The National Service Framework for Mental Health
The National Service Framework for Mental Health is one of a package of frameworks introduced by the current government. It was introduced in September 1999 and covers a ten year period. The overall aims are twofold:-
1. To improve the service provided to users
2. To challenge the popular myths surrounding mental illness
The National Service Framework was developed by the ‘External Reference Group’ chaired by a Professor Graham Thornicroft. The group was comprised of health and social care professionals, service users, carers, health and social service managers and partner agencies. They recommended that service users expected the service will:-
- Involve service users/carers in planning and delivery of care
- Deliver quality treatment which is known to be appropriate and effective
- Be suited, accessible and non discriminatory to those who use the service
- Promote the safety of service users, carers and the public
- Offer choices which promote independence while delivering continuity of care for as long as required
- Be well co-ordinated between all staff and agencies
- Empower and support staff
- Be accountable to the public, service users and carers
One of the major objectives is to create an integrated system, where agencies, carers, service users and others work together. Addressing major gaps in the current system is a high priority, i.e. staffing levels, outreach teams, secured accommodation together with equity of access and safety issues.
Standard One
Health and social services should:
- Promote mental health for all, working with individuals and communities
- Combat discrimination against individuals and groups with mental health problems, and promote their social inclusion
Standard Two
Any service user who contacts their primary health care team with a common mental health problem should:
- Have their mental health needs identified and assessed
- Be offered effective treatments, including referral to specialist services for further assessment, treatment and care if they require it
Standard Three
Any individual with a common mental health problem should:
- Be able to make contact round the clock with the local services necessary to meet their needs and receive adequate care
- Be able to use NHS Direct, as it develops, for first level advice and referral on to specialist help-lines or to local services
Standard Four
All mental health users on Care Programme Approach (CPA) should:
- Receive care which optimises engagement, anticipates or prevents a crisis, and reduces risk
- Have a copy of a written care plan which:
- includes the action to be taken in a crisis by the service user, their carer, and their care co-ordinator
- advises their GP how they should respond if the service user needs additional help
- is regularly reviewed by their care co-ordinator - be able to access services 24 hours a day, 365 days a year
Standard Five
Each service user who is assessed as requiring a period of care away from their home should have:
- Timely access to an appropriate hospital bed or alternative bed or place, which is:
- in the least restrictive environment consistent with the need to protect them and the public
- as close to home as possible - A copy of a written after care plan agreed on discharge which sets out the care and rehabilitation to be provided, identifies the care co-ordinator, and specifies the action to be taken in a crisis
Standard Six
All individuals who provide regular and substantial care for a person on CPA should:
- Have an assessment of their caring, physical and mental health needs, repeated on at least an annual basis
- Have their own written care plan which is given to them and implemented in discussion with them
Standard Seven
Local health and social care communities should prevent suicides by:
- Adhering to Standards One to Six
and in addition: - Support local prison staff in preventing suicides among prisoners
- Ensure that staff are competent to assess the risk of suicide among individuals at greatest risk
- Develop local systems for suicide audit to learn lessons and take any necessary action