensive range of mental health services, but it is not a substitute for basic community provisions."
Subject(s)
Community Mental Health Services/organization & administration , Mental Disorders/therapy , Community Mental Health Services/trends , Comprehensive Health Care/organization & administration , Continuity of Patient Care/organization & administration , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Health Occupations/education , Humans , Long-Term Care/organization & administration , Patient Care Planning , WorkforceABSTRACT
This is a descriptive paper. It outlines the running of a specialist service aimed to meet the needs of long-term mentally ill patients who live in community settings in an inner urban district of London. The service functions in an outreach model from an office base on a large public housing estate. No patient care premises are available on site, consequently all patient activities are carried out in public rooms and other non-mental-health venues. The staffing of the Team and details of its organisational practice are described: demographic and clinical statistics for two years' working are presented. Advantages and disadvantages of the outreach model are discussed. The need for such a specialist service in contrast to the traditional generic service model is argued. The paper is intended as a basic description to underlie current evaluative studies. No evaluation data are presented here.
Subject(s)
Deinstitutionalization/trends , Health Services Needs and Demand/trends , Mental Disorders/rehabilitation , Patient Care Team/trends , Catchment Area, Health , Health Services Misuse/trends , Humans , London , Long-Term Care/trends , Mental Disorders/psychology , Referral and Consultation/trends , Self-Help Groups/organization & administration , Social SupportSubject(s)
Community Mental Health Services/trends , Consumer Behavior , Deinstitutionalization/trends , Mental Disorders/rehabilitation , Patient Care Team/trends , Adolescent , Adult , Aged , Communication , Female , Health Services Accessibility/trends , Humans , Long-Term Care/trends , Male , Mental Disorders/psychology , Middle Aged , Social Environment , Social Support , Social Work, Psychiatric/trendsABSTRACT
The 30-item General Health Questionnaire (GHQ) has been validated against the criterion of a standardized psychiatric interview in the community. Used for screening, the GHQ misclassified 25 per cent of 105 respondents, being worse for men. Specificity and sensitivity were above .70. The alternative use of the GHQ as an estimator and as an indicator of morbidity in epidemiological surveys is described and discussed.
Subject(s)
Epidemiologic Methods , Female , Humans , Interview, Psychological , London , Male , Mass Screening/methods , Mental Disorders/epidemiology , Sex Factors , Surveys and QuestionnairesABSTRACT
Results of the investigation of a sample of size N = 200, half of whom live in the vicinity of a main airport, are reported. Three health indicators were examined: (1) annoyance reactions measured with a scale which did not include symptoms; (2) a symptom score, obtained with a screening instrument which identifies possible psychiatric cases; and (3) confirmed psychiatric cases identified with a traditional diagnosis after an interview by a psychiatrist. Noise was undoubtedly associated with annoyance. An association between noise and psychiatric measures was only present in a subgroup of respondents of high education. There was a marked association between annoyance and psychiatric measures. An attempt was made to clarify the nature of this relationship. Hypersensitivity to noise was associated with a high frequency of psychiatric symptoms and should be considered among the high risk factors for psychiatric illness.
Subject(s)
Aircraft , Mental Disorders/etiology , Noise/adverse effects , Adolescent , Adult , England , Female , Humans , Male , Mental Disorders/diagnosis , Middle Aged , Pilot ProjectsABSTRACT
The published work relating to effects of noice on man and animals is reviewed from the standpoint of mental health. Evidence from a number of different disciplines shows that the presence of meaning in the noise is of critical importance in determining the persistence of physical reactions to the noise. The existing evidence linking noise with mental illness is found to be unsatisfactory. The concept of annoyance and the relevance of noise annoyance to mental illness are discussed. Some specific suggestions for further work are put forward.
