Mel Knapp
Dados Biográficos
| ID | 143907 |
|---|---|
| NOME | Mel Knapp |
| PRENOMES | Mel |
| SOBRENOME | Knapp |
| ASSINATURA | KNAPP M |
| AFILIAÇÕES | London School of Economics and Political Science |
| ORCID | 0000-0003-1427-0215 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 127 |
| TOTAL DE CITAÇÕES | 356 |
| TOTAL COMO AUTOR | 127 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1974 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 10 |
Research on dementia and inequalities in care and support – a map of the terrain and discussion of key issues
Inequalities and inequities in health and social care are a significant focus of attention. We need to understand these issues in dementia care as well, particularly given the projections for increases in the number of people being affected by the condition and the related rise in costs to individuals, families, communities and nations. We provide a map of the terrain of research concerning inequalities in dementia diagnosis, care and support in …
Preferences for Models of Care for Older People With High Care Needs
Introduction The rising number of older adults, many with long‐term conditions or limitations in activities of daily living, is expected to increase demand for social care services and for housing options to accommodate their future care needs. Additionally, an increasingly diverse population may require care models that respond to different preferences, beliefs and values. This study aims to explore how preferences to meet future care needs vary…
‘They Just Said It Was My Mood. I Was Trying to Get Attention’
OBJECTIVES: Between the 1970s and the early 1990s, over 30,000 individuals in the United Kingdom were infected with human immunodeficiency virus (HIV) and/or hepatitis C virus following treatment with NHS-supplied blood and blood products, with devastating consequences. This study aims to better understand the psychological support needs of these individuals and their families, and to identify barriers to accessing support in England. METHODS: Fo…
The double disadvantage faced by adolescents from low socioeconomic backgrounds with mental health problems affects earnings up to mid-life
Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their emplo…
Who should pay for social care for older people in England? Results from surveys of public attitudes to the funding of adult social care
While debate on how best to pay for social care in England continues, information about public attitudes on this issue is limited. We asked representative samples of the public whether care costs for older people should be met by the state, met by the service user or shared between state and user. We used an online survey of people aged 18-75 (n = 3,000) and interview survey of people aged 65 and over (n = 466). Respondents were given four vignet…
Parent‐ and teacher‐reported associations from adolescent bifactor models of psychopathology
BACKGROUND: Adolescent mental health problems have lasting impacts on health and social functioning later in life. Evidence to date mostly comes from studies of specific diagnostic categories/dimensions, but hierarchical models can elucidate associations with general as well as specific dimensions of psychopathology. We provide evidence on long-term outcomes of general and specific dimensions of adolescent psychopathology using both parent and te…
Involuntary psychiatric treatment during the Covid-19 pandemic. An international qualitative study
During the first wave, respondents reported a decrease in the use of involuntary treatments, while a gradual increase was seen in the following months. Italy extended compulsory psychiatric treatment to a group of new users, including young people and adolescents with acute crises; in other contexts, the main users are chronic psychiatric patients
The link between cognitive health and neighbourhood
People can perceive impacts of neighbourhoods on brain functioning and suggest ways local areas can be improved to support cognitive health. There is support for the idea of population-level interventions to support cognitive health
Local Online Information for Carers in England
This article reports on a study of local online information for carers in England. It sets this in the context of the Care Act 2014 which gave local authorities (LAs) specific responsibility for providing information to carers. The study selected four varied case study LAs and explored the content of their websites to see what carers might find available and accessible. We found the LA websites differed, with some LAs making use of local voluntar…
Are profiles of social, cultural, and economic capital related to living well with dementia? Longitudinal findings from the Ideal programme
New policies and efforts from the government, philanthropic foundations, the voluntary and primary care sectors are needed to address social, cultural, and economic disadvantage among people with dementia
Costs of common perinatal mental health problems in South Africa
Whilst important progress has been made in South Africa with regards to mental health policies and interventions that include assessment and management of perinatal mental health problems, substantial underinvestment prevents progress. Findings from this study strengthen the economic case for investing in perinatal mental health care
Living Well” Trajectories Among Family Caregivers of People With Mild-to-Moderate Dementia in the Ideal Cohort
The findings indicate the importance of prompt identification of, and support for, caregivers at risk of the declining capability to "live well" and may assist in identifying those caregivers who could benefit most from targeted support
Longitudinal Trajectories of Quality of Life Among People With Mild-to-Moderate Dementia
Understanding individual trajectories can contribute to personalized care planning. Efforts to prevent decline in perceived QoL should primarily target psychological well-being. Efforts to improve QoL for those with poorer QoL should additionally address functional impairment, isolation, and disadvantage related to social structure
The sociocultural framing of public attitudes to sharing the costs of social care for older people in England
Twelve synchronous online focus groups were conducted, each involving four to six members of the general public who had expressed in-principle support for sharing the costs of social care for older people between service users and government. These explored participants' reasons for preferring a shared approach and their views on how costs should be shared, with particular attention given to the sociocultural frames employed. Four main sociocultu…
Costs and cost‐effectiveness of the meeting centres support programme for people living with dementia and carers in Italy, Poland and the UK
We examined the costs and cost-effectiveness of the Meeting Centre Support Programme (MCSP) implemented and piloted in the UK, Poland and Italy, replicating the Dutch Meeting Centre model. Dutch Meeting Centres combine day services for people with dementia with carer support. Data were collected over 2015-2016 from MCSP and usual care (UC) participants (people with dementia-carer dyads) at baseline and 6 months. We examined participants' health a…
How have the Care Act 2014 ambitions to support carers translated into local practice? Findings from a process evaluation study of local stakeholders' perceptions of Care Act implementation
The Care Act 2014 imposed new statutory duties on English local authorities in relation to family or informal carers and it broadened carers' statutory entitlements to assessment, care and support, irrespective of eligibility for local authority funding of the person they care for. Despite this legislative framework, local authorities appear to be translating the new legal obligation into practice in different ways. This paper draws on evidence f…
The Implementation of Connecting People in Community Mental Health Teams in England
Loneliness and social isolation have become significant concerns in many countries, particularly amongst people experiencing mental health problems. A social intervention—Connecting People—has been found to increase their access to social capital, though it has been difficult to implement with high fidelity in community mental health teams (CMHTs) in England. This study aimed to evaluate outcomes for mental health service users of a practitioner-…
Public preferences for paying for social care in later life in England
There is ongoing debate about how the funding system for social care of older people in England should best be reformed. We investigated how public attitudes to individual and state responsibility for paying for social care in later life vary with demographic and socio-economic characteristics. Four vignettes of individuals in need of home care or residential care with varying levels of savings, income and housing wealth were presented to a sampl…
Economics and mental health
Economics and mental health are intertwined. Apart from the accumulating evidence of the huge economic impacts of mental ill‐health, and the growing recognition of the effects that economic circumstances can exert on mental health, governments and other budget‐holders are putting increasing emphasis on economic data to support their decisions. Here we consider how economic evaluation (including cost‐effectiveness analysis, cost‐utility analysis a…
The high cost of unpaid care by young people
High individual impacts and costs to the state of providing unpaid care, and the potential of such impacts to compound existing inequalities, have many implications for policy and practice in the health, social care, employment and welfare benefits sectors. In particular, the findings reinforce the case for reducing the need for young people to provide unpaid care, for example through better provision of formal care services, and to provide ongoi…
Self-management and HeAlth Promotion in Early-stage dementia with e-learning for carers (SHAPE)
ClinicalTrials.gov Identifier: NCT04286139, registered prospectively February 26, 2020, https://clinicaltrials.gov/ct2/show/NCT04286139
The role of formal care services in supporting young people who provide unpaid care in England
A large proportion of long-term care for people with disabilities and/or long-term health conditions is provided by unpaid carers, including young people, with potential impacts on their education, employment and health. Supporting carers is a focus of long-term care practice and policy in many countries. A key part of this support in England is through provision of services to the person with care needs (often called ‘replacement’ care). We aime…
Exploring the cost‐effectiveness of advance care planning (by taking a family carer perspective)
Advance care planning is considered an important part of high-quality end-of-life care. Its cost-effectiveness is currently unknown. In this study, we explore the cost-effectiveness of a strategy, in which advance care planning is offered systematically to older people at the end-of-life compared with standard care. We conducted decision-analytic modelling. The perspective was health and social care and the time horizon was 1 year. Outcomes inclu…
Valuing recovery-oriented practice at the interface between mental health services and communities
BACKGROUND: Implementing recovery-oriented mental health services is a policy priority in many countries. In addition, some governments have prioritised new forms of organising, financing and governing the provision of mental health services with a stronger focus on co-delivery and involving communities. Most research in the recovery field has focused on interventions. There is limited knowledge about the role of organisational characteristics an…
Deinstitutionalisation and community living – outcomes and costs
Mental Health Policy Development and Implementation in Four African Countries
The purpose of the research programme introduced in this article is to provide new knowledge regarding comprehensive multisectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme undertakes an analysis of existing mental health policies in four African countries (Ghana, South Africa, Uganda, Zambia), and will carry out and evaluate interventions to assist in the development and implementation of mental he…
Commissioning for Quality
The introduction of social care markets was one of the main planks of the Conservative government's community care reforms of 1990. The Labour government, whilst emphasising collaboration rather than competition, has not sought to reverse this policy. What have been the consequences? We discuss a decade of market-related change under five heads: purchasers, providers, commissioning, care planning and delivery, and users and carers. There have bee…
Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for
Previous UK research has found expressed unmet need for services by unpaid working carers and among disabled and older people. There are, however, suggestions from research that views on unmet needs for services differ between carers and care-recipients. Working carers in the UK say that the care-recipient is sometimes reluctant to accept services and the few international comparative dyad studies that have been carried out find that carers perce…
Personalisation through Individual Budgets
In England, ‘personal budgets’ are being implemented at a time of financial austerity. They are part of a growing trend internationally to give users of publicly funded social care and support more choice and control. In the individual budgets' (IB) pilot, people were allocated and had control over the way their IB was managed and spent, offering the opportunity to explore the potential of IBs to deliver better outcomes for people than convention…
Assessing the Role of Increasing Choice in English Social Care Services
This article aims to explore the concept of choice in public service policy in England, illustrated through findings of the Individual Budgets (IB) evaluation. The evaluation tested the impact of IBs as a mechanism to increase choice of access to and commissioning of social care services around the individual through a randomised trial and explored the experiences and perspectives of key groups through a large set of interviews. The article prese…
From Providing to Enabling
Government policy seeks to introduce competition into the supply of social care through the separation of purchasing and providing responsibilities. A study of 24 local authority social service departments has explored the initial steps taken to prepare for the new enabling role, including the creation of a mixed economy of care. Very few were seeking to create a market in social care. Most argued that the inherent nature of social care rendered …
Direct Payments in England
Direct payments have moved to the heart of the government's drive for increased user choice. At the same time, implementation has remained disappointing. This article explores the demand, supply and related factors associated with patterns of local variability in uptake and intensity of care package provision. Statistical analyses are conducted for key client groups – people with physical disabilities, older people, people with learning disabilit…
Long term economic impact associated with childhood bullying victimisation
Being bullied is associated with mental health problems in childhood, with increasing evidence of persisting negative impacts, and increased mental health service use, into adulthood. There are also impacts of bullying victimisation on employment, income and being in poverty, but little is known about the long-term economic impacts. We therefore aimed to estimate the most important economic consequences at age 50 of being bullied in childhood: to…
Does integrated governance lead to integrated patient care? Findings from the innovation forum
Good integration of services that aim to reduce avoidable acute hospital bed use by older people requires frontline staff to be aware of service options and access them in a timely manner. In three localities where closer inter-organisational integration was taking place, this research sought patients' perceptions of the care received across and within organisational boundaries. Between February and July 2008, qualitative methods were used to map…
Prices, contracts and motivations
English The social care reforms of the early 1990s have had profound effects on the domiciliary care system. The adoption of markets and the ‘enabling’ role for local authorities are central features. In contrast to much of the original rhetoric that lay behind these reforms, economic theory emphasises the importance of the institutional arrangements in affecting performance. Given the discretion that local authorities have over the specific form…
Movement and change
Promoting the development of a flourishing independent sector alongside good quality public services was a key objective of the community care reforms of the last decade. This paper charts some of the ways the independent domiciliary care sector is changing, as local authorities shift the balance of their provision toward independent sector providers and away from a reliance on in-house services. Two surveys of independent domiciliary care provid…
Revisiting the Causes of Stress in Social Work
Social workers in adult social care are at particular risk of job-related stress, although the contribution of different organisational and policy changes to this phenomenon is subject to debate. This paper explores a theoretical framework from the occupational psychology literature (the Job Demand/Control Model) to identify the characteristics of those most at risk of stress, in a sample of 249 social workers and other care managers working in E…
Economic barriers to better mental health practice and policy
Mental health systems in many countries are seriously under-developed, yet mental health problems not only have huge consequences for quality of life, but--particularly in low- and middle-income countries--contribute to continued economic burden and reinforce poverty. This paper discusses economic barriers to improving the availability, accessibility, efficiency and equity of mental health care in low- and middle-income countries. Six sets of bar…
Competition in the Mixed Economy of Care
The 1990National Health Service and Community Care Actintroduced sweeping changes to health and social welfare services. The reforms to community care were dominated by the introduction of markets for social care. We argue that the new markets cannot be guaranteed to deliver the range of services required to meet community care objectives. When they began to assume their new responsibilities, few key purchasers had a basic understanding of the fu…
How have the Care Act 2014 ambitions to support carers translated into local practice? Findings from a process evaluation study of local stakeholders' perceptions of Care Act implementation
The Care Act 2014 imposed new statutory duties on English local authorities in relation to family or informal carers and it broadened carers' statutory entitlements to assessment, care and support, irrespective of eligibility for local authority funding of the person they care for. Despite this legislative framework, local authorities appear to be translating the new legal obligation into practice in different ways. This paper draws on evidence f…
Personalisation and Partnership
As in other countries, improving collaboration between health and social care services is a long-established objective of English social policy. A more recent priority has been the personalisation of social care for adults and older people through the introduction of individualised funding arrangements. Individual budgets (IBs) were piloted in 13 English local authorities from 2005 to 2007, but they explicitly excluded NHS resources and services.…
Implementing Consumer Choice in Long‐term Care
In common with many advanced welfare states, England has increasingly relied on consumerist principles to deliver both greater quality and improved efficiency in the long‐term care system. The Individual Budget (IB) pilots marked the next step in this process, through a new system of funding whereby greater control of resources is given to service users, in lieu of direct in‐kind care provision. IBs have the potential to transform the market for …
Safeguarding and System Change
Cash for care or consumer-directed services are increasing in scope and size in Europe and North America. The English Department of Health initiated a pilot form of personalised support for adults (Individual Budgets) in 13 local authorities that aimed to extend opportunities for users of social care services to determine their own priorities and preferences in the expectation that this will enhance their well-being. This article reports on and d…
Commissioning care services for older people in England
One of the key objectives of the community care reforms of 1990 in the United Kingdom was the development of a flourishing independent sector alongside good quality public services. The aims of the reforms were to increase the available range of options, widen consumer choice and promote independence. The purpose of the study reported here was to examine – from the perspective of older service users, their carers and care managers – experiences a…
The Motivations of Domiciliary Care Providers in England
The independent sector domiciliary care market has always been an integral part of the social care system in England, but has become especially important in recent years. Its smooth running is crucial for the delivery of an effective community care policy. This paper argues that the motivations of these providers is an important aspect of this system's functioning, and derives a typology which captures the most important ingredients which theory …
The Quality of Life of People 12 Years after Resettlement from Long Stay Hospitals
We report service users' views on three important domains of their quality of life in the community 12 years after resettlement for long-stay hospitals. These concerned their living environments, daily activities and future aspirations. We asked a series of open questions as part of a structured interview with service users with learning disabilities (n = 196) and mental health problems (n = 102). The study is the longest reported follow-up of de…
Hotel and Dependency Costs of Residents in Old People's Homes
A comparison of costs to the organization of alternative forms of care requires estimates for similar types of client. The degree of dependency is the main characteristic in which comparability is necessary with regard to services for the aged. This paper presents estimates of the costs incurred in providing residential care for clients of four degrees of incapacity for self-care - the capacity implicit in Bevan's residential hotel model of the o…
Size of Family of Orientation, Birth Order, and Fertility Values
Previous research has established that family size preferences vary directly with the size of the family of orientation. This relationship was found to be stronger among firstborn women and among women who felt close to their families. Data from 635 high school sophomores are used to test two of these propositions. Partial support is found for the relationship between family size preferences and size of family of orientation. However it is sugges…
Barriers to Receipt of Social Care Services for Working Carers and the People They Care For in Times of Austerity
Reconciliation of unpaid care and employment is an increasingly important societal, economic and policy issue, both in the UK and internationally. Previous research shows the effectiveness of formal social care services in enabling carers to remain in employment. Using quantitative and qualitative data collected from carers and the person they care for in 2013 and 2015, during a period of cuts to adult social care in England, we explore barriers …
Private, Voluntary or Public? Comparative cost-effectiveness in community mental health care
English Two prominent features of mental health policy in the UK in recent years have been the run-down of hospital provision and the changing of the balance between public and other provider sectors. This article examines the cost, quality of care and outcome implications. Public, voluntary and private providers of mental health care are compared, based on a long-term study of people moving out of psychiatric hospitals in London. Costs are found…
Size of Family of Orientation, Birth Order, and Fertility Values
Previous research has established that family size preferences vary directly with the size of the family of orientation. This relationship was found to be stronger among firstborn women and among women who felt close to their families. Data from 635 high school sophomores are used to test two of these propositions. Partial support is found for the relationship between family size preferences and size of family of orientation. However it is sugges…
The Decomposition of Differences in Two-Party Alignment
The association between major-party alignment and social class has been of central interest to political scientists for some time, stimulating statistical investigations of varying degrees of sophistication. A particulary appealing approach has been suggested by Butler and Stokes allowing decomposition of a party’s share of the vote into what they term class composition, class support, and interaction effects. The appeal of this method derives no…
Hotel and Dependency Costs of Residents in Old People's Homes
A comparison of costs to the organization of alternative forms of care requires estimates for similar types of client. The degree of dependency is the main characteristic in which comparability is necessary with regard to services for the aged. This paper presents estimates of the costs incurred in providing residential care for clients of four degrees of incapacity for self-care - the capacity implicit in Bevan's residential hotel model of the o…
On the determination of the manpower requirements of old people's homes
THE determination of the optimal level of staffing of residential homes has received much attention in the thirty years since the National Assistance Act. However, each recommendation for a staff‐resident ratio has been based on only a partial study of the many determinants. This paper sets out those determinants of manpower requirements suggested by an economic model of residential care. Using data collected in the Census of Residential Accommod…
Planning for Balance of Care of the Elderly
The Quality of Life in Institutions for Elderly People
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Cost Information and Residential Care of the Elderly
A notable feature of most recent policy statements regarding care of the elderly is a reference to the costs of care. Public expenditure cuts at a time when the numbers of old people, and dependent old people, are increasing have heightened the already growing concern about the resources needed for providing care. This paper has two basic aims. The subsidiary aim is to examine this growing concern, with particular reference to the British experie…
Investigating labour turnover and wastage using the logit technique
The aims of this paper are twofold: to identify those personal characteristics of trainee social workers, and their locations within a social services department, which are associated with high propensities to change jobs and to leave social work altogether, and secondly to describe and apply a relatively new and very powerful analytical technique to effect this identification. This technique—polychotomous logit analysis—is particularly well suit…
Classifications of the elderly population
To the existing ways of categorizing elderly individuals we here add a reasonably objective approach using recent survey data and statistical methods of multivariate analysis. The groupings obtained have been surprisingly clear-cut, so that simple rules can be devised for discriminating between clusters. We suggest this analysis as a useful way of gleaning information about elderly people, information which may help in the efficient allocation of…
Inter-Sectoral Cost Comparisons
It is often argued that there are significant differences in the costs of providing public and non-public services. However, these arguments have almost invariably been based on crude comparisons of bald expenditure figures of rather dubious validity. In this paper we describe and apply a conceptual framework which attempts to place such inter-sectoral comparisons on a more reliable basis. Our application is to day care services for elderly peopl…
The Outputs of Old People’s Homes in the Post‐war Period
It has proved useful in studies of the personal social services, and in other areas of social policy, to make a distinction between final and intermediate outputs. Final outputs measure changes in individual client well‐being compared with changes in well‐being in the absence of a caring intervention. In other words, final outputs measure the degree of success of a service or a care unit in meeting its client‐level policy objectives, where due co…
Cost variations in Scottish adult training centres
1983). Cost variations in Scottish adult training centres. Local Government Studies: Vol. 9, No. 3, pp. 17-30
Predicting turnover rates among the staff of English and Welsh old people's homes
The Economics of Social Care
The Cost of Residential Care for the Elderly
Despite the important role played by cost considerations in policy decisions regarding services for the elderly there has been relatively little reliable research on this topic. A large nationally representative survey of old people's homes conducted by the Personal Social Services Research Unit in England and Wales in 1981 provides a firm foundation for the careful examination of the cost of residential care. Focusing on residential homes in the…
Economics and Social Policy (Book)
The Economics of Social Care
Journal Article The Economics of Social Care Get access The Economics of Social Care. By MARTIN KNAPP. (Basingstoke: Macmillan, 1984. Pp. xiv + 251.)Paying for Welfare. By HOWARD GLENNERSTER. (Oxford: Basil Blackwell, 1985. Pp. xi + 273. £19.50 hardback, £7.50 paperback.) Joseph M. Jackson Joseph M. Jackson University of Dundee Search for other works by this author on: Oxford Academic Google Scholar The Economic Journal, Volume 95, Issue 379, 1 S…
The Costs of Residential Child Care
The long-awaited report of the House of Commons Social Services Committee (1984), Children in Care , drew attention to two very durable features of policy-making in the personal social services: the influence of costs on both policy and practice, and the dearth of reliable cost data. For example, much of the discussion during the Committee’s examination of witnesses from the Department of Health and Social Security (DHSS) focused on the relative …
The Conceptualisation of Output and Cost-Benefit Evaluation for Leisure Facilities
Cost-benefit and cost-effectiveness analyses have become widely used tools for the justification of leisure-related expenditures, but are based on a number of inadequate assumptions. The narrow conceptualisations both of outputs and of inputs, and an oversimplified production function linking them are the main problems. Participation is usually assumed to provide an adequate measure of output or benefit accruing to the participant, but it is a me…
Paying for Welfare (Book)
Modelling the initial placement decision for children received into care
Hidden cost multipliers for residential child care
1987). Hidden cost multipliers for residential child care. Local Government Studies: Vol. 13, No. 4, pp. 53-73
Performance Measurement in Child Care
Almost every policy pronouncement at central government and local authority level advocates an increase in the proportion of children placed with foster families from among those admitted to care, that is no longer living with their biological or adoptive parents. Every local authority in England has successfully increased this proportion over a ten year period but they are finding it increasingly difficult to do so as child care populations chan…
Policy Issues for the Uk Voluntary Sector in the 1990s
The Comparative Costs of Community Service and Custody in Scotland
This paper examines the costs of community service orders, and compares them with the costs of alternative custodial sentences. Twelve Scottish community service schemes are studied. Costs are disaggregated to component activities (assessment, matching, placement supervision and breaches), and average costs per offender calculated and compared. It is found that, while cheaper than custody, community service is not as cheap as recent central gover…
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