SCIE Introduction to...adult mental health services
Interventions
The interventions that may be offered are various and depend on local need and availability. They may be offered:
- on a one-to-one basis or in a group setting
- in the service user’s home or a mental health service or community setting
- by the mental health service or by external services.
Vocational interventions
Where a need has been identified as part of a service user’s recovery plan, the AMH worker will support an individual’s access to vocational and/or work-based support services.
Social care interventions
A number of service users will need support in the home – for example, help with household or daily living activities. This may include helping a person get to group-based interventions.
A number of areas may offer specialist day care support.
Therapeutic interventions
A wide range of therapies may be available in each area, but it is important to note that they are not suitable for all. The service user's wish to engage in any therapy is crucial. Service users will need a specialist assessment to take part in any therapeutic intervention – all are time-limited, and there is often a waiting list. Bear in mind that the relationship formed between the service user and the mental health professional is also part of the therapeutic process.
Below is a brief description of some key therapies:
- Cognitive Behavioural Therapy (CBT) is a collaborative problemfocused psychological intervention. The individual and the therapist work together to set goals and strategies for achieving them using an interaction of thought, feeling and behaviour. It may be used to treat a range of problems, including depression and anxiety, and more complex disorders such as psychosis
- Dialectic Behavioural Therapy (DBT) developed following attempts to use CBT with individuals with a personality disorder. The therapy is based on a set of strategies, which emphasise that change must happen if a person is to improve their life. The treatment sets specific targets and stages to reach.
- Psychodynamic therapy aims to look at the roots of the individual’s emotional distress, often by exploring motives, needs and defences. It is one of a number of therapies regularly used to treat a variety of conditions such as depression, persistent self-harm and personality disorder.
- Psychosocial interventions for psychoses involve a number of interventions including working with drug treatment, therapies and rehabilitation strategies. They can include CBT, social skills training and psycho-education. Family intervention for carers may also be appropriate.
- Family therapy or family systems therapy is a branch of therapy that treats the whole family. Family therapists consider the family as a system of interacting members. The interaction of family members is seen as the root of problems, rather than it being down to an individual.
Medical interventions
In AMH services a range of treatments are available and the decision to offer medication is made by either the psychiatrist or the GP. The provision of medication is one tool that can aid recovery, used alongside other interventions.
Due to the range of medication available it is not possible to give a brief overview of each. However, there are key questions you may want to ask the prescribing doctor:
- What is the medication?
- What might be the side effects for the individual?
- How long will it be prescribed?
- How often will it be reviewed?
- What alternative choices are there?
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Electroconvulsive therapy (ECT) is a procedure that involves applying a brief controlled electric current to the brain – through the scalp – under a general anaesthetic. The decision to use this treatment is taken after a full discussion with the service user and is usually only prescribed if alternative treatments have failed to improve the service user’s health. It remains a controversial treatment.
