Glossary

A service within A&E departments for mental health assessments and referral to specialist services.

A  disorder or symptom that develops suddenly and is usually of short duration (under 6 months). Acute conditions may or may not be severe and in some contexts 'acute' can refer to behavioural symptoms of high intensity.

There are various types of advance statement/directive. They can include statements of an individual’s wishes in certain circumstances, for example instructions to refuse some or all medical treatment or requests for certain types of treatment. They can also state someone must be consulted at the time a decision needs to be made. The individual should seek advice about the legal status of these statements/directives. They might also be called Living Wills.

Where a person acts as a champion for a patient or carer, speaking out on issues of concern in order to exert some influence on their behalf. A 'lay' advocate could be employed to do this or it could be one of a range of people including a pharmacist, doctor, voluntary worker or a carer.

An advocate is a person who can support a service user or carer through their contact with health services. Advocates will attend meetings with patients and help service users or carers to express concerns or wishes to health care professionals. Although many people can act as an advocate (friend, relative, member of staff) there are advocacy services available that can be accessed through the Trust. These advocates are trained and independent.

This is the support or care that a person can expect to receive once discharged from inpatient care. Typically a discharge plan will be developed with the service user by the multidisciplinary team which will make clear what care and support will be provided.

Extreme emotional disturbance, disquiet or unrest.

To make or become better, more bearable, or more satisfactory; improve.

Drug used to ameliorate the symptoms of psychosis and schizophrenia. These can be taken orally or by intra muscular injection and include older type drugs, e.g. Stelazine, and newer drugs, with possibly fewer side effects, such as Risperidone and Amisulpiride.

Having or showing little or no feeling or emotion, and having or showing little or no interest or concern for emotional, social or physical life.

Approved Social Workers (ASW) have specialist training and experience in identifying disorders of mental health and are familiar with the problems experienced by users of mental health services and their families. They are employed by Local Authority Social Services and work in hospitals and in the community as part of the community mental health teams. They will organise social care support for people in contact with mental health services, such as helping with housing and getting welfare benefits. They work closely with health professionals and can also act as care co-ordinators for people on care programmes.

Art therapists practice art therapy and have a considerable understanding of art processes underpinned by a sound knowledge of therapeutic practice. They work with both individuals and groups in a variety of residential and community based settings, for example: adult mental health; learning disabilities; child and family centres; palliative care and the prison service.

Art therapy is a form of psychotherapy that uses art media as its primary mode of communication. Clients who are referred to an art therapist need not have previous experience or skill in art, the art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client. The overall aim of its practitioners is to enable a client to effect change and growth on a personal level through the use of art materials in a safe and facilitating environment.

A process to identify the needs of an individual and evaluate the impact of those needs on their daily living and quality of life.

The process of carrying out a clinical audit project follows a cycle of identifying a topic, setting standards, measuring current practice against these standards, agreeing recommendations and implementing change. This cycle is repeated to ensure change has occurred and improvement is maintained.

A system of quality improvement in local government and the NHS which sets a duty to deliver services of a clear standard, covering cost and quality, by the most effective, economic and efficient means available.

Requires agencies to work together to produce joint investment plans for older people, adults with mental health problems, people with learning disabilities and for welfare to work for disabled people.

A mood disorder characterised by the presence of manic or hypo manic symptoms; consisting of manic episodes where a person has a euphoric or highly elevated mood and then very extreme low mood or episodes of depression, causing significant distress or dysfunctional changes in personality and behaviour.

This is the professional association for academic, clinical and other chartered psychologists in Britain.

A senior healthcare professional in each NHS organisation who is responsible for safeguarding the confidentiality of patient information. The name comes from the Caldicott Report, which identified 16 recommendations for the use and storage of patient- identifiable information.

CAMHS provides specialist assessments and treatments for children and young people from age 0-18 years, referred with significant mental health difficulties

A care plan is a written plan that describes the care and support that staff will give a service user. Service users should be fully involved in developing and agreeing the care plan, sign it and keep a copy.

The independent regulator of health and social care in England. This includes the care provided in hospitals, care homes, people’s own homes or elsewhere, whether provided by the NHS, local authorities, private companies or voluntary organisations. The CQC also protects the rights of people detained under the Mental Health Act.

New level of PCT, which includes social services commissioning as well as GP and community health services. Care trusts are designed to allow close integration of health and social care and they commission and provide within the same NHS organisation.

Relatives or friends who voluntarily look after individuals on a part-time or full-time basis.

An act to provide for the assessment of the ability of carers to provide care; and for connected purposes. It gives people who provide substantial care on a regular basis the right to ask for an assessment from social services.

The Carers' Council is an internal Trust committee established to enable carers and the Trust to work in partnership to develop and improve the services offered by the Trust. Members of the council are either carers of current service users or those who have received services within the last four years. The Carers' Council sets out a work programme each year which sees speakers attend meetings to give presentations on a variety of different topics, for example, Trust treatment priorities, getting people back to work and recovery strategies

1999 national strategy supporting an estimated six million carers. Its main features are: grants to allow English local authorities to help carers take a break; credits towards a second pension; council tax reductions for more disabled people and their carers; more carer-friendly employment policies and support for young carers, including those at school.

The Clinical Governance Support Team (CGST) has three aims: to support individual doctors in participating in developmental appraisal; to support organisations in providing healthy appraisal schemes; to support confidential, formative, robust and consistent appraisal, fit to contribute to revalidation, for all UK-registered doctors.

CAMHS is a term used to refer to mental health services for children and adolescents. CAMHS are usually made up of multidisciplinary teams including psychiatrists, psychologists, nurses, social workers and others.

The Citizens Council is a sub-committee of the National Institute for Health and Clinical Excellence (NICE) Board. It is made up of 30 individuals from a range of age, ethnic, and geographical backgrounds and provides advice on the guidance NICE issues on the treatments and care that people can expect in the NHS. For further details on the citizen’s council see www.nice.org.uk.

Clinical effectiveness focuses on ensuring that staff are providing the best and most effective care for people using health services. This is done using a variety of methods including clinical audit and evidence-based practice.

A framework that ensures that NHS organisations monitor and improve the quality of services provided and that they are accountable for the care they provide.

Systematically developed statements, based on scientific research, which assist in decision-making about appropriate healthcare for specific clinical conditions.

A scheme for assessing a Trust’s arrangements to minimise clinical risk for service users and staff. Trusts need to pay ‘insurance’ which can offset the costs of legal claims against the Trust. Achieving CNST Levels (1, 2 or 3) shows the Trust’s success in minimising clinical risk and reduces the premium that the Trust must pay.

Different ways of describing and/or prescribing a ‘plan’ for providing a particular health service. Clinical pathways were introduced in the early 1990s in the UK and the USA as structured, multidisciplinary plans of care designed to support the implementation of clinical guidelines and protocols. They are designed to support clinical management, clinical and non-clinical resource management, clinical audit and also financial management. They provide detailed guidance for each stage in the management of a patient (treatments, interventions etc.) with a specific condition over a given time period, and include progress and outcomes details. Clinical pathways aim to improve, in particular, the continuity and co-ordination of care across different disciplines and sectors.

A talking therapy that focuses on 'here and now' problems and difficulties. Instead of looking for the causes of distress or symptoms in the past, it focuses on ways to improve someone's state of mind now. CBT can help people to change how they think (cognitive) and what they do (behaviour). CBT has been shown to help with many different types of problems. These include: anxiety; depression; panic; phobias (including agoraphobia and social phobia); stress; bulimia; obsessive-compulsive disorder; post-traumatic stress disorder; bipolar disorder and psychosis.

This is the professional body that represents occupational therapists and produces guidance.

The Commission for Healthcare Audit and Inspection in Healthcare (CHAI) has been set up to help to improve the quality of healthcare by ensuring an independent assessment of the standards of services provided to patients, whether the services are NHS or private.

The Commission for Patient and Public Involvement in Health was set up in January 2003 to ensure that the public is involved in decision making regarding health and health services. It is also an independent, non-departmental public body sponsored by the Department of Health.

The process by which commissioners (e.g. PCTs) decide which services to purchase and which provider to purchase them from.

Social care and treatments outside of hospital, to patients/clients with an identified physical or mental illness or disability. The main aim of community care policy has always been to maintain individuals in their own homes wherever possible, rather than provide care in a long-stay institution or residential establishment.

A multidisciplinary team offering specialist assessment, treatment and care to people in their own homes and in other settings. The CMHT are a group of professionals including Social Workers, Nurses, Support Workers, Psychologists, Occupational Therapists and Psychiatrists. They provide help for service users who are experiencing a variety of moderate to severe mental health problems. This support can take the form of psychological help or more practical support with all aspects of health related needs, with ready access to other therapies and expertise. Once referred to the team, service users receive an assessment of their mental health needs and may be offered further help to address their mental health problems. This help will usually be provided by a named individual from the team who is called a Key Worker.

If you are an informal patient, you have the right to refuse any treatment you do not want. You have a right to receive full information about the treatment, its purpose and possible side effects. If consent is not obtained, the treatment cannot normally be given.

The way that an organisation checks that its policies are being carried out. This includes internal and external audit for financial matters, employment policies and all areas in which the organisation interacts with the public.

The CORE Outcome Measure is one way to find out if an intervention has been successful. It includes both the service user’s and the clinician’s assessment of the treatment. It is a 34-item questionnaire designed to measure a 'core' of clients' global distress, including subjective wellbeing, commonly experienced problems or symptoms and life/social functioning. In addition, items on risk to self and others are included to assist risk assessment in NHS and other sectors. The main purpose of the tool is to offer a global level of distress which is expressed as the average mean score of the 34-items that can be compared with clinical thresholds before and after therapy to help determine clinical and reliable change. The measure has been extensively validated and key publications demonstrate that it has good psychometric properties and considerable utility for both clinical assessment and clinical governance initiatives.

Advice and psychological support from health professionals to help people deal with personal difficulties. It is used to address a variety of areas, such as problems at school, work or in the family, and to help people to deal with addictions and provide support for those suffering from mental health problems.

Councils are directly elected local bodies which have a duty to promote the economic, social and environmental wellbeing of their areas. They do this individually and in partnership with other agencies.

The Court of Protection has several roles in looking after the financial affairs of people who cannot legally do it themselves. These include making Enduring Powers of Attorney, making wills, and generally giving directions and orders for the management of the individual's property and financial affairs.

The Care Programme Approach is a standardised way of planning a person’s care. It is a multidisciplinary approach that includes the service user, and, where appropriate, their carer, to develop an appropriate package of care that is acceptable to health professionals, social services and the service user. The care plan and care co-ordinator are an important part of this. This is the main way by which care is co-ordinated and delivered to individuals by secondary care services. It means that all individuals involved in the care will discuss the care with the user of the mental health services and their family/friend/carer. The Care Programme Approach is a standardised way of planning a person’s care. It is a multidisciplinary approach that includes the service user, and, where appropriate, their carer, to develop an appropriate package of care that is acceptable to health professionals, social services and the service user. The care plan and care co-ordinator are important parts of this.  Ensures that PCTs and social services departments have systematic arrangements for assessing the health and social care needs of mentally ill people, and that people referred to secondary services get appropriate care, including an individual treatment plan. From February 2010 the CPA will only refer to the coordination of care for service users with complex mental health needs. See our Service Users and Carers section for more information.

Community Psychiatric Nurse. A CPN sees people who are living in the community. This is most often in the person's own home but it can also be in clinics based, for example, in a GP's surgery. CPNs provide support to people through difficult periods of their illness. They may also see patients who are currently well to check everything is okay and be the first point of contact if the patient starts becoming unwell again. A CPN will help patients with their medication and make sure that the patient understands what they should be taking and when.

A mental health crisis is a sudden and intense period of severe mental distress.

A Crisis Resolution Team aims to respond to people in crisis. It aims to provide an assessment and treatment service, 24 hours a day, 7 days a week wherever people are.

Communal care which is usually provided away from a service user's place of residence with carers present.

A hospital where patients receive day care only, continuing to live at home. A person would typically attend for several hours during the day, rather than just attending a specific session as part of their programme of treatment and care.

False beliefs which are not consistent with the culture or subculture to which the individual belongs and have no root in reality. They could be paranoid delusions (e.g. when someone thinks someone is trying to kill them) or religious delusions e.g. thinking you are God or Jesus or a supernatural being.

Dementia is a syndrome (a group of related symptoms) that is associated with an ongoing deterioration of the brain and its abilities. These include thinking, language, memory, understanding and judgement. The main symptoms of dementia are progressive memory loss, disorientation and confusion. People with dementia may also have problems controlling their emotions or behaving appropriately in social situations. Aspects of their personality may change. Most cases of dementia are caused by damage to the structure of the brain which could be caused by Alzheimer's disease, cerebrovascular disease or strokes.

The Mental Health Foundation describes depression as a range of moods from low sprits to a severe problem that interferes with daily life. ‘Clinical' depression is not just about being sad or upset: it is an overwhelming feeling of hopelessness and being unable to cope that may lead to thoughts of death or suicide. For more information visit:
http://www.mentalhealth.org.uk/page.cfm?pagecode=PBBFDP
http://www.rcpsych.ac.uk/info/dep.htm

Directorate of Health and Social Care.

A Dementia Intensive Care Unit. At Norfolk and Waveney Mental Health Trust this is a new service being built on the Julian Hospital site to serve the needs of dementia patients with the most intensive and challenging care needs that cannot be managed initially in specialist nursing care provision. It is designed to provide a therapeutic resource which promotes wellbeing and helps people with dementia function better in every day life.

Home care to support service users and their carers.

A form of treatment that focuses the intentional use of healing aspects of drama and theatre in the therapeutic process. It is a method of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth, giving people the opportunity to look back and help resolve problems. It may then achieve relief from deeply suppressed emotions.

The term dual diagnosis is used to describe the co-morbid condition of a person considered to be suffering from a mental illness and a substance misuse problem. Dual diagnosis is also used to describe someone who has been diagnosed with more than one mental health problem.

New duty placed on NHS bodies and local government to develop joint health improvement programmes involving other parts of the NHS, local voluntary organisations and businesses.

Early Intervention Services provide support and treatment in the community for young people with psychosis and their families. The specific age range can vary between 13-25yrs. The aim of EI is to reduce the period of untreated psychosis, which evidence shows is likely to lessen future problems and improve the person’s health and wellbeing in the long term. Research suggests that early detection and treatment will significantly increase recovery.

The powers to detain a person for an initial assessment to determine whether the use of compulsory powers is appropriate. For example a Section 136 or a Section 5(2), Mental Health Act.

An Enduring Power of Attorney (EPA) is a legal document that enables someone to appoint one or more persons to manage their financial affairs and property, either now or in the future.

Elderly Severely Mentally Ill.

A systematic analysis of information on the effectiveness and use of treatments in providing the best health outcomes.

Family therapy practitioner who helps individuals address mental health problems by involving their family in therapy. The types of problems family therapists work with include relationship difficulties, divorce and separation, illness in parents or children, bereavement, school and college difficulties and other life-changes that cause upset and pain.

A form of therapy performed with families and family members. Family therapists work with individuals, couples and other involved people such as doctors, teachers and family friends, where appropriate. Family therapists consider individuals within their family context and in other personal relationships to help support them in overcoming emotional difficulties and coping with mental illness.

A severe reduction in emotional expressiveness. People with depression and schizophrenia often show flat affect, this means they may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions and appear extremely apathetic.

This is a person who has been detained in hospital under the Mental Health Act (1983).

NHS Foundation Trusts are a new type of NHS Trust in England. They have been granted more operational and financial freedom than other NHS Trusts. They were created to devolve decision-making from central Government control to local organisations and communities so that they are more responsive to the needs and wishes of their local people.

Functional disorders or mental health problems are those which are not due to structural abnormalities of the brain or natural deterioration.

GPs are family doctors who provide general health services to a local community. They are usually based in a GP surgery or practice and are often the first place patients go to with a health concern.

The social care workforce regulator in England. They register social care workers and regulate their conduct and training. The council, which started in 2001, promotes high standards of conduct, practice and training for social care workers, establishing a code of practice and a register of social care workers.

A team usually consisting of a psychiatrist, nurse and social worker. The team provides a mobile service offering availability 24 hours, seven days a week and an immediate response. The team provides a gate keeping function to hospital admission and enables earlier discharge from hospital.

The provision of hospital and certain community health services, such as district nursing. These services are provided in the main by NHS trusts.

IAPT is a programme with one principal aim, to support Primary Care Trusts in implementing National Institute for Health and Clinical Excellence (NICE) guidelines to increase access to and provision of treatment for people suffering from depression and anxiety disorders.

The Independent Complaints Advocacy Service (ICAS) supports patients and their carers wishing to pursue a complaint about their NHS treatment or care. It is a free and confidential service that is independent of the NHS and tailored to individual client need. For more info visit: http://www.seap.org.uk/icas/

Voluntary, charitable and private care providers. Independent Sector Healthcare Providers (ISHPs) are private sector healthcare providers which have been contracted to provide services to NHS patients. NHS patients treated in healthcare settings managed by an ISHP are still NHS patients. All care is free at the point of treatment and patients can expect the same level of service they would expect from the NHS.

An informal patient is a person in hospital voluntarily. Most people admitted to hospital are informal patients.

This refers to the use of information held by the Trust, in particular computerised information and information sharing. It is the responsibility of professionals across agencies to share relevant information to ensure that everyone involved in a person’s care is kept informed.

Services provided by the NHS, where the patients/service users are accommodated on a ward and receive treatment from specialist health professionals.

Integrated Care Pathways are a multidisciplinary and multi-agency approach to mapping patients’ care from admission through to discharge and ongoing care. The aim is pull together all the information into one file that will make it easier for the clinicians involved to give the best care for the patient. Integrated Care Pathways have been defined as:
'A multi professional plan of care that provides detailed guidance for each stage in the care of a patient with a specific condition over a given period of time.' Riley (1998).

Health and social care professionals (social workers) working together in health and social care professional teams to provide seamless care.

Care which bridges hospital and home care and is often rehabilitative. Many people could be treated in intermediate care facilities rather than in hospitals once their initial surgery or treatment is finished.

Trained mental health staff who provide a link between your local doctor and specialist mental health services.

An NHS initiative designed to encourage public and private investment in community services. LIFT companies buy and develop NHS estates, then lease them back to NHS Trusts.

Local Implementation Teams bring together a wide group of stakeholders in mental health, including service users and carers, to plan and oversee the development of mental health services in their local area. They work closely with primary care, which is responsible for commissioning health services. LITs plan and monitor the National Service Framework (NSF) locally. They are made up of representatives from most agencies responsible for planning and providing mental health services locally and include representatives from the voluntary sector and people representing service users and carers.

Intensive rehabilitation service for mentally-disordered offenders, provided in a custom built low security environment.

An individual’s ability to manage and cope with the stress and challenges of life and to manage any diagnosed mental health problems as part of leading their normal everyday life. Although definitions of mental health are personal and are dependant upon individual life experiences and life context, a useful definition of mental health is that used by the World Health Organisation: “Mental health is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.”

The Mental Health Act (1983) is a law that allows the compulsory detention of people in hospital for assessment and/or treatment for mental disorder. People who are detained under the Mental Health Act must show signs of mental disorder and need assessment and/or treatment because they are a risk to themselves or a risk to others. People who are detained have rights to appeal against their detention.

For the purposes of the Mental Health Act, Trusts are defined as Mental Health Act Hospital Managers. In practice, these are usually non-executive directors and/or lay people appointed by the Trust to carry out the Trust’s responsibilities under the Mental Health Act. The review of the Mental Health Act recommends removing their ability to discharge patients.

The National Director for Mental Health, Professor Louis Appleby. The term can also be used to refer to anyone with power and influence over mental health policy and legislation. Professor Appleby has played a central role in plans to reform mental health services as part of the Government’s NHS Plan, bringing in a range of new services including home treatment, early intervention and assertive outreach teams, and mental health legislation. He has led numerous initiatives including to reduce suicides and improve the physical environment of mental health wards and smoke-free wards. His current priorities are psychological therapies, stigma, race equality, suicide prevention, public mental health, inequalities and dementia.

This is an independent panel of people. A detained person can appeal against their detention to this panel. The panel can discharge the detained person or make other recommendations. It is possible to appeal to High Courts against Mental Health Review Tribunal decisions.

A mental health trust provides treatment, care and advice for patients who have mental health problems. The services may be provided from a hospital or in the community. Mental health services can be provided through GPs, other primary care services or through more specialist care. This might include counselling and other psychological therapies, community and family support or general health screening. People who need more involved support can be referred for specialist care which is normally provided by mental health trusts or local council social services departments. Services range from psychological therapy to very specialist medical and training services for people with severe mental health problems.

A mental health charity that offers news and information on all aspects of mental health. Visit: http://www.mind.org.uk/

A team or group consisting of representatives from several different professional backgrounds who all have different areas of expertise. For example, a community mental health team made up of mental health and social care workers.

Music therapists use music experiences to therapeutically work with children and adults who have a wide range of needs, including learning disabilities, physical, emotional and psychological disorders and sensory impairments. The music therapists work in a variety of settings, such as hospitals, special schools, day centres, the community, the prison service and in private practice.  They may be employed by the National Health Service, local Education Authorities or the Department of Social Services.

Music therapy is both an allied health profession and a social science. It is an interpersonal process in which a trained music therapist uses music and all of its facets - physical, emotional, mental, social, aesthetic and spiritual - to help clients to improve or maintain their health. Music therapists primarily help clients improve their observable level of functioning and self-reported quality of life in various domains (e.g. cognitive functioning, motor skills, emotional and affective development, behaviour and social skills) by using music experiences (e.g. singing, song writing, listening to and discussing music, moving to music) to achieve measurable treatment goals and objectives.

The National Institute for Health and Clinical Excellence (NICE) was set up as a Special Health Authority for England and Wales on 1 April 1999. It is part of the NHS, and its role is to provide patients, health professionals and the public with authoritative, robust and reliable guidance on current ‘best practice’. This guidance covers both individual health technologies (including medicines, medical devices, diagnostic techniques and procedures) and the clinical management of specific conditions.

Helps local development centres and national programmes implement policy and resolve local challenges in developing mental health services. Launched in 2002, NIMHE takes a lead in connecting mental health research, development, delivery, monitoring and review.

The NSF for mental health was introduced by the Government in 1999. It establishes a set of minimum national standards of clinical quality and access to services in mental health. The objective of the NSF is to drive up performance and decrease geographical variations in care standards. There is an NSF dedicated to mental health that set standards around mental health promotion, treatment and service user involvement. There is also an NSF for Older People that has a section on mental health for older people.

Negative symptoms are thoughts, feelings, or behaviours normally present that are absent or diminished in a person with a mental disorder such as apathy, poor motivation, social withdrawal.

The term ‘next of kin’ is widely used, but there is no statutory definition. In practice the general rule has been to recognise spouses and blood relatives as next of kin. The Mental Health Act 1983 defines a list of certain people who can be treated as the ‘nearest relative’ of a patient. A ‘nearest relative’ has a number of important powers and functions, including the right to discharge a patient who has been formally detained in hospital, make an application for a person to be admitted for assessment, treatment or guardianship and also to object to applications for treatment or guardianship being made by a social worker. Only certain categories of people can become a ‘nearest relative’. First in the list are spouses, and then unmarried heterosexual couples.

A person who is appointed to represent a patient in discussions in matters related to their care.

A member of the Trust’s board who represents community interest and uses their knowledge and expertise to help improve trust services.
Non-Executive Directors have a responsibility to ensure the trust is fully accountable to the public for the services it provides and the public funds it uses.

Norfolk and Waveney Mental Health Foundation Trust.

Occupational therapists in mental health emphasise the relationship between occupation, mental health and wellbeing. They work with service users and carers to develop and maintain a personally satisfying routine of everyday activities that creates a sense of purpose and direction to life. They will typically look at service users’ self-care, leisure and work activities and the individual’s hopes and aspirations.

Occupational therapy enables people to engage as independently as possible in the activities (occupations) which enhance their health and wellbeing. Occupational therapists and support workers help people of all ages who have physical, mental or social problems as a result of accident, illness or ageing, to do the things they want to do. These could be daily activities that many of us take for granted like brushing teeth, to more complex activities such as caring for children or succeeding in studies or work. Occupational therapists in mental health work with people with all types of mental distress including depression, anxiety, psychosis, bipolar disorder and personality disorders. They work with people of all ages from children to older adults and in all settings such as hospitals, community teams and specialist services. They value recovery and social inclusion and have a ten-year strategy called Recovering Ordinary Lives.

In terms of eligibility for accessing Older People's Services at the Trust, this means adults over 65 years old (retirement age).

Illness affecting memory and other functions that is often associated with old age and is biologically based e.g. deterioration of the brain or structural abnormalities. Dementia, including Alzheimer’s Disease, is an organic mental illness.

A psychotic state in which the predominant features are delusional beliefs that the individual is being persecuted in some way. Psychoses can be caused by stress and alcohol or drug abuse. 20% of individuals experiencing psychosis may recover and have no future recurrences.

A computer system used to record information about the care provided to service users. The data can only be accessed by authorised users. PAS will soon be replaced by a newer system.

All NHS trusts are required to have a Patient Advice and Liaison Service. The service offers patients information, advice, quick solution of problems or access to the complaints procedure.

An independent group, set up by the Commission for Patient and Public Involvement, that overviews the work of an NHS organisation. There is a forum for each NHS trust and Primary Care Trust.

A team that visits hospitals to check on cleanliness. PEAT carries out an annual assessment of inpatient healthcare sites in England that have more than 10 beds. It is a benchmarking tool to ensure improvements are made in the non-clinical aspects of patient care, such as cleanliness, food and infection control. The assessment results help to highlight areas for improvement and share best practice across healthcare organisations in England.

Pharmacist

A pharmacist is an expert in medicines and their use. The majority of pharmacists practice in hospital pharmacy, community pharmacy or in primary care pharmacy, working to ensure that patients get the maximum benefit from their medicines. They make, dispense and sell medicines and advise medical and nursing staff on the selection and appropriate use of medicines. They provide information to patients on how to manage their medicines to ensure optimal treatment. Pharmacists are able to undertake additional training in order to allow them to prescribe medicines for specific conditions.

Physiotherapists help and treat people of all ages with physical problems caused by illness, accident or ageing. Physiotherapy is a healthcare profession which sees human movement as central to the health and wellbeing of individuals. Physiotherapists identify and maximise movement potential through health promotion, preventive healthcare, treatment and rehabilitation. The core skills used by physiotherapists include manual therapy, therapeutic exercise and the application of electro-physical modalities. Physiotherapists also have an appreciation of psychological, cultural and social factors which influence their clients.

Play therapy helps children understand muddled feelings and upsetting events that they haven't had the chance to sort out properly. Rather than having to explain what is troubling them, as adult therapy usually expects, children use play to communicate at their own level and at their own pace, without feeling interrogated or threatened. Play therapy helps children in a variety of ways. Children receive emotional support and can learn to understand more about their own feelings and thoughts. Sometimes they may re-enact or play out traumatic or difficult life experiences in order to make sense of their past and cope better with their future. Children may also learn to manage relationships and conflicts in more appropriate ways.

Mental health services which can be provided through your GP or other community primary care services. This might include counselling and other psychological therapies, community and family support or general health screening. For example, people experiencing bereavement, depression, stress or anxiety can get help from primary care or informal community support. If they need more involved support they can be referred for specialist secondary care.

A primary care trust (PCT) is a type of NHS trust, that provides some primary and community health services, or commissions them from other providers, and commissions secondary care. Many PCTs are now calling themselves NHS and then the name of their geographical area to make it easier for local people to understand how the NHS is managed locally, e.g. NHS Norfolk. Collectively PCTs are responsible for spending around 80% of the total NHS budget. PCTs will work with local authorities and other agencies that provide health and social care locally to make sure that the local community's needs are being met and make sure that the organisations providing local health and social care services are working effectively.

A Psychiatric Intensive Care Unit (PICU) is a locked inpatient ward in a hospital where some people detained under the Mental Health Act may stay. Patients are placed in PICU because they are assessed as being a risk to themselves or others and require more intensive treatment and care. They are returned to an unlocked ward as soon as their condition is stable.

A qualified medical doctor specialising in the prevention, assessment, diagnosis, treatment, and rehabilitation of mental illness. Patients may suffer from a range of conditions, including depression, anxiety, personality, behavioural or eating disorders, drug or alcohol problems, dementia, schizophrenia and learning disabilities.

Group work, using psychological therapy techniques, to address mental and emotional problems such as anxiety, depression, trauma, severe stress.

Psychosis or psychotic disorders involves distorted perceptions of reality and irrational behaviour often accompanied by hallucinations and delusions.

A psychotherapist may be a psychiatrist, social worker, psychologist, mental health nurse or other mental health professional who has had further specialist training in psychotherapy.

Treatment of mental and emotional problems – such as anxiety, depression or trauma – by psychological methods. Patients talk to a therapist about their symptoms and problems with the aim of learning about themselves.

A programme of therapy and re-enablement designed to restore independence and confidence and reduce disability. The programme may include occupational therapy to help with domestic and vocational skills that people will need when they return to living independently.

Residential care refers to nursing homes and residential care homes that provide around the clock care for vulnerable adults and older adults who can no longer be supported in their own homes, are staying in care or are being cared for in hospital.

The professional body for pharmacists and the regulatory body for pharmacists and pharmacy technicians in England, Scotland and Wales. The primary objectives of the Society are to lead, regulate, develop and represent the profession of pharmacy.

A chronic mental health condition that causes a range of different psychological symptoms. These include: hallucinations - hearing or seeing things that do not exist, and delusions - believing in things that are untrue. Hallucinations and delusions are often referred to as psychotic symptoms or symptoms of psychosis. Psychosis is when somebody is unable to distinguish between reality and their imagination. Schizophrenia is diagnosed when, in the absence of drug or alcohol abuse, a psychotic state is persistent i.e. longer than 6 months or recurrent.

Secondary care is specialist care, usually provided in hospital, after a referral from a GP or health professional. Mental Health Services are included in secondary care.

These are specialist mental health services provided usually by a Mental Health Trust. Services include support and treatment in the community as well as a range of inpatient services.

This is someone who uses health services. Other common terms are patient, service survivor and client. Different people prefer different terms. They are people who need health and social care for their mental health problems. They may be individuals who live in their own homes, are staying in care or are being treated in hospital.

At NWMHFT this is a group of service users formed to draw the expertise of those who have made use of mental health services into the establishment of strategic intentions and planning for future services.

A junior doctor; either a GP or psychiatry trainee. They are responsible for the day to day medical care of inpatients under the supervision of their Consultants.

The Single Assessment Process (SAP) for older people was introduced in the National Service Framework for Older People. The purpose of the single assessment process is to ensure that older people receive appropriate, effective and timely responses to their health and social care needs, and that professional resources are used effectively.

Personal care for vulnerable people, including individuals with special needs which stem from their age or physical or mental disability and children who need care and protection.

The state whereby vulnerable or disadvantaged groups are able to access all of the activities and benefits available to anyone living in the community.

Society’s negative attitude to people with mental health problems, often caused by lack of understanding. Stigma is prejudice and discrimination which constitutes a major problem for people who experience mental ill health.

Term used to describe a pattern of disordered language use that is presumed to reflect disordered thinking. It is usually considered a symptom of psychotic mental illness, although it occasionally appears in other conditions. Disordered thinking is revealed through making odd connections between words, using words in an odd way leading to speech that is often difficult to follow.

User involvement refers to a variety of ways in which people who use health services can be involved in the development, maintenance and improvement of services. This includes patient satisfaction questionnaires, focus groups, representation on committees, involvement in training and user-led presentations and projects.

Adults aged 18 – 65.