Regional Governance in England: A Changing Role for the Government's Regional Offices?

Debates about the appropriate territorial scales of government to meet the challenges of economic, political and social change have gained momentum in Western Europe in recent years. In the UK, political mobilization has transformed constitutional arrangements in Northern Ireland, Scotland and Wales. By contrast, in the English regions, a less radical approach has been adopted, but the outcome has been a strengthening of the institutions of regional governance. A key feature has been the enhanced responsibilities of the Government Offices for the Regions, which have been encouraged to build on their traditional administrative functions and adopt a more strategic role. This article explores the Offices' contribution to regional and local governance. Our central argument is that although increasingly expected to act as a bridgehead between national and sub-national government and a focus for regional policy coordination, their potential role in filling the missing gap in English regional governance has not yet been fully grasped

Developmental neuropsychiatry: A new model of psychiatry for young people with and without intellectual disability

Deinstitutionalization of young people with intellectual disability means that they are now cared for by families and served by community-based professionals. Normalization, which has been the guiding philosophy for this re-integration, has challenged child psychiatry to accept its responsibility for the mental health of this special needs group. It is argued that this group, with its special mental health needs, has had an influence on the conceptual framework of child psychiatry, particularly our understanding of development. This article examines the influence of the psychiatry of intellectual disability on child psychiatry and the influence of child psychiatry on the understanding of the mental health needs of those with intellectual disability. In particular, the management of young people with intellectual disability has required child psychiatry to expand its understanding of a biopsychosocial approach. Some of the resulting changes and challenges are presented to illustrate the benefits for both child psychiatry and the psychiatry of intellectual disability. The interaction of different conceptual biases has led to a new and broader conceptual spectrum of developmental neuropsychiatry. Developmental neuropsychiatry recognizes the need to integrate social science and preventative strategies at one end of the spectrum, with the genetics, molecular biology of human behaviour and targeted pharmacology at the other, and consider the developmental and interactive nature of such models. This article argues that this emerging, dynamic and broader conceptual framework of developmental neuropsychiatry enhances our understanding of the child mental health of all children. The article looks at some of the implications for assessment, diagnosis and treatment. As mental health needs become a greater public health priority, the advances in basic sciences will reinvigorate this medical specialty and training programmes will need to reflect these. Copyrigh