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Objective To investigate the cost effectiveness of joint crisis plans, a form of advance agreement for people with severe mental illness. Design Single blind randomised controlled trial. Setting Eight community mental health teams in southern England. Participants 160 people with a diagnosis of psychotic illness or non-psychotic bipolar disorder who had been admitted to hospital at least once within the previous two years. Intervention Joint crisis plan formulated by the patient, care coordinator, psychiatrist, and project worker containing contact information, details of illnesses, treatments, relapse indicators, and advance statements of preferences for care for future relapses. Control group was standardised service information. Main outcome measures Admission to hospital; service use over 15 months. Results Use of a joint crisis plan was associated with less service use and lower costs on average than in the standardised service information group, but differences were not significant. Total costs during follow-up were £7264 (€10 616, $13 560) for each participant with a joint crisis plan and £8359 (€12 217, $15 609) for each participant with standardised service information (mean difference &pound1095; 95% confidence interval -- 2814 to 5004). Cost effectiveness acceptability curves, used to explore uncertainty in estimates of costs and effects, suggest there is a greater than 78% probability that joint crisis plans are more cost effective than standardised service information in reducing the proportion of patients admitted to hospital. Conclusion Joint crisis plans produced a non-significant decrease in admissions and total costs. Though the cost estimates had wide confidence intervals, the associated uncertainty suggests there is a relatively high probability of the plans being more cost effective than standardised service information for people with psychotic disorders. [ABSTRACT FROM AUTHOR]

Reports on a study that compared the risk of compulsory psychiatric admission in mental health facilities among ethnic groups in London, England. Methodology of the study; Setting; Research design; Subjects; Outcome measures; Indications that the risk of compulsory admission is increased in black patients.

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Focuses on the psychiatric treatment and care services provided to the adults in Great Britain. Presentation of national targets and indicators for mental health; Influence of employment on the psychiatric morbidity; Details on the mental ill health costs.

Presents a debate on the number of psychiatric beds need to be commissioned in Great Britain. Inadequacy of places for mentally disordered offenders; Policy of admission of patients; Importance of collaboration among agencies for mentally ill.

Examines the emergency psychiatric services in England and Wales. Use of questionnaires to determine public health; Comparison of psychiatric emergency services during and after office hours.

The author reflects on the Center for Social Justice (CSJ) report "Completing the Revolution: Transforming Mental Health and Tackling Poverty." The author is critical on the content of the report due to its implication on the unfinished revolution in mental health care that affects families and economic life in Great Britain. Moreover, the author discusses several topics omitted in the report including its failure to discus the relevant health care received by British people.

The author reflects on the mental health strategy published by the coalition government for England. They provide an overview of the mental health strategy, including its main goals and commitment investments. They emphasize the limitations of the strategy, including its failure to offer a plan to address the diagnostic problems in mental health. They argue that the strategy provides no details on how its goals can be achieved.

Evaluates the private inpatient psychiatric care for profit systems in Great Britain. Increase in number of acute private psychiatric hospitals; Introduction of the Priority Hospital Group; Provision of the Private Patient Plan.