bluuebunny/crossref_metadata_2025 huggingface dataset:
European Knowledge Centre for the Prevention of and Response to Sexual Abuse of People with a Learning Disability
Authors: Lesseliers Joan , Madden Phil
Published: September 2011

The purpose of the project was to establish a European Knowledge Centre for the Prevention of and Response to Sexual abuse of People with a Learning Disability. The idea of founding a Knowledge Centre originates from the need for systematic structural support for exchanging information and knowledge about sexual abuse ‐ particularly for and from a service provider's perspective. Because of the negative impact of abuse, early and appropriate assistance is very important. Preventative work in educating people with learning disabilities about sexuality is also vital, to enable them to make informed relationship and sexual choices and to cultivate greater resilience. The Knowledge Centre is easily accessible, allowing enquirers to gain information and to be linked to other services and networks to learn about their experiences and research, and to forge new links.
Screening Adults with Down's Syndrome for Early Signs of Alzheimer's Disease
Authors: McBrien Judith , Whitwham Sarah , Olverman Karen , Masters Stuart
Published: September 2011

Given the now well‐recognised risk of Alzheimer's Disease (AD) for adults with Down's Syndrome (DS) as they reach middle age, services for people with learning disability (LD) need to meet this new challenge. Good practice guidance from the Foundation for People with Learning Disabilities (Turk et al, 2001) recommended that every service for people with learning disability should set up a register of adults with DS, conduct a baseline assessment of cognitive and adaptive functioning before the age of 30 years, develop specialist skills in this area, offer training to other professionals, front‐line staff and carers, and seek high‐quality co‐ordination between agencies. This article reports the progress of one LD service in meeting these challenges, highlighting the successes and difficulties that may guide other teams considering such a development.
Quality Development in Supported Living Services for People with Learning Disabilities: Introducing AQUA‐UWO
Authors: Aselmeier Laurenz
Published: September 2011

This paper reports on the manual AQUA‐UWO, an instrument for quality development in supported living services developed by a research group at the Centre for Planning and Evaluation of Social Services at the University of Siegen in Germany. The extension of supported living services in Germany is still marked by conceptual and financial uncertainty. Debates about the concept and quality of supported living are still not advanced. Against this background, AQUA‐UWO identifies key issues for supported living and formulates professional standards for work in, and management of, supported living. Service user rights for self‐advocacy and self‐determination form the basis of quality assurance and development of supported living services. The first part of the instrument covers conceptual foundations, quality comprehension and methodical procedures. The second part covers key issues, identifies working procedures and clarifies quality standards. The third part includes materials which can be used to support the process of quality development.
Evaluating the Impact of Family Therapy for Adults with Learning Disabilities and Their Families
Authors: Baum Sandra
Published: September 2011

Evaluating a family therapy service for adults with learning disabilities and their families presents a challenge to clinicians. To begin this process we focused on collecting data from the first and last sessions, by using our own tools developed to assess whether goals identified at the beginning of therapy had been achieved at the end. Routine information was also collected from the nine families seen by the team, including number of sessions, duration of interventions, major themes and models of intervention used. The results suggest that the evaluation tools were being used consistently by the different raters. Socio‐demographic data and details of interventions of all families seen are also summarised. Although we are still in the early stages of assessing whether the service we provide is effective, some encouraging results are evident, enabling us to continue to refine our methods of evaluation.
Gender Identity, Cross‐Dressing and Gender Reassignment and People with Learning Disabilities
Authors: Wilson Daniel
Published: September 2011

This paper addresses the question of gender and identity in relation to a number of considerations for supporting men with learning disabilities who cross‐dress (wearing the clothes of the opposite sex), or want gender reassignment (accessing hormonal and surgical treatment to develop the physical characteristics of the opposite sex). Drawing on practice experience, it identifies a number of issues which will need to be considered when working on these topics, and presents a model for taking forward work with staff and service users.
Parents with Learning Disabilities: An Audit of Referrals made to a Learning Disability Team
Authors: Elvish Jennifer , Hames Annette , English Sue , Wills Caroline
Published: September 2011

Annual increases in the number of parenting referrals made to a learning disability team over a ten‐year period led to this audit. The increase in the number of these referrals highlights a growing need for services to support parents with learning disabilities, to ensure that children remain in the family home wherever possible. Previous research has identified several factors that may reduce a learning‐disabled parent's ability to parent his or her children effectively, including social and familial issues. This audit aimed to examine the relationship between parents' demographics and children's outcomes, specifically whether children were removed from the family home. Information was gathered from the files of both the learning disability team and social services, and involved all parenting referrals made to this team between 1994 and 2003. The findings of this audit suggest that the earlier services can become involved with parents, the better the outcomes for their children will be. If services do not become involved early on, the children are more likely to have developmental problems, and once child protection proceedings have begun there is a very high likelihood that children will be removed from the family home.
Person‐Centred Approaches and Quality of Life
Authors: Beadle‐Brown Julie
Published: September 2011

This mainly conceptual paper summarises the current conceptualisation of personalisation as it applies to people with learning disabilities. It goes on to map out how the drive towards the personalisation of services, its most recent iterations of person‐centred planning, person‐centred funding and person‐centred action, contributes to a better quality of life for people with intellectual disabilities, using the domains and indicators of quality of life set out in the Schalock et al (2002) international consensus. In doing so it describes what you would see in services where person‐centred approaches were being successfully implemented.
An Insight into Implementing Person‐Centred Active Support
Authors: Rhodes Junelle , Hamilton David
Published: September 2011

This paper provides reflections on the implementation of an active support staff training programme for staff working in community residential facilities for adults with an intellectual disability. Outcomes for the people with an intellectual disability were consistent with recent research findings indicating that active support can lead to improved opportunities for participation in everyday activities within the home. We propose that the success of the training programme was largely influenced by three key elements: ensuring that there is expertise in, and support for, this approach to service provision among key service managers, provision of in vivo one‐to‐one practical staff training in addition to classroom‐based theoretical input, and inclusion of elements of person‐centred planning approaches in combination with active support. Future research should focus on how best to maximise the effectiveness of active support staff training.
Asperger's Syndrome
Authors: Attwood Tony
Published: September 2011

This paper provides a brief overview of research, knowledge and practice regarding Asperger's syndrome, an autistic spectrum disorder that has only recently been acknowledged by clinicians. The paper reviews our knowledge of the degree and nature of the impairments of social understanding of such individuals, especially their problems with making and keeping friends, perception of social and emotional cues, understanding and management of emotions, and ability to recognise the thoughts and feelings of others. Difficulties with communication and conversation skills are explained, as well as the person's tendency to develop areas of expertise and special interests. People with Asperger's syndrome have an unusual profile of cognitive abilities; some have signs of movement disturbance and some are extraordinarily perceptive of sensory experiences. The prevalence and aetiology of Asperger's syndrome are discussed briefly.
Assessing the Quality of Service Provision for People with Challenging Needs Placed out of Borough
Authors: Becker Paul
Published: September 2011

This paper describes the secondment of a health professional to the care management team to assess the efficacy and cost‐effectiveness of out‐of‐borough placements for individuals who present challenging behaviour. Lambeth Partnership agreed that dedicated psychologyl challenging needs time of a practitioner with more than 10 years' experience in the borough would be available to the care management team, creating collaborative working and enhancing the existing service. To assess the quality of services, a questionnaire was developed that covered demographics, types of service provision and intervention package employed (including monitoring and outcome measures), implementation of person centred‐planning (PCP) and the views of the key stakeholders. This paper summarises the findings of five months of assessing the quality of service provision for people with challenging needs placed out of the London Borough of Lambeth.
Learning Disability and Sexual Abuse: Use of a Woman‐Only Counselling Service by Women with a Learning Disability: A Pilot Study
Authors: Howlett Sue , Danby Joanne
Published: September 2011

This paper reports on a pilot study on how women with a learning disability access a mainstream rape crisis centre, used by women who had been sexually abused at any time during their lives. It examines how the pilot was set up, criteria for inclusion, monitoring and evaluation, the outcomes for the women who accessed it and its benefits. The paper also looks at issues raised by the work and future ways of helping other providers to make their services inclusive and open to this group, and makes general recommendations.
‘I Count Myself as Normal, Well, not Normal, but Normal Enough’ Men with Learning Disabilities Tell their Stories about Sexuality and Sexual Identity
Authors: Wheeler Paul
Published: September 2011

Discussion of sexuality and its expression is commonplace. Looking in a newspaper or turning on the television provides evidence of this. It is also a topic of discussion among academics from various backgrounds. However, in relation to people with learning disabilities, such discussion is often framed in negative terms and is concerned with such things as abuse, HIV and STIs, ‘unwanted’ pregnancy and challenging sexual behaviour. There is little published research into the question of how men and women with learning disabilities experience their sexuality or sexual identity. This study sought to explore how a group of men with learning disabilities in South Wales experienced their sexuality and sexual identity, using an interpretative phenomenological analysis. It found that, although the participants saw themselves as sexual beings, their opportunities for expressing their sexuality were often limited and controlled by others. It also found that the participants saw themselves more in terms of their ‘differences’ from other men than of their similarities. Recommendations for changes in practice and policy that may facilitate the appropriate expression of sexuality by men with learning disabilities are made.
A Psychosocial Profile of Hospital‐Based Adults with Learning Disability Prior to Community Relocation
Authors: Newman David , Platten Melanie
Published: September 2011

Following the implementation of key actions resulting from Valuing People (DoH, 2001), people with learning disabilities resident in hospital will be relocated into the community. This paper examines psychological, social and quality of life indicators applied to a group of 50 service users, 36 of whom are soon to be relocated into community housing. The methodology employs a range of psychometric measures in order to describe intellectual and social functioning, mental health, levels of challenging behaviour and quality of life and choice opportunities. The aim was to compile a profile of the individuals as a group in order to inform service planning and provision. Results illustrate that the group contains a range of individuals with complex and enduring needs. A discussion of the opportunities and challenges that lie ahead for these individuals and the services that support them is presented. The study presents an opportunity to re‐apply this methodology in future years in order to evaluate whether community living has brought tangible benefits to the group.
Supported Employment in Scotland: Some Issues from Research and Implications for Development
Authors: Hunter Susan , Ridley Julie
Published: September 2011

This article arises from the authors’ experience of undertaking research on behalf of the Scottish Executive, following the deliberations of a national working group focusing on employment (Scottish Executive, 2003) set up to progress the recommendations of the Same as You? review (Scottish Executive, 2000), Scotland's equivalent of Valuing People (DoH, 2001). The detailed findings of the research study and its methodology can be found elsewhere(Ridley et al, 2005); only a brief summary is given here. The main purpose of this article is to contribute to a debate about the achievements and under‐achievements of supported employment in the contemporary Scottish context. The research findings are used to discuss where we are now, some of the main problems, and how policy and practice need to move forward and develop. We suggest that the time is ripe to initiate strategic change in policy and professional practice. Supported employment must be firmly embedded in the wider employment landscape and the practice agenda of professionals, in order to ensure that real, paid jobs in integrated settings become a routine option for people with learning disabilities who express these aspirations.
What is the Effect on a Child of Having a Parent with Learning Disability?
Authors: Hewitt Olivia
Published: September 2011

The number of parents with a learning disability is growing rapidly, as the closure of institutions and the rise of community living encourage this population to take on roles that were previously denied to them (DoH, 2001). People with a learning disability are seen as people first, with the right to be a parent and raise a child, a valued role in society. The rise in the number of parents with a learning disability can also be attributed to the discontinuation of enforced sterilisation and increasing opportunities to form relationships in which consensual sex is accepted and supported (Martin & Ticktum, 1987). Accordingly, the research on the ability of parents with learning disability to provide adequate parenting is expanding. However, research on the effect on the child of having a parent with a learning disability is still limited. This article will first look at the literature on factors affecting the ability of parents with a learning disability to care for their children adequately. The effects of having a parent with a learning disability will then be considered, and finally the implications for clinical practice will be outlined.
Investigating the Experiences of People who Have Been Homeless and are in Contact with Learning Disability Services
Authors: Hebblethwaite Amy , Hames Annette , Donkin Martin , Colman Mark , Forsyth Alison
Published: September 2011

This paper explores the experiences of people who have been homeless and in contact with learning disability services. The research adds to the very limited evidence, particularly in the UK, on how services can better meet the health and social needs of this group. All people with learning disabilities who were homeless and known to either local social services or health learning disability services in a large city in the North East of England were identified. Semi‐structured interviews were conducted with 14 participants at their current accommodation. Content analysis was used to identify common themes. Interview data indicated that breakdown of social support was the main cause of homelessness, and that in temporary accommodation people with learning disabilities were vulnerable to exploitation by other residents. Concerns were also expressed about the quality of housing, mental health was a recurring theme and the importance of ensuring that people with learning disabilities receive adequate treatment for these difficulties is discussed. Access to health care in general is facilitated by support in arranging and attending appointments. Mediation services may play a key role in preventing people with learning disabilities from becoming homeless through relationship breakdown. The study also suggests that improvements in temporary accommodation are needed, including housing designed specifically for people with learning disabilities, in order to react effectively to episodes of homelessness.
Successful Multi‐Disciplinary and Multi‐Treatment Working for a Person with Learning Disability who Experienced Major Depressive Disorder
Authors: Mackay Fiona , Wilson Claire
Published: September 2011

Janette1 is a young woman with both a mild intellectual disability and moderate physical disabilities who experienced a major depressive disorder at a stage in her life when many young adults leave home. This case study exemplifies the success of a multi‐disciplinary, multi‐agency and multi‐element intervention for severe depression in relation to the tasks of adolescence. The impact of a combination of treatments (including attendance at an assessment day unit, electro‐convulsive therapy (ECT) and cognitive behavioural therapy (CBT)) on Janette's mood has been assessed regularly using the Glasgow Depression Inventory ‐ Learning Disability (GDS‐LD) scale (Cuthill, 2003). There is currently very little literature on either using ECT with people with learning disabilities or assessing depression in this population. The multiple inputs, in Janette's case, have had the desired effect of greatly improving her mood, which has been sustained via outpatient follow‐up and tailoring of day and respite services.
An Evaluation of the Introduction of Facilitated Person‐Centred Planning with People with Learning Disabilities Leaving a Hospital Setting: Sharing the Knowledge
Authors: Cook Tina , Abraham Lucy
Published: September 2011

This article considers some of the issues raised by an evaluation of facilitated person‐centred planning (PCP) for six people with severe and complex learning disabilities residing in a long‐stay hospital. The hospital is earmarked for closure, and all six are to be resettled. Using a realist approach, evaluators explored such questions as whether the views of people with severe learning disabilities had been accessed, what makes PCP person‐centred and who should participate in a plan. These questions raised awareness of the effect of timescales and a selective training programme in relation to PCP, and the impact this has had on effective person‐centred planning.
Copying Letters to Patients: Views of Professionals Working with People with Learning Disability
Authors: Sawhney Indermeet , Morgan John , Tajer Afsaneh
Published: September 2011

The National Health Service Plan (DoH, 2000) requires that patients receive copies of correspondence between health professionals about them, as of right. Patients with learning disabilities are not exempt from this rule. Copying letters to patients with learning disabilities is undoubtedly going to be challenging and complex for professionals working with them and, because of the heterogeneous nature of this group, specific guidelines need to be in place to support professionals in this task. The aim of the study was to ascertain the views of various professionals working in learning disability teams, on the copying of clinical letters to patients and their carers. The majority of respondents commented that, if letters are copied to patients with learning disabilities, then the persons may find it difficult to understand them, and a separate ‘simpler’ letter may need to be sent. Despite expressing concerns about this policy, the majority stated that they will be sending copies of letters regularly in their clinical practice in the future.
Health Inequalities Experienced by People with Learning Disabilities: Problems and Possibilities in Primary Care
Authors: Nocon Andrew , Sayce Liz , Nadirshaw Zenobia
Published: September 2011

It is well documented that the health of people with learning disabilities is worse in many ways than that of the rest of the population, and their lives are shorter. The article reports on the results of a wide and diverse research programme, including reviews of the relevant literature, consultation, area studies and an inquiry panel, designed to gather the most complete picture possible of these health inequalities and the aspects of health services that permit them. The areas covered are morbidity, access to services, diagnosis, health problems, health promotion, health checks and services for people from black and minority ethnic populations. Inequalities are found in all these areas, some arising from professional prejudice, some from inadequate responses to characteristics shown by learning‐disabled people and some from unidentified causes. The article concludes with a summary of the measures needed to rectify the situation.
Working Systemically in a Learning Disability Service: What do Colleagues and Carers Think?
Authors: Smyly Selma , Elsworth Julie , Mann Judith , Coates Emma
Published: September 2011

Telephone interviews were conducted with 64 participants who attended an initial systemic consultation meeting within a community‐based psychology service for people with a learning disability. Most participants found the sessions helpful and liked the reflecting conversations, which they said broadened their views on the presenting problems and offered a positive approach to the meeting, as well as enabling as many views as possible to be heard. However, depending on whether they were carers, colleagues or client and family members, participants' views varied on how prepared and comfortable they felt about the format of the meetings. The authors felt that the results lend support to the overall helpfulness of using an initial systemic consultation meeting when working with this client group.
Love and Loving Relationships in People with Learning Disabilities: A Scientific Approach
Authors: Morentin Raquel , Arias Benito , Jenaro Cristina , Rodríguez‐Mayoral J , McCarthy Michelle
Published: September 2011

Love has been a recurring theme through history and literature, and its relevance to health, well‐being and quality of life has been widely acknowledged. However, the scientific study of love has not yet reached people with learning disabilities. The study reported here was based on research with 376 people with learning disabilities in Spain, and aimed to analyse their appraisal of love, loving relationships and related issues (global evaluation, satisfaction, role of the family and self‐determination). A Likert‐type measure was developed, and the outcomes indicate that the measures have satisfactory psychometric characteristics. It is also evident that the theoretical model of love for people without disabilities can be applied to individuals with disabilities, and includes three key factors (‘commitment, stability and idealisation’, ‘passion and physiological arousal’ and ‘intimacy and romanticism’). It also indicates that the perceptions of love in people with learning disabilities are relatively idealised and influenced by context, and interference from family and self‐determination are key issues.
Learning disability policy in the UK
Authors: Whitehead Simon , Curtice Lisa , Beyer Stephen , McConkey Roy , Bogues Siobhan
Published: September 2011

This article provides separate, but linked, overviews of learning disability policy in the four countries of the UK, commenting on current policy and its links to the wider policy agenda, delivery strategies and challenges for the future. The authors are each responsible for the element relating to their country.
Health checks and people with learning disabilities
Authors: Cobb Janet , Giraud‐Saunders Alison , Kerr Mike
Published: September 2011

This article addresses the need for health checks for people with learning disabilities as a proven route to identifying and tackling health inequalities, what health checks should look like (covering physical and mental health) and how they should be followed up, and how practices and primary care trusts (PCTs) can implement health checks, involving people with learning disabilities and family carers and drawing on the expertise of community learning disability teams. Experience from Wales and England of offering health checks is described, and some key learning points are drawn out. In particular we recommend the appointment of a strategic health facilitator to lead the introduction of health checks and to ensure that the results are used to improve the health and health care of the population of people with learning disabilities.
Residential schools for children with learning disabilities in England: recent research and issues for future provision
Authors: McGill Peter
Published: September 2011

Approximately 3000 children and young people with learning disabilities attend residential schools or other residential placements. Many of these young people have complex needs, and their placement reflects a failure of local provision to support their families and provide inclusive local services. Such placements reduce family contact, increase young people's vulnerability and accentuate the difficulties of transition to local adult provision. We should reduce the need for residential school placements by substantially improving the quality of family support and the capacity and inclusiveness of local services. Returning young people to their local communities requires a significant improvement in local authority planning so that local capacity can be developed to meet their needs.
A better life: the implementation and effect of person‐centred active support in the Avenues Trust
Authors: Beadle‐Brown Julie , Hutchinson Aislinn , Whelton Beckie
Published: September 2011

Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person‐centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid both to training staff and to the motivational structures within the organisation. Both the quality of support provided by staff and the level of engagement increased significantly after the introduction of person‐centred active support. In addition, people experienced decreased self‐stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learnt about the implementation are provided.
Deinstitutionalisation and community living for people with intellectual disabilities in Austria: history, policies, implementation and research
Authors: Buchner Tobias
Published: September 2011

This article starts with a brief overview of the history of housing for people with intellectual disability in Austria. The system of care and Austrian disability policy are also examined, focusing on implementation of deinstitutionalisation and community living. The following analysis of services provided in the field of housing for people with intellectual disabilities shows that support is provided in undistinguished, generalised service packages based on a competency model. Academic research on community living is quite rare in Austria, and fails to take into account the subjective perspective of people with intellectual disabilities.
Supporting people with complex mental health needs to get a life! The role of the Supported Living Outreach Team
Authors: Ayres Martin , Roy Ashok
Published: September 2011

This paper reports on the development and service delivery of the Supported Living Outreach Team for people with severe psychiatric, behavioural and forensic needs in a city with a population of 1.1 million. The authors discuss the reasons why the team was formed, and the partnerships it has formed with local housing and care providers in order to enable people with very complex needs to lead ordinary lives in their local communities. The pathway of team involvement is described, starting with the initial assessment, setting up and monitoring of new schemes, through to discharge. Also described are the measures the team uses to monitor its effectiveness, the benefits the team has brought to the service, and the hurdles and barriers it has had to overcome on its journey to support people with complex needs to live safely in their local communities.
The Autism Bill 2008/2009: implications for children and adults with autism spectrum disorder (ASD) and their families, carers and professionals, and the need to differentiate between differences and disabilities
Authors: Mackenzie Robin , Watts John
Published: September 2011

The first autism‐specific piece of legislation in England and Wales, the Autism Bill, put forward by Cheryl Gillan as a private member's bill, has now gone forward to House of Commons committee stage, after attracting almost universal support among MPs, charities and the media. It seeks to redress the widespread lack of local authority provision for the needs of people with autism (defined in the Bill as including all autism spectrum disorders, including Asperger's Syndrome): children, adults (defined as those over 18) and their families. Currently, despite legislative and policy provision for the disabled, many autism spectrum disorder (ASD) children are without appropriate education or assistance before, during and after the transition to adulthood. At least a third of adults with ASD were estimated in the National Autistic Society's report I Exist to be suffering from serious mental health difficulties as a result of lack of support, while families and carers of adults with ASD have been found to be frequently unable to obtain assistance (Rosenblatt, 2008). This article will provide details of the Bill before considering its implications for ASD children, adults and their families.
Valuing Tom: will Valuing People Now change the lives of people with profound and multiple learning disabilities?
Authors: Dawkins Beverley
Published: September 2011

Valuing People Now (DH, 2009) recognises that some people, particularly those with complex needs, have been missing out. It has made ‘including everyone’ a priority for the next three years. With reference to Tom's story, this paper will consider the reasons why people with profound and multiple learning disabilities (PMLD) remain among the most marginalised people in society today, what has changed since Valuing People (DH, 2001) and what needs to change in the next three years of delivering Valuing People Now (DH, 2009) if we are to rise to the challenge of ‘enabling extraordinary people to live ordinary lives’ (McConkey, 1998).
Estimating future numbers of adults with profound multiple learning disabilities in England
Authors: Emerson Eric
Published: September 2011

This article summarises recent work, commissioned by the Department of Health, which estimated the future need for health and social care services for adults with profound multiple learning disabilities (PMLD) in England. This estimation process involved four stages: identifying children with SEN associated with PMLD; adjusting for the effects of child mortality; estimating the number of adults with PMLD in England; and estimating net changes in the number of adults with PMLD in England. The overall findings suggest sustained and accelerating growth in the number of adults with PMLD in England over the time period 2009‐2026 and hence the need and demand for health and social care services for adults with PMLD.
Development of a Crisis Service
Authors: Barker Ingrid
Published: September 2011

A crisis service, with a crisis house, has been developed in East Surrey as part of the implementation of the mental health strategy. This article traces the change process, the way in which the service has developed and identifies learning points for the future.
Integrated Care of Seriously Mentally Ill People Within a General Practice Setting
Authors: Lawton Kenneth
Published: September 2011

In response to workload pressures and increasing demands upon primary care services, the Great Western Road Medical Group in Aberdeen, along with its attached community mental health team (CMHT), offers an integrated approach to the care of seriously mentally ill people in the community. This article describes the service as it is currently operating.
The Clubhouse Model in the UK: a Personal Overview
Authors: MacLean Colin
Published: September 2011

The Clubhouse model is described, from the perspective of an early innovator. Some of the strengths of the model, as one component of a comprehensive local service, and potential weaknesses arising from incomplete replication, are highlighted.
Work ‐ Whose Business is it Anyway?
Authors: Shepherd Geoff
Published: September 2011

Finding employment is often a key element in recovery from mental ill health but, argues Professor Geoff Shepherd, few professionals place work at the top of their list of priorities during their efforts to support clients through rehabilitation. It is, he suggests, time for change. Mental health services need to recognise the importance of employment and accept that it is their business.
The National Service Framework for Mental Health: Progress, Prospects and Priorities
Authors: Boardman Jed , Parsonage Michael
Published: September 2011

It is nearly eight years since the National Service Framework for Mental Health was published, setting ambitious 10‐year targets. This article draws on findings presented in a recent Sainsbury Centre for Mental Health report on progress to date. It concludes that although the framework confirmed the status of mental health as a health priority for the government, a likely shortfall in funding means that goals will not be met in full. The authors stress that this is not a criticism of policy; rather it reflects the ambitious nature of the government's mental health agenda.
Monitoring the Physical Health of Patients on Long‐term Antipsychotics ‐ How Easy Will It Be?
Authors: Ahmad Kauser , Sadiq Fareeha , Bouch Joe
Published: September 2011

The physical health of patients with severe mental illness is often neglected or managed poorly, and regular review of physical health is now being strongly advised. The study described here explored the feasibility of such reviews in a community mental health care setting. A small group of patients was invited to attend for blood tests and a brief physical examination. The findings from the study suggest that the monitoring of patients with severe enduring mental illness is an important but difficult task. It will require careful planning and the engagement of patients, general practitioners and community mental health teams.
An Intervention for Alcohol‐Related Violence
Authors: McMurran Mary
Published: September 2011

Alcohol‐related violence is a social phenomenon and a serious public health issue that features regularly in the headlines. This article describes a cognitive behavioural treatment programme designed to help angry, impulsive drinkers, typically young white men, to control their violence, and outlines research undertaken to assess the programme's effectiveness.
Supporting Change: Implementing New Ways of Working in East Lancashire
Authors: Greenwood Paul , Ryan Tony , Keaveny John , Deo Ripu
Published: September 2011

This article describes the processes undertaken to implement change in East Lancashire adult mental health services through New Ways of Working. The views of users, carers and staff of the services at the start of the project are described, and an overview offered of the development work that took place to support the change. Barriers to change are also described.
Developing and Using Social Capital In Public Mental Health
Authors: Falzer Paul
Published: September 2011

Social capital has played a prominent role in recent initiatives to improve mental health and enhance the quality of services. However, efforts to substantiate a link between social capital and mental health have been daunted by equivocal findings and conceptual confusion. These consequences are in part due to having two prominent approaches that offer disparate and inconsistent accounts about what comprises social capital, how to increase it and how to use it to benefit mental health policy and practice. This paper lays the groundwork for a rapprochement.
Service User Involvement in the National PD Development Programme
Authors: Haigh Rex , Lovell Kath , Lyon Fran , Duggan Maria
Published: September 2011

Abstract This paper is a compilation of four contributions which endeavour to bring together the numerous strands of service user involvement that have been integral to the work, thinking and culture of the National Personality Disorder Development Programme.
Working Across Whole Systems: Using Managed Clinical Networks
Authors: Shields Fiona , Mullen Tom
Published: September 2011

Abstract This article looks at the benefits of and obstacles to using a whole systems approach to plan and deliver personality disorder services. It does so using the example of the Leeds Managed Clinical Network, a community pilot service that employs whole system working to support people with personality disorder.
Society and Mental Health: The Place of Religion
Authors: Shaw Ian
Published: September 2011

As the consumer culture exerts a growing influence, considerable attention has been paid recently to achieving ‘happiness’ and improving mental health via psychological therapies. But is it the case that individuals have ‘something the matter’ with them or more that society is failing to offer a sense of belonging? This paper considers whether it may be helpful to try rebuilding a sense of community and spirituality in people's everyday lives.
Hamlet, the State of Emotion and the International Crisis of Meaning
Authors: Pupavac Vanessa
Published: September 2011

Drawing on Shakespeare, and in particular Hamlet's psychological crisis, this paper examines the relationship between emotions and meaning, a key theme in artistic work since Aristotle but, it is argued, largely ignored in psychology and the social sciences. Now, however, against a background of international terrorism, lessons are being learned from literature's insights.
The Internet: A Place for Different Voices in Health and Medicine? A Case Study of Attention Deficit Hyperactivity Disorder
Authors: Foroushani Pooria
Published: September 2011

Lay people might disagree with the ‘formal’ knowledge of medicine produced in medical schools and the internet has provided an opportunity for them to present their ideas. Attention deficit hyperactivity disorder (ADHD) is a new concept and has always been a controversial topic. Many people are presenting their views regarding ADHD on the web. This article explores a sample of ADHD‐related materials found by Google and evaluates the possible effects that different voices may have on ‘formal’ knowledge.
Opening the Floodgates? The Possible Use of Supervised Community Treatment in England and Wales
Authors: Lawton‐Smith Simon
Published: September 2011

The UK government's Mental Health Act 2007 introduces compulsory supervised community treatment (SCT) to England and Wales. Estimates of the possible level of use of SCT are helpful both to address patient fears and to plan services. The number of patients under SCT is likely to rise over time, although the level of use will depend on a number of contextual variables and whether evidence of clinical and social benefits is forthcoming.
The Inclusion Web: A Tool for Person‐centered Planning and Service Evaluation
Authors: Hacking Sue , Bates Peter
Published: September 2011

Supporting community participation and social inclusion is a key goal of modernised day services but there is a lack of instruments to measure these outcomes. This paper discusses issues around the measurement of social inclusion, presents a pilot study and introduces the Inclusion Web, a strategy to record changes in social networks and environment while supporting the concept of a shared perspective of social inclusion. Two aspects of social and community participation are quantified and tallied over eight life domains: people (personal relationships) and places (institutions that matter to the individual).
Functioning of Individuals with Korsakoff Syndrome: A Pilot Study of Supported Group Living in Northern Ireland
Authors: Irvine Christine , Mawhinney Sonia
Published: September 2011

As rates of dangerous drinking increase, services must improve their understanding of the needs of people with alcohol‐related brain damage such as Korsakoff syndrome (KS). This study looked at indications of change in key functioning areas for four people with KS living in a new supported living environment. The research highlighted the individualised and complex needs of people with KS and suggests that three specific factors may influence changes in functioning.
Impact of the Increase in State Benefits on the Pattern of Expenditure by Patients in a High Secure Hospital
Authors: Harper Sarah , Ferriter Michael , Cormac Irene
Published: September 2011

Obesity and associated health risks are significant problems in the psychiatric population. This study measured the impact of increases in state benefits on patients' expenditure on foodstuff and consequent increase in calorie consumption. Data were obtained on increases in state benefits and stock levels of foodstuff ordered by the patients' shop and snack bar before and after the increase in benefits. Calorie levels of the extra stock were calculated. The results indicate that changes in state benefits led to increased expenditure by patients' on foodstuff and a significant increase in calorie provision.
Whither DSM and ICD, Chapter V?
Authors: Middleton Hugh
Published: September 2011

Consideration is given to the extent to which the DSM and ICD approach to psychiatric case definition and treatment supports clinical activity. Their validity as a way of defining ‘mental illness’ is found wanting and they do not, in themselves, usefully guide treatment. These conclusions are set in a critical realist approach to ‘mental illness’, which draws attention to the legitimacy of several differing perspectives, each reflecting their own sets of interests and allegiances. DSM‐V and ICD‐11 are due to be published in 2012 and 2014 respectively, and their architects are called upon to be clear about which of these constituencies they are representing.
Human Givens Therapy: The Evidence Base
Authors: Corp Nadia , Tsaroucha Anna , Kingston Paul
Published: September 2011

This paper reviews the current evidence base for human givens therapy in the context of mental health. A systematic literature search was conducted from which it is concluded that the evidence base for human givens therapy is currently limited: most evidence proffered is expert opinion supported with brief case studies or anecdotal evidence, with the exception of two descriptive studies both concerning trauma and the rewind technique. This paper calls for further research to be undertaken to examine the effectiveness of human givens therapy and for mainstream mental health, counselling and psychotherapy journals to provide space for healthy debate.
Developing Inter‐professional Training for Conflict Resolution ‐ A Scoping Audit and Training Pilot
Authors: Young Andy , Turner James
Published: September 2011

Managing violence is an important clinical and managerial responsibility within contemporary mental health practice and there have been considerable developments across the country to pave the way for a more ‘standardised’ approach to conflict resolution. Many trusts employ someone to lead on ‘conflict resolution’ but the precise nature of the lead role and the responsibility attached to it vary greatly between organisations. Similarly, some trusts have sophisticated systems for delivering and monitoring conflict training and updates, whereas others do not. The project described here sought to clarify how training for conflict resolution is organised within a sample of mental health trusts in England. Data was generated by questionnaire and telephone interview with trust leads, and the audit findings were then analysed and used to inform an inter‐professional training pilot in one local trust. It is now expected that frontline staff will enter into conflict resolution training as defined by the NHS Security Management Service (2004) and be trained in accordance with a national syllabus of training standards. Audited opinion suggests that the training co‐ordinator role is associated with improved governance in relation to conflict‐resolution training. Arguably, if national benchmarks and standards are to be met in relation to conflict resolution, trusts need to invest in training infrastructure and at least consider the merits of funding a dedicated co‐ordinator role and inter‐professional training.
The Interface Between Dangerous Offender Sentencing and Psychiatry
Authors: Bickle Andy
Published: September 2011

Many violent and sexual offenders are mentally disordered or will develop mental disorders while serving their sentence. The Criminal Justice Act 2003 introduced major changes to the sentencing of 'dangerous offenders'. The disposal given to these offenders has implications for subsequent clinical management in secure mental health units, prison and, ultimately, in the community, particularly when it is an indeterminate sentence. This paper argues that the Act also has implications for psychiatric evidence submitted to the courts in such cases. The changes appear to carry significant resource implications too, especially for community forensic psychiatry.