STICKLAND Nicolette, GENTRY Tom
Examines the extent to which the current provision of mental health services fails to meet the increasingly high demand from the ageing population. The report shows that currently 3 million people in the UK over the age of 60 are living with depression; this figure is set to rise to 4.3 million in the next 15 years due to the growing number of older people in our society; the NHS is not providing those in later life with mental health problems with sufficient treatment options, such as talking therapies and integrated care plans. The report makes a number of recommendations to build on progress already made and ensure that older people’s mental health gains not only parity of esteem with physical health concerns but parity with other age groups. These include: creation of a work stream dedicated to meeting older people’s mental health needs, as part of the implementation of Mental Health Taskforce recommendations; local health and care commissioners should fully understand the prevalence of common mental health conditions among the over 65s in their areas; each clinical commissioning group and local authority should consider appointing “older people’s mental health champions”; and all services should be appropriately funded and equipped to deliver fully integrated care that addresses mental and physical health and comorbidity.
This guidance describes the use of non-medical interventions, sometimes called ‘social prescribing’ or ‘community referral’, to improve mental health and wellbeing. Social prescribing supports improved access both to psychological treatments and to interventions addressing the wider determinants of mental health. It can contribute to greater awareness of the relative contribution to mental wellbeing of individual psychological skills and attributes (e.g. autonomy, positive affect and self-efficacy) and the circumstances of people’s lives: housing, employment, income and status. The guide: examines the benefits of social prescribing; outlines the policy context and evidence base for social prescribing; gives guidance on commissioning social prescribing; provides information on interventions and how to deliver social prescribing; and describes the findings of a social prescribing development project commissioned by Care Services Improvement Partnership (CSIP) North West. Overall, the guidance aims to support localities in developing, implementing and evaluating social prescribing schemes, with a special focus on mental health and wellbeing. The report recommends that social prescribing is made available as part of prevention and early intervention within primary care, and also to support recovery from severe mental distress.
PERLE Jonathan G., NIERENBERG Barry
The authors believe that with the current and growing prevalence of mental illness a major shift and expansion of clinical practice must occur to overcome the mental health burden and facilitate positive change. This article offers an outline of, and case for, incorporating telehealth in mental health practice. For the purposes of this review, telehealth specifically refers to synchronous web camera-based interventions. Novel options, including mHealth (mobile) and the use of computer tablets, are discussed. The implications for practice including training are considered, as well as potential future directions for the field. It is concluded that the available data supports telehealth as an effective mode for the treatment of clients who are unable to pursue mental health services as they are available. It appears that with careful planning, telehealth systems can significantly impact the quality, timeliness, and availability of services in almost any mental health care system. The authors emphasise that the goal is not to substitute for a “real” person but to integrate telehealth into overall provision. In some cases a consistent face-to-face interaction may be the best care but this may not always be possible. The authors conclude by emphasising the importance of appropriate training for the mental health professionals if telehealth is to be effectively.