Editorial
| DOI | https://doi.org/10.1108/17556228200800015 |
| Published date | 01 September 2008 |
| Date | 01 September 2008 |
| Pages | 2-3 |
| Author | Ian Baguley |
| Subject Matter | Health & social care |
2
Editorial
Grasping the nettle
Despite government policy that aims to improve services
and outcomes for those who use them, we continue to
struggle to deliver an adequate service in many specialities
and areas. Acute inpatient care continues to be criticised
for its lack of ability to care effectively, community
services are often difficult to access and the failure of
services to implement a meaningful care programme
approach continues to be a cause for concern.
Key to the successful implementation of policy,
evidence-based, or best practice, and new and more
effective service models, is commissioning. The current
rhetoric around ‘world class commissioning’ is at least an
acknowledgement of the importance of commissioning
but if we are to move to a position where the
commissioning of services is more than just adequate
(and we probably have a way to go before we reach
adequate), then we need to stop and take stock. This is
important – we may know wherewewant to be
(outcomes), we might know something about how to get
there(although this is tricky) but we don’t always know
exactly where we are now.
Having a clear understanding about the current
situation is something of a challenge, and gathering
precise information about the current state of services can
be a painful process. The results of this process can be even
more painful and cause problems for clinicians, managers,
policy makers and politicians – so why would we do it?
If we don’t take some time to find out where we are
now,we won’t even know in which direction to go to
achieve our outcomes. Understanding our starting point
may provide valuable clues concerning strategies we may
be able to employ on our journey.
Two recent reports that focus on mental health in
prisons (Brooker & Duggan et al,2008; Brooker &
Ullmann et al,2008) highlight the challenges we all
(including commissioners) face. The two reports provide
an honest appraisal of the current state of prison mental
health care in England, a situation that should be a cause
of some embarrassment to all of us who work in mental
health. Despite these reports giving an accurate
description of ‘where we are now’ and consequently
pointing out the direction we need to go to improve these
services, they may prove uncomfortable reading for some.
Politicians, mindful of public opinion, may well shy
away from doing anything meaningful. Those responsible
for forming policy may be nervous about suggesting a
course of action that may be considered ‘brave’ (yes – ‘Yes
Minister’ is alive and well) and commissioners may find it
difficult to take anything other than a short-term
approach and put off the commissioning of good quality
mental health services for prisoners until other targets
have been achieved.
Prison mental health care is an obvious example to
use, of the challenges and difficulties that commissioners
face and all commissioners arerequired to make
judgements, in all areas and specialties, about where
finite resources should be targeted. Clarity about where
we arenow can only help.
This edition of the Journal has something of a focus
on CAMHS and will help to describe something about
where CAMHS services are now. Nixon, Hooton and
Jones describe the results of a project undertaken in the
North West that examined the capabilities of staff to
work with children and young people with a learning
difficulty. Ruth Edward and colleagues describe the
results of a study to identify the difficulties in developing
amore strategic approach to education and training in
CAMHS and propose a more systematic approach to
CAMHS workforce planning that incorporates education
and training needs.
Steven Walker describes how new service models, that
are more appropriate and accessible, can be introduced to
meet the increasing demands placed on CAMH services.
Away from the CAMHS theme, David Palmer and Cath
Maffia discuss how to include refugees and asylum seekers
in the development of services and Marjorie Lloyd
provides an interesting and thought-provoking paper on
Professor Ian Baguley
Director CCAWI, University of Lincoln
The Journal of Mental Health Training, Education and Practice Volume 3 Issue 3 September 2008 © Pavilion Journals (Brighton) Ltd
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