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The National Institute of Health Research MHRN established the Feasibility and Support to Timely recruitment for Research (FAST-R) service in 2011, to provide rapid patient and carer feedback on research documents, prior to ethical review. The aims were to improve the feasibility of studies, to speed up regulatory processes and enhance study set up and completion. The purpose of this paper is to explore whether and how the FAST-R service benefits the review process.

An independent evaluator analysed the comments made by FAST-R members on 85 studies over the past 3.5 years. The evaluation team reflected on the nature of these comments and the implications for future practice.

The FAST-R members’ comments fell into seven categories relating to: the quality of the information, the informed consent process, care and protection of participants, practical arrangements for participants, data protection and confidentiality, recruitment and research design. Based on the evaluation team’s experience of research document review, some of these comments were similar to those made by ethics committees. In other cases, the FAST-R Panel provided a different kind of input by identifying concerns specific to service users and carers.

Patient/carer involvement in reviewing research documents brings added benefits to existing processes because their views are informed by their knowledge and experience. They are able to question assumptions and highlight concerns that people lacking their perspective might otherwise miss. These findings suggest that patient/carer involvement should form an integral part of ethical review, and that the FAST-R model might be usefully applied to other areas of health and social care research.

This original work adds value to the practice of patient and public involvement in research.

This paper aims to examine reform of mental health legislation in England and Wales. It covers the period from the introduction of the 1983 MHA to the proposed reforms outlined in the Wessley Review that was published in December 2018.

This is a literature-based project.

Reform of the mental health legislation reflects two potentially conflicting strands. One is the state’s power to incarcerate the “mad”, and the other is the move to protect the civil rights of those who are subject to such legislation. The failures to development adequately funded community-based mental health services and a series of inquiries in the 1990s led to the introduction of Community Treatment Orders in the 2007 reform of the MHA.

The development of mental health policy has seen a shift towards more coercive approaches in mental health.

The successful reform of the MHA can only be accomplished alongside investment in community mental health services.

The paper highlights the tensions between the factors that contribute to mental health legislation reform.

The combination of heightened emphasis on risk and its management in mental health, the precautionary principle, the idea of genetic susceptibility, advances in screening technology, and the promise of preventive pharmaceutical intervention is highly potent, especially in a world in which preventive prescription of psychiatric medication has become routine. Psychiatric professionals are given the obligation of governing, and being governed, in the name of risk, and in a political and public sphere suffused by the dread of insecurity. But there are risks in seeking to govern risk in a biological age. In this paper Nikolas Rose argues that the public, politicians and professionals alike might do better to refuse the demands of risk, and learn to live with uncertainty.

The aim of the research reported here was to determine how Lithuanian citizens engaged in information-seeking behaviour in response to the stress caused by the Russian invasion of Ukraine.

An interview survey was designed, using a semi-structured interview schedule. A convenience sample of 21 participants was obtained and the interviews lasted between 20 and 70 min. The schedule design was guided by the transactional theory of stress and coping and employed the Perceived Stress Scale.

A majority of participants experienced moderate to high levels of stress associated with the war in Ukraine. Information seeking and discussing information found with family members and friends played a significant role in helping to moderate stress. Most of the participants understood more than one language and, consequently, were able to compare local information sources with international sources. Only five participants were active users of social media, the rest were critical of these sources. All participants valued those sources they believed to be reliable and truthful.

The small convenience sample of educated urban participants limits generalizability but provides indicative findings for future investigations into information behaviour during prolonged international conflicts.

The study highlights the importance of media literacy in managing psychological stress during geopolitical tensions, demonstrating how strategic information seeking and social support can serve as effective coping mechanisms.

The research reveals psychological impacts of war beyond direct conflict zones, illustrating how communities develop collective emotional resilience through informed, critically engaged information practices.

The study provides unique insights by examining war-related stress in a neighbouring country not directly experiencing conflict, applying stress-coping theory to understand intricate information-seeking behaviours during a geopolitical crisis.

Over the last 12 years there have been substantial developments in UK law and policy relevant to mental health social work practice. The previous legal frameworks across the jurisdictions were very similar but the new laws have developed in different ways and provide greater opportunities for comparison. Across all the jurisdictions policy developments, especially in the areas of recovery and risk assessment, have influenced the way that mental health social workers practice.

This exploratory study used case study vignettes with 28 respondents to examine how these major legal and policy developments impact on social work practice.

There were variations in how levels of risk are defined and often a lack of clarity about how this informs decisions. There was a consensus that recovery is important but difficulties in understanding how this might apply in crises. Predictably, differences in legal and policy contexts meant that there were a variety of perspectives on how mental health social workers applied the laws in their jurisdictions.

The limited focus on research informed practice and the lack of transparency in decision making across areas of risk assessment and intervention, use of recovery approaches and the use of mental health laws suggest the need for a more evidence-based approach to training, education and practice.

There is very limited previous research on practitioner experiences of the complexities involved in implementing mental health law. This paper provides some insights into the issues involved and for the need for more detailed examination of the decision-making processes involved.

Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI).

A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed.

Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted.

The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system.

To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

The purpose of this paper is to propose a recovery-focused approach to risk and safety and what this might look like in practice.

Review of recovery approaches and the ways in which traditional approaches to risk might hinder people in their recovery journey. Consideration of the principles of a recovery-focused approach to safety.

A recovery-focused approach to risk based on co-produced safety plans that enable people to do the things they value as safely as possible and shared responsibility for safety. Four key principles of a recovery-focused approach to promoting safety, autonomy and opportunity are proposed.

A recovery-focused approach to risk and safety is central to the development of recovery-focused practice within services. This paper outlines such an approach.