national Mental Health - GOV.UK

1 Mental HealthModern Standards and Service Modelsnational service frameworksSeptember 1999A national ServiceFramework forMental HealthForeword by the Secretary of State11 The national Service Framework for Mental Health32 Standards, interventions, evidence and 13service modelsStandard one14 Mental Health promotionStandard two and three28 Primary care and access to servicesStandard four and five41 Effective services for people with severe Mental illnessStandard six69 Caring about carersStandard seven76 Preventing suicide3 Local implementation834 Ensuring progress945 national support for local action104 Finance.

2 Revenue, capital and estates 105 Workforce planning, education and training 108 Research and development 113 Clinical decision support systems 117 Information strategy 120 Conclusion 1236 Annex A - Outcome indicators for severe Mental illness 124 Membership of the External Reference Group 127 Glossary

3 128 Bibliography 136 References 138c o n t e n t s p a g eNational Service Framework forM e n t al H e a l t hModern Standards & Service ModelsModern Standards & Service ModelsPage 1 Foreword by the Secretary of StateAt any one time one adult in six suffers from one or other form of Mental other words Mental illnesses are as common as asthma.

4 They range from morecommon conditions such as deep depression to schizophrenia, which affectsfewer than one person in a hundred. Mental illness is not well understood, itfrightens people and all too often it carries a its prevalence and importance Mental illness hasn t had the attention itdeserves. That s why the Government is determined to give it a much higherpriority. That is why we decided that Mental Health should have the same priorityas coronary heart disease in our programme of national Service Frameworkswhich will lay down models of treatment and care which people will be entitledto expect in every part of the this national Service Framework for Mental Health spells out national standard sfor Mental Health , what they aim to achieve, how they should be developed andd e l i v e red and how to measure perf o rmance in every part of the standards are founded on a solid base of evidence.

5 Which has beenexamined and validated by the External Reference Group chaired by ProfessorGraham Thornicroft. I am very grateful to them for their thorough andprofessional work which should help raise standards, tackle inequalities and meetthe special needs of women, men, and different ethnic national Service Framework fleshes out the policies announced in our WhitePaper Modernising Mental Health Services . It will be a guide to investment in mentalhealth services including the extra 700 million which the Government is pro v i d i n gover this year and the next two. It will be backed up, in due course, by changes tobring the law on Mental illness up to date to reflect modern treatments and care ,following the root and branch review conducted by the independent expert gro u punder Professor Genevra Richard s o n.

6 national Service Framework - Mental HealthPage 2 Most people who suffer from Mental illnesses are vulnerable and present no threat toanyone but themselves. Many of these patients have not been getting the tre a t m e n tand care they need partly because the system has found it so difficult to cope withthe small minority of mentally ill people who are a nuisance or a danger to boththemselves and Government is committed to do whatever is necessary to deliver a modernand dependable Health service, fit for the new century. Mental Health services andthe professionals who provide them will get the attention and resources theydeserve.

7 This national Service Framework will set the standards and thesestandards will be Hon Frank Dobson MPSecretary of State for HealthModern Standards & Service ModelsPage 3 The national Service Framework for Mental Health developing the national Service Framework for Mental Health a new vision for Mental Health a Government wide agendaIntroductionThe new NHS andModernising social Serviceswere landmarks for the future of healthand social services. The two White Papers set out a range of measures to drive upquality and reduce unacceptable variations, with services responsive to individual needs,regardless of age, gender, race, culture, religion, disability, or sexual First Class Service explained how NHS standards would be.

8 Set by the national Institute for Clinical Excellence and national Service Frameworks delivered by clinical governance, underpinned by professional self-regulation andlifelong learning monitored by the Commission for Health Improvement, the new national PerformanceAssessment Framework, and the national Survey of , A New Approach to social ServicesP e rf o rmance described a Perf o rmance AssessmentFramework for social services, outlining plans to strengthen assessment by the Department ofHealth and detailed proposals for national perf o rmance indicators for social first two national Service Frameworks cover two of the most significant causes of illhealth and disability in England - coronary heart disease and Mental Health - twopriorities in Saving lives: Our Healthier Nation.

9 The national Service Frameworks havealso been identified as priorities in Modernising Health and social Services: NationalPriorities Guidance for 1999/00 - 2001 national Service Framework focuses on the Mental Health needs of working ageadultsup to 65. Mental ill Health is so common that at any one time around one in sixpeople of working age have a Mental Health problem, most often anxiety or person in 250 will have a psychotic illness such as schizophrenia or bipolar affectivedisorder (manic depression).Most people with Mental Health problems are cared for by their GP and the primary care is what most patients pre f e r, and is more likely to be effective when specialist servicesp rovide support, and where there is local agreement on how to provide integrated care.

10 Generally, for every one hundred individuals that consult their GP with a Mental healthp roblem, nine will be re f e r red to specialist services for assessment and advice, or for tre a t m e n t . Service Framework - Mental HealthPage 4 Some people with severe and enduring Mental illness will continue to require care fromspecialist services working in partnership with the independent sector and agencieswhich provide housing, training and services, including social care, should ensure effective and timely interventionsfor individuals whose Mental Health problems cannot be managed in primary care alone,for example, patients with severe depression or psychotic disorders.