A comparison of service users placed out of their local area and local rehabilitation service users

Killaspy, Helen; Rambarran, Dolly; Harden, Cressida; Fearon, Dave; Caren, Graham; McClinton, Kath

doi:10.1080/09638230701879235

Cited by 13 publications

(14 citation statements)

References 7 publications

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“…Local resources however lacked capacity and sometimes speciality resulting in some service users being placed in accommodation away from their local area in ‘out‐of‐area treatments’ or ‘OATs’ (Ryan et al . 2004, Killaspy et al . 2009), defined as ‘a placement outside the geographical boundaries of the commissioners of secondary mental health services’ (Department of Health 2006).…”

Section: Introductionmentioning

confidence: 99%

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Relocating from out‐of‐area treatments: service users' perspective

Rambarran

2012

Psychiatric Ment Health Nurs

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Asylum closures over recent decades resulted in mental health services being increasingly sited in the community. However, under provision of highly supported accommodation led to service users being placed away from their local area in 'out-of-area treatments' (OATs). OATs have raised major concerns in relation to enabling service users' recovery, owing to limitations in promoting autonomy, social dislocation and costs. In 2004, an OATs project was set up in a London Borough to address these concerns. In the first 4 years, the project succeeded in relocating 22 service users to less restrictive environments locally. This study aims to explore the outcome of relocation from service users' perspective. A qualitative methodology was utilized. Semi-structured interviews were carried out with seven service users who relocated. All seven service users shared a strong aspiration for independent living but there was associated loneliness. Five welcomed increased contact with family and friends, but lacked social confidence, inhibiting social inclusion. Service users with long-term and consistent care managers were more able to address fears. Five out of seven service users concluded that relocation increased their autonomy thus enhanced their quality of life.

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Section: Introductionmentioning

confidence: 99%

“…Out‐of‐area treatments were initially chosen on the basis that the service provider was able to meet the needs of the service user at time of placement. However, for some, their improvement over time was not matched by a change in the services they received (Killaspy et al . 2009).…”

Section: Introductionmentioning

confidence: 99%

Relocating from out‐of‐area treatments: service users' perspective

Rambarran

2012

Psychiatric Ment Health Nurs

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“…17 An estimate of the financial flows that could be reinvested into local rehabilitation services and supported accommodation by repatriating 40% of the individuals currently placed in out-of-area treatments nationally is well over £100 million. This figure includes the costs of local placements that offer a similar level of support to the out-of-area placement.…”

Section: Repatriating Service Users Locallymentioning

confidence: 99%

“…In some areas, the associated financial flows have been reinvested into rehabilitation services and high-quality supported housing initiatives, developed through successful collaborations between third-sector providers, commissioners and local mental health services. 17 These whole-system approaches are willing to 'invest to save' by employing one or two staff to carry out detailed reviews of all individuals placed out of area in the first instance and successfully reinvesting the additional costs of out-of-area treatments into the local mental health economy. The success of this type of approach is dependent on good, coherent commissioning in partnership with local rehabilitation services and providers of residential care and supported accommodation.…”

Section: Repatriating Service Users Locallymentioning

confidence: 99%

“…Even where the distance from home is not so great, being placed outside the local area leads to a lack of continuity of care coordination and care management, which results in longer stays than are necessary. 17 In addition, mental health commissioners have been found to have inaccurate data about the individuals they fund in these placements and inadequate systems for reviewing the need for their ongoing care. 18 …”

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confidence: 99%

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A Fair Deal for mental health includes local rehabilitation services

Killaspy

Meier

2010

Psychiatrist

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SummaryLack of policy for mental health rehabilitation services has led to disinvestment and expansion of out-of-area placements in in-patient, nursing and residential care settings in the independent sector. Although a minority provide very specialist services that cannot be provided locally, and many provide good-quality care, there are significant concerns about the lack of rehabilitation focus in some of those services, poor links with local care managers and the social dislocation caused by being placed many miles from home. Additionally, out-of-area placements cost more than local rehabilitation services. There is, therefore, a compelling case for all individuals with complex mental health problems to have access to local rehabilitation services in order to expedite their recovery and social inclusion. The Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists has recently published a service template to guide commissioners and service providers in the UK in the kinds of rehabilitation services they need to provide locally.

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