Planned changes to the training of health professionals could impact on the numbers coming into the workforce and therefore make matters worse. The government has proposed that from 1 August 2017, all new nursing, midwifery and allied health professional students on pre-registration undergraduate and post-graduate courses will receive their tuition funding and financial support through the standard student support system, rather than NHS bursaries and tuition funded by Health Education England. According to the Government, under the loans system, students on nursing, midwifery and allied health courses will typically receive around 25 per cent more in the financial resources available to them for living costs than at present. This will, however, no longer be a grant but will be in the form of a loan which will need to be paid back after graduation in the same way as any other student loan 24 .
To our knowledge, this is the first study to highlight that the barriers to accessing mentalhealth services clearly exist, but not at the point where previously reported. From this research it appears that there is generally good access to mentalhealth services in the first instance following referral but that the real barriers exists once within the system, particularly when access to more specialist mentalhealth services is being sought. The majority of children and youngpeople cared for by these foster carers had been referred to CAMHS and the foster carers reported a quick referral and initial assessment via their supervising social worker or the social worker of the child. However once in the mentalhealth system, barriers were experienced in terms of delays between the onset and recognition of problems and the delivery of services. For the foster carers in our study the experience of long waiting times for specialist assessment and long term treatments, such as psychotherapy, generated real feelings of anxiety and powerlessness. Interestingly this emotional response has not been discussed specifically in the literature but was certainly an issue for the foster carers interviewed. A number of reports highlight waiting times and accessibility as a national problem and priorities for service transformation have been outlined (DCSF/DH 2010; DH 2015; MentalHealth Task Force 2016).
Germany has a public, multi-payer healthcare system (health insurance companies, community organizations or federal states). Mentalhealthcare provision is distributed among different sectors and characterized by considerable regional differences. Since 2009, health insurance has been mandatory for the whole population, either in public (non-profit) or private health insurances. Insurances are obliged to provide a broad service package for the treat- ment of mental disorders, including in- and outpatient care and outpatient psychotherapy restricted to three therapy types (Cognitive-Behavioral Therapy, Psychodynamic Psychotherapy, and Psychoanalysis). The official age boundary for the transition to adult care is 18 years with various exceptions in clinical practice. However, finding the right treatment for youngpeople with mentalhealth problems is challenging. Furthermore, the service transi- tion from child and adolescent to adult care coincides with the vulnerable transition to adulthood with multiple devel- opmental challenges and high demands for supportive alliances [15, 16]. Youngpeople who also struggle with chronic mentalhealth problems are less prepared than their peers to take responsibility due to delayed identity development and increased rumination .
At this stage, it is clear from a sample of 22,000 youngpeople assessed by head- space nationally that this service is seriously addressing the issues of access and engage- ment , a conclusion further evidenced by the heavy demand for eheadspace services from across the nation. However, headspace is still a work in progress. Important gaps remain, notably the fact that more than half of Australia is not yet covered, as the current level of funding, together with Australia’s geographic constraints, does not yet allow full national coverage. Furthermore, access rates for young men, some ethnic populations and young adults, while improved, are still too low, and the program does not yet adequately cover those with more complex and serious stages of mental illness. Clearly, the success of these reforms will ultimately only be able to be assessed after careful evaluation, and evidently more health services research is necessary to develop, refine, adapt and evalu- ate new service models, both within their individual contexts and cross-sectorally.
2016/17, Place2Be worked directly with 282 schools and provided training to a further 100 schools. Place2Be focuses on early intervention, providing a variety of MH support to help CYP deal with life challenges and build resilience. Place2Be has enlisted over 1000 volunteers on placement, most of whom are college/university students working towards a MH qualification. Volunteers of placement deliver counselling sessions for children in schools supervised by a Place2Be manager who oversees group counselling sessions and self-referral sessions for pupils along with support for teachers and parents. 32 These managers use tablets to collect data and feedback
Therefore in order to address this crisis, the following document ‘Future in mind’ (DH 2015, p.13) was introduced to target several key areas of mentalhealthcare for children and youngpeople these being: “promoting resilience, prevention and early intervention, developing the workforce, accountability and transparency, improving access to support and care for the most vulnerable”. However following a review being undertaken on the progress and challenges of its implementation, several barriers still exist impacting on the transformation of mentalhealth services (Firth 2016).
Several selective prevention approaches are available to enhance protective factors or provide specific support for individuals and groups at risk of health problems. It has been noted that children and youngpeople in public care have an increased risk of emotional or behavioural problems than the general population: 45% of children aged five to 17 in public care in England have a diagnosable mental disorder (Meltzer et al 2008). A selective intervention for this vulnerable group might be the provision of independent living programmes designed to provide youngpeople leaving the care setting with social skills to limit any disadvantage and assist successful transition into adulthood. A review of such programmes indicated that they may improve education, employment and housing- related outcomes (Donkoh et al 2006).
Substantially, 51 716 people aged 12 to 25 years received mentalhealthcare through ATAPS during the nine year analysis period. By comparison, and in the context that ATAPS funding is capped while Better Access funding is not, around 194 901 people aged 15–24 years received psychological therapy and focused psychological strat- egies in 2007–2009 via the Better Access program . A further 14 548 consumers aged 12 to 25 years were re- ferred to ATAPS but did not take up the service (22% of all referrals), which is similar to the non-uptake rate for the entire ATAPS program, at 21% , but lower than that (27%) reported elsewhere . Previous findings have demonstrated that the likelihood of using services increases with symptom severity;  therefore it is pos- sible that people referred to ATAPS but who do not take up the service have less severe symptoms. Other possible reasons for not taking up the service which could be fur- ther examined are lack of motivation or readiness to change; stigma associated with seeking mentalhealthcare; miscommunication with the GP; or access issues, such as the location or cost of the service.
The level of information provided to clients varied across clients, clinicians, services, and also within clients across time. Generally the information received was described as lacking or poor. Many clients sought information else- where, including other clinicians (e.g. pharmacist), the Internet, and asking friends and family members. One cli- ent [client 04] even attended a conference on mentalhealth to better inform himself. Some clients felt reluctant or unable to ask for more information from their clinician, particularly if the rapport was compromised. Yet informa- tion was seen as an important factor in the decision-mak- ing process, especially in terms of feeling comfortable with the decision. The type of information desired by clients overall was summarized well by client 10, who felt that it was important to know about “ alternative stuff ” (treatment options), to have “ realistic expectations ” , good information about cognitive therapy and medication, and to be pro- vided with honest information about potential risks (mainly side effects). Caregivers reported receiving even less information, and this compounded their feelings of exclusion (e.g. lack of awareness of what was going on during clinical sessions) and confusion (e.g. coming to terms with the experiences, diagnoses and treatment options for their child). Some caregivers received informa- tion from their child who shared items such as fact sheets with them, and others initiated their own research (usually on the internet).
Participants described how important it was to have a contact person in whom they had confidence. A precondition for them to speak openly was being listened to in a nonjudgmental manner and being allowed and invited to tell their narrative. Although it was expressed that it could be easier to talk to friends and family – whom they trusted more than professional helpers – it was also described how they could talk to friends about less seri- ous issues and to professionals about more difficult problems. Participants felt that confiding in people with experiences similar to their own, such as family situations, psychological problems, or healthcare, was of special importance, as these people could more easily understand their situation.
Jack is a 90 year old man, who is blind. He is admitted to an inpatient ward for assessment following questions about his mental state and psychosis. He appears anxious and afraid in this strange place he cannot experience visually and this is maintained over a number of days. Nurses attempt to develop a relationship with him, serve him meals in his room and reassure him. On one occasion they find his room barricaded and the man shouting and sounding distressed inside. They manage to dislodge the barricade, in the process adding to the man’s fear. Once inside, he attempts to attack the nurses with a cutlery knife. He brandishes the knife indiscriminately, deliberately and intentionally, shouting threats as he does so and so the nurses retreat. The next few hours are spent attempting to talk through the situation with the man to no avail. Eventually, they reluctantly decide they must restrain him and they bring an end to the incident. He is tearful and apologetic. The staff complete an incident form. The following day, the unit manager demands an explanation as to why a 90 year old blind man was restrained.
All participants were asked if they had any long-term physical or mental conditions or disabilities that had affected - or were likely to affect - them for at least twelve months (as before, parents answered on behalf of children aged 0-12). Those who reported having such a condition were asked to say whether it limited their daily activities in any way. This enabled conditions to be further classified as either ‘limiting’ or ‘non-limiting’. As the question did not specify that conditions had to be doctor-diagnosed, responses will have been subject to some distortion due to variation in individuals’ perceptions. This question is part of the new mentalhealth indicators set for children. 10 The relevant indicators
Discursively constructed as deviants and trouble-makers, deprived and depraved (Havemann 1986 as cited in Mann, 2000) the very real issues that the youth brought into the system are left not dealt with and, due to the nature of the system, these issues are compounded. The systems youth exits the system even more mentally unstable and further excluded from their communities (this does not apply to all systems youths) now that they are unattached to any familial form, without educations, jobs or homes. The reality that the majority o f youths enter the system due to neglect is seemingly lost upon the general population, and the fact that the current system further harms these youngpeople appears to be of no concern to citizens in our communities. If the young person, as an anti-citizen, did in fact receive an offer of inclusion (e.g., attendance at an alternative school program or time to find employment while still on assistance) but could not or would not conduct themselves appropriately, they are excluded from their communities, risking permanent sequestration from their community (Rose, 1999). Upon reaching the age of “inevitable disposability” (referring to the age limits for provision of services and programs as described in the provincial or territorial legislation) and without the
Child and adolescent mentalhealth is an essential component of overall health and its importance is gaining increased recognition. Current events have heightened an interest in the mentalhealth of youth. Unfortunately, too often this is due to concerns about the mentalhealth consequences of war, prolonged conflict, natural disasters, AIDS, and substance abuse. Special populations of repatriated child soldiers and street children are a vivid reminder of the many children who have been deprived of an environment that could support healthy development. Further, there is an increased understanding that children who are not mentally healthy can have an adverse impact on the stability and economic viability of nations. Of particular importance throughout the world is the fact that positive mentalhealth plays a role in supporting compliance and adherence to a broad spectrum of health regimens.
Reflecting obligations under national and international law, we recognise that the protection of children’s rights is central to any period in custody. As such, custody must ensure the emotional health and well-being of children and youngpeople by keeping them safe and protecting them from harm. Considerable improvements have been achieved since responsibility for commissioning the secure estate was transferred to the YJB in April 2000. There are encouraging signs of progress with fewer children and youngpeople entering youth custody and a reduction in reoffending rates for children and youngpeople finishing custodial sentences. The recent, significant reduction in the number of children and youngpeople in custody means that the secure estate is now going through a period of change. This presents an opportunity to consider the most appropriate way of reducing surplus capacity and ensuring decommissioning plans reflect the changing age profile of those coming into custody. It also provides an opportunity to consider whether different regimes can deliver improved outcomes for children and youngpeople while offering better value for money.
ized by the transition from the Ford “total” factory to the “lean”, globalized factory, where the various functions (e.g., planning, production, commercial, managerial, and so forth) are no longer vertically integrated, in the same place (the factory) and often at the same time (production cycles and shifts), rather they spread hori- zontally in the space and time of the “global village”. The so-called Fourth Industrial Revolution started in the early 2000s, favoured by the increasing spread of the Internet, which allows to interconnect machines, per- sonnel and production processes in one or more con- nected production units. On the one hand, production gained unimaginable potentialities in terms of quality, punctual deliveries and absence of waste. Also, it was possible to avoid direct exposure of the worker to dan- gerous processes (with a consequent change of the professional risks and with implications also for health and safety tasks within the company). On the other hand, work adopted growing characteristic of hetero- directivity; differently than Fordism, when the human be- ing controlled and governed machines within the pro- duction processes, now it is the worker who undergoes a growing control by the information he/she receives, just in time, from the ultra-computerized and intercon- nected systems, even because the complexity of pro- duction processes often goes beyond the capacity of the human being to govern them. This paved the road to the reappearance in the production systems of some features of Fordism, for this named Neo-Fordism, which currently coexists with Post-Fordism (Tab. I).
commissioning group (CCG) and require collaboration across CCGs and, in some cases, local authorities. Examples of such interventions/services include psychodynamic psychotherapy; specialist eating disorder teams who are able to offer a range of interventions including eating disorder-focused family therapy for anorexia nervosa; dialectical behaviour therapy or other evidence-based treatment for youngpeople who repeatedly self-harm; and treatments for youngpeople with psychoses. As self-harm and anorexia are both common reasons for admission to hospital, the provision of such services also has the potential to reduce the need for hospital admission as well as improving outcomes. In addition, there should be access to what are sometimes called crisis/home- treatment services providing intervention aimed at reducing the need for hospital admission.
Our definition of homelessness and who is consequently included or excluded affects research results and their comparability. Homelessness can mean literally without shelter, that is, roofless. This is congruent with the Department of the Environment and Transport and the Regions, England (DETR) definition of ‘rough sleeping’ which includes people sleeping in the open air, or places not designed for habitation (SEU, 1998). Tenants who have been told to leave within 28 days are ‘threatened with homelessness’ and are legally recognised as homeless (Smith and Gilford, 1993). The Royal College of Physician’s working party on health and homelessness describes unofficial homelessness as those sleeping rough and those ‘at risk’, for example in hospital or prison or with no fixed abode, and the ‘hidden’ homeless, for example those sleeping on friends’ floors or staying in hostels on a temporary basis (Wrate and Blair, 1999). The Report of the Social Exclusion Unit, Policy Action Team 12: YoungPeople (PAT, 2000) states that there are approximately 32,000 homeless 16 – 21 year olds in Britain. In comparison to our EU neighbours the UK’s 16 and 17 year olds are disproportionately homeless. Although differing definitions (McCabe et al., 1998) make it difficult to gain a truly representative sample of homelessness in a statistical or narrative form. The important lesson to learn is that while ‘rooflessness’ may be the extreme end of the homeless continuum, fragile and insecure accommodation renders youngpeople highly vulnerable to both potential rooflessness, and to many of the same psychosocial stressors.
This study analyses the health situation of the elderly people in Sylhet City slum areas. Primary data are used and collected from the elderly people of Sylhet slum areas. After the analyzing of the data are getting many points about the factors those are influenced the health situation of aged people in Sylhet City slum areas. This study portrays the health condition of people especially aged people in slum areas how do they live there, what type of treatment they take, how about aware of government initiatives about the healthcare, how much spend to their health condition etc. This study, basically, conducts the people whose age range in more than 50 years old and also lives in a slum under the Sylhet City Corporation whose are seemed as vulnerable. This study depicts that the current health condition of respondents. There are almost half of the respondents are suffered various aged problem such as general weakness, less eye vision, hand shaking, pressure and so on. They have also affected many serious problem like heart disease, diabetic, asthma etc. Aged people’s family have minimum earning member with low income that’s why they can’t afford the treatment paying bills. In sometimes, the medical care facilities have to stop when they are unable to pay medical bill. This study also finds that the elder people getting aware about their health situation. Nowadays, they are going to take their medical care at the nearby hospital’s. Recent, most of the respondents have checked up at their local doctor’s chamber, hospital’s etc. By contrast, the consciousnesses about health, day by day, are increasing but financial condition falls major impact to continue their treatment. Another point is found from this study that make the lowering price of treatment is depended on the relationship between stuffs of the hospitals and somewhere else. Due to deprivation, they can’t continue their medical treatment.
So we know that youngpeople spend quite a bit of time on the internet. Even prefer it to TV. Devices and online content start to become a part of their lives very early on. Many will also be sophisticated users of apps, and use a range of devices proficiently, including games consoles. This generation of under 18s will have different expectations from digital communications compared to adults.