Presentation on theme: "Im depraved on account Im deprived The interface between health and social care Jan Cubison Sheffield Perinatal Mental Health Service 0114 2716069"— Presentation transcript:
Im depraved on account Im deprived The interface between health and social care Jan Cubison Sheffield Perinatal Mental Health Service
A romp through 4 decades 1970sNature v. nurture 1980sC/conservatism 1990sIntegration of health & social care 2000 on…
1960s Child care officer 1968 Seebohm Committee Recommended that the specialist areas of local authority social work should be fused Single community based response to the range of needs that individuals, families and communities presented Probation still separate
1970s Generic social work 1969 Children and Young Persons Act 1970 Chronically Sick and Disabled Person Act 1970 Local Authority and Social Services Act
Health Health was another country
Mental Welfare Officer The 1959 Mental Health Act encouraged the development of community care End of moral defect, lunacy and mental deficiency psychopathic disorder had to be susceptible to medical treatment
Debate mad or bad – or sad? 60s R.D. Laing The Divided self T.Szasz The myth of mental illness 1960 Strong debates between role of social worker as radical activist for social change or social police Autonomy of the medical profession
Cycle of deprivation 1970s dissertation Explanation of structural factors leading to cycle of poverty and poor mental health Politicised to blame behaviour of parents for passing on poverty and deprivation to their children
1980s Individualism Making money High unemployment 1983 Mental Health Act Approved social workers
1990s Back to specialisation 1989 Children Act emphasised need for partnerships with 1990 National Health Service and Community Care Act introduced internal market 1994 Diploma in SW replaces CQSW Social workers - Adult or Children
new post working with pregnant and new mothers with mental health problems Employed by NHS Trust Across mental health and child care
2000 and on… Set up and manage small perinatal mental health service Little health treatment for personality disorders Social workers offer support and behaviour modification Training in therapies
2003 Development of treatment services for personality disorder Multiagency teams Psychological therapies available across primary and secondary care NICE guidance National Institute for Mental Health in England Personality disorder: No longer a diagnosis of exclusion Policy implementation guidance for the development of services for people with personality disorder
Issue date: January 2009 Borderline personality disorder Borderline personality disorder: treatment and management NICE clinical guideline 78 Developed by the National Collaborating Centre for Mental Health Issue date: January 2009 NICE clinical guideline 77 Developed by the National Collaborating Centre for Mental health Antisocial personality disorder Treatment, management and prevention
What works well between health and social care?
What does not work well between health and social care?
How can the interface between health and social care be improved?
Joint work in perinatal mental health All cases discussed jointly – psychiatrist & social worker Joint care antenatal clinic Joint training Multiagency meetings Joint CPA / CIN meetings Involve service users, volunteers Postcode, ethnicity audit
NICE guideline:Pregnancy and complex social factors due Sept 2010 Rigorous methodology Dearth of evidence SCIE involved Not joint guidance Health employs specialist midwives in domestic abuse, safeguarding children, asylum seekers, teenage pregnancy, substance misuse
Integration of research and practice Research traditionally led by health RCTs – gold standard Social care research often qualitative
National Institute for Health and Clinical Excellence (NICE) NICE is an independent organisation Their work is underpinned by the need for: –transparency –collaboration –involvement of stakeholders NICE provides national guidance, sets quality standards and manages a national database to improve peoples health and prevent and treat ill health.
Social Care Institute for Excellence (SCIE) Registered charity On line database Joint NICE and SCIE guideline –Parent-training/education programmes in the management of children with conduct disorders July 2006 (TA guidance) –Dementia Supporting people with dementia and their carers in health and social care Nov 2006 – Looked after Children September 2010
The White Paper, Equity and excellence: Liberating the NHS July 2010Equity and excellence: Liberating the NHS "no decisions about me without me NICE to develop quality standards for social care NICE on a firmer statutory footing, securing its independence and core functions Extend NICE remit to social care care services minister Paul Burstow has made clear SCIE... continue to have a role but it wont be the same role they played directly alongside NICE in the past