Advertisement

Journal of Public Health Policy

, Volume 28, Issue 4, pp 465–481 | Cite as

‘Carers’ of People with Mental Health Problems: Proposals in Current Public Mental Health Policy in Nine Countries

  • Iain K Crombie
  • Linda Irvine
  • Lawrence Elliott
  • Hilary Wallace
Article

Abstract

This study investigates how public mental health policy addresses the role and needs of those who care for people with mental health problems. Public mental health policy recognises that carers are at increased risk of poor health. Countries want to ensure that mental health services are responsive to the needs of “carers”, that carers participate in the planning and implementation of services and that more information should be made available to carers. Respite care is recommended as a way to improve the health of both carers and service users. Unfortunately, policies only identify possibilities for intervention, and rarely identify specific actions to be taken or clarify who has responsibility for delivering interventions. Further the financial implications of the proposals and the need for additional trained staff are seldom discussed. Current proposals for helping carers are inadequate.

Keywords

public mental health policy carers service provision respite care 

References

  1. Hirst M . Carer distress: a prospective, population-based study. Soc Sci Med. 2005;61:697–708 (Epub 2005 February 17).CrossRefGoogle Scholar
  2. Bruce DG, Paterson A . Barriers to community support for the dementia carer: a qualitative study. Int J Geriatr Psychiatry. 2000;15:451–457.CrossRefGoogle Scholar
  3. Lyonette C, Yardley L . Predicting mental health outcomes in female working carers: a longitudinal analysis. Aging Ment Health. 2006;10:368–377.CrossRefGoogle Scholar
  4. Schneider J, Murray J, Banerjee S, Mann A . EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: I – Factors associated with carer burden. Int J Geriatr Psychiatry. 1999;14:651–661.CrossRefGoogle Scholar
  5. Mafullul YM, Morriss RK . Determinants of satisfaction with care and emotional distress among informal carers of demented and non-demented elderly patients. Int J Geriatr Psychiatry. 2000;15:594–599.CrossRefGoogle Scholar
  6. Wynaden D, Orb A . Impact of patient confidentiality on carers of people who have a mental disorder. Int J Ment Health Nurs. 2005;14:166–171.CrossRefGoogle Scholar
  7. Hervey N, Ramsay R . Carers as partners in care. Advances in Psychiatric Treatment. 2004;10:81–84.CrossRefGoogle Scholar
  8. Rapaport J, Bellringer S, Pinfold V, Huxley P . Carers and confidentiality in mental health care: considering the role of the carer's assessment: a study of service users', carers' and practitioners' views. Health Soc Care Community. 2006;14:357–365.CrossRefGoogle Scholar
  9. Donaldson C, Tarrier N, Burns A . Determinants of carer stress in Alzheimer's disease. Int J Geriatr Psychiatry. 1998;13:248–256.CrossRefGoogle Scholar
  10. Szmukler GI, Wykes T, Parkman S . Care-giving and the impact on carers of a community mental health service. PRiSM Psychosis Study. 6. Br J Psychiatry. 1998;173:399–403.CrossRefGoogle Scholar
  11. Hoskins S, Coleman M, McNeely D . Stress in carers of individuals with dementia and Community Mental Health Teams: an uncontrolled evaluation study. J Adv Nurs. 2005;50:325–333.CrossRefGoogle Scholar
  12. Woods RT, Wills W, Higginson IJ, Hobbins J, Whitby M . Support in the community for people with dementia and their carers: a comparative outcome study of specialist mental health service interventions. Int J Geriatr Psychiatry. 2003;18:298–307.CrossRefGoogle Scholar
  13. Dening T, Lawton C . The role of carers in evaluating mental health services for older people. Int J Geriatr Psychiatry. 1998;13:863–870.CrossRefGoogle Scholar
  14. Cleary M, Freeman A, Walter G . Carer participation in mental health service delivery. Int J Ment Health Nurs. 2006;15:189–194.CrossRefGoogle Scholar
  15. Jeon YH, Brodaty H, Chesterson J . Respite care for caregivers and people with severe mental illness: literature review. J Adv Nurs. 2005;49:297–306.CrossRefGoogle Scholar
  16. Simpson R, Wakefield P, Spiers N, Jagger C, Lindesay J . Carer-held records for dementia: a controlled trial. Int Psychogeriatr. 2006;18:259–268.CrossRefGoogle Scholar
  17. Oyebode JR . Carers as partners in mental health services for older people. Adv Psychiat Treat. 2005;11:297–304.CrossRefGoogle Scholar
  18. Home Office. Caring about Carers: National Strategy for Carers. London: UK Parliament England; 1999. Available at http://www.carers.gov.uk/pdfs/Care.pdf, accessed 5 December 2006.
  19. National Health Committee. How Should We Care for the Carers? Wellington: National Advisory Committee on Health and Disability; 1998. Available at http://www.nhc.govt.nz/publications/PDFs/carers.pdf, accessed 5 December 2006.
  20. Ministry for Health Social Services and Public Safety. Valuing Carers. Belfast: Northern Ireland Assembly; 2002. Available at http://www.dhsspsni.gov.uk/publications/2002/valuing_carers.pdf, accessed 5 December 2006.
  21. Department of Health Social Services and Public Safety. Informal Carers Report. Belfast: Northern Ireland Assembly; 2001. Available at http://www.dhsspsni.gov.uk/publications/archived/2001/informal_carers_report.pdf, accessed 5 December 2006.
  22. Astron. The Future of Unpaid Care in Scotland. Headline Report and Recommendations. Edinburgh: Scottish Executive; 2006. Available at http://www.scotland.gov.uk/Resource/Doc/94653/0022797.pdf, accessed 5 December 2006.
  23. Astron. The Future of Unpaid Care in Scotland. Scottish Executive response to Care 21 Report. Edinburgh: Scottish Executive; 2006. Available at http://www.socialworkscotland.org.uk/resources/cp-wf/TheFutureofUnpaidCareinScotlandMinsterialResponse.pdf, accessed 5 December 2006.
  24. Social Care Policy Division. Caring about Carers. The Carers Strategy in Wales – Implementation Plan. National Assembly for Wales, 2001. Available at http://www.markwalton.net/wales/carersstrategypdf.pdf, accessed 5 December 2006.
  25. Department of Health. National Service Framework for Mental Health. London: UK Parliament; 1999. Available at http://www.dh.gov.uk/assetRoot/04/07/72/09/04077209.pdf, accessed 5 December 2006.
  26. Ministry of Health and Social Services. Adult Mental Health Services for Wales. Equity, Empowerment, Effectiveness, Efficiency. Cardiff: The National Assembly for Wales; 2001. Available at http://www.wales.nhs.uk/publications/adult-health-e.pdf#search=%22equity%2C%20empowerment%2C%20effectiveness%20wales%202001%22, accessed 5 December 2006.
  27. Australian Health Ministers. National Mental Health Plan 2003–2008. Canberra: Australian Government; 2003. Available at http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/EE630ADE7F40F80FCA2572220002D081/$File/plan03.pdf, accessed 5 December 2006.
  28. Expert Group on Mental Health Policy. A Vision for Change. Dublin: Department of Health and Children; 2006. Available at http://www.dohc.ie/publications/pdf/vision_for_change.pdf?direct=1, accessed 5 December 2006.
  29. Ministry of Health. Draft Action Plan. Te Tahuhu – Improving mental health 2005–2015. The Second New Zealand Mental Health and Addiction Plan. Wellington: Government of New Zealand; 2006. Available at http://www.moh.govt.nz/moh.nsf/0/DB9D3FD858442637CC25713300106AC2/$File/te-tahuhu-draft-action-plan-mar06.pdf, accessed 5 December 2006.
  30. Social Exclusion Unit. Mental Health and Social Exclusion. London: Office of the Deputy Prime Minister; 2004. Available at http://www.socialexclusionunit.gov.uk/downloaddoc.asp?id=134, accessed 5 December 2006.
  31. The Standing Senate Committee on Social Affairs, Science and Technology. Out of the Shadows at Last. Transforming Mental Health, Mental Illness and Addiction Services in Canada. Canadian Parliament, 2006. Available at http://www.parl.gc.ca/39/1/parlbus/commbus/senate/com-e/soci-e/rep-e/pdf/rep02may06part1-e.pdf, accessed 5 December 2006.
  32. The Scottish Office. A Framework for Mental Health Services in Scotland. Edinburgh, 1997. Available at http://www.show.scot.nhs.uk/publications/mental_health_services/mhs/index.htm, accessed 5 December 2006.
  33. US Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockwell, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. Available at http://www.surgeongeneral.gov/library/mentalhealth/home.html, accessed 5 December 2006.
  34. Task Force on Mental Health Promotion. Minding Our Health. Belfast: Northern Ireland Ministry of Health; 1999. Available at http://www.dhsspsni.gov.uk/publications/archived/2000/mohstrategy.pdf, accessed 5 December 2006.
  35. Minister of Health. Te Tahuhu – Improving Mental Health 2005–2015: The Second New Zealand Mental Health and Addiction Plan. Wellington: Ministry of Health; 2005. Available at http://www.moh.govt.nz/moh.nsf/0/F2907744575A9DA9CC25702C007E8411/$File/tetahuhu-improvingmentalhealth.pdf, accessed 5 December 2006.
  36. Department of Health and Human Services, Administration on Aging. Older Adults and Mental Health: Issues and Opportunities. 2001. Available at http://www.aoa.gov/press/publications/Older-Adults-and-Mental-Health-2001.pdf, accessed 5 December 2006.
  37. Welsh Assembly Government. Mental Health Policy Guidance. Cardiff, 2003. Available at http://www.wales.nhs.uk/sites/documents/438/mental%2Dhealth%2Dpolicy%2Dimple%2Dguide%2De%2Epdf,accessed 5 December 2006.
  38. Brodaty H, Thomson C, Thompson C, Fine M . Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry. 2005;20:537–546.CrossRefGoogle Scholar
  39. Crawford M, Aldridge T, Bhui K, Rutter D, Manley C, Weaver T, et al. User involvement in the planning and delivery of mental health services: a cross-sectional survey of service users and providers. Acta Psychiatr Scand. 2003;107:401–402.CrossRefGoogle Scholar
  40. Walker E, Dewar BJ . How do we facilitate carers' involvement in decision making? J Adv Nurs. 2001;34:329–337.CrossRefGoogle Scholar
  41. Commonwealth Department of Health and Aged Care. National Action Plan for Promotion, Prevention and Early Intervention for Mental Health. Canberra: Commonwealth of Australia; 2000. Available at http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/EF1F6AF1B2554334CA25720D001ADDA8/$File/promote.pdf, accessed 5 December 2006.
  42. Commonwealth Department of Health and Aged Care. Promotion, Prevention and Early Intervention for Mental Health – A Monograph. Canberra: Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care; 2000. Available at http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/mental-pubs/$FILE/monograph.pdf, accessed 5 December 2006.
  43. Mentality. Making It Happen. A Guide to Delivering Mental Health Promotion. London: Department of Health; 2001. Available at http://www.publications.doh.gov.uk/pdfs/makingithappen.pdf, accessed 5 December 2006.
  44. Ministry of Health. Building on Strengths. Wellington: New Zealand government; 2002. Available at http://www.moh.govt.nz/moh.nsf/0/4A305BD9534765FFCC256CBC0010A6A5/$File/buildingonstrengths.pdf, accessed 5 December 2006.
  45. Department of Health, Social Services and Public Safety. Promoting Mental Health. Strategy and Action Plan 2003–2008. Belfast: Northern Ireland Assembly; 2003. Available at http://www.dhsspsni.gov.uk/publications/2003/promoting_mental_health.pdf, accessed 5 December 2006.
  46. Scottish Executive. National Programme for Improving Mental Health and Well-Being. Action Plan 2003–2006. Edinburgh, 2003, Available at http://www.scotland.gov.uk/library5/health/npmh.pdf, accessed 5 December 2006.
  47. Astron. The New Mental Health Act: Rights of Carers. Edinburgh: Scottish Executive; 2006. Available at http://www.scotland.gov.uk/Resource/Doc/150172/0039968.pdf, accessed 5 December 2006.
  48. US Department of Health and Human Services. Healthy People 2010. Washington DC: US Government Printing Office; 2000. Available at http://www.healthypeople.gov/Publications/, accessed 5 December 2006.

Copyright information

© Palgrave Macmillan Ltd 2007

Authors and Affiliations

  • Iain K Crombie
    • 1
  • Linda Irvine
  • Lawrence Elliott
  • Hilary Wallace
  1. 1.Department of Public HealthUniversity of DundeeDundeeScotland

Personalised recommendations