Editorial

Citation

Samele, C. (2012), "Editorial", Mental Health Review Journal, Vol. 17 No. 2. https://doi.org/10.1108/MHRJ.55817baa.001

Editorial

Article Type: Editorial From: Mental Health Review Journal, Volume 17, Issue 2

Recent developments on the mental health policy front include publication of the new national framework to improve mental health and well-being (DH, 2012b). This implementation strategy aims to put into practice the vision outlined by the No Health Without Mental Health published last year (DH, 2011). The idea of the implementation framework is to monitor the strategy’s progress through measuring mental health outcomes. However, the endeavour to improve outcomes coincides with the announcement that spending in real terms on mental health has fallen by £150 m since 2001 (DH, 2012a). So, making improvements to mental health services such as increasing access and the quality of services will become that much harder.

Despite these difficulties the desire to improve mental health services and monitor progress is strong. The papers included within this issue reflect that desire. Joseph et al. and Stanbridge et al. focus on the important issue of carers and families. Recognising and understanding carers’ role, the impact of caring and how best to support carers continues to be an important pursuit. Joseph and colleagues have produced a generic evidenced-based tool to measure quality of life from the perspective of both carers and professionals. The tool assesses multiple domains of functioning, including positive functioning and problematic areas, so aiming to provide a unique balance between positive and negative experiences. Developed in two stages, the first study was an initial assessment of a 100-item tool via national carers’ centres to identify the most useful themes to measure. The resultant 40-item scale was tested in a second study to see whether it was able to measure the impact of interventions. Carers receiving support from either one of seven voluntary sector services or a Nottinghamshire “End of Life” project. The tool was applied at two time points (pre- and post- intervention) and was able to monitor changes in quality of life scores and demonstrate where services can best target their support.

The theme of families and carers continues with Stanbridge et al.’s Family Liaison service evaluation. Designed to raise awareness and increase inclusive practice as part of the assessment and admission process within an inpatient psychiatric ward. Based on audit data the service was able show how contact and meetings with families were achieved relatively quickly. Feedback from families was largely positive and “being heard” and “communicating with each other” was viewed as particularly valuable. In the majority of cases staff too found meetings with families helpful as part of the assessment and care planning process. The significance of this service is the proactive face to face approach to meeting with families and how valuable this is to ensuring better care for service users receiving inpatient psychiatric care.

In examining the Human Givens approach to therapy the two papers by Tsaroucha and colleagues seek to measure and evaluate this in primary care. This approach is based on the premise that when a person has their innate physical and emotional needs met they will be mentally healthy. The authors developed a 14 item, self-report, Emotional Needs Audit (ENA) and tested its validity and reliability to measure well-being, quality of life and emotional distress. The ENA was found to identify unmet emotional needs and monitor the effectiveness of treatment, alongside other previously validated measures. The introduction of a pilot primary care mental health service using the Human Givens approach provided the opportunity to assess its effectiveness. Focused on those with depressed mood, the Human Givens approach appeared to show some promise although standard care was similarly effective. The main advantage of the Human Givens approach, as the authors argue, is that it is a comparatively short therapy requiring only one or two sessions, potentially making cost savings if introduced as standard treatment.

Hyland and Boduszek’s paper takes us on a detailed tour of cognitive therapy and the theory of rational emotive behaviour therapy. They compare and attempt to reconcile both theories by describing both their similarities and differences as documented in the literature. However, as the authors note, the distinction between these two therapeutic models are difficult to resolve. Cognitive therapy has proved successful for a range of psychiatric and psychological conditions, but there is a trend among cognitive behaviour therapists to draw on various therapeutic techniques without a theoretical understanding of how psychological distress is developed and maintained. The authors call for researchers to “bring together the disparate theoretical models into a single integrated, coherent and empirically derived model” to advance the area.

Chiara Samele

References

DH (2011), No Health without Mental Health, Department of Health, London

DH (2012a), Investment in Mental Health: Working Age Adult and Older Adult Reports, Department of Health, London

DH (2012b), No Health without Mental Health: Implementation Framework, Department of Health, London, July