Max Rutherford and Sean Duggan
Forensic mental health services play an important role in providing treatment and accommodation for people diverted from prison or the courts who require secure and specialist…
Abstract
Forensic mental health services play an important role in providing treatment and accommodation for people diverted from prison or the courts who require secure and specialist mental health treatment. There are more than 3,500 people in medium and high‐secure hospitals who have been directed there by the courts or prison system, and nearly 1,000 new admissions are received each year. Yet, the facts and figures relating to these services are patchy and not widely published. This paper builds on an earlier statistical briefing produced by the Sainsbury Centre for Mental Health in 2007, and seeks to provide an up‐to‐date and improved understanding of this area of service provision by presenting the most recent data and figures.
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Tom Ricketts, Charlie Brooker and Kim Dent‐Brown
Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental…
Abstract
Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting
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Gareth Edward Ross and Jonathan Michael Auty
Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The…
Abstract
Purpose
Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The purpose of this paper is to explore the experience of making psychological changes on a TC from the perspective of residents.
Design/methodology/approach
Interpretative Phenomenological Analysis was used to explore the experience of five former residents of the TC at HMP Gartree.
Findings
Four main themes emerged, each with two sub-themes: Motivation to Change (sub-themes: Engagement, Determination); Environment (sub-themes: Boundaries, Experience of care); Removal of Masks (sub-themes: Embracing vulnerability, Emerging authenticity) and Relationships (sub-themes: Re-enacting the past, Challenge from peers). Findings are discussed in relation to existing literature.
Research limitations/implications
Understanding service users perspectives on what helps facilitate change can help staff empathise with their experiences and strengthen their relationships. The importance of clear and consistent boundaries that are perceived as fair and the development of meaningful relationships with staff in creating an atmosphere that enables change has implications for other therapeutic or supportive environments. This research represents the experiences of five participants who were motivated to take part and comfortable to speak to a professional about their experiences. As such, generalisations about the wider TC population should be made cautiously and further research would be beneficial.
Originality/value
The research adds to the underrepresented area of service user perspectives in a forensic TC. It contributes a rich account of the experience of psychological change that can help staff working in TCs understand and relate to their residents experiences.
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Grégoire Billon, Chris Attoe, Karina Marshall-Tate, Samantha Riches, James Wheildon and Sean Cross
The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches…
Abstract
Purpose
The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches to healthcare education. Preliminary findings of a simulation training course to support healthcare professionals to work with people with intellectual disability are then presented.
Design/methodology/approach
This study employed a mixed methods design to assess the impact of the simulation course. Quantitative data were collected using the Healthcare Skills Questionnaire and a self-report confidence measure; qualitative data were collected using post-course survey with free text responses to open questions.
Findings
Healthcare skills and confidence showed statistical improvements from pre- to post-course. Qualitative analyses demonstrated that participants perceived improvements to: attitudes, communication skills, reasonable adjustments, interprofessional and multi-disciplinary working, knowledge of key issues in working with people with intellectual disabilities.
Practical implications
Encouraging findings imply that simulation training to address health inequalities in intellectual disabilities is a valuable resource that merits further development. This training should be rolled out more widely, along with ongoing longitudinal evaluation via robust methods to gauge the impact on participants, their workplaces, and people with intellectual disabilities.
Originality/value
The authors believe this paper to be the first to assess an interprofessional, high-fidelity simulation course, using actors as simulated patients to address the mental and physical health needs of people with intellectual disabilities. The rigorous use of co-production and co-delivery, alongside promising findings for this training method, represent a useful contribution to the literature.
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The general consensus amongst policy makers regarding the causal explanations for the involvement of young people in the August Riots of 2011 seems to have centred on “mindless…
Abstract
Purpose
The general consensus amongst policy makers regarding the causal explanations for the involvement of young people in the August Riots of 2011 seems to have centred on “mindless criminality” and “thuggery”. These explanations have tended to be quite one dimensional where complexity has been avoided in favour of simplicity. Issues of structural inequality, poverty and social injustice appeared to be negated by political figures in favour of an emphasis on neo-liberal, individualistic explanations and solutions. Understanding that there have been very different interpretations of the riots, where some have come to very different opinions from the same data, the purpose of this paper is to revisit the causes and meanings of the rioting that took place over a five-day period in August 2011. Second by drawing on social democratic perspectives the paper stipulates several factors that if not dealt with may give rise to future rioting.
Design/methodology/approach
The paper takes the form of a conceptual analysis. I draw on the work of a number of key academics and commentators to enrich the analysis.
Findings
Within the paper it is argued that the policies that emanate from neo-liberal political ideologies have impacted disproportionately on working class children and young people. More specifically the paper finds that problems experienced are deemed to be the responsibility of the individual, side-lining the influence of ecological and socio-economic factors.
Originality/value
In the light of the criticisms of neo-liberalistic approaches, social democratic perspectives are drawn upon in order to consider new ways of approaching the issues facing children and young people within contemporary society. Such perspectives are concerned with addressing structural inequality, poverty and social injustice.
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This chapter draws on 10 years of ethnographic fieldwork collected in gay bars from three American cities to explore the strategies LGBTQ subcultures deploy to recreate meaningful…
Abstract
This chapter draws on 10 years of ethnographic fieldwork collected in gay bars from three American cities to explore the strategies LGBTQ subcultures deploy to recreate meaningful places within the vestiges of local queer nightlife. As gentrification and social acceptance accelerate the closures of LGBTQ-specific bars and nightclubs worldwide, venues that once served a specific LGBTQ subculture (i.e., leather bars) expand their offerings to incorporate displaced LGBTQ subcultures. Attending to how LGBTQ subcultures might appropriate designated spaces within a gay venue to support community (nightlife complexes), how management and LGBT subcultures temporally circumscribe subcultural practices and traditions to create fleeting, but recurring places (episodic places), and how patrons might disrupt an existing production of place by imposing practices associated with a discrepant LGBTQ subculture(place ruptures), this chapter challenges the notion of “the gay bar” as a singular place catering to a specific subculture. Instead, gay bars increasingly constitute a collection of places within the same space, which may shift depending on its use by patrons occupying the space at any given moment. Beyond the investigation of gay bars, this chapter contributes to the growing sociological literature exploring the multifaceted, unstable, and ephemeral nature of place and place-making in the postmodern city.