Introduction to the policy

Center for Mental Health and Institute has explored the issues that occur due to the use of alcohol and it has tried to understand the present scenario in the UK. It is important to identify the present scenario, inform the policy importance and to identify the research practice. There are key policy aspects and documents that are recorded with mental health care services in the United Kingdom. Many people take alcohol without a certain limit which leads to a mental health problem (Care Quality Commission, 2015). There are few people who get help from mental health services. There are national policies that are related to making scant reference towards mental health issues. An integrated help is provided in this approach while practicing this policy. Alcohol and Mental Health Policy is implemented to support people suffering from mental health due to the misuse of alcohol. Barriers to greater integration of services have been felt in order to increase the funding of the policy and workforce shortages are felt at the same time. Improving the support for those who need help in co-occurring conditions is the aim of the policy that can beat the first place. There are continuous challenges that are felt such as identifying the needs of people and meeting the needs of people in an effective manner (Greenfield, 2001).

The UK government has urgently developed a comprehensive strategy to control the use of alcohol and alongside work on a second Five Year plan to view the near future. NHS England works on the strategy to control the use of alcohol and meet the solutions to be considered in the future. The alcohol strategy includes the population level in order to address the marketing and licensing of alcohol and the service level action that ensures that there are more people who join up to help (Local Government Association, 2014). As such there are several commitments that are addressed in terms of using alcohol and the difficulties of the people. The five-year plan includes an action that addresses the relationship between mental health and use of alcohol. It even includes access to effective assistance to people who are suffering from the condition. The report includes several strategies that are related to specific aspects of alcohol policy and mental health policy and practice (Humphreys, 2005).    

Alcohol use can have an adverse effect on a person and can affect the mental health with several mental health problems. Alcohol use disorders have observed being associated with a major range of problems such as depression, antisocial personality disorder, and bipolar disorder. There are English hospitals where there are more than 200,000 patients admitted for mental and behavioral disorders because of alcohol use (Wusthoff, 2014). The hospital accounted to more than 20% of the admissions of alcohol-related problems. Furthermore, there are several disorders that may serve to a delay in the recovery of the condition of the patient. Alcohol use has been a common response when the reasons have been observed to mental health difficulty. As such people are suffering from co-occurring difficulties that have been observed from alcohol use and mental health consequences (Najavits, 2000). Effective help has not been yet provided to people who have been suffering from co-occurring mental health due to use of alcohol. Effective statutory services have been observed with a dual diagnosis because of the use of alcohol. There are some 86% of people who have been suffering from an addiction to alcohol and it is important to note that co-occurring condition may prevail in them with difficult times. According to Public Health England, approximately 45% of the mental health patients have the problem of alcohol use and drug use in the year 2016. There are poorer outcomes that have been observed in the country as it may lead to tragic loss of life in terms of suicide and other tragedies that is due to mental health using alcohol (Laing, 2015).

Alcohol and mental health: The evidence

The Alcohol and Mental Health Policy has been implemented in order to help people suffering from the co-occurring condition. There are several policy development strategies by the government that have been prominently used in order to work on the measures taken for controlling the condition in the country (ResPublica, 2016).

Government policies are related to alcohol and mental health issues in the UK. This has predominantly developed in order to work effectively for the policy formation. There is a National Service Framework that addresses the Mental Health NSF-MH (Hughes, 2006). The policies are steady in relation to the mental health policies to be introduced in the country. Very few policies have actually met the needs of people who have been suffering from comorbid problems. In the year 2011, there was a cross-government strategy that was introduced with No Health without Mental Health strategy. The current five-year strategy for Mental Health is adopted in the year 2016 with Mental Health Taskforce. The recent strategy has a major recommendation of drug and alcohol use co-morbidity which ensures the outcomes-based interventions. This will help in interventions to tackle drug addiction and alcoholism. There are several local areas that have developed and have demonstrated the excess use of alcohol being dangerous for the body. Intense care and support will be provided by the policy while it is important that the policy will provide care to people with comorbid substance misuse (Gash, 2013). This is possible while making the funding contribution by the government while this fund supports the use of social impact and care for society to work on innovative and new services for people in the UK.

There are certain government policies that are ignored and have linked with the mental health 2012 policy. The government alcohol strategy which was introduced in 2012 has majorly two objectives such as recognizing the problem and setting the specific actions so as to address them in accordance with the policy initiatives. The current alcohol policy has initiated with the voluntary partnership agreement in accordance with the alcohol industry. Moreover, the policy supports the link between the problem of excessive use of alcohol and the effects of mental health. The one policy of parallel policymaking is in accordance with the Dual Diagnosis that has been practiced along with the research and has then been published by the Department of Health in the year 2002. There is a parallel service provision that coexists within nature while using an integrated model. The major support is given by the community of mental health services which is in a liaison role for substance use specialists. People get support and meet the needs of overcoming of alcohol use with the help of dual diagnosis (Sandel, 2012).

There is a joint commissioning panel that supports the mental health care of people with the guidance of drug and alcohol use (Benbow, 2008). The Joint Commissioning Panel for Mental Health observed that there should be no agreed model that should be used specifically and for delivery of drug and use of alcohol. As such there are several guidelines that are set towards the quality of care. The guidance from PHE Public Health England has several expectations from the policy with people suffering from co-occurring mental health and alcohol problems. The two principles are everyone’s job and no wrong door principle. The first principle suggests that it is the responsibility of people as such the commissioners and the providers of health care to meet the needs and work on several conditions so as to find the solution and work on the basis. The other principle highlights the no wrong door system in which the providers should take care of the services for the people with a co-occurring stage and should provide treatment at such point of time. These are the guidelines that are set for the suggestions to be made by local NHS and the commissioners of public health policy. It helps to focus on agreeing with the pathway of care and support to the people and tends to enable the care for multiple agencies. There is a named care coordinator that should be appointed for people with the co-occurring condition. There are strong senior leadership goals that are set in order to work on the criminal justice system and provide service to the people (NHS England, 2015).

Theoretical approaches

The Alcohol and Mental health policy are implemented in order to work on quality care services to people suffering from the co-occurring condition. Appropriateness and quality are the major access to providing quality service. Support from the people and the mental health community is the basic necessity that would solve the problem of co-occurring alcohol use disorder. This is slightly a better position in covering the combined services of mental health problems (Weaver, 2003). The biggest issue that has been observed in the policy is about the local alcohol services that do not respond towards the mental health support. There are barriers that have been observed while providing the services and these need to be noted by the health care service providers. A survey was carried for 100 respondents in which the recordings of co-occurring condition people were noted. The health policy has notified that the respondents working in the mental health services felt that the condition was worse. The mental health service providers did not respond well for the health services that need to be taken strict action (Scourfield, 2012).

The policy is practiced while improving the support of a change that the people need for mental health care. The funding shortage is the real problem that respondents viewed in terms of the current problem in practice. There should be a joined partnership between alcohol services and mental health services in order to provide sufficient services to people with the co-occurring condition (Department of Health, 2002). There are many suggestions that have been emphasized while trying to improve the support and focus on deficits for national policy. The dual diagnosis has majorly fallen off the national level agenda. The coordinated policy would be a better practice to link towards the substance use and alcohol service. There are other regulations that need to be focused on drug and alcohol services (Hutton, 2015). The control of drug and alcohol services may lead to a better option for people who are suffering from the co-occurring condition. The major picture lies in relation to the support of services provided by the government and central directions that influence the local services to fund the picture. There are policies and practices that support the major collaboration between mental health services and alcohol services. There should be a ring-fencing of services that provides funds from both the services such as alcohol services and mental services community. Together this may lead to boost people for a specialist training program for people who are addicted to alcohol. Practitioners have trained alcohol services and mental health services providers to a certain level that meets the demand of people with the combined needs to be focused on the policy. The solutions for all the levels of systems lie with the national policy and this is in response to the local systems, culture, and process of implementation. With the significant and the long-term gap that was observed previously in the health policy has now filled the gap around both mental and alcohol services. Comorbidity is for nobody’s business and instead, it is everybody who should take care for the society and the problems (Darvish, 2015).        

Policy developments

The alcohol and mental health policy are for social care and health of the people in the UK. There is extensive support that is given by the government in order to work on the suggested path that would guide for commissioning and care for people (Health and Social Care Information Centre, 2014). To support the principle and to provide the health care service in form of meeting the needs of the co-occurring condition of the people is necessary (Connolly, Macgabhann and Mckeown, 2015). This agrees to the major pathway of support and care by the government that enables the delivery of care for several agencies and meeting the individual needs of people. It is important to know that the government has appointed a named care coordinator who helps the people suffering from co-occurring conditions. This is the major highlighted service that works on multi-agency care plan (Public Health England, 2015). The policy even undertakes the joint responsibility of alcohol providers and mental health community services that include criminal justice, primary care, and specialist care. This helps people to enable the access care to be taken for people to work in suitable needs (Burns, Hyde, and Killett, 2016). There are commission local pathways that help to access people for services such as domestic abuse, homelessness, and physical healthcare services. The policy makes sure that people are access to a range of service that recognizes the recovery of a person suffering from the co-occurring condition due to alcohol use. There is a long-term support that is provided by the government to the people for support and care for the society. The framework includes the delivery of care that guides to strong therapeutic alliance, care that reflects the motivation of the person, collaborative delivery care and therapeutic optimism (Drummond, 2017).  

The UK policy framework for health and social care policy largely sets out the major principles for practicing management and social care research (Moyes, Heath and Dean, 2016). The principles help to promote the standards and interests of people with public health service to be described with proportionate and ethical conduct. There are social care research and management of health that supports the high-quality study in the UK for building the confidence of patients and public (Institute of Public Care, 2014).  There are several principles that are set at high-level standards for relevant legislation. As such there are supported arrangements that are provided by the policy with collaboration and consistent approach towards standardized regulatory practices. The policy emphasizes the health and social care research that is the responsibility of Health Research Authority HRA. The principles of good policies and practices are observed in the UK with health and social care research. The principle protects the patient’s interest and helps to consider quality services provided to the public. This describes the major ethical standards and assurancebased management care so as to facilitate the quality services that ensure confidence among patients and the public for a speedy recovery (Joint Commissioning Panel for Mental Health, 2013).   The principles of health and social care include safety, competence, patient involvement, scientific and ethical conduct, protocol and integrity and transparency and legality. It is the responsibility of organizations and individuals to clear the lines of communication and work on the standards as per the information involved in the research. If the communication pathways are clear, the roles and responsibilities can be easily demonstrated with the discussion of issues and agreements (Gilchrist, Blazquez and Torrens, 2011).

The Health Research Authority (HRA) and the other organization that is the UK Health Departments have committed to providing services that ensure a positive environment. The patients and users get an opportunity towards participating in social care research with particular management conduct and confidence (Delgadillo, 2015). Moreover, safe and effective treatments are provided in order to meet the social care services for the public with ethical and sound research that benefits the public, patients and service organizations. To work on high-quality research, there is applied research that works on the decision and predictable timelines of growth. High-quality research and ethical standards are met while providing the health and social care services that benefit the service users and the public at large (Hendry, 2014). The purpose of health and social care policy works towards achieving health and well-being of public in the UK. The policy has improved care services with quality measures taken to work on better quality that benefits the country from jobs and money in the UK environment. The dual diagnosis has a national level agenda that lacks the coordinated policy linking with alcohol and mental health policy. There are no rules and regulations that the society provides in order to make awareness to the people for providing the services that help to recover the health of people and provide social care for the public (Hansen and Bjerge, 2017). The policy ensures the support and collaborates with the mental health services and alcohol services for ring-fencing and providing funds that help the people to recover from mental health illness. There is major awareness about alcohol issues to be described to the patient. A specialist training would lead to a major awareness among people while providing a healthy environment to the public (King’s Fund, 2016).

There is a policy development process that works on the plan that the government inputs in order to have the final policy outcome in the UK. The health care policy is framed with four key stages that consist of the policy-making process. Each stage reveals its importance with the health care policy that is implemented for the development of the people and the country. A health care policy sets several rules and practices in order to achieve the desired outcome (Bowman, 2015). With the help of the policy implementation, there are several benefits that are derived in order to live in the community with harmony and unity. The factors should be understood in order to work on the policy and its results. The organizations help to use these factors properly in order to have a clear understanding of the policy implementation and processes. The health and social care policy is developed by the government for patient safety with better quality and services. Below are the stages that include the agenda setting, policy formulation, policy implementation, and policy evaluation and auditing.

The first stage of the policy development stage is problem identification and setting the agenda for the policy that needs to be implemented. The UK government has recognized problems of mental health among people who use excessive alcohol in their daily lives (Andrews, Issakidis and Carter, 2001). Use of alcohol may lead to mental health and the research thus focuses on identifying the problem and solving the issue while implementing the policy in the UK. There are brainstorming and extensive research that is possible while observing the survey that was conducted on respondents. There are possible solutions and interventions that lead to a list of prioritized plans and process to be taken in order to set the agenda with power and influence. The Alcohol and mental health policy will influence people in order to save the lives of people who are suffering from the co-occurring condition (Delgadillo, 2012). The mental illness an individual suffers when using alcohol leads to a critical situation of a co-occurring condition which discusses the problems that a patient encounters during the illness. The major problem in the UK is the use of alcohol and mental health which needs to be solved with the help of policy formulation.

There are several ways in which the policy is formed while taking effective measures for the actors and evidence. New methods lead to work on brainstorming process which formulates the policy and process. The policy makers for health and social care have new methods to solve the problem of alcohol and mental health while the first step was to identify the level of problem that the country is facing. From the HRA (Health Research Authority), the research suggests that it is important to formulate and implement the Alcohol and Mental Health Policy in the UK with a five-year view forward plan. People are involved in several stages with the processes and legislatures.

Organizing the policy process is the first step that addresses the policymakers to decide on the development process which leads to the development process. Moreover, it helps to classify the structure of the policy with certain goals and priority components in the planning process. The policy needs to be organized while working together to achieve a standardized goal that means alcohol services and mental health community services need to work together to work on the policy outcome. These are the two groups that are involved in the policy process that is recognized (Moeller and Dougherty, 1997).

The main problems are identified by the groups that would work on policy implementation and this required workforce that has skills in healthcare and concerned departments. Both the services work together for achieving the clarity of actions and problems addressing the issues and suggesting the solutions for policy implementation (Mazzucato, 2012). The proposal of the policy implementation is prepared by the government while involving organizations and individuals to work with responsibilities and recommended actions are taken towards unanimous functions taken by the government. The need to work on the identified problems is pinpointed in this stage so as to closely look towards the steps that involve planning and organizing the policy functions and principles to be adopted with several strategies. There is a baseline that is evaluated and monitored by the government in making a detailed plan for situation analysis. The goals are set towards the national health policy by the UK government in order to emphasize the health and social care policy for people (CHPI, 2013).

After the problem has been recognized, setting the steps to realize the goals and objectives of the policy is important. Thereby realistic objectives and goals are achieved with planning an approach that addresses the central problem of alcohol use and mental health. The specific policy is to be implemented that works on essential drugs to be controlled by alcohol services and the community programs that are set towards achieving the results of affordable drug control (Public Health England, 2017). The next step is to draft the policy in the text form. After systematic analysis, the major objectives and methods are arranged in a way that the aim of the policy is realized. The government works on specific goals that have to be discussed with regards to the outline of the national health care policy to be arranged effectively in the UK environment. Public Health England (PHE) has helped to set standards and worked on the health and social care standards. The broader perspective is realized and the goals are established in order to make sure that the policy is reliable and will consider high-quality services in the community. During this process, there are certain actors and evidence that help to focus on policy implementation which is the next policy development stage.  

In this stage, The Alcohol and Mental Health Policy is translated into action. The UK government has introduced and implemented this policy in order to make effective change in the public and make awareness about mental health aspects and alcohol use. This stage entails the circulation of the proofs and facts that adopts the policy and implementation. The financial resources are important to be financed with correspondent plans and interventions that are felt in the policy implementation stage. The challenges of implementing the policy are to be coordinated among organizations and UK government services so as to successfully apply the policy change.  

Policy evaluation is the last step of the policy development process. From the first stage of problem identification and agenda setting, the problem is been recognized that is a health care problem in the UK while focusing on alcohol and mental health policy. The problem is recognized with effective research criteria by HRA and the solutions are measured in order to work on the policy implementation stage. The Health care policy is implemented and evaluated in order to check the policy outcome that is the final outcome of the policy. This is an ongoing process stage that leads to the basis of modification from agenda setting to policy implementation. Proper auditing is required, and the research evidence is collected while proofreading the benefits of policy implementation in the UK with health and social care policy to be introduced effectively.

Conclusion

A comprehensive alcohol strategy should be developed by the UK government in order to control the co-occurring condition in England. The report consists of specific aspects of alcohol policy and practices. The Five years forward view will help in enacting the health care policy that benefits the public and the UK environment. There is sustainability that is measured effectively with emergent integrated care services that improve the support for the patients and the health of people suffering from co-occurring condition and alcohol problems. These help to bring together the alcohol providers and mental health services to enact upon and work on the agreed plans for integrated support (Hayes, 2011). The Improving Access to Psychological Therapies IAPT program will help to ensure that people suffering from alcohol difficulties are not excluded from the therapy services provided by the UK government.

References

Andrews, G., Issakidis, C. and Carter, G. (2001). Shortfall in mental health service utilisation. British Journal of Psychiatry, 179, 417–425.

Bergly T, Hagen R and Grawe R., (2015). Mental health and substance use problems among patients in substance use disorder treatment as reported by patients versus treatment personnel Journal of Substance Use, 20(4), 2015, pp.282-287.

Bowman, A. et al (2015) ‘Business elites and undemocracy in Britain’ in ‘Elites on Trial’, Research in the Sociology of Organizations, Volume 43, 305-336.

Burns, D, Hyde, P and Killett, A, (2016), ‘How financial cutbacks affect job quality and care of the elderly,’ in Work and Employment Relations in Healthcare. Industrial Labor Relations Review. (Forthcoming)

Benbow, S (2008), “Failures in the system: our inability to learn from inquiries”, The Journal of Adult Protection, Vol. 10 Iss: 3, pp.5 – 13

Connolly J., Macgabhann L. and Mckeown O. (2015). Developing a dual diagnosis service in Cork, Ireland by way of participatory action research (PAR) Advances in Dual Diagnosis, 8(1), 2015, pp.29-41.

Care Quality Commission (2015), The State of Health Care and Adult Social Care in England, 2014/15

Delgadillo J, Godfrey C, Gilbody S and Payne S (2012) Depression, anxiety and comorbid substance use: association patterns in outpatient addictions treatment. Mental Health and Substance Use Vol. 6, Iss 1, 2013

Darvishi N, Farhadi M, Haghtalab T and Poorolajal J (2015) Alcohol-Related Risk of Suicidal Ideation, Suicide Attempt, and Completed Suicide: A Meta-Analysis. PLoS ONE 10(5): e0126870. doi:10.1371/journal.pone.0126870.

Department of Health. (2002). Mental Health Policy Implementation Guidelines: Dual Diagnosis Good Practice Guide

CHPI (2013), The Future of the NHS? Lessons from the market in social care in England, https://chpi.org.uk/wp-content/ uploads/2013/10/CHPI-Lessons-from-the-social-care-marketOctober-2013.pdf

Delgadillo J, Gore S, Ali S, Ekers D, Gilbody S, Gilchrist G, McMillan D and Hughes E (2015) Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment. Journal of Substance Abuse Treatment, 55. pp. 6-14. ISSN 07405472

Drummond, C. (2017). Cuts to addiction services are a false economy. https://blogs.bmj.com/bmj/2017/05/25/colin-drummond-cuts-to-addiction-services-inengland-are-a-false-economy/

Greenfield, T.K. (2001). Individual Risk of Alcohol-Related Disease and Problems, Chapter 21 in Heather N., Peter T.J., Stockwell T. (eds) (2001), International Handbook Alcohol Dependence and Problems, John Wiley & Sons Ltd, pp. 413–439.

Gash, T, Panchamia, N, Sims, S and Hotson, L (2013), Making public service markets work, Institute for Government

Gilchrist G, Blazquez A and Torrens M (2011) Psychiatric, Behavioural and Social Risk Factors for HIV Infection among Female Drug Users. AIDS and Behavior, Vol. 15, No. 8, 11.2011, p. 1834-1843

Hansen J. and Bjerge B., (2017). What role does employment play in dual recovery? A qualitative meta-synthesis of cross-cutting studies treating substance use treatment, psychiatry and unemployment services  Advances in Dual Diagnosis, 10(3), 2017, pp.105-119

Moyes H, Heath J and Dean V., (2016). What can be done to improve outcomes for prisoners with a dual diagnosis? Advances in Dual Diagnosis, 9(1), 2016, pp.14-25.

Hughes, Liz (2006) Closing the gap: a capability framework for working effectively with people with combined mental health and substance use problems (dual diagnosis). Care services improvement programme, DH/University of Lincoln

Hayes R, Chang, C, Fernandes A, Broadbent M, Lee W, Hotopf M, Stewart R. (2011) Associations between substance use disorder sub-groups, life expectancy and all-cause mortality in a large British specialist mental healthcare service. Drug and Alcohol Dependence, 2011vol. 116 Issue 1.

Humphreys C, Regan L, River D and Thiara R (2005) domestic violence and substance use: tackling complexity. British Journal of Social Work, 1 of 18

Health and Social Care Information Centre (2014), Community Care Statistics, social services activity, England 2013-14.

Hendry, J (2014), Reconstruction after the crisis: a manifesto for collective bargaining, Institute of Employment Rights

Hutton, W (2015), How Good We Can Be?: Ending the Mercenary Society and Building a Great Country. Little, Brown

Institute of Public Care (2014), The Stability of the Care market and Market Oversight in England

Joint Commissioning Panel for Mental Health. (2013). Guidance for commissioners of drug and alcohol services. London: RCPsych and RCGP.

King’s Fund/Nuffield Trust (2016), Social Care for Older People: Home Truths.

Laing, B., (2015), Care of Older People: UK Market Report. 27th edition, p240

Local Government Association (2014), Towards Excellence in adult social care: progress with adult social care priorities England 2013-14.

Moeller, F.G., Dougherty, D.M., (1997). Antisocial Personality Disorder, Alcohol, and Aggression. National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://pubs.niaaa.nih.gov/publications/arh25-1/5-11.htm

Mazzucato, M (2012), The entrepreneurial state: debunking private v public sector myths. London: Anthem

NHS England (2015) Guidance to support the introduction of access and waiting time standards for mental health services in 2015/16. London: NHS England; 2015

Najavits LM, Crits-Christoph P, DierbergerA.(2000).  Clinicians’ impact on the quality of substance use disorder treatment. Substance Use and Misuse. 2000;35(1214):2161–2190.

Public Health England. (2017). Better care for people with co-occurring mental health and alcohol/drug use conditions.

Public Health England (2015) Young people’s statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2014 to 31 March 2015

ResPublica (2016), The Care Collapse: The imminent crisis in residential care and its impact on the NHS

Scourfield, P (2012), Caretelization revisited and the lessons of Southern Cross, Critical Social Policy, 32(10, 137-148

Sandel, M (2012), What Money can’t Buy: the Moral Limits of Markets. London: Allen Lane

Wusthoff E, Waal H and Grawe R. (2014) The effectiveness of integrated treatment in patients with substance use disorders co-occurring with anxiety and/or depression – a group randomized trial. BMC Psychiatry. 14:67.

Weaver, T., (2003) Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry Sep 2003, 183 (4) 304-313.