National Mental Health Services Assessment: Final Report
ANNEX 3 - GLOSSARY OF TERMS
AMPs: Approved Medical Practitioners
A new term established by the new Act. An AMP is a doctor with additional specified psychiatric training in the Mental Health (Care and Treatment) (Scotland) 2003 Act, who is approved by an NHS Board. He/she is then qualified to undertake short and longer term detention orders under the new Act.
ARTs: Area Redesign Teams
Teams formed from local groups of professionals, service users and carers who look for better ways to organise their local services. This is not a standard term, and there are variations across the country. ARTs are similar to the Joint Commissioning Teams that were described in the Framework for Mental Health Services in Scotland 1997.
Bridging Finance
Resources allocated by NHS Boards from within their overall funds to cover the double running costs incurred as wards and hospitals reduce in size and patients transfer to care in community settings.
The Care Commission
The Scottish Commission for the Regulation of Care is a new national regulatory and inspection body established following the Regulation of Care (Scotland) Act 2001. Its principal responsibility is for the regulation and inspection of all residential Scottish care services provided or commissioned from social work departments
CAMHS: Child and Adolescent Mental Health Services (see SNAP Report)
For Scotland's Children was published in 2001 by the Scottish Executive and looked at the health needs of vulnerable children leading to the setting up by the Health Minister of the Child Health Support Group.
Capital Receipts
The sale proceeds arising from the disposal of property, buildings etc.
Change Fund Initiative
A funding mechanism set up to help local authorities put in place the recommendations made in The same as you? for services for people with a learning disability, and to help deliver this change agenda.
Code of Practice
A Code of Practice sets out the who, what, where and when for professionals and others for the delivery of an Act's objectives, in this instance the Mental Health (Care and Treatment) (Scotland) Act 2003.
CRE: Commission for Racial Equality
An independent body set up under the Race Relations Act 1976. It aims to eliminate racial discrimination, promote equal opportunities, encourage good relations between people of different racial/ethnic backgrounds, and monitor the Race Relations Act.
CHPs: Community Health Partnerships
Partnership for Care stated that Local Health Care Co-operatives (see LHCCs) should evolve into CHPs, which will have a new role more consistent and enhanced in the planning and delivery of services, working as part of a decentralised but integrated healthcare system.
Co-morbidity
This is a rather confusing term, which is similar to 'co-occurring' and 'dual diagnosis' (see below). The most common use is when a person has both a serious mental health problem/illness at the same time (co-occurring) as a problem with drugs or alcohol.
CMHT: Community Mental Health Team
Care in the community is now provided by a range of professionals and support staff from the health service, social work and voluntary sector. This is done through teams that outreach from secondary care and connect and work in their local community areas and provide a bridge between 'primary' care and hospital care.
CPA: Care Programme Approach
A way of co-ordinating the multidisciplinary and interagency planning and provision of care for people with severe mental illness (including dementia) who require structured arrangements for their care and supervision. It ensures that staff from different agencies regularly meet together to review progress with a service user and his/her carers, and also record unmet need. It has been government policy since 1992 ( Scottish Office Circular SWSG16/96) but has not been applied in a systematic way throughout Scotland.
CPN: Community Psychiatric Nurse
A registered mental nurse (RMNs) who has had additional training to work in community settings as well as hospital. In the past this involved a college diploma, but over the last few years when services have increasingly been provided in the community, the term has come to mean specially trained nurses who work in the community as part of a team. A CPN will have a 'case-load' of people with mental health problems who receive direct support, but will also spend time liaising with the primary care team, social work and hospital services.
'De-facto' Detention
Sometimes people who are not officially detained under the Mental Health Act 1984 may in practice be detained when a ward is locked for the safety and security of another individual, especially in an Intensive Psychiatric Care Unit, or for their own safety; for example, when they have dementia and may wander out of the ward and get lost. The latter situation is increasingly being resolved by having an 'open' (unlocked) ward that has a difficult way of opening the door, unlikely to be mastered by someone with dementia. The Mental Welfare Commission has continually expressed concerns about locked wards and the new Act places greater emphasis on a person's right to the lowest appropriate level of security.
Delayed Discharge
A 'delayed discharge' is the term used when a person has to remain in hospital after the time their responsible medical officer says that they are clinically able to leave, but the agreed community care arrangements are not available (usually due to lack of appropriate accommodation).
Designated Medical Officer
This new term replaces that of the 'second opinion' doctor set out in the 1984 Act. Designated medical officers are doctors appointed by the Mental Welfare Commission. They are consultant psychiatrists of a least 3 years experience and receive special training for this role.
Dual Diagnosis
This term is similar to 'co-morbidity', described above, which now refers mainly to people with co-occurring mental health problems and substance misuse. However, traditionally the term was applied also to people who have a mental illness in addition to a learning disability. People with a learning disability are more at risk of a mental illness than the general population. People with a learning disability also often have considerable physical disabilities although this is not usually consumed under the term 'dual diagnosis'. A focus on needs rather than diagnosis is probably best at an individual level, but harder to summarise at the level of service planning.
ESF: European Social Fund
A significant source of European funding which helps disadvantaged groups in the community who, for a variety of reasons, are excluded both economically and socially. These funds are used to add value to policies introduced by Governments with the aim of a more inclusive society.
Forensic Services
Applies mainly to the range of services, care, support and accommodation for mentally disordered offenders. The skills and expertise of the staff may, however, also be called upon to treat people with serious problems who have not committed an offence just as general psychiatrists will work with offenders and provide aftercare. In Scotland general psychiatric services and forensic services are less separate than in England. The social service input comes from both the criminal justice system and local authority social work teams, and close links are made with other agencies such as courts and prisons.
Healthy Living Centres
Projects that offer information, advice and practical support for the improvement of healthy living. These centres are funded by Lottery money, and so far Scotland has been allocated around 34.5m.
ICP: Integrated Care Pathway
A formalised and agreed interagency and multidisciplinary programme to enable people to receive the best care in the best possible way. It shows what should happen when, who does what and when, to ensure progress to better health.
Care Pathway
As above
HRC20. Assessing the Risk for Violence Version 2
One of the commonly used tools used by professionals in assessing the risk of violence presented by people who usually have a forensic presentation.
IPCU: Intensive Psychiatric Care Unit
Small wards that provide an environment and level of care necessary for people who are severely or acutely ill, needing close observation and more intensive treatment, or who may require higher levels of supervision because of a forensic history.
Joint Future
The strategic policy for providing improved joint planning and working between the statutory organisations; namely health and social work. This initiative was introduced following the publication of the Scottish Executive's report; Community care: A Joint Future in November 2000.
LHCC: Local Health Care Co-operative
Currently the key building blocks for primary care services; they have made good progress in developing into responsive and inclusive organisations that are the main focus of planning and development for community health services.
Liaison Psychiatry
Within psychiatry this term is used to describe the sub-specialty that provides psychiatric assessment and treatment to patients attending general hospitals (whether inpatients or outpatients or Accident and Emergency). It is concerned with the interface between physical and psychological health and this involves many more professions than doctors alone, especially psychologists and nurses. Liaison health services work closely with the social services in terms of family and local authority support.
MHO: Mental Health Officer
Mental health officer; a social worker trained and approved to carry out statutory duties under the Mental Health Act.
Medium Secure Unit
Can also be referred to as a regional forensic psychiatric unit and includes some community services or supports. The security is at a level between an IPCU or low secure local forensic services and the special security at The State Hospital.
Millan Report
New Directions: Report on the Review of the Mental Health (Scotland) Act 1984 was the findings of a committee chaired by Rt. Hon. Bruce Millan. This report and its recommendations led to the new Mental Health Bill being introduced to Parliament during 2002.
MDO: Mentally Disordered Offender
Mentally Disordered Offender is a term used for people who have a mental illness or a learning disability, and have come into contact with some element of the criminal justice system.
New Futures Fund
Launched in 1998 by the Scottish Executive, this funds projects that target problems of social exclusion and unemployment. Much of the funding is targeted at projects working with drug users.
NES: NHS Education for Scotland
Established in 2002, NES promotes multidisciplinary training and education of healthcare professionals across Scotland, bringing a strategic approach to staff development and supporting the NHS reforms across the country.
NHS24
A telephone health and advice helpline for Scotland available on a 24-hour basis.
NMD: Neurosurgery for Mental Disorder
Surgical procedure for the destruction of brain tissue to relieve specific mental disorders.
Office of the Public Guardian
Established under the Adults with Incapacity (Scotland) Act 2000 (AWI Act), this supervises any guardian or authorised person carrying out functions relating to the property of financial affairs of another person. The Office of the Public Guardian also receives complaints under AWI Act and may consult the Mental Welfare Commission or any local authority on matters relating to the functions under AWI.
OT: Occupational Therapist
A state registered professional, an OT is primarily concerned with a person's ability to live as independent a life as possible, and uses various 'activities' as the treatment tool including leisure, creative, domestic and self care, and work related tasks to allow people to gain new or regain lost skills.
Partner Organisations
These are a range of organisations working together to provide the best possible care: NHS Boards, Trusts, GPs, LHCCs, Local Authorities, social work departments, voluntary organisations, and others that will include Community Health Partnerships, courts, Scottish Ambulance Service and the prison services.
PAF: Performance Accountability Framework
A process for assessing and comparing the performance of NHSScotland across a range of key services to improve accountability and services. The PAF is completed on an annual basis by the Scottish Executive Health Department and each NHS Board area.
Perinatal Mental Illness
A range of mental health problems or illnesses that women may experience during pregnancy or following the birth of a child.
Pharmacist
A specialist in issues concerning medication
Psychiatric Morbidity
A professionally understood term used to describe the presence of a significant mental illness.
Psychiatrist
A medical doctor who specialises in the care and treatment of people with mental health problems, and can prescribe drugs as well as providing psychological treatments. There is a long post-graduate training and exams before a person can apply for a consultant post.
Psychiatric Specialties
There are 6 recognised specialties within the Royal College of Psychiatry and these are; adult psychiatry, children and adolescents, forensic, learning disabilities, old age, and psychotherapy.
Psychological Interventions
Methods used to treat a range of mental health needs based around talking treatments involving one to one, group, family or counselling approaches, or psychosocial interventions (PSI) carried out by a range of professionals.
Psychologist
A chartered clinical psychologist aims to reduce psychological distress and enhance and promote psychological health and well-being and work with people with a mental or physical health problem and those with a learning difficulty or disability.
RMO: Responsible Medical Officer
The responsible medical officer is always a consultant or a locum consultant, who has overall legal responsibility for the care a patient receives.
SAYIG: Same as you? Implementation Group
During 2003-04 the Same as you? Implementation Group will consider services for children, advocacy and day care services.
SIAA: Scottish Independent Advocacy Alliance
Previously known as Advocacy 2000 this became SIAA in 2002 with a principal aim of ensuring advocacy is available to any vulnerable person who needs it in Scotland.
SIGN: Scottish Intercollegiate Guidelines Network
Established in 1993 to improve the quality of healthcare in Scotland by reducing the variations in practice and outcomes through the development and dissemination of national clinical guidelines, often referred to as SIGN guidelines.
SNAP: Scottish Needs Assessment Project.
A working group of professionals from a given field who report to the Scottish Executive on the needs both met and unmet in any specialty area of healthcare. Often referred to as a SNAP Report.
Supporting People
A funding arrangement introduced in 2003 to support vulnerable people needing support with a range of difficulties to live in the community.
Mental Health Tribunal
A new body established under the terms of the Mental Health (Care and Treatment) (Scotland) 2003 Act. The Mental Health Tribunal for Scotland ('the Tribunal') will be a new body, established by the new Act. The Tribunal will make decisions covering a wide range of situations - for example, on applications for a Compulsory Treatment Order. Given the nature of the decisions to be made, the Tribunal will require expertise in both mental health law and the provision of care and treatment to people with mental disorder. NHS Boards (including The State hospital) and local authorities are required, where practical, to provide accommodation where hearings can be held.
Workforce Development
An approach to addressing the existing problems in recruitment and retention of key staff in the NHSScotland workforce
WTE: Whole Time Equivalent
A term used to describe the number of people that would be employed if everyone worked full-time. For example, two half-time people make 1 WTE