bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating mental health and housing services
Authors: Palfrey Colin
Published: August 2011

It is increasingly important for voluntary organisations seeking funding to provide hard evidence that their projects are achieving beneficial results for their clients. While service user evaluation of services is of paramount importance, cost‐effectiveness and the views of partners in the statutory and voluntary sectors must also be taken into account if a comprehensive evaluation of services is to be achieved.Gofal Cymru commissioned external researchers to carry out a detailed assessment of its housing support and advice projects. The findings confirmed that these services provide value for money for funding agencies. Data from the research can now be used as hard evidence in the organisation's bids to extend these projects into other local authority areas.
Designing services with residents: Residents leading the continuum of support services
Authors: Lazar Jamie
Published: August 2011

Bournemouth Churches Housing Association has developed a continuum of accommodation and support services through consultation with residents and local authorities. This is a holistic continuum of services that is designed to be flexible enough to enable residents to move between different services offered as their support needs change. Ultimately, the continuum of support services is intended to empower residents in achieving independent living after moving from fully supported services, to semi‐supported services, to independent accommodation with floating support. It has been possible to develop this range of services by mapping accurately support needs and developing effective professional working relationships with partnership agencies, such as Supporting People Administering Authorities.
Review of supported housing in South West England
Authors: Bannan Mark , Watson Lynn
Published: August 2011

A partnership of agencies in South West England commissioned a review of supported housing, with the primary aim of linking supported housing (and the Supporting People programme) with other regional strategies and initiatives such as housing, health, crime reduction and community safety. The review produced a new conceptual framework for the planning and management of housing and support services, with a strong emphasis on aims and outcomes. It also brought together data on current services across the region and identified key trends and issues to be addressed. Many of the recommendations and proposals have been incorporated into the draft Regional Housing Strategy, due to be finalised in May 2005.
The influence of the family on the future housing preferences of seniors in Canada
Authors: Weeks Lori , Branton Olive , Nilsson Thomy
Published: August 2011

We addressed how family factors influenced the future housing preferences of seniors. A total of 100 adults ranging in age from 65 to 98 participated in face‐to‐face interviews. The vast majority of the respondents had no plans to move, and most wanted to remain living in close proximity to family. The results showed several linkages between family support currently provided and the future housing preferences of seniors. The results of this study have implications for developing programmes and services to support seniors and their family members to accommodate ageing in place. Further research is needed to understand more completely how family factors influence seniors' housing preferences.
Involving young tenants in decision‐making
Authors: Middleton Catherine
Published: August 2011

Over the course of 2004, People for Action (PfA) ran a programme looking at ways of increasing the involvement of young tenants in housing association decision‐making. This report on the project summarises the lessons that have been learnt from the work.
Housing for Chinese elders in Middlesbrough: Case study for the Housing Learning and Improvement Network
Authors: Stephenson Deborah
Published: August 2011

This case study provides an example of a local community development partnership between a housing association and a Chinese community association, involving housing for older people, a community centre and retail/business space.
Home care service for people with dementia: Case study for the Housing Learning and Improvement Network
Authors: Russell Jeff , Hovey Lisa , Fairlie Carole
Published: August 2011

This case study gives an example of a pioneering, specialist home care service for people with dementia living in their own homes in the Borough of Poole in Dorset.
The support plan: Centrepiece of high‐quality service or missed opportunity?
Authors: Allen Terry
Published: August 2011

The support plan is central to the Supporting People programme. A service user without one is not eligible for funding, and it forms a core objective of the formal Quality Assessment Framework. This article suggests not only that many support plans are not in place, but also that others are implemented poorly. This is a missed opportunity to deliver high‐calibre services, be accountable to the service user and address some of the key factors which make for a successful outcome.
The way forward for Supporting People: Challenges and opportunities for BME organisations
Authors: Matharoo Darshan , Davis Sarah
Published: August 2011

At a significant time in the development of the Supporting People programme, this article considers the focus on individual service users, the proposals put forward to achieve it and the impact of this emphasis, reflecting the wider policy focus in other public services and the inherent tensions between the stated aims and delivery in a context of limited resources. In particular it focuses on the role of and impact on black and minority ethic (BME) providers.
Visionary leadership in housing: connecting to health and care
Authors: Davis Sarah
Published: August 2011

The article explores how the Government's framework of local strategic partnerships and local area agreements provides opportunities for greater collaboration between the strategic housing role for local authorities and leadership in health and social care, although the details of the framework are still to be developed.
Weavers Restaurant Trust
Authors: Hales Roger , Sharma Aruna
Published: August 2011

The article describes Weavers Restaurant Trust, set up by Providence Row Housing Association to provide support into work for disabled and disadvantaged people in the East End of London. In the past seven years, the Trust has grown into a highly successful enterprise, providing a unique quality of training and winning numerous awards. Most important, is has assisted many people to find suitable skilled employment.
Inspiring a joint Jewish and Muslim treatment service
Authors: Sufrin Rabbi
Published: August 2011

Few cultural clashes receive more press coverage than the Jewish and Muslim conflict. Beyond the headlines, both communities suffer from the same social problems ‐ drink and drug misuse. Though these are not uncommon, especially among young people, both communities suffer from shame and cultural blindness to their problems. In a controversial and bold pilot, an East London treatment service is uniting Jewish and Muslim communities by establishing the UK's first Jewish and Muslim drug and alcohol treatment service. Though still in its infancy, the project is drawing great acclaim, including that of Tony Blair.
Equality and diversity: making it real
Authors: Barker Matthew
Published: August 2011

Action Housing & Support commissioned an independent, external audit of its practices, policies and procedures. The articles outlines its findings, and considers the implications they will have for the service.
Housing with capacity: the Mental Capacity Act explained
Authors: Williamson Toby
Published: August 2011

The Mental Capacity Act 2005 comes into effect in England and Wales in 2007. The Act contains principles, procedures and safeguards to empower people to make decisions for themselves wherever possible, but also to ensure that decisions made on their behalf if they lack the mental capacity to make the decision themselves are done in their best interests. The Act will apply to anyone working in the supported housing field or residential care where residents may lack the capacity to make decisions as a result of illness, injury or disability. This article gives an overview of the Mental Capacity Act and its relevance to the field of supported housing.
Implementing direct payments for people with a learning disability
Authors: Swift Paul
Published: August 2011

The article reports on research on the variable take‐up of direct payments. Direct payments offer huge potential for people with learning disabilities, but implementation has been patchy. Care managers are crucial to getting more people on to direct payments, but many feel ill‐equipped to help people take advantage of direct payments, and also doubt their usefulness, either to their clients or to the development of services. Creative solutions, such as an active peer‐support group and using circles of support or trusts, coupled with user‐friendly systems backed up with training and managerial support, can result in greater take‐up and more success stories.
Community safety: housing drug and alcohol users
Authors: Duffin Michelle
Published: August 2011

This article reports on the difficulties of finding adequate housing for vulnerable groups including drug users and ex‐drug users.
Improving mental health in a changing NHS
Authors: Tyson Kathryn
Published: August 2011

No‐one doubts the progress that has been made, through implementation of the National Service Framework for Mental Health (NSF) (DoH, 1999), in improving services for people with mental health difficulties. More needs to be done to continue these improvements and, in the current context of system and focus change for the NHS, success will depend on identifying the most promising areas to make progress.
Volunteer‐aided Computerised Cognitive Behavioural Therapy (cCBT) Project
Authors: de Vares Andy
Published: August 2011

A computer‐based programme, Beating the Blues, has been approved for use in the NHS for treating people with mild to moderate depression. It has been welcomed as an important addition to the range of treatment options available. However, some people have expressed reservations about whether this method of delivery would be appropriate for everyone. This article describes the Volunteer‐aided Computerised Cognitive Behavioural Therapy (cCBT) Project, an innovative way to make Beating the Blues more accessible to individuals. This project is being developed by Making Space, in partnership with other public and third sector organisations, and is funded by the Department of Health.
Protecting young people from homelessness and escalating drug and alcohol use
Authors: Day Caroline , Paul Chris
Published: August 2011

In recent years the political and practice climates have changed greatly, towards a focus on preventing negative experiences and vulnerability in the lives of children and young people, but at present many efforts suffer from two defects: they apply adult treatment ideas to young people, and they are not joined‐up responses. The article argues that young people are different from adults, having not yet established set patterns of behaviour, and that this offers a chance to intervene before the point of crisis. While they may misuse drugs and alcohol, in the main this is symptomatic of other problems that they need our support to face, which can be offered most effectively by services that are holistic and integrated, and which deal first with their emotional and family needs while also addressing personal development and vocational skills and training. These interventions need to begin well before the current housing crisis points around age 16 or 17.
Mental health in later life, a neglected area of policy and research allocation: summary of the UK Inquiry into Mental Health in Later Life
Authors: Hurst Philip , Minter Jane
Published: August 2011

This article is a ‘taster’, and summarises the issues identified in the UK Inquiry report on Mental Health in Later Life. It looks at how the Inquiry undertook its work, how older people with mental health problems are often overlooked and what their views and experiences are of accessing services, what actions are proposed for the housing, health and care sectors, and key issues and recommendations. Age Concern is committed to auditing the response to the recommendations and will report progress in 2009.
The use of Talking Mats to improve communication and quality of care for people with dementia
Authors: Murphy Joan , Gray Cindy , Cox Sylvia
Published: August 2011

Enabling people with dementia to continue to communicate their views, needs and preferences as their condition progresses is essential for development of person‐centred services and care facilities. This paper describes part of a 15‐month research project funded by the Joseph Rowntree Foundation. It examined the effectiveness of Talking Mats, a low‐technology communication tool, to help people with dementia express their opinions, in comparison with usual communication methods. The study involved 31 people at different stages of dementia who were interviewed about their well‐being under three conditions: unstructured (ordinary) conversation, structured conversation and Talking Mats conversation. The study found that Talking Mats can improve the communication ability of many people at all stages of dementia in expressing their views about their well‐being.
Clean Break drugs and housing project
Authors: Evans Alice
Published: August 2011

This article summarises the findings of Homeless Link's research, Clean Break. Through action research in three London boroughs, Homeless Link with Tribal Consulting took a systems approach to identifying the barriers to active engagement of homeless drug users in structured treatment in accessing appropriate housing and housing‐related support. The work showed that, despite the barriers facing people on their treatment journey, existing resources, if integrated, could overcome many of them.
Health and homelessness ‐ a whole‐systems perspective
Authors: Read Sue
Published: August 2011

People who are homeless often have multiple, complex health needs. Health services need to be adapted to ensure that they receive appropriate care in a cost‐effective way, and that this is done in partnership with other agencies so that their needs are met in an holistic and productive manner. This can be achieved by modifying existing care pathways, by provision of specialist services or both. Any local solution will depend on the number of people who are homeless and their needs. The undertaking of joint strategic needs assessments offers an opportunity to influence commissioners to ensure that the needs of people who are homeless are included in future care and support developments.
The house keys: an innovative approach to supported housing in Rome
Authors: Maone Antonio , Berardi Rossella , Spagnuolo Olga
Published: August 2011

The rigid linear model of community mental health care in specialist temporary accommodation in Rome failed to deliver the progress in service user outcomes. A radical review and co‐production exercise by staff, service users and relatives commissioned a flexible recovery‐based model that better met the needs of people in Rome.
Delivering public sector transformation: building the strategic relationship between housing, health and care
Authors: Davis Sarah , Porteus Jeremy
Published: August 2011

This article looks at the challenges for delivering personalisation across public services, the key for transformation of those services. Based on a recent publication, Housing Health and Care (Davis et al, 2009), it argues that the policy context, performance systems and local frameworks are now possibly better placed than ever before to deliver the integrated working that can underpin sustainable communities and allow for really personalised services.
The socially excluded adults public service agreement
Authors: Eisenstadt Naomi
Published: August 2011

The Social Exclusion Task Force, based in the Cabinet Office, works across government to ensure that the opportunities enjoyed by the vast majority of people in the UK today are extended to those whose lives have been characterised by deprivation and exclusion. The Task Force recognises that much has already been achieved through investment in public services, tax and benefit changes, and the national minimum wage. However, intensive collaborative support is needed for the most vulnerable individuals and families, whose difficulties are complex and persistent. The development of the first public service agreement (PSA) for very vulnerable adults is a major step forward in addressing the needs of some of our most disadvantaged citizens.
Using Supporting People funding in individual budgets
Authors: McAllister Kate
Published: August 2011

Following the Communities and Local Government (CLG) pilot exercise, all sites remain committed to the concept of individual budgets. There are many positive stories of how individual budgets (IBs) have made a real difference to people's lives, enabling true person‐centred support and informed choices about integrated packages of care and support. There were also impressive examples of creative joint working at site level, where sites adopted pragmatic solutions and worked round obstacles wherever possible. Based on experiences to date, all the pilot sites feel that IBs have a key role to play, but that they should not be considered as the only option for personalising housing‐ related support services and increasing choice. Commissioned Supporting People (SP) services can be responsive and person‐centred, as well as providing consistent coverage over large geographical areas, and some authorities consider that commissioned SP services can work alongside IBs and promoted this model as a viable alternative. More work is needed to understand better how IBs can work together with commissioned services to deliver a seamless service.
Appreciative inquiry: a fresh approach to continuous improvement in public services
Authors: McAlliste Kate , Luckcock Tim
Published: August 2011

How many of us are running out of ideas to improve performance and deliver elusive goals and targets? The demand to raise standards is never far away from political rhetoric, the drive to improve outcomes for stakeholders is a constant imperative of leadership, and inspection regimes hold us to account by confronting us with the deficit between progress and outstanding issues. But do we really think we have found the best approach to delivering this change? Have we developed a method which optimises the continuous improvement agenda in a way that enables services to thrive rather than feel overwhelmed by the needs we are trying to meet? How do we close the gap between our innate sense of idealism and the real‐world problems of which we are only too aware? There is a fresh approach which works well, by placing people at the centre of the change process. It is called appreciative inquiry. This article explains how it has been used by Liverpool Council to powerful effect.
Toronto's Housing First programme and implications for leadership
Authors: Falvo Nick
Published: August 2011

The emergent Housing First model, focused on new means of rapid rehousing of the homeless, is popular in North America among policy makers and the mass media. Yet little has been written on the Housing First model's transferability to Canadian municipalities. This report documents, analyses and interprets Toronto's Streets to Homes (S2H) programme, using primary and secondary research including semi‐structured key informant interviews. The report concludes with a brief consideration of the article's implications for leadership.
Supporting People and the future of housing‐related support
Authors: Eliot Jake , Hamilton Nigel
Published: August 2011

This article is based on a briefing paper originally issued by the National Housing Federation and Sitra as an update to their members on Supporting People and the future of housing‐related support. The article considers the current issues in providing housing‐related support and offers a range of measures to help connect housing, health and social care more effectively and ultimately to offer improved services and better commissioning. The article ends in a summary of the actions that the two organisations will be taking to help protect and preserve local Supporting People services and to make sure that Supporting People will develop, adapt and respond to future needs.
The recession: its impact on third sector organisations
Authors: Scragg Terry
Published: August 2011

This article describes the response to a survey of third sector organisations and their experience of the impact of the current economic climate. The findings from a small range of organisations provide a snapshot of the current pressures and problems facing the sector.
Personalisation and housing: a service user view
Authors: Beresford Peter
Published: August 2011

The policy of personalisation is essentially about matching services and support to address the unique needs and shared rights of each person as a service user. We can get some idea of the implications this new policy may have for housing by looking at some recent real‐world examples from social housing.
Good Lives sexual offender treatment for mentally disordered offenders
Authors: Gannon Theresa A. , King Tracy , Miles Helen , Lockerbie Lona , Willis Gwenda M.
Published: August 2011

Purpose

The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally disordered offenders.

Design/methodology/approach

As evaluation and work on the SOTG is necessarily ongoing, case study descriptions of each patient who attended the SOTG and of their progress throughout SOTG are described.

Findings

Overall, the case study progress reports suggest that mentally disordered male patients made some notable progress on SOTG despite their differential and complex needs. In particular, attention to each patient's life goals and motivators appeared to play a key role in promoting treatment engagement. Furthermore, patients with lower intelligence quotient and/or indirect pathways required additional support to understand the links between the Good Lives Model (GLM) and their own risk for sexual offending.

Research limitations/implications

Further evaluations of SOTG groups, that incorporate higher numbers of participants and adequate control groups, are required before solid conclusions and generalisations can be made.

Practical implications

Practitioners should consider providing additional support to clients when implementing any future SOTGs for mentally disordered patients.

Originality/value

This is the first paper to outline and describe implementation of the GLM in the sexual offender treatment of mentally disordered male patients group format. As such, it will be of interest to any professionals involved in the facilitation of sexual offender treatment within this population.
Pathways to episodes of deliberate self‐harm experienced by mentally ill men in a high‐secure hospital over the course of their lives: an exploratory study
Authors: Adamson Vidyah , Braham Louise
Published: August 2011

Purpose

There is a dearth of research exploring pathways to episodes of deliberate self‐harm (DSH) within mentally ill men in high‐secure hospitals. This study aims to explore pathway(s) to episodes of self‐harm experienced by this group over the course of their life.

Design/methodology/approach

A total of seven men with a history of repetitive DSH participated in audio‐taped semi‐structured interviews. Transcribed interviews were analysed using grounded theory methods.

Findings

Two pathways to episodes of DSH emerged and were termed: the relief, and the response to mental health problems pathways. Participation within a dyadic suicide pact emerged as an unexpected theme.

Research limitations/implications

There were a number of limitations within this study. Participants did not describe DSH episodes, which occurred within the high‐secure hospital and it was unclear as to the stage of their illness or whether co‐morbid difficulties were present during the episodes of DSH. Further research is required to substantiate the two pathways to episodes of DSH found within this study.

Practical implications

The present study offers a theoretical framework for clinicians working with mentally ill men within high‐secure hospitals, who have a history of DSH and identifies the need to carefully assess each individual episode of DSH.

Originality/value

This study is the first to explore pathways to episodes of self‐harm as experienced by mentally ill men within a high‐secure hospital by interviewing patients directly.
What are we doing about weight management in forensic psychiatry? A survey of forensic psychiatrists
Authors: Haw Camilla , Stubbs Jean
Published: August 2011

Purpose

Patients in secure units are at high risk of obesity because of antipsychotic medication, restrictions on freedom, and poor motivation to eat healthily and exercise. The aim of this paper is to investigate how consultant forensic psychiatrists address weight management, particularly with respect to inpatients.

Design/methodology/approach

Based on a review of the literature, a structured questionnaire was developed and piloted locally. After revising the questionnaire, it was sent to all 442 consultant psychiatrists listed by the Royal College of Psychiatrists as having a special interest in forensic psychiatry.

Findings

A total of 183 usable questionnaires were returned (response rate 45.9 per cent). Most respondents monitored patients' weight and had some access to a dietitian. Respondents rated a median of 40 per cent of their inpatients as obese. A total of 68.9 per cent said their patients did not have unrestricted access to food. Use of weight loss drugs such as orlistat was infrequent. A few patients had been referred for bariatric surgery but most had been judged unsuitable.

Research limitations/implications

The responses reported in this paper are based on participants' self‐report and have not been confirmed by independent observation. Further research is needed to determine which weight loss measures are effective for psychiatric patients in real‐life situations.

Practical implications

Obesity appears to be common among forensic inpatients despite weight monitoring, dietetic interventions and exercise programmes. Comprehensive and continuing efforts are needed to help patients lose weight and lead healthier lifestyles.

Originality/value

This survey reports on clinicians' views and clinical practice.
The Motivation of Arsonists* ‐Reflections on Research and Practice
Authors: Prins Herschel
Published: August 2011

The offence of arson is examined within a very brief cultural and historical context; reference is made to the law and the size of the problem in the UK and elsewhere. Some typologies are put forward and proffered for improving understanding and management.
Risk Assessment and Risk Management: Practice and Policy Implications
Authors: Kemshall Hazel
Published: August 2011

This paper reviews the current issues in risk assessment and risk management facing practitioners, and draws upon current literature to argue for an holistic approach to assessment. The demands of risk management in a climate of risk avoidance are briefly reviewed, and key principles for effective risk management offered.
Responding to People with Learning Disabilities in the Probation Service
Authors: Mason Jonathan
Published: August 2011

People with learning disabilities have a number of vulnerabilities which makes the process of probation difficult for them to cope with without further support. This paper looks at ways to improve this support and demonstrates ways in which services can be developed to meet clients' needs.
Renewal of Section 3 of the Mental Health Act: a clarification of the law
Authors: Keys Robert
Published: August 2011

There is some confusion over the use of Section 20 of the Mental Health Act. Case law may continue to inform our understanding in this challenging area of forensic practice.
Restraint versus Restraints: defining the concepts for review and measurement
Authors: Macilwaine Helen , Watson Carole , McKenzie Ian
Published: August 2011

There are considerable differences between the USA and the UK in terms of the practice of in‐patient care, particularly in the use of restraint. The American legal system defines restraint in terms of physical, mechanical, and chemical restraints, of which only physical and chemical restraints are routinely used in the UK. There is a need to agree a standard definition of restraint as it is used in the UK, which may be valuable as one proxy for quality. Such information would enable nurses to make appropriate use of the published literature, make valid comparisons within and between institutions, and provide evidence about the kind of nursing education and nursing practice development needed to produce quality patient care.
Policy and Practice in Suicide Prevention
Authors: Jenkins Rachel , Singh Bruce
Published: August 2011

Governments have increasingly directed attention to reducing mortality and morbidity due to a variety of causes. This paper provides an international review of policy and practice in suicide prevention. The role of national policies and practice are outlined and discussed. The value of a co‐ordinated approach to reducing the burden of disease due to suicide and parasuicide is stressed.
Reflections on risk assessment: suicide in prisons
Authors: Crighton David
Published: August 2011

The area of risk assessment of suicide in prisons is addressed. The role of mental disorder, anger and violence are considered. A theoretical model of suicidal behaviour is presented. The value of such models, as a means of integrating research data into evidence‐based practice is reviewed.
Suicide Prevention within New York City Department of Corrections Facilities
Authors: Snow Louisa
Published: August 2011

The approach to suicide prevention recently implemented by the New York City Department of Corrections (NYDoC) is outlined. Comparisons are reported between New York City and other areas within the United States. A dramatic fall in suicide rates has been evident in the NYDoC that has not been seen elsewhere in the United States. The way in which this has been achieved is outlined and discussed.
Time and Confinement: Towards a Common Sense of Socio‐temporality in a Special Hospital
Authors: Chandley Mark
Published: August 2011

Special hospitals are notorious for their social isolation. In this sense they are not unlike tribal societies. These hospitals, like their tribal counterparts, are ripe for local time reckoning to emerge. A previous study that focussed on tribal societies is used here to illustrate socio‐temporal issues ‐ primarily because of their social isolation, which is comparable with the isolation from wider society of the special hospital, a factor that is essential for local time reckoning to emerge at any significant level.
Applying Theory and Research to Offender Rehabilitation ‐ What Should Practitioners Know?
Authors: Day Andrew , Howells Kevin
Published: August 2011

Surveys of offender treatment programmes have revealed that practitioners delivering specialist programmes are often unaware of much of the theoretical and research literature behind the interventions they deliver. For practitioners working less routinely with offenders, such as forensic nurses, this problem is likely to be more acute. In this paper, we provide a general overview of the theoretical and research literature relevant to programmes targeting sexual and aggressive offending that should be of interest to a range of professionals working with offenders in different clinical settings.
Prisons as Schools of Crime ‐ a Myth Debunked?
Authors: Dennis Warren
Published: August 2011

Prisons have been considered ‘schools of crime’ (Walker, 1995) This study examines this notion in relation to burglary. Questionnaires and a burglary‐related task were completed by 31 participants in a category B prison. A correlational analysis was used to examine how knowledge of burglary‐specific cues and antecedents to crime might increase with time spent in prison. The effect of antecedents was also analysed with respect to the perceived burglary‐difficulty of a property. No changes were found with time for the specific cues (eg barriers to the property) but were present for one antecedent, self esteem (P<0.05), for the burglary group. An example of a predictor of perceived burglary‐difficulty was risk‐taking behaviour. The results are interpreted as indicating that prisons do not act as ‘schools of crime’. Future research possibilities are then discussed.
A Comparative Study of Stress Among Forensic and Acute Mental Health Nurses
Authors: Chalder Gill , Nolan Peter
Published: August 2011

This study sought to address one of the most critical issues that mental health professionals endure in modern health care, namely stress at work. Though it has been discussed for some time in the literature relating to mental health services, it still remains one of the biggest impediments to the provision of high quality care. In this study, two groups of mental health nurses were compared: forensic and acute mental health nurses. Stress levels were ascertained using a standardised assessment tool, the Mental Health Professional Stress Scale (MHPSS). Though both groups reported high levels of stress, no significant differences were found between them. Though both groups perceived certain aspects of their work as being stressful, each group identified different causes for stress within their respective work environments. This paper discusses some of the implications of these findings and highlights the importance of protecting staff from unpropitious work environments and burn‐out.
New Law, New Enlightenment? Will Reform of Current Mental Health Legislation Lead to Improved Care for Mentally Disordered Offenders?
Authors: Humphreys Martin , Kenney‐Herbert Jeremy
Published: August 2011

This paper sets current proposals for reform of mental health legislation in the context of historical development of care for mentally disordered offenders and those who require similar services. The authors reflect on the fact that the National Service Framework and the various documents related to reform of the Mental Health Act 1983, seem to do little to address the area of the treatment of people suffering from psychiatric disorders who fall foul of the criminal justice system and bring little that is new to the field of forensic practice. They suggest that the ‘safety first’ approach seems still to be paramount.
A Review of Forensic Learning‐disability Research
Authors: Lindsay William , Macleod Fiona
Published: August 2011

This paper reviews several issues in relation to offenders with intellectual disabilities. Although some authors have indicated an increased prevalence of offenders amongst the population of individuals with intellectual disabilities, other carefully controlled studies using recognised IQ tests have found only slightly increased incidences. Studies conducted in forensic settings have reported results somewhat different to those conducted in clinical settings with respect to both prevalence and characteristics. It is noted that individuals with learning disabilities commit offences across the spectrum of criminal behaviours but there may be some over‐representation in sexual offences and arson. Issues of assessment and treatment are also addressed with comments being made on extensions of interventions into community settings. With the amount of research increasing over the last 10 years, we are becoming clearer about the relevant issues involved in designing studies, developing assessments and providing treatment to this client group.
Clinical Risk Assessment for People with Learning Disabilities Who Offend
Authors: Taylor John , Halstead Simon
Published: August 2011

The England and Wales National Health Service (NHS) Executive's guidance on the discharge of mentally disordered people, including those with learning disabilities, requires that risk assessment is a component part of the Care Programme Approach (CPA). The guidance indicates that whenever possible, risk assessments should be carried out systematically using a standardised approach. For a number of reasons, practitioners are resistant to moving away from reliance on clinical judgements when making their assessments. This paper explores the issues underlying this tension. A solution is offered to the difficulty clinicians often experience in incorporating risk assessment tools into their clinical practice. A case example is given to illustrate how clinical assessments of offenders with learning disabilities can be utilised to estimate the risks presented. By demonstrating this procedure, a protocol for reaching clinically defensible decisions about the risks presented by clients is described, which also allows for the targeting of priority therapeutic and management interventions.
Police custody: An area of concern?
Authors: Blaauw Eric
Published: August 2011

This article describes three studies on several aspects of police custody in The Netherlands. The first study shows that the quality of accommodation, facilities, interaction and differential treatment are substandard in Dutch police stations, but dependent of the organisational size, degree of specialisation of the custodial task and extensiveness of duty‐prescriptions and registration. Detention circumstances in police stations are worse than in remand centres. The second study reveals high prevalence rates of symptoms of depression and somatisation (SCL‐90) among police custody detainees. Police custody detainees' symptom levels are higher than those in a jail population and a male general population. The third study addresses the prevalence rates of suicides and other deaths in Dutch police custody in the period 1983‐1993 and shows that the mortality rate, suicide rate and deadly poisoning rate are higher than those in remand centres and the general population. The findings of the three studies demonstrate that police custody is an area of concern.
Measuring Insight in a High‐security Forensic Setting Using the Behavioural Status Index
Authors: Woods Phil , Reed Val , Collins Mick
Published: August 2011

One of the challenging facets of mental health care can be that of trying to deal with a patient's level of insight. Problems that seem apparent to assessing practitioners are sometimes not regarded in the same way by the patient. Measuring a concept like insight is not easy. The Behavioural Status Index (BSI) breaks insight into components and measurable criteria. Such a measurement instrument provides opportunities for detailed analysis of function, opportunity for very specific interventions, further detailed assessment and measurement of progress. This paper begins with a theoretical introduction to the concept of insight and a description of the BSI. Data analysis then follows for the BSI insight subscale. Data were collected, using a repeated measures method from a sample of 503 individual patients in two high‐security mental health hospitals. Results are reported for the central tendency and spread of items; the differences between the Mental Health Act 1983 classifications of mental illness, psychopathic disorder and learning disabilities, patient‐ward dependency level and gender; and the relationship between items, within the subscale. The relationship between items suggests two distinct groupings of acceptive (the ability to recognise and differentiate inner feelings of tension or anger) and cognitional (conscious awareness of inner states) behaviours.
The Role of the Forensic Nurse Consultant Observed
Authors: Chalder Gill , Nolan Peter
Published: August 2011

A survey of the views of members of a forensic mental health team on the post of forensic nurse consultant was carried out by means of a questionnaire. All respondents were supportive of the development of the post and hoped that the consultant would be the ‘voice’ of nursing, a strong individual with the confidence and competence to challenge traditional interprofessional boundaries and to raise the profile of mental health nurses within the clinical team. Concerns, however, were expressed that the post might have too many facets and that the consultant could become a victim of elevated expectations, unable to meet all the demands. Respondents advised that in order to avoid consultant burnout, the role needs to be clearly defined, to retain a clinical focus and to provide time for continuing professional development. For postholders to be effective, it is essential that they are supported at all levels of the organisations in which they work.
Nursing In‐Patients with Personality Disorder: a Schema‐Focused Approach
Authors: Murphy Naomi , McVey Denis
Published: August 2011

Research suggests that the majority of forensic clients have significant personality difficulties. Providing quality nursing care to this client group is identified as particularly difficult. This paper outlines how schema‐focused therapy has been introduced to nursing staff working with personality disordered clients in an in‐patient setting in order to enhance their practice with this client group. A brief overview is given of Young's (1994) schema‐focused therapy model and a detailed description of how this model has been incorporated into in‐house training and used to guide nursing treatment plans and individual nursing interventions. Although this strategy has not been formally evaluated, feedback suggests that both staff and patients believe that the quality of care provided since its introduction has improved significantly.
Medication, Schizophrenia and the Forensic Multidisciplinary Team
Authors: Stubbs Jean , Haw Camilla
Published: August 2011

This article examines the issues involved in the treatment with antipsychotic medication of forensic patients with schizophrenia. Poor compliance with medication may lead to a worsening of positive psychotic symptoms and increase the risk of re‐offending. Nurses and other members of the forensic multidisciplinary team spend long periods of time with patients and may form close therapeutic alliances with them. These staff have an important role in helping patients with medication‐related issues, thereby improving treatment outcome.
Control and restraint in the UK: service user perspectives
Authors: Sequeira Heather , Halstead Simon
Published: August 2011

This study examines the experiences of physical restraint procedures reported by in‐patients of a secure mental health service. Interview data were subjected to thematic content analysis in accordance with grounded theory methodology.Patients had differential experiences of similar physical procedures. Most reported some negative psychological experience of restraint. Anger and anxiety were two major themes. Some respondents held the perception that restraint was used to punish patients and several suggested that restraint incited further violence and aggression. Some female service users reported that restraint evoked flashbacks of previous sexual trauma.A subset of female respondents gave contrasting accounts of restraint, suggesting that they purposely brought about the restraint to gain a sense of containment or as a way to release feelings.Possible implications of these responses for clinical practice are discussed.
Mentally disordered offenders: the need for a diversion service in a rural area
Authors: Jones Chris , Jones Brenda , Ward Shirley
Published: August 2011

Over the last decade many ‘diversion from custody’ schemes have been established and there is evidence of their effectiveness in reducing the number of mentally disordered offenders inappropriately remanded in custody. In North Wales there has been pressure to establish such a scheme but it is not clearwhether models developed in large urban areas are applicable to the problems of a rural community.This paper describes a study of male prisoners remanded in custody from North Wales during a four month period to identify need for such a service. In four months 298 prisoners were remanded from North Wales. Only seven courts remanded more than 16 (equivalent to one remand per week); the busiest court remanded 83, equivalent to five per week.In total, 42 prisoners reported a history of mental disorder; records were available on 28 of these, of whom ten were considered to have a mental disorder requiring admission.Only a small number of individuals in this study required diversion from custody (approximately one per week), but in those cases there was significant unmet need. The conclusion was that an effective diversion scheme would have to be able to provide a service to numerous and widely spread courts, most with a low level of activity.
Section 2 life‐sentenced prisoners: an exploratory study
Authors: Brady Karen , Dennis Warren
Published: August 2011

This paper reports the findings of an initial exploratory study of the section 2 life‐sentenced prisoner population within one large prison in the south of England. Data were collected on 18 section 2 life‐sentenced individuals within the prison population and analysed to identify significant differences between those sentenced for ‘acquisitive’ offences and those sentenced for an offence of ‘violence’.Violent offenders were significantly more likely to have a higher level of violent previous convictions. Both groups were observed to have a high percentage of adjudications for anti‐social behaviour in prison. Importantly, those convicted of an offence of violence were perceived as being at significantly higher risk of suicide and self injury than were those convicted of an acquisitive offence. There was also an elevated level of drug‐related adjudications within the acquisitive offender group. Implications of these findings for practice are discussed.
Psychological services in HM Prison Service and the National Probation Service: working towards an effective partnership
Authors: Towl Graham
Published: August 2011

The numbers of psychologists employed in HM Prison Service have doubled in the past three years to over 600 staff. HM Prison Service is the largest single employer of applied psychologists. With a governmental focus firmly on ‘joined up’ services in the criminal justice field (Boateng, 1999), the launch of the National Probation Service (NPS) in April 2001 has set the scene for closer partnership working between the two organisations. There has not historically been a national structure for the employment of psychologists in the probation service. With the creation of the NPS and an increased emphasis on partnership working, a national integrated role for psychologists is ripe for development. This presents both organisations with some significant partnership challenges and opportunities (Towl, 2000).
An opinion survey of mentally disordered offender service users
Authors: Vaughan Phillip , Stevenson Susan
Published: August 2011

An opinion survey of mentally disordered prisoners was undertaken to ascertain their views on the responsiveness of mental health and criminal justice services to their perceived needs while in the community.The findings reveal that their illness and offending behaviour were not deemed serious enough to warrant intervention by forensic psychiatric services but their needs were too complex for mainstream community care services. They felt vilified and marginalised by many professional workers and were unlikely to seek help themselves. Psychiatric intervention was therefore usually precipitated by a crisis. Hospital and prison aftercare was not always pursued, leading to deterioration in mental health and/or offending behaviour, followed by further detention.The authors argue the need to broaden the referral criteria of community agencies to avoid excluding MDOs. They make a number of recommendations to ensure this vulnerable group receives adequate ongoing care and support following release.