Publication digest

On this page, we collate regular updates from substance misuse expert @andrewbrown365 on research and policy papers that you might have missed.

2 November

  • Housing support for ex-offenders (England and Wales) – a briefing note from the House of Commons Library  it sets out the support available to people leaving prison and the relevant duties of local authorities. It also considers how a prison sentence affects a person’s ability to receive Housing Benefit.  The paper makes clear how having multiple needs makes individuals in these circumstances even more vulnerable.
  • A second class ending: Exploring the barriers and championing outstanding end of life care for people who are homeless – a report from the Care Quality Commission drawing on the work of the Faculty for Homeless Health.  It argues that the needs of homeless people are not well understood or considered by health and care services and that where services do exist, they are often fragmented and work in relative isolation.  The report includes case studies of what are considered excellent primary care and specialist community services.
  • Role of nurses in alcohol and drug treatment services – a joint PHE and Royal College of Nursing piece of guidance.  The document describes where nurses add value to the delivery of drug and alcohol treatment including in delivering interventions, assessing the physical health of people in treatment, and in medication management (particularly amongst those with multiple needs).
  • Resettlement of women sex workers a research report which explores the lived experiences of resettlement for street sex-working women alongside the views of professionals from community-based projects that have supported this group in their transitions from custody to the community. Recognising the multiple needs of this group the report suggests that rehabilitation should focus on four key areas:  housing, trauma, substance misuse and safety.
  • Deaths and serious incidents in police custody – a review carried out for the Home Office which finds that during the 11 years, 2004/05 – 2014/15, 49% of those who died had alcohol and/or drug related factors identified specifically as a cause of death in a post-mortem examination. It makes some strong points about how difficult the police (and NHS) find it to manage the care of intoxicated people who are taken into custody under section 136 of the Mental Health Act.  And reflects on evidence about how difficult police officers find dealing with alcohol withdrawal.
  • Code of practice: Mental Health Act 1983 – documents to support the implementation of the Mental Health Act, which includes clear guidance that people who are intoxicated should not be refused a health based place of safety except in specific circumstances.  It reiterates that drug or alcohol use on their own are not a reason to detain a person under the Act, but that some conditions associated with drug and alcohol use –  eg withdrawal state with delirium or associated psychotic disorder, acute intoxication, organic mental disorders associated with prolonged abuse of drugs or alcohol – do fall under the Act’s remit.
  • Mental Health Act 1983: implementing changes to police powers – guidance from the Department of Health and Home Office which points out that intoxication should not (on its own) be enough to use the powers of the MHA to detain someone.  However, where someone is detained and is also intoxicated this could be a reason to extend their detention beyond the initial 24 hour period if the person detained is unable to be assessed properly.

15 September

  • Homelessness – A recent report from National Audit Office looks at the scale of the problem and the impact of government policy on the levels of homelessness.  The report estimates that homelessness at present costs the public sector in excess of £1 billion a year, the lion’s share going on temporary accommodation.  It recognises the very steep rise in the number of rough sleepers – up by 232% between 2009/10 and 2016/17.  The report contrasts the government’s ‘light-touch’ approach to working with local authorities to previous periods where there has been high levels of homelessness, and is critical of the failure to assess the impact of welfare reform on the issue. Included in the recommendations the NAO call for the government to publish a strategy on how they intend to reduce homelessness.
  • Health and Justice annual report 2017 – a report looking at the considerable health needs of people in prisons and other secure settings.  It details the multiple needs of this group of people, in particular their substance use and mental health problems.  The report also details other health issues including blood-borne viruses and other infectious diseases, and the issues for what is an increasingly elderly prison population.  It concludes by making the point that robust and comprehensive data can help policy makers and services understand and meet the needs of the people in the secure estate.
  • Alcohol related brain damage (ARBD) – A briefing on the SMMGP website by Professor Ken Wilson, a consultant psychiatrist and specialist in alcohol related brain damage.  The briefing covers prevalence, what we know about the amounts alcohol consumption that may cause brain damage, and makes a case for treatment services to assess and treat people for extended periods of time when necessary.

10 August

  • Importance of strengthening prisoners’ family ties to prevent reoffending and reduce intergenerational crime – a review conducted by Lord Famer on behalf of the Ministry of Justice that makes the case for much more involvement of families in the lives of prisoners.  This includes recognising the role that families may play in motivating prisoners behaviour inside prison (for example drug use) and the impact of those relationships on the mental health of prisoners.
  • Homelessness projections: Core homelessness in Great Britain – a summary report produced by Herriot Watt University for Crisis examines the current and projected levels of different categories of homelessness. The figures set out in this report describe current levels of core homelessness across England, Scotland and Wales, their projected levels until 2041, factors driving these and the potential impact of policy measures to address the issue.
  • Mortality among a cohort of heavy drinkers in Edinburgh & Glasgow – a piece of research looking at the factors associated with the early death in a group of heavy drinkers in two cities in Scotland over the course of just over 2 years.  They report that 16% of the original group of over 600 participants died and that  compared to participants who were designated as ‘long term’ survivors there were higher numbers of deaths amongst those with coexisting drug use, and amongst those drinking white cider and cheap vodka.

25 July 2017

  • HMI Prison Annual report 2016-17 – the report details the findings from inspections of the prison estate and police custody.  It details the pressures and difficulties that are being faced by the system, and includes the result of a survey of prisoners.  In respect of substance misuse the report concludes that rates of dependence remain very high for men (particularly where they also have mental health issues), and has risen for women coming into prison.  They find that treatment in prison continues to be well run, but that access to treatment services in police custody can be patchy (despite high levels of need) and that it remains easy access to drugs (and to a lesser extent alcohol) in many prisons.
  • Housing First in Liverpool – a feasibility study for providing Housing First across the city, the report from Crisis provides an analysis of the level of need for homelessness services, the sort of response that people with lived experience are looking for, and the challenges of developing a Housing First response for those who are most likely to benefit.
  • Mental health in prison – the National Audit Office’s assessment of the resources and effectiveness of services to meet mental health needs in prison.  While they find that those who can access treatment are able to expect generally of a good standard of clinical care, they worry about the ability of the prison system to identify those in need.  In other areas the report reaches some damning conclusions; for example, it says that the government “does not know how many people in prison have a mental illness, how much it is spending on mental health in prisons or whether it is achieving its objectives.”
  • Family Safeguarding Hertfordshire: an evaluation – produced for the DfE this evaluation by the University of Bedfordshire looks at how the redesign of a family safeguarding service in Hertfordshire has served the needs of the families involved, and makes an estimation of the savings could be associated with the changes.  Based on a multi-disciplinary team the service appears to have been able to reduce the costs to the children’s social care budget, and improved the life satisfaction of families.  The report includes recommendations for local and national audiences.

26 June 2017

  • Managing Alcohol Related Brain Injury in the Community – an old (2011) but still relevant presentation about alcohol related brain injury by Professor Ken Wilson.  The presentation covers the prevalence of brain injury in heavy drinkers, a develops a medical case for intervening, provides case studies of those who are likely to need services, and describes a service (and the outcomes they measured) for a small cohort of patients.
  • The impact of organised crime in local communities – a report from the Police Foundation which makes the case for widening the lens on organised crime’s impact on local communities.  The report argues that local policing of organised crime has tended to focus on drug dealing, but suggests that it should widen to include the adult sex market, sexual exploitation of children, and organised fraud.  Based on data from three neighbourhoods the report suggests that between 5% and 17% of crime is linked to organised crime.  The authors argue drug dealing, violence and fraud account for approximately three quarters of the known harms experienced by local communities.  They find that the  overlap between drug dealing and sexual exploitation of adults and children is significant, and describe the proximal and distal risk factors that have been observed in childhood sexual exploitation.
  • Performance Tracker – a report from CIPFA, the Chartered Institute of Public Finance and Accountancy, and the Institute for Government which gives a data-driven assessment of the government’s performance in running public services.  Of particular interest is their assessment of prisons, where they note that assaults on staff have increased by around 70% since 2009, and big decreases in the numbers apparently completing drug treatment in prison – down by 88% in the five years since 2009/10.  However, the numbers quoted in the report are substantially different from recent data published by Public Health England, which suggests caution needs to be taken in interpreting these findings.  PHE found that 23% of the 39,276 people who left drug and alcohol treatment in secure settings did so free of their dependence.
  • Evidence-based interventions for managing illicit drug dependence – A short paper from the BMA looking at the evidence for supervised consumption rooms and heroin assisted treatment.  The BMA argue that clinicians have “a key role to play in treating the harms associated with illicit drug dependence, including advocating for the provision of evidence-based treatments in local areas with a high level of need.”
  • Mental health and new models of care; Lessons from the vanguards – a paper from the Kings Fund and Royal College of Psychologists which, based on the experience of vanguard sites, argues that there should be deeper integration of mental and physical health systems and services. From the interviews and research that were conducted with vangard sites the authors draw out principles for success, and provide some examples of promising practice.  This includes looking at services that are designed around complex needs and while the majority are focused on older people, the report does mention that in Blackpool there is a service aimed “specifically at people with complex mental health needs, substance abuse and/or social problems.”
  • Tackling alcohol misuse in NHS hospitals – a comprehensive guide to help providers in the NHS to think about the role that hospitals play in reducing alcohol harm.  There are sections on the costs to the NHS associated with frequent alcohol admissions, what assertive outreach services (often working with people with multiple needs) look like and the impact they have been able to show.  A complementary piece of research also from South London looks at the perceptions of community alcohol treatment amongst a group of alcohol frequent attenders at Emergency Departments.
  • Webinar on housing and mental health – an hour long King’s Fund on-demand session on the role of housing in accelerating discharge from mental health care.

18 May 2017

  • Tackling alcohol misuse in NHS hospitals – a comprehensive guide to help providers in the NHS to think about the role that hospitals play in reducing alcohol harm.  There are sections on the costs to the NHS associated with frequent alcohol admissions, what assertive outreach services (often working with people with multiple needs) look like and the impact they have been able to show.  A complementary piece of research also from South London looks at the perceptions of community alcohol treatment amongst a group of alcohol frequent attenders at Emergency Departments.

4 May 2017

  • Community Sentences; Where did it all go wrong? – this piece of research looks at the changes to community sentences and the requirements that have gone with them (which can include drug, alcohol and mental health treatment).  It finds that there has been a big drop in the number times they are used, and explores reasons for that fall.  The report concludes with some policy recommendations, including developing a different response (based on Hawaii’s Opportunity Probation with Enforcement programme) to the 24,679 offenders per year who serve community sentences for theft and drugs offenders and have more than six previous convictions.
  • Austerity, sanctions, and the rise of food banks in the UK – a report in the British Medical Journal which reviews the evidence that’s available around use of food banks and provides a new analysis of the available data.  The researchers find that the highest levels of food bank use have occurred where there have been the highest rates of sanctioning, unemployment, and cuts in central welfare spending.
  • The Long-term Sustainability of the NHS – A House of Lords Select Committee has produced a report on the long-term future of the NHS.  Amongst the things that the committee reflect on are issues to do with public health.  The committee are critical of the cuts to public health funding, and argue that the NHS could be doing more particularly to meet its ambitions around parity of esteem for people with mental health problems.  It also calls for the NHS Constitution to be recast, to emphasise the personal responsibility that individuals have for maintaining health.

16 March 2017

  • Patient Perspectives and Nurses’ Perspectives – two documents from the Hepatitis C Trust providing different perspectives on the experience of the disease.  The patient perspective includes issues such as: awareness and stigma; testing; and treatment.  The report makes a set of recommendations including making sure that testing takes place in drug and alcohol services, and raising awareness of the condition.  The report on nurse perspectives focuses on the treatment cap and how this impacts on nurse patient relationship and the effect on patients themselves.
  • Domestic abuse: a resource for health professionals – a new resource from the Department of Health aimed at health professionals, but which may have wider appeal.  The document points to research which shows that where A&E staff include independent domestic violence advisers people with multiple needs are more likely to disclose.  It also reports that about a third of cases of parental mental ill health and substance misuse (alcohol and/or drugs) are concurrent with domestic abuse.
  • No one judges you here – a new report from Adfam in which older people affected by a loved one’s substance use talk about their experiences.  Amongst the things that those interviewed discuss are: the sense of shame they have, having to struggle to access services, how difficult it is to know what to do in the face of their loved one’s dependence, and the experience of being a kinship carer. The report concludes by offering some messages to professionals about how they would like to be treated in those relationships.
  • Social interventions in mental health – an editorial in the International Journal for Research in Social and Genetic Epidemiology and Mental Health Services calling for action in developing interventions that: reduce stigma and social exclusion; increase understanding and alleviate the impact on mental health of social adversities; and promote good relationships and support within communities.

 

2 March 2017

  • Guidance on brain injury and homelessness – new from Homeless Link, this guidance is aimed at practitioners to help them work with and understand the circumstances of those people with brain injuries.  It includes a checklist for practitioners covering crises, tips on quick problem solving, and ways of working over the shorter term.
  • Police effectiveness 2016 – a review by Her Majesty’s Inspector of Constabulary which looks at how effective the police are at preventing crime and anti-social behaviour, investigating crime, protecting the vulnerable and victims of crime, and the response to organised crime.  The section on protecting the vulnerable suggests there has been an increased focus on domestic abuse and childhood sexual exploitation, but argues that data collection by the police service remains poor.  It says that the identification of vulnerability is vitally important, enabling forces to plan effectively and be in a position to respond effectively to calls for service. The inspectorate say that next year’s report will have a focus on working with people with mental ill-health. Reports on the effectiveness of individual forces available here.
  • Substance Misuse and Homelessness in Greater Manchester – an analysis of data from the National Drug Treatment Monitoring System (NDTMS) about the number of people in treatment across the Manchester combined authority.  The Lifeline Project show that of the 10,000 people who started treatment for drugs or alcohol last year 1,500 had a housing problem or were sleeping rough.  The report demonstrates that across Greater Manchester there was a 70% decrease in the number of people citing a housing or eviction risk between the start and end of treatment. Greater Manchester will no longer receive the public health grant from April this year, instead all services will be funded through retained business rates, this is the model that the government are planning for the rest of the country to adopt by 2019/20.

23 February 2017

  • Benefit Sanctions – a short report by the Public Accounts Committee which amongst their recommendations suggests that the DWP should undertake a trial of warnings (rather than sanctions) for first sanctionable offences.  They also point out that sanctions can make things worse for people with housing-related barriers to employment and ask the Department to set out what more it will do to assure itself that Housing Benefit is not being stopped in error due to sanctions.
  • Preventing prison suicide: Staff perspectives – a paper from the Centre for Mental Health and Howard League for Penal Reform drawing on focus groups with staff in 8 prisons and 6 health care providers. The paper points out the dramatic rise in the number of deaths by suicide in England’s prisons in recent years, as have incidents of self harm.  It notes that although prisoners can have multiple needs, often they do not meet the threshold for a mental health referral and therefore receive little support in prison.  The paper talks about a range of suggestions made by prison staff to improve things, these include: collaborative working across the prison estate; increased use of peer support; building flexible patient-centred approaches which focus on trusting relationships; and investment in staff through training and support.

9 February 2017

  • The Linked Environment for Alcohol Death Research – a report from Public Health Wales which gives an overview of research to identify factors that may reduce future mortality related to alcohol use in Wales.  The report links the health records of just under 8 thousand people who died from alcohol in Wales in the ten years 2005-14.  They report that an assessment for alcohol or drug treatment was recorded for less than 25 per cent, despite the fact that most alcohol deaths are the result of many years of heavy or binge drinking.
  • Mental health in the West Midlands Combined Authority – a report by the Centre for Mental Health and University of Birmingham looking at the social and economic cost of mental health in the West Midlands.  They report that the cost of mental health problems in the region is around £12.6 billion.  They suggest that more attention could be given to better work between mental health and drug and alcohol treatment provision where people experience coexisting condition.
  • Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool – a report from the Public Health Institute at Liverpool John Moores University which looks at the change of policy in Liverpool around testing on arrest.  The change from testing all those who were arrested for ‘trigger’ crimes to undertaking tests on a more targeted basis reduced the number of tests by half, but had only a marginal (6%) increase in the proportion of positive tests.  The report details concerns by the community treatment provider, the police and others that  lower numbers of drug using offenders are coming into treatment.
  • Health and social care integration – the National Audit Office examine the delivery of integrated health and social care services with a focus on the Better Care Fund and suggest that there is no compelling evidence to show that integration in England leads to sustainable financial savings or reduced hospital activity.

27 January 2017

  • The ‘Men and Masculinities’ Programme – this is a practice briefing produced by Cranstoun and DVIP looking at the programme the two organisations run addressing domestic abuse amongst men in substance misuse treatment.  They report that 25% of men (n=30) in the cohort were willing to sign up for treatment within a domestic violence perpetrator programme.  They also suggest the combination of these interventions didn’t appear to damage the outcomes achieved for drug and alcohol treatment.  The report is cautious about claiming that the programme ends violence at this stage, but they report some encouraging results.
  • Mental Health in General Hospitals: Treat as One – This report from the National Confidential Enquiry into Patient Outcome and Death highlights the quality of mental health and physical health care for patients aged 18 years or older with a significant mental disorder who are admitted to a general hospital.  It identifies co-existing conditions in many of the patients, and has points to make about the quality of assessment.
  • Faulty by design. The state of public-service commissioning – the paper by the Reform think tank takes a critical look at how services are commissioned and makes recommendations around a focus on outcomes, integration of commissioning, and the pace at which devolution is happening.  It has a section on multiple needs drawing on the Hard Edges report.
  • Tackling tuberculosis in under-served populations – this is guidance from PHE for TB Control Boards about delivering programmes to reduce TB in under-served populations.  Almost one in five TB cases are amongst people with substance use disorders, homeless people, people with mental ill-health, and those in touch with the criminal justice system.  PHE suggest that TB Control Boards, which are constituted at a regional level,  should be working closely with colleagues in public health to address the holistic medical and social care needs of people with complex lives who have TB.  The guidance includes sets of recommendations for local government and the Boards.

19 January 2017

  • Housing First A case study on Fulfilling Lives in Islington and Camden – looking at the experience of setting up and running a Housing First model as part of the Big Lottery funded project on multiple needs.  The report discusses how the project team interact with landlords and housing providers, work to ensure that practicalities (such as housing benefit claims) are delivered, and some of the impact that the approach has had on the lives of those housed under the scheme.
  • Support after suicide: a guide to providing local services – produced by Public Health England this guide looks at the reasons for providing services to people bereaved by suicide, what those who have been through the experience valued, and some case studies of services that have been developed.  A useful companion piece might be these guidelines for those whose work brings them into contact with adults bereaved after a drug or alcohol-related death.
  • Rebalancing Act – a report from Revolving Doors aimed at those commissioning, providing (and experiencing) health and justice services.  The report provides a comprehensive overview of the varying needs that people in touch with the criminal justice experience, and provides pointers and levers that may help in understanding and addressing some of those issues.

5 January 2017

  • It’s no life – a report from Crisis looking at the experience of violence and anti-social behaviours that rough sleepers experience.  Seventy seven per cent (353) of those surveyed reported being a victim of anti-social behaviour and/or crime in the past 12 months.
  • “The Type of Girl That Would Do That”  – a report from Changing Lives using a peer led approach to research into sex work in Durham and Darlington.  The report describes the experience of twenty women involved in ‘survival’ sex work and escort work and has sections reflecting on the services that come into contact with women involved in prostitution.  The report makes clear the multiple needs of the women interviewed (particularly those engaged in ‘survival’ sex work).

15 December 2016

  • Reducing Opioid-Related Deaths in the UK – new ACMD report looking at the large increase in the number of deaths associated with heroin (and other opioid) overdoses.  It makes a number of recommendations to reduce harm, including sustaining the investment in treatment services, ensuring that treatment follows the best available evidence, and to extend harm reduction interventions.  The report recognises the particular vulnerability of heroin users with multiple needs and recommends assertive outreach as one way of reaching this cohort.
  • Mental health crisis care for Londoners – new guidance for how Londoners detained under the powers set out in section 136 of the Mental Health Act should be treated.  Includes a requirement that those assessed as having coexisting conditions (dual diagnosis) should expect onward referrals, discharge plans or discharge letters are received by the appropriate care provider within the next working day and that onward services are provided with the information gathered throughout the assessment.
  • The role of public health in the prevention of violence – a report from the Faculty of Public Health looking at how violence impacts on health and the ways that it could be reduced through public health interventions.  The report calls for: measuring violence-related health needs; identifying the root causes of violence and possible solutions; and makes the case for effective interventions and building partnerships to prevent or reduce violence-related harm.

 

8 December 2016

  • Quality at a cost – the annual statement from Quality Watch, a project from the Nuffield Trust and Health Foundation, looks at outcomes from across the health and care systems.  It concludes that while public health outcomes have broadly been maintained there are causes for concern, particularly around alcohol misuse and sexually transmitted diseases.  The report also suggests that parity of esteem for those with mental ill-health has not yet been achieved, and suggests that there needs to be information collected from wider systems that support people with mental health problems.
  • The Frontline Battle – the findings from an inquiry by the All Party Parliamentary Group on Alcohol Harm into the impact of alcohol on Emergency Services.  It details the population wide issues that the police, ambulance and emergency departments face as a result of alcohol consumption, with the Metropolitan Police Service quoted as estimating that  80% of violent crimes at weekends are linked to alcohol consumption.  There isn’t a huge focus on people with multiple needs, but the report does highlight the complexities of finding the right interventions for those with coexisting mental health and alcohol use disorders.
  • Stepping up to the place – a joint document from the LGA, ADSS, NHS Confederation and NHS Clinical Commissioners setting out a vision for integration of health and social care services. The organisations suggest the core of good integration focuses on: a shared commitment to holistic care shaped around the individual; shared leadership across the systems; and building common infrastructure and workforces for those systems. To support the vision the organisations have built a tool for self-assessment.  This focuses on two core questions: having the essentials for the integration journey; and organisational readiness for delivering integration.  It asks those using it to work through a set of questions which are designed to lead to an action plan for deepening integration.  There are also a number of case studies which highlight effective integration.

1 December 2016

  • Benefit sanctions – a report by the National Audit Office looking at the effects of social security sanctions finds that the DWP is not doing enough to find out how sanctions affect people on benefits.  It reports that for those sanctioned there are negative impacts on mental health, including depression and anxiety; financial and emotional impacts such as falling into arrears with rent and bill payments; and worsening relationships with jobcentre staff.
  • Stop the Scandal: the case for action on mental health and rough sleeping – a report from St Mungo’s on the mental health needs of rough sleepers and the response (or lack of it) from commissioners of mental health services for this client group.  Freedom of Information requests show that only 32 per cent of the areas where 10 or more people are sleeping rough on any one night commission mental health services actively targeting people sleeping rough.  The consequences of rough sleeping on mental health and other needs are explored through interviews with 21 people who are St Mungo’s clients.
  • Tackling Street Drinking – guidance issued by the Association of Police and Crime Commissioners.  It identifies nine things that the police could do which would develop and improve a multi-agency response to street drinking and reduce the associated harms, including mental ill-health, intimate partner and wider violence, and drug use.

17 November 2016

  • Children in Custody 2015-16 – an analysis of 12-18-year-olds’ perceptions of their experiences in secure training centres and young offender institutions.  The report makes the point that those who are already experiencing emotional and mental health issues are also more likely to have substance misuse issues.
  • Homelessness Reduction Bill – a briefing from the House of Commons library on the provisions of the Bill and some of the background to its genesis ahead of the Second Reading debate.
  • Experiences of Homelessness and Brain Injury – qualitative research in which 5 homeless people with brain injuries talk about their experiences, and how the injuries have impacted on their lives.  The paper points out that two studies have shown very high rates (70% and 90%) of homeless people with a brain injury reporting their first injury occurring before they became homeless.

26 October 2016

  • Health & Justice annual review 2015/16 – PHE’s annual assessment of changes in the health and justice system.  The report discusses the public health needs of people in prisons and other prescribed places of detention, including a strong focus on multiple needs.
  • Mental Health Service Interventions for Rough Sleepers Tools and Guidance – a set of tools from Pathway, a homeless health charity, for outreach workers.  Co-existing mental, physical and substance use disorders are common amongst rough sleepers.  These tools may help practitioners to assess multiple health needs in that population.
  • A Matter of Conviction – the RSA have been looking at what might be the elements of a prison reform programme that increase the focus on rehabilitation and desistance.  One of the proposals they make is to increase the control that governors have over drug and alcohol services inside their prisons, which they argue could be particularly useful in ensuring continuity of care for those on short sentences.  They also call for Health and Wellbeing Boards to be required to explicitly include prisoners in their guidelines.
  • Reducing preventable deaths among people who inject drugs – a report by Kirsten Horsburgh, the coordinator of the national take-home naloxone programme in Scotland.  Kirsten has been investigating how some other countries have been trying to reduce drug related deaths and makes recommendations that she believes would impact on the high rates that affect the UK.

20 October 2016

  • Nowhere safe to stay – a report from St Mungo’s on the experience of people sleeping rough. It points out how scary rough sleeping is, the extreme risks rough sleepers are forced to take, and how it affects their physical and mental health and substance use conditions.
  • Psychosis data report – a PHE report into the available data for a range of indicators across the psychosis care pathway.  It shows that twice as many people with serious mental illness smoke than the general population, and that they are 5 times as likely to die of liver disease and respiratory diseases than the general population.  The report makes a range of suggestions for improving data for this group of people, including ensuring there is a common definitions of incidence and prevalence of psychosis and SMI in community populations, primary care, specialist mental health and drug and alcohol services.
  • The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness – the annual report points out that over half the patients in touch with mental health services, who died by suicide over last 20 years, had a history of alcohol or drug misuse. It also finds that over that period 556 patients that died of homicide (89%, excluding unknowns) had a history of either alcohol or drug misuse or both, an average of 51 homicides per year. The report makes a clinical recommendation that specialist alcohol and drug services should be available, with the ability to manage clinical risk, working closely with mental health services, with agreed arrangements for “dual diagnosis” patients.

4 October 2016

  • Through the Gate Services for Short-Term Prisoners – HM Inspectorate of Probation and HM Inspectorate of Prisons have inspected these services and make the point that most of the prisoners in this category had multiple and complex needs which were often not properly identified and planned for.  The inspectors say “the minimum requirements for resettlement are: a safe place to sleep, from the day of release; access to enough money to meet basic needs including food, clothing, and transport; a sense of hope for the future; and active links into services that can assist them with other needs, for example substance misuse and mental health services.”
  • The economics of housing and health – a King’s Fund report on the role of housing associations in improving health.  Some focus on mental health and in the context of preventing domestic violence and antisocial behaviour on multiple needs.
  • Transforming Rehabilitation Inquiry – report from the Public Accounts Committee.  Makes the case that only by engaging with wider services – health, housing, employment – can the needs of those on probation be met, and the rehabilitation of those individuals progressed.

15 September 2016

  • Gate to Gate – report looking at some of the things that could be done to support veterans with mental health problems that enter the criminal justice system.
  • Local public service reform – the National Audit Office look at the scale and range of efforts being made to reshape the local state to meet the challenges of austerity.  Some interesting case studies of actions being taken to meet the needs of communities in a more coordinated manner, and to reduce demand on services.

8 September 2016

  • Sustainability and transformation plans (STPs) explained – the King’s Fund’s primer on how the NHS is developing plans to improve health at a local level covering three headline areas: improving quality and developing new models of care; improving health and wellbeing; and improving efficiency of services.
  • Local public service reform – report from the Institute of Government looking at what those involved in the integration of services at a local level need to do their job better. This includes: more real-time learning; opportunities to ‘dig deeper’ into the messy reality of implementation; face-to-face conversations; and peer-led (rather than central government led) approaches to integration.
  • Rough sleepers: access to services and support (England) – a briefing from the House of Commons Library providing some detail on issues around accommodation, access to healthcare and benefits, food assistance, training and employment, and registration to vote.

15 August 2016

  • Dual dilemma – Turning Point’s new report on the difficulties for those with co-existing mental health and substance use conditions, with recommendations for policy and practice.
  • Evaluation of physical health services for people with severe mental illness – blog from the National Institute for Health Research which looks at new research about the need to join up health care around physical and mental health for those with severe mental health needs.
  • The Debt Effect – analysis by Citizen’s Advice which finds those with unmanageable debt are 24 per cent more likely to experience poor mental health than the general public.
  • Evaluating a Dialogical Psychologically Informed Environment (PIE) Pilot – evaluation of the PIE approach as part of the Fulfilling Lives project. The researchers find that the approach improves staff performance, gives staff the tools to work with people with multiple needs, and in particular those with the highest levels of need.
  • Devo-health: what and why? IPPR’s take on the agenda around devolving and integration of health and local government services, with a focus on what has been happening in Manchester.

21 July 2016

14 July 2016

  • Evaluation of the offender liaison and diversion trial from RAND Europe – the report finds that a significant proportion of those in the scheme with mental health problems are suffering from multiple conditions. It suggests that practical support – booking and ensuring attendance at appointments etc. – were valued and meant higher engagement with health services.
  • The English social care system in 2016 a set of slides from the Kings Fund providing some of the the wider context in which decisions at a local level are being made.
  • Traumatic brain injury – an economic analysis from the Centre for Mental Health – it makes the case that traumatic brain injury is associated with much higher chances of having mental ill-health, substance use disorders, and offending behaviours. It makes clear the causal relationship (which runs both ways) between alcohol misuse and traumatic brain injury.

7 July 2016

22 June 2016

  • Money on your mind – report from the Money and Mental Health Institute which finds that drug and alcohol dependence is one of four mental and behavioural problems (alongside bipolar disorders, personality disorders, ADHD or ADD)  which consistently appeared to contribute to poor financial decision making during periods of mental ill-health.

16 June 2016

8 June 2016