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Ms Rosie Winterton: Guidance on advance refusals is included in the Department of Health's "Reference Guide to Consent for Examination or Treatment" published in March 2001. A copy of the guide has been placed in the Library and is also available from the Department of Health's website at http://www. dh.gov.uk/assetRoot/04/01/90/79/04019079.pdf
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Mr. Burstow: To ask the Secretary of State for Health pursuant to his answer of 30 January 2004, Official Report, column 559W, on long-term care, if he will place in the Library copies of the survey and estimates by the Personal Social Services Research Unit referred to in the explanatory note. 
Dr. Ladyman: In the explanatory note referred to in my answer of 30 January 2004, Official Report, column 559W, the estimate of the proportion of privately funded older care home residents receiving disability benefits is from Netten A., Darton R. and Curtis L. (2002). Self-Funded Admissions to Care Homes. A report of research carried out by the Personal Social Services Research Unit (PSSRU), University of Kent on behalf of the Department for Work and Pensions, (Department for Work and Pensions Research Report No. 159). A copy of this report is available in the Library.
The estimate of private expenditure on private home care was obtained from PSSRU. It derives from research on projections of demand for long-term care for older people. A copy of a recent discussion paper on this PSSRU studyComas-Herrera A., Pickard L., Wittenberg R. et al. (2003) Future demand for long-term care, 20O1 to 2031: projections of demand for older people in England, PSSRU discussion paper 1980will be placed in the Library.
Mr. Burstow: To ask the Secretary of State for Health pursuant to the answer of 30 January 2004, Official Report, column 559W, on long-term care, what the basis is of the assumption in the explanatory note that there are 58,000 privately funded residents of residential care homes in England. 
Dr. Ladyman: The figure of 58,000 is an estimate in the absence of data on numbers of privately funded residents in residential care homes. There were around 120,000 older local authority supported residents in independent sector care homes in March 2003. The "PSSRU 1996 Survey of Care Homes for Elderly People", www.pssru.ac.uk/pdf/dp1423~2.pdf, found that around one third of older residents of independent sector residential care homes were privately funded. This suggests that an estimate of around 58,000 is reasonable.
Mr. Burstow: To ask the Secretary of State for Health pursuant to the answer of 20 January 2004, Official Report, column 1110W, on long-term care, whether the Department's proposals in response to the Royal Commission, including free nursing care and changes to the residential charging rules, will have changed these costs. 
Dr. Ladyman: The estimated cost of £1.5 billion for England covers only the cost of free personal care and excludes the cost of free nursing care, as that has been implemented. The estimate would have been higher if free nursing care had been included. In principle, this also applies to the 12-week disregard of housing assets and the uprating of the capital limits which the Government announced in their response to the Royal Commission. The estimate of around 100,000 privately
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Ms Rosie Winterton: The specific and general duties of the Race Relations (Amendment) Act 2000 places an onus on statutory bodies to identify and tackle racial discrimination faced by the black and minority ethnic community.
In support of this for mental health services we have issued for consultation "Delivering Race EqualityA Framework for Action" which sets out what those planning, delivering and monitoring local primary care and mental health services need to do to improve services for users, relatives and carers from black and minority ethnic communities. This is backed up by a programme of work by the National Institute for Mental Health in England (NIMHE).
NIMHE has also issued "Engaging & ChangingDeveloping effective policy for the care and treatment of Black and minority ethnic detained patients". The document provides guidance in relation to the development of policies concerning the care and treatment of black and minority ethnic communities in the areas of ethnic monitoring, racial harassment, the use of interpreters and the provision of culturally appropriate care and staff training.
Ms Rosie Winterton: The NHS Plan introduced an improving working lives standard in 2000 which makes it clear that every member of staff in the national health service is entitled to work in an organisation which can prove that it is investing in improving diversity and tackling discrimination and harassment. All NHS organisations including mental health trusts have to achieve the standard, which is a key performance indicator, part of the star rating system.
In relation to tackling racial harassment an improving working lives toolkit "Improving Working Lives: Tackling Racial Harassment in the NHSGood Practice Guidance" was issued in 2001. This guidance sets out key principles on tackling racial harassment in NHS employment.
The need for local policies to deal with staff/patient and patient/patient racial harassment where patients have been detained under the Mental Health Act is highlighted in the National Institute for Mental Health document "Delivering Race EqualityA Framework for Action and Engaging and ChangingDeveloping effective policy for the care and treatment of Black and minority ethnic detained patients".
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(b) hanging with the use of a non-collapsible curtain track and (c) hanging with the use of a collapsible curtain track. 
|Deaths from hanging|
Figures for hangings using non-collapsible and collapsible curtain tracks are not available.
Ms Rosie Winterton: A detailed service specification for assertive outreach teams, which includes information on staffing requirements, is contained in the "Mental Health Policy Implementation Guide" (2001), which is available from the Department's website at http://www. publications.doh.gov.uk/mentalhealth/implementationguide. htm and is also available in the Library.
Ms Rosie Winterton: According to the Durham mental health service mapping database www.dur.ac.uk/service.mapping/amh), over 95 per cent. of assertive outreach teams, which are operational, are multi-disciplinary.
The inter-relationship of teams and services and their working arrangements are local matters in the context of national guidance on standards of care, the evidence concerning best practice, and the targets set within the NHS Plan.
Guidance on the configuration of teams and services is provided in the Mental Health Policy Implementation Guide, which is available from the Department's website at http://www.publications.doh.gov.uk/mentalhealth/implementationguide.htm and is also available in the Library.
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problems, including two standards specifically concerned to ensure that each person with severe mental illness receives the range of mental health services they need. The NSF also set out evidence concerning the importance of early intervention for young people with the first sign of a psychosis.
The "NHS Plan" (2000) provided extra investment by 200304 to fast-forward the NSF and set a target of 50 early intervention teams to be established by 2004 to ensure all young people who experience a first episode of psychosis receive the early and intensive support they need.
Further details were set out in the "Mental Health Policy Implementation Guide" (2001) which is available from the Department's website at http://www. dh.gov.uk, a copy of which has also been placed in the Library.
Mr. Burstow: To ask the Secretary of State for Health pursuant to his answer of 2 February 2004, Official Report, column 687W, on mental health, how many carer support workers are employed in the NHS. 
Tim Loughton: To ask the Secretary of State for Health when he expects the full complement of (a) early intervention, (b) assertive outreach and (c) crisis resolution teams to be established, as set out in the National Service Framework for Mental Health. 
Mrs. Gillan: To ask the Secretary of State for Health how many prisoners have been (a) diagnosed with and (b) treated for mental health disorders in each year since 1997, broken down by prison establishment. 
Dr. Ladyman: The information is not available in the form requested. A survey of psychiatric morbidity among prisoners in England and Wales in 1997, by the Office for National Statistics, showed that 90 per cent. of prisoners have at least one significant mental health problem, including personality disorder, psychosis, neurosis, alcohol misuse and drug dependence. Around 5,000 people in prison at any one time have a severe mental illness though they will not all be acutely ill.
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including mental health services to meet those needs. NHS funded prison mental health in reach teams will be providing services in 90 prisons by March 2004.
Dr. Ladyman: In 1997 the Office for National Statistics (ONS) undertook a survey of "Psychiatric morbidity amongst prisoners in England and Wales". The report included a range of information on the prevalence of specific mental health problems in black and minority ethnic prisoners. A copy of the ONS study is available in the Library.
Dr. Ladyman: The provision of national health service community-style mental health services will be in around 90 establishments by March 2004. An evaluation of the in-reach programme has been commissioned through the NHS forensic research and development programme and is expected to start shortly.
Mrs. Gillan: To ask the Secretary of State for Health what programmes are in place to ensure swift identification of prisoners with mental health disorders upon arrival at prison establishments; and which prison establishments operate such programmes. 
Dr. Ladyman: Her Majesty's Prison Service and the Department of Health are working together to implement a revised reception health screening process by March 2004. The new process focuses explicitly on ensuring prompt and effective identification of individuals with mental health problems.
The new reception screening arrangements are being introduced into the following establishments in England by March 2004: Durham, Eastwood Park, Feltham, Glen Parva, Holme House, Leeds, Liverpool, Manchester, New Hall, Wandsworth, Brixton, Bedford, Lewes, Preston, Styal, Wormwood Scrubbs, Woodhill, Dorchester, Exeter, Highpoint North, Lincoln, Norwich, Pentonville, Hull, Chelmsford, Nottingham, Hindley, Altcourse, Ashfield, Blakenhurst, Bristol, Brinsford, Castington, Gloucester, Leicester, Highdown, Birmingham, Forest Bank, Onley, Parkhurst, Shewsbury, Stoke Heath, Winchester, Elmley, Brockhill, Bullingtdon, Doncaster, Long Lartin, Lancaster Farms, Wetherby, Wakefield, Holloway, Belmarsh, Full Sutton, Huntercombe, Reading, Warren Hill, Werrington, Low Newton, Kirkham and Morton Hall.
Dr. Ladyman: The specialist care of severely mentally ill prisoners is provided by mental health teams, which are staffed by national health service employees and broadly correspond to local community mental health teams. There are currently 90 such teams operating in the following establishments in England:
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Phase 1: (introduced during 200102): Belmarsh, Birmingham, Brixton, Bullwood Hall, Chelmsford, Durham, Eastwood Park, Feltham, Frankland, Holloway, Leeds, Leicester, Pentonville, Wandsworth, Winchester, Whitemoor, Woodhill and Wormwood Scrubs.
Phase 2: (introduced during 200203): Ashfield, Bedford, Blakenhurst, Bristol, Brockhill, Dorchester, Exeter, Glen Parva, Holme House, Hull, Lewes, Lincoln, Liverpool, Long Lartin, Manchester, Moorland, New Hall, Norwich, Nottingham, Onley, Parkhurst, Portland, Preston, Rochester, Styal and Wakefield.
Phase 3: (introduced during 2003-O4): Albany/Camp Hill, Altcourse, Aylesbury, Blantyre House, Brinsford, Buckley Hall, Bullingdon, Canterbury, Castington, Coldingly, Cookham Wood, Dartmoor, Deerbolt, Doncaster, Dovegate, Drake Hall, Elmley, Forest Bank, Foston Hall, Full Sutton, Garth, Gartree, Gloucester, Haverigg, Highdown, Highpoint North/Highpoint South, Hindley, Hollesley Bay/Warren Hill, Huntercombe, Kingston, Lancester Farms, Littlehay, Low Newton, Maidstone, Northallerton, Reading, Risley, Shrewsbury, Stafford, Stoke Heath, Swaleside, Swifen Hall, Thorn Cross, Werrington, Wetherby and Wolds.
Dr. Ladyman: This information is not available. Most healthcare staff working in prisons will be involved in some way in caring for individuals with mental health problems. By March 2004 we expect to meet the NHS Plan commitment for 300 additional staff to provide specialist community type mental health services to over 5,000 prisoners.
Dr. Ladyman: In England the total amount allocated specifically to primary care trusts for national health service mental health services in prisons was £1,719,000 in 2O0102; £3,685,000 in 200203 and £9,400,000 in 200304. A breakdown of this information, by prison, has been placed in the Library. We expect total expenditure on these services to double to around £20 million by 2O0506.
Ms Rosie Winterton: Released prisoners can access the full range of mental health services available to the population in which they become resident. An important function of national health service mental health in-reach teams working in prisons is to ensure effective through-care for prisoners with serious mental health problems, to be followed up by support from appropriate mental health services on release.
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