Developing community mental health services: an evaluation of Glasgow's mental health resource centres

Greater Glasgow Health Board's strategy for the development of community me ntal health services includes the establishment, over a 7-year period, of m ulti-disciplinary community mental. health resource centres throughout Glas gow. An evaluation of the first phase of the development was carried out in three resource centres. This focused on three key themes: the establishmen t of multi-disciplinary teams, targeting of those with the most severe illn esses and the participation of users in the care process. The evaluation ex ercise comprised five substantive elements: analysis of the clinical databa se; interviews with staff within each of those centres, interviews with rep resentatives of key external agencies associated with each centre; a survey of general practitioners; and a survey of the views of clients, their care rs, their key workers, and their general practitioners (GPs). Clients were generally very satisfied with the services and felt that the resource centr es met all their mental health needs. Although the majority of current cent re cases had severe mental illnesses and those with the more severe conditi ons had the highest contact rates there was evidence that in the absence of a clear framework for referral the centres were also providing services fo r those with less severe illnesses. Despite a wish by centre staff to move towards modes of working less dominated by health professionals and more in clusive of other resources and especially of clients themselves, these goal s remained to be achieved: there was a lack of clarity in the definition of the appropriate target groups for the centres; access to crisis support wa s regarded as problematic; the concept of: multi-disciplinary team working had yet to be fully realized with evidence suggesting that some psychiatris ts working in the resource centres had not embraced many aspects of the new approach to service delivery including a focus on the severely ill; and pr ogress towards the ideal of active client involvement bad been slow.