Pursuing the adoption pathway: the lived experiences of people living with HIV

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Medicine, madness and murderers: the context of English forensic psychiatric hospitals

Approach: We used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and our analysis was informed by Lefebvre’s writings on space. Purpose: The purpose of this paper is to add to our understanding of context by shedding light on the relationship between context and organisational actors’ abilities to resolve ongoing challenges. Findings: Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely. Value: The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned

Blue remembered skills : mental health awareness training for police officers

The Bradley Report (Bradley, 2009) has raised a number of important questions regarding the treatment of individuals who are experiencing mental health problems and find themselves in the criminal justice system. One of the key recommendations is that professional staff working across criminal justice organisations should receive increased training in this area. This paper explores the experiences of two professionals, a mental health nurse and a social worker, involved in providing training for police officers. It goes on to consider the most effective models of training for police officers

A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care : prevalence, treatment, risk assessment and other clinical considerations

Purpose – Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings. Design/methodology/approach – Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews andMeta-Analyses guidelines. Findings – A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed. Originality/value – To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings. Keywords: Autism spectrum disorder, Secure hospital, Asperger’s syndrome, High secure psychiatric hospital, HSPC, Secure forensic setting

Informal mental health patients: what are they told of their legal rights?

Purpose – This study sought to determine what written information is given to informally admitted patients in England and Wales regarding their legal rights in relation to freedom of movement and treatment. Design/methodology/approach - Information leaflets were obtained by a search of all National Health Service mental health trust websites in England and health boards in Wales and via a Freedom of Information Act 2000 request. Data were analysed using content analysis. Findings - Of the 61 organisations providing inpatient care, 27 provided written information in the form of a leaflet. Six provided public access to the information leaflets via their website prior to admission. Although the majority of leaflets were accurate the breadth and depth of the information varied considerably. Despite a common legal background there was confusion and inconsistency in the use of the terms informal and voluntary as well as inconsistency regarding freedom of movement, the right to refuse treatment and discharge against medical advice. Research implications - The research has demonstrated: the value of Freedom of Information Act 2000 requests in obtaining data. Further research should explore the effectiveness of informing patients of their rights from their perspective. Practical implications - Work should be undertaken to establish a consensus of good practice in this area. Information should be consistent, accurate and understandable. Originality - This is the only research reporting on the availability and content of written information given to informal patients about their legal rights. Keywords: Informal inpatient, legal rights, Mental Health Act Code of Practice, voluntary patients, written information. Paper type: Researc

Indirect payments: when the Mental Capacity Act interacts with the personalisation agenda.

This paper reports findings from a study that aimed to explore how practitioners were bringing together the demands of the personalisation agenda, in particular the offer of direct payments (DPs), with the Mental Capacity Act, and to investigate current practices of offering and administering indirect payments for people who lack capacity to consent to them, including the use of 'suitable person' proxies under the new regulations (DH, 2009). The study adopted a qualitative interview-based design; participants were social work practitioners (67) and recipients of 'indirect' payments (18) in six local authorities in England in 2011-2012. The paper reports on five key decision-making points in the indirect payments process: the decision to take on an indirect payment, the assessment of mental capacity, the identification of a suitable person, the establishment of the care recipient's best interests and the decisions about how to execute the indirect payment. We found that practitioners and suitable people had different experiences of the system, although in both cases, there was overarching support for the benefits of enabling people who lack capacity to consent to a DP to receive their social care funding in the form of an 'indirect' payment via a proxy suitable person

The Risk of Unexploded Ordnance on Construction Sites in London

Greater London, among many large cities, was subject to bombing by the German military in both the World Wars and was the target of many air raids during the Second World War (WW2). This was particularly the case during the Blitz, September 1940 – May 1941, when over 28,000 high explosive bombs and parachute mines were dropped on London. Post war research conducted in 1949 estimated that approximately 12,750 t of bombs, including V1 and V2 rockets, were dropped on London. The night of 16th – 17th April 1941 was one of the worst bombing raids, when 446 t of bombs were dropped on London and over 58 t did not detonate. Unexploded bombs remain buried underground today, as they were unidentified at the time or abandoned owing to difficulties in recovering them. Uncharted bombs continue to pose a potentially significant hazard for developments around London. This paper considers the probability of discovering unexploded ordnance (UXO), particularly WW2 ordnance, during intrusive groundworks in London. The prevalence of unexploded ordnance has been assessed using data obtained from governmental organisations to estimate the likelihood of discovery in London

Earnings management in public healthcare organizations: the case of the English NHS hospitals

This paper explores whether NHS hospitals in England managed their earnings upward before applying to the government for foundation trust (FT) status—a scheme that allowed them greater financial freedom and management autonomy—in order to present an overly positive picture and increase their chances for a successful application. The paper shows that NHS FTs adjusted discretionary accruals upward for up to two years before applying for FT status. This practice was negatively associated with their future financial performance. Our study contributes to the growing literature on earnings management in the healthcare sector, by taking an event-study approach applied to this sector when significant institutional changes take place