Draper makes some important points in her commentary that I would support unequivocally. However it must be stressed that the findings were an accurate reflection of what the students (in Northern Ireland) had experienced and said at that time.
Given that much confusion has (and continues) to surround supernumerary status it was necessary to settle upon an operational definition that encapsulated the essence of being supernumerary. In hindsight however I would concede that the protection of time has been an issue and would support Drapers assertion that its inclusion in any definition would be important.
Overall, the commentary adds to the debate and serves a useful function in providing focus and direction for the more urgent points raised in the study.
To establish levels of mental health at a community level and to model the relationship between mental health difficulty, health-related impact and health related quality of life in school pupils aged 11-18 years old.
The issue of psychosocial and mental health in school pupils is a topic of considerable academic and public interest. The incidence of mental health problems in children 11-18 years shows marked differences between countries and within countries. Much of the epidemiological literature has focused on diagnostic categories rather than population health.
The study employed a cross-sectional survey.
A cross-sectional survey of 1786 school children aged 11-18 years was conducted in Scotland. Participants completed the strengths and difficulties questionnaire and the SF-10 for Children.
This group of school pupils had similar levels of mental health needs and psychosocial health status as UK and age-related US norms. They had poorer levels of physical health status. The most important predictors of psychosocial health status were difficulty category, impact, physical health status and chronicity. The most important predictors of impact were difficulty category, chronicity and psychosocial health status.
There is a need to tackle psychosocial health problems in schools. Problems are often chronic in nature and whilst still having an impact on the life of pupils may not be severe enough for a diagnosis which would trigger treatment in the conventional sense. Psychosocial health is predicted by physical health therefore nursing interventions which are focussed on both physical and psychosocial health may be needed.
This study suggests that in some geographical areas in UK targeting of services to 'high-need' schools is not necessary and universal services are required. Problems need to be detected before they reach current treatment thresholds. Interventions should be school-based with a focus on impact on classroom learning and family difficulties.
To provide an overview of the changes in the caseload and working practices of community nurses for people with learning disabilities (CNLDs) over an 11-year period within one region of the UK.
Recent reviews of government policy within the UK and internationally have highlighted the need to promote inclusion and health facilitation for people with learning disabilities (intellectual disabilities). The CNLDs have been highlighted as having an integral role in achieving these objectives. However, little is known about the current role of community nurses and how this has evolved over the past decade.
A survey design was used in which the total population of CNLDs within one region of the UK were asked to complete a postal questionnaire.
Forty community nurses in Northern Ireland completed questionnaires. This provided information about 1559 people with learning disabilities on their current caseloads. Results showed less involvement with children, more focus on adults with physical and mental health needs and nurses often appeared to have a monitoring rather than an active clinical role. Data also identified an increasing caseload size and a pattern of referral largely from within learning disability services.
The role of CNLDs has altered in Northern Ireland over the past 11 years with some evidence of a reorientation towards a more health-oriented focus. Further consideration needs to be given to how well this will meet the changing needs of people with learning disabilities and their families in light of the increasing emphasis on the provision of inclusive services.
Community nurses need to review their current role, caseload management and links to primary and acute care if the policy objectives of inclusive services and health facilitation are to be achieved. It will also be necessary to revise their education preparation in light of the changing role of CNLDs.
