Debating personal health budgets.

Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery.

Attitudes to visits by children to parents hospitalised with acute psychiatric illness.

BACKGROUND: There is no published research on attitudes of psychiatrists towards children visiting parents who are acutely-unwell and inpatients in psychiatric hospitals. Nor is there information on facilities available for such visits. OBJECTIVES: (I) To assess the attitudes of Irish psychiatrists towards children visiting. (II) To determine the availability of child-friendly facilities within admission units. METHOD: A questionnaire was posted to every consultant psychiatrist accepting acute adult admissions in the Republic of Ireland and Northern Ireland. RESULTS: The response rate was 69%. Ninty-seven per cent were in favour of children visiting. Almost half felt that decisions on visits should depend on the particular situation, considering the child, parent, ward, etc. However, only 11% of units had a room/area designated for children visiting. 90% had no facilities they considered child-friendly on their unit. A majority felt that arrangements for children visiting were inadequate. CONCLUSIONS: This topic is of interest to psychiatrists, and can be contentious, particularly when considering supervision of, and legal responsibility for, children visiting. Guidance on these issues would aid psychiatrists and hospital management. Poor facilities and infrequent visits may be a factor in the early development of stigma towards mental illness. Further research, improvements in facilities and staff training in liaison with children are needed.