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Terms beginning with O P and R
- Outcome
- Patient Advice and Liaison Service (PALS)
- Patient and public involvement (PPI)
- Personal health budgets
- Primary care
- Positive symptoms
- Prodromal symptoms
- Provider
- Psychological treatment
- Psychotic like experiences (PLEs)
- Randomised controlled trial
- Recovery
- Refractory
- Responsible Clinician
Outcome
An ‘outcome’ is a result. Mental health professionals and researchers talk about outcomes when they describe what happens to people’s health and quality or life after treatment or therapy, for example, or what happens to people’s health and quality of life if they do not have a particular treatment. A ‘long-term’ outcome is what happens to people’s health and quality of life over a number of years. Researchers measure outcomes to see if a particular treatment or package of support is effective. One outcome they might measure would be the number of relapses people have, for example. Another might be the number of times people are admitted to hospital.
The government is introducing very specific outcomes as a way of measuring the success of social care and mental health services.
Patient Advice and Liaison Service (PALS)
All NHS trusts have a Patient Advice and Liaison Service (PALS). The role of PALS workers is to provide support, advice and information to patients and their families. They can also tell you how to complain about a service, and explain the trust’s complaints procedures.
Patient and public involvement (PPI)
PPI is a term used in research to describe the involvement of people who use services and their family members as advisors, consultants or collaborators rather than as participants in trials and studies.
Personal health budgets
The government is piloting ‘personal health budgets’, which introduce direct payments into health services. The idea is to give people greater choice: they can use direct payments to purchase the healthcare they need. The way personal health budgets work is very complicated, and what happens in the pilot schemes will be evaluated to inform future recommendations for making personal health budgets and direct payments for health available to everyone. The pilot programme will run until 2012.
Primary care
The NHS has ‘primary’ and ‘secondary’ services. Primary care services are the first point of contact with the NHS: a GP, a dentist, an optician, for example. NHS walk-in centres, and the NHS Direct phone service are also primary care services. Secondary services are specialist services like mental health services that are run within a specific area. Mostly you need to be referred to a secondary service by your GP. Sometimes, very specialist services take referrals from across the country: these may be referred to as tertiary services.
Positive symptoms
The 'positive symptoms’ of schizophrenia are the more obvious signs of psychosis – delusions, hallucinations and disordered thinking.
Prodromal symptoms
Before people experience a first episode of psychosis, they may experience what health professionals call ‘prodromal symptoms’. Someone may become depressed or anxious, find it difficult to concentrate or have problems remembering things, stop seeing their friends, act in a strange and uncharacteristic way, be less interested in study, work or hobbies and care less about how they look. They may become socially withdrawn and spend much more time alone. They also sometimes have experiences resembling the symptoms of psychosis – hearing voices every now and then, being occasionally suspicious and paranoid for example.
Provider
A ‘provider’ is any organisation that provides health or social care and support. It may be an NHS organisation, a voluntary organisation, a charity or a private organisation.
Psychological treatment
Psychological treatments are ‘talking therapies’. A therapist will meet with individuals or family members to discuss their experiences, how they feel and what they do. Some psychological treatments, like cognitive behaviour therapy, focus on the links between feelings, thoughts and behaviour. Some, such as family therapy (also called family intervention), focus on how families negotiate to solve problems together and cope with problems. Others, such as cognitive remediation therapy, focus on working to improve memory and attention.
Psychological therapists who work with people with psychosis are usually called clinical or counselling psychologists. They mainly work in the NHS, and must be registered with the Health Professions Council.
Psychological treatment is sometimes called psychological ‘intervention’.
Psychotic like experiences (PLEs)
An estimated five to eight per cent of people who do not have a diagnosis of a mental illness experience 'psychotic like experiences' – they may hear voices, have paranoid thoughts and delusional beliefs, for example. These sort of experiences are more common among adolescents, and younger children can also have them. Research studies have shown that for most people, these experiences are temporary and disappear over time. A very small proportion of people who have these experiences go on to develop a mental health problem such as schizophrenia or bipolar disorder.
Randomised controlled trial
A randomised controlled trial (or RCT) is a type of research project used mostly to test how effective treatments or services are. People who agree to take part in a RCT are randomly chosen to have different treatments or services so researchers can compare the effectiveness of each. The random selection means the results are not biased or 'fixed'. Many researchers think that the evidence from a properly conducted and randomised controlled trial provides the clearest answer about which treatments work best. Guidance from the National Institute for Health and Clinical Excellence (NICE) is based on evidence from randomised controlled trials for this reason.
Recovery
There are two meanings to the word ‘recovery’. The first is the traditional meaning – when the symptoms of an illness are gone, people are said to have ‘recovered’. Health professionals call this a ‘clinical recovery’.
The second meaning is about recovering a life worth living, without necessarily having a clinical recovery. This occurs when someone builds a life that is satisfying, fulfilling and enjoyable, whether or not he or she continues to experience the symptoms of an illness. There is a lot of work going on to make mental health services more supportive of this second type of recovery and the government has included this kind of recovery as a priority in its strategy about mental health, published in February 2011.
Refractory
The term 'refractory schizophrenia' is used when antipsychotic medication makes little difference to the symptoms of the illness. 'Treatment-resistant' is a more commonly used term.
Responsible Clinician
The Responsible Clinician is is the name given to the senior professional in charge of someone’s care when they are detained in hospital for assessment or treatment under the Mental Health Act.
