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In this study we demonstrate how the Health of the Nation Outcomes Scales for secure and forensic service users (HoNOS‐secure) tracks risk and recovery in men with mental illness and men with learning disability in a secure care pathway. Total and individual HoNOS‐secure item ratings made by multi‐disciplinary teams across the course of a period of admission (mean 15 months) for 180 men were examined. There was significant positive change on the clinical and risk‐related scales of HoNOS‐secure for patients in the learning disability care pathway (N = 48) between initial and final ratings. In the mental health care pathway (N = 132 patients) an apparent lack of change masked a more complex picture, where initial decline in HoNOS‐secure ratings was succeeded by significant improvement. Results suggest that it is challenging to measure clinical and risk‐related medium‐term clinical outcomes objectively for these patients, particularly in relation to core issues of treatment of mental disorder, and reduction of both problem behaviour and risk to others. However, it is important that practitioners continue to strive to demonstrate the benefits of care and treatment through appropriate outcomes measures.

The purpose of this paper is to describe how aggressive and violent incidents differ across specialist gender, security and mental health/learning disability pathways in specialist secure care.

The paper uses a retrospective survey of routinely collected incident data from one 207‐bed UK independent sector provider of specialist medium and low secure mental health care for male and female adults with primary diagnosis of mental illness or intellectual disability.

In total, 3,133 incidents involving 184/373 (49.3 per cent) patients were recorded (68.2 per cent other‐directed aggression, 31.8 per cent self‐harm). Most incidents occurred in the medium secure wards but more than half of the most severely rated self‐harm incidents occurred in low security. Men were disproportionately involved in incidents, but a small number of women were persistently involved in multiple acts. Incidents were most common in the intellectual disability pathway.

Incidents, especially those of lower severity, can be under‐reported in routine practice. Information about incident severity was limited.

Aggressive incidents do not occur homogenously across forensic and secure mental health services but differ substantially in their frequency and nature across security levels, and gender and mental health/intellectual disability pathways. Different approaches to training and management are required to ensure appropriate prevention and intervention. Future practice should draw on emerging theories of differential susceptibility.

This paper extends current knowledge about how incidents of violence and aggression differ across secure settings.

The purpose of this paper is to provide an example of patient-led co-production.

The New Economics Foundation’s six principles of co-production (nef, 2013) have been used to frame the activities undertaken during the author’s relationship with a community mental health nurse.

This paper describes a co-produced project between a patient and a community mental health nurse to create a range of resources and to deliver training, resulting in mutual benefit for both parties.

This paper invites policy makers to consider the unique role that community mental health nurses can play in supporting patients with long-term challenges that have developed because of an imbalance and an abuse of power within earlier relationships; by adopting a co-production approach, centred on the patient’s interests and skills, a working partnership can be achieved wherein both parties feel that they matter.

Co-production is usually used with groups of stakeholders working together in an equitable way to design or deliver a new service; this paper, however, seeks to demonstrate how the process can be effectively used when the project is patient-led within the context of a therapeutic relationship.

The purpose of this paper is to explore the research which has examined the link between autism spectrum disorders (ASDs) and offending behaviour and the impact of prison on individuals with ASDs. Studies suggest that inmates with ASDs may be at an increased risk of bullying, confrontations, exploitation, anxiety and social isolation as a result of their ASD traits such as obsessions, social naivety and impaired empathy.

An extensive review of the literature.

The review identifies a modest amount of studies (n=4) which have explored the experience of individuals with ASD in prison and highlights that inmates with ASDs face a multitude of problems when they enter prison. Despite an extensive literature search only one study was identified which investigated the knowledge and understanding of ASDs amongst prison staff.

Further research is urgently needed to consider the specific problems faced by inmates with ASD, to identify how to make the prison environment safer and more supportive for inmates with ASD and how to reduce the likelihood of re-offending.

This review highlights that, to date, there has been relatively little to guide service design in order to develop support services for individuals with ASD in prison. There has been a scarcity of studies investigating the effectiveness of various treatment models to target offending behaviour in individuals with ASD.

This paper fulfils an identified need to study and identify the specific problems faced by inmates with ASD and to identify changes which are required to provide an environment in prison which is safer and more supportive.

I REMEMBER one elderly librarian who insisted on keeping the works of obscure authors like Lermontov on the shelves, even when faced with the plain fact that no dates were ever stamped on the labels of the books in question. Whatever happened, the books stayed, year‐in, year‐out. Here, then, was a librarian of the old school, a guardian of culture, keeping to his post while the inner‐city housewives ran for the Mills and Boons on the returned‐books trolley like piranhas hot on the scent of human flesh. He didn't care: sitting at his desk, making careful notations on the backs of book‐cards, he could ignore the crowd and think about Lermontov.

The chapter aims at representing the results of a case study with concern to the economic and environmental crisis triggered by Ilva in Taranto.

The case study design follows an ethnographic approach. The analysis is based on the collection of some qualitative interviews and documentation related to the environmental conflict engendered by the Ilva of Taranto, which has been the largest steel mill in Europe since the 1990s.

The analysis of the empirical data shows some interesting insights about (a) the growing contradictions in time of crisis in the relationship between the ‘the four pillars’ of sustainability (economy, social justice and society, environment, culture); (b) the importance of the social pillar in playing a key role in the management of local conflicts and in stimulating change within social and economic organizations; (c) the difficulty to promote sustainable policies through a multilevel governance approach able to synthesize the complexity of the scenarios emerging at the local, regional, national and European levels, in order to create an alternative way of development.

The ethnographic approach is useful to analyse in depth the core of the environmental conflict and the divergent developmental scenarios expressed by the different categories of actors.

To examine how an external performance review process introduced as part of the public sector modernisation agenda in England and Wales has impacted on HR service provision and processes in local government and the extent to which it has acted as a catalyst for the development of more integrative and innovative HR practices to support organisational performance.

A case study analysis of the Best Value Review (BVR) process of HR services at two county and two unitary authorities generated data from multiple sources including interviews, focus groups, consultative meetings as well as internal documentation. This approach was adopted to offer perspectives from different stakeholders in the employment relationship.

There was found to be a frequent lack of synergy between organisational goals, departmental plans and the performance objectives of individuals combined with an absence of shared understandings about human resourcing priorities or commitment to the processes needed to strategically integrate HR policies.

Whilst providing insights into the Best Value (BV) approach to public sector modernisation, a wider generalisation of the findings cannot be drawn from four case studies.

Line management and the HR function need to share better understandings concerning the HR practices needed to support the modernisation agenda and their respective HR responsibilities.

This paper reveals that the BV performance regime was not encouraging, and even limiting, a corporate approach to the HR policies and practices required to develop longer term organisational capability.