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Still not receiving the support they deserve ... final evaluation report for the Stella Project Young Women's Initiative

AVA’s Stella Project has been working to improve services for adult women affected by overlapping Domestic Violence (DV) and Problematic Substance Use (PSU) for over ten years. Through provision of training and development work with practitioners, the organisation received frequent requests to advise agencies about how these matters affected younger women. Although this was an issue that was increasingly identified by practitioners, the UK evidence base on how to effectively support such young women was weak. In 2010, AVA successfully sought funding from the John Paul Getty Jnr Charitable Trust for a research and development project to address this gap in the evidence base. Following an open invitation to tender, AVA commissioned Forensic Psychological Services at Middlesex University to conduct the research phase of the project and to evaluate the Stella Project’s intervention with agencies working with young women affected by DV and Sexual Violence (SV) and PSU. The project’s scope allowed the Stella Project to support two London boroughs in developing their responses to these young women. AVA invited all London boroughs to submit an Expression of Interest to be involved. From 14 interested boroughs, AVA selected the London Borough of Enfield (LBE) and the Royal Borough of Kensington and Chelsea (RBKC), primarily because they are different demographically but also based on their strategic commitment to the project and the existence of relevant agencies to participate in the project. In both boroughs, the Domestic Violence Co-ordinator and the Drug and Alcohol Action Team Manager nominated four relevant agencies to participate in the project. Within each borough, agencies were selected to represent both the Violence Against Women and Girls (VAWG) and substance misuse sectors, and to cover the full age range of young women whose needs the project would address (14 to 25 years). In both boroughs, this resulted in representation from the Independent Domestic Violence Advocacy services, the young people’s substance misuse services and the Drug Intervention Programmes (DIPs), and in Enfield, the Youth Offending Service

ADT Final Report: Alternatives to Detention, Douglas County

About the Report The authors of this report are Madison Schoenbeck, Joseph Mroz, Dr. Joseph Allen, Dr. Roni Reiter-Palmon, and Dr. Ryan Spohn. This report includes a variety of new data sources, including interviews with service providers, a focus group with Douglas County intake officers, and a stakeholder survey distributed across Douglas County. Data for this report was collected between May 9, 2016 and November 15, 2017 unless otherwise specified. Funding for this evaluation was generously provided by Douglas County, NE and The Sherwood Foundation, in contract with UNO’s Nebraska Center for Justice Research

The Phenomenological Experience of Student Advocates Trained as “Defenders” to Stop School Bullying

We investigated lived experiences of student-advocates trained in a brief, bystander bullying intervention program to stop bullying as “defenders.” Personal values, taking perceived risks, implementing bullying intervention strategies, and positive sense of self were core themes with a textural-structural description helping define student’ experiences. Implications and future research are discussed

Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: Prevalence and association with burnout

Background: Midwives provide care in a context where life threatening or stressful events can occur. Little is known about their experiences of traumatic events or the implications for psychological health of this workforce. Objectives: To investigate midwives’ experiences of traumatic perinatal events encountered whilst providing care to women, and to consider potential implications. Design: A national postal survey of UK midwives was conducted. Participants: 421 midwives with experience of a perinatal event involving a perceived risk to the mother or baby which elicited feelings of fear, helplessness or horror (in the midwife) completed scales assessing posttraumatic stress symptoms, worldview beliefs and burnout. Results: 33% of midwives within this sample were experiencing symptoms commensurate with clinical posttraumatic stress disorder. Empathy and previous trauma exposure (personal and whilst providing care to women) were associated with more severe posttraumatic stress responses. However, predictive utility was limited, indicating a need to consider additional aspects increasing vulnerability. Symptoms of posttraumatic stress were associated with negative worldview beliefs and two domains of burnout. Conclusions: Midwives may experience aspects of their work as traumatic and, as a consequence, experience posttraumatic stress symptomatology at clinical levels. This holds important implications for both midwives’ personal and professional wellbeing and the wellbeing of the workforce, in addition to other maternity professionals with similar roles and responsibilities. Organisational strategies are required to prepare midwives for such exposure, support midwives following traumatic perinatal events and provide effective intervention for those with significant symptoms

Dynamic and static factors associated with discharge dispositions : the national trajectory project of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada

The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the "least onerous and least restrictive" possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset (N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into account a combination of empirically validated static and dynamic risk factors, as represented by the items of the HCR-20 risk assessment scheme. Particular attention was being paid to the behavior of the patient between hearings (e.g., violent acts, compliance with conditions). Severity of index offense was associated with review board decisions; though index severity is not related to recidivism, it is an important consideration in terms of public perceptions of the justice system and can be related to better established risk factors (i.e., criminal history and prior violence). Historical factors had more influence on the decision to detain someone, while clinical factors were more influential on an AD decision. Disposition stability was the most common trajectory, meaning that a patient with a prior CD disposition was most likely to receive another CD disposition at the next hearing. Static and dynamic risk factors found in the HCR-20 influenced review board determinations, although presentation of a complete structured risk assessment is the exception, not the norm. Results suggest that clinicians recommending less restrictive dispositions are more likely to include a comprehensive risk assessment with their recommendation. An alternative explanation is that, when there is no comprehensive assessment of risk, the review board tends to be more cautious and apply more restrictive dispositions. The practice seems to be contrary to the legislation at the time of the study, given that there should be a presumption that the patient is not a significant threat

A person-centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia-A participatory action study

Background Numbers of people with an intellectual disability and dementia are increasing with a need to reduce associated stress or agitation. This study aimed to identify effectiveness of psychosocial interventions in social care settings and, uniquely, explore use of photovoice methodology to develop dialogue about dementia. Methods This mixed-method participatory action study used goal-setting theory with 16 participants with intellectual disability and dementia, and 22 social care staff across 11 sites. Five co-researchers with intellectual disability were part of an inclusive research team collecting data using existing and bespoke tools including photovoice. Analysis used descriptive and inferential statistics and framework analysis. Results 74% of individual goals met or exceeded expectations with reduction in some ‘as required’ medication. Qualitative findings include themes of enabling care and interventions as tools for practice. Photovoice provided insight into previously unreported fears about dementia. Conclusions Individualised psychosocial interventions have potential to reduce distress or agitation

Melancholic versus non-melancholic depression: differences on cognitive function. A longitudinal study protocol

<p>Abstract</p> <p>Background</p> <p>Cognitive dysfunction is common among depressed patients. However, the pattern and magnitude of impairment during episodes of major depressive disorder (MDD) through to clinical remission remains unclear. Heterogeneity of depressive patients and the lack of longitudinal studies may account for contradictory results in previous research.</p> <p>Methods/Design</p> <p>This longitudinal study will analyze cognitive differences between CORE-defined melancholic depressed patients (n = 60) and non-melancholic depressed patients (n = 60). A comprehensive clinical and cognitive assessment will be performed at admission and after 6 months. Cognitive dysfunction in both groups will be longitudinally compared, and the persistence of cognitive impairment after clinical remission will be determined.</p> <p>Discussion</p> <p>The study of neuropsychological dysfunction and the cognitive changes through the different phases of depression arise a wide variety of difficulties. Several confounding variables must be controlled to determine if the presence of depression could be considered the only factor accounting for group differences.</p