Public and Private Welfare Activity in the United Kingdom, 1979 to 1999

This paper analyses the shifting balance between public sector and private sector welfare provision in the United Kingdom over the past two decades. Five sectors - education, health, personal social services, housing, and income maintenance and social security - are examined over three time points, 1979/80, 1995/96, and 1999/2000. Burchardt's (1997) typology is used to classify welfare activities according to who funds them, who provides them, and who decides on the provider and/or amount of service. It is found that shifts in the composition of welfare activity have been relatively small and gradual: around half of all welfare activity, dropping from 52 percent to 49 percent, is entirely public; around a quarter, rising from 24 percent to 29 percent, is entirely private; and the remainder involves a mixture of both sectors. Within the latter group, there was a notable increase over time in the contracting-out of public services, which rose from 6 percent to 10 percent of all welfare activity.welfare, social spending, privatisation, contracting-out, public provision, private provision

A Map of Mental Health

This paper provides a comprehensive picture of mental health services in England, including staffing and expenditure, and the number of people in need and the number treated. Historically, this information has been split across sub-sections of the health and social services; and the readily available information often appeared to give inconsistent answers. This paper brings together and interprets the available evidence to provide a single coherent map of mental health need and services, from children to older adults and across both health and social care services, in England.mental health, NHS, mental health services, mental health staff, public health, expenditure

Improving Access to Psychological Therapy: Initial Evaluation of the Two Demonstration Sites

The Government's Improving Access to Psychological Therapy (IAPT) programme aims to implement NICE Guidance for people with depression and anxiety disorders. In the first phase of the programme, two demonstration sites were established in Doncaster and Newham with funding to provide increased availability of cognitive-behaviour therapy-based (CBT) services to those in the community who need them. The services opened in late summer 2006. This paper documents the achievements of the sites up to September 2007 (roughly their first year of operation) and makes recommendations for the future roll out of IAPT services.Cognitive Behavioural Therapy, CBT, Psychological therapy, Evaluation, Cost benefit analysis, IAPT

A map of mental health

This paper provides a comprehensive picture of mental health services in England, includingstaffing and expenditure, and the number of people in need and the number treated.Historically, this information has been split across sub-sections of the health and socialservices; and the readily available information often appeared to give inconsistent answers.This paper brings together and interprets the available evidence to provide a single coherentmap of mental health need and services, from children to older adults and across both healthand social care services, in England

Improving access to psychological therapy: Initial evaluation of two UK demonstration sites

Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed ‘demonstration sites’) during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55–56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed