HC Deb 22 April 2002 vol 384 cc110-2W
Matthew Green

To ask the Secretary of State for Health (1) what plans the Government have to improve training and support for families and close friends of people suffering from schizophrenia; [47916]

(2) what additional support and training for families and close friends of people suffering from schizophrenia has been put in place since 1997; [47735]

Jacqui Smith

The National Service Framework for Mental Health (MHNSF), launched in 1999, sets out clear standards for the modernisation of mental health services by setting out new standards for the delivery of specialised assessment, treatment and care.

It covers the main issues for mental health services, for service users, their carers and those working in local health and social care communities, including action on stigma and inequalities in mental health.

In the MHNSF, Standard Six was set to provide support specifically to carers. It states that All individuals who provide regular and substantial care for a person on care programme approach 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.

By October 2004, mental health services are expected to have identified and assessed all carers of those people with mental health problems as well as agreeing and implementing their carer support plans. To ensure that the friends and families of those people with mental health problems receive the information they need to support them in their role, the Department has produced a leaflet, "A Commitment to Carers', that informs families and friends what they should expect from mental health services. This leaflet was widely distributed not only to service users and their families but also to mental health services and helps to outline that modern, responsive mental health services need to acknowledge the importance of the support networks that families and friends provide to those people with mental health problems.

The NHS Plan, launched in 2000, states that: by 2004, 700 more staff will be recruited to increase the breaks available for carers, and to strengthen carer support networks. There are very few such staff at present. By then around 165,000 carers will be receiving the support they need to continue to provide care.

The Department is developing guidelines on a service specification for support of carers of people with mental health problems. These guidelines will be included in the Mental Health Policy Implementation guide by May 2002.

Matthew Green

To ask the Secretary of State for Health (1) what research(a) has been carried out since 1997 and (b) is planned to assess (i) the importance of swift treatment for patients suffering from schizophrenia and (ii) the impact on their recovery of delayed treatment and care; [47924]

(2) what research is planned to assess the different rates of recovery of patients suffering from schizophrenia, according to (a) different social groups and (b) whether they received private or public care; [47920]

(3) what research (a) has been carried out since 1997 and (b) is planned to assess the effectiveness of different non-drug treatments and combinations of treatments, with particular reference to (i) one-to-one and (ii) group therapy for schizophrenia. [47917]

Jacqui Smith

The main Government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC) which receives its funding via the Department of Trade and Industry. In 1999–2000 MRC spent £17.6 million on mental health disorders research which includes the investigation, prevention, diagnosis and treatment of the whole spectrum of mental health problems ranging from mild depression to severe psychosis.

The Department has funded a number of projects on schizophrenia since 1997. Ongoing projects The CUTLASS Study: a multi-centre randomised controlled trial of atypical anti-psychotic drugs in severe schizophrenia. The management of patients with a diagnosis of schizophrenia in primary care. Group cognitive behaviour therapy (CBT) for schizophrenia. Implementing family interventions for people with schizophrenia in a routine clinical service. South Thames evidence-based practice: implementation and evaluation (STEP). Completed projects Suicide in Schizophrenia: a systematic review of risk factors and review of effects of pharmacological and psychosocial treatments in preventing suicide. A systematic evaluation of the clinical and cost effectiveness of 'atypical' anti-psychotics in the treatment of schizophrenia. Systematic reviews of (i) comparative studies of depot neuroleptic drugs, and (ii) studies of oral v. depot neuroleptic agents for patients with schizophrenia: clinical, social and economic outcomes. Systematic review of the effectiveness of day care for people with severe mental disorders. The clinical effectiveness and cost effectiveness of the use of the newer (atypical) anti-psychotic drugs in the treatment of schizophrenia. Development and evaluation of personalised patient information for patients with schizophrenia living in the community. What factors are associated with continuing contact with specialist psychiatric services among people with chronic psychosis identified in general practice. A pilot study of the mental health crisis cards.

Details of all Department of Health funded research are available on the National Research Register (NRR) www.doh.gov.uk/research.

A number of initiatives are either in progress or identified for future action. The Department has commissioned a literature review and scoping exercise relating to the early intervention in psychosis for the development of service models. Further primary research in this area may be required. In addition, the Department has also commissioned work in relation to services for women, in-patient care and assertive outreach. Although not explicitly targeting people with schizophrenia, they will clearly also be addressed as part of these studies. Future priorities include dual diagnosis (substance misuse and severe mental illness) and the management of mental health in primary care.

The Department has recently conducted a review of mental health research carried out in the NHS. Future research strategy will take account of the gaps identified.

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