Recommendations from a Royal College of
Psychiatrists’ enquiry.
In the 60 years of the National Health Service (NHS) there has
probably never been unanimity of view on the design of mental
health services. Every generation has brought its priorities,
trends and pendulum swings; every crisis has brought its reactions
– and sometimes its overreactions. The College identified that
there exists not only a need, but also an opportunity, for service
redesign in mental health.
This report draws on evidence given during hearings held in
February 2010, a number of written responses submitted to the
enquiry’s evidence committee, and presentations delivered at a
one-day seminar held in March 2010. Although exhaustive neither in
its scope nor in the breadth of those from whom it sought evidence,
the enquiry nevertheless represents a serious effort to consider
service redesign in mental healthcare and to give voice to the
people who work at the heart of our mental health services. The
document aims to identify areas for future service development that
reflect the needs and aspirations of users of mental health
services, those who care for them and also the people who deliver
those services.
The document is a distillation of the views of a broad church,
comprising more than 50 psychiatrists, psychologists, nurses,
occupational therapists, social workers, commissioners, trust chief
executives, academics, health economists, voluntary sector
organisation chief executives, service users, carers, medical
directors and national mental health programme leads.
The report then examines the following topics, giving
recommendations on each:
- Creating efficiencies and improving productivity
through redesigned services and care pathways
- Consultant expertise at the beginning of the
pathway
- Standardised outcomes
- Investing to save through the development of family
mental healthcare
- Out-of-area treatments
- Mental health of older people
- In-patient care
- Statutory and voluntary sector partnerships
- Housing
- Employment and mental health
- Substance misuse
- Relationship between physical and mental
health
- Psychological therapies
- Peer support